One cannot turn a blind eye to the positive economic turn Africa is taking. Once shunned upon, Africa is now forecasted to achieve the fastest growth in the world in the next decade, the world is starting to look into the continent and with this comes a great interest to improve the state of health care, financial institutions, electricity and safe water to name a few. The rise of the urban middle class who are willing to pay for better services, better healthcare and treatments has opened the door to the private sector, which is starting to play a new role, often working in partnership with international and local donors and governments to provide better healthcare facilities and increased access to medicine at an affordable price.
For the remaining majority of Africans who are far from being able to pay for basic healthcare, new models of care are being designed, as governments begin to acknowledge the importance of preventive methods over remedial action. This, in turn, is empowering communities to make their own healthcare decisions. At the same time, some countries are experimenting with different forms of universal health provision.
Africa’s healthcare systems have reached a turning point. With the life expectancy in Africa averaging 53years, infectious and parasitic diseases remain the leading cause of death. As much as strides are still being made in reducing the number of HIV related deaths, Africa still leads with 91% of the worlds HIV-positive children living in Africa. Reported malaria deaths are also still on the rise even though malaria is preventable. Not all is gloom and doom, the rising awareness and use of technology in Africa is leading to a change of mindset on how to improve systems and processes of reaching the poorest African places for people to have treatment. Increased collaboration between NGOs and government entities along with private sector is opening channels for extensive research, investments and improvements in Africa’s healthcare systems.
Africa already has made impressive inroads in the telecommunications sector. The growth of mobile connectivity is exponential; Africa is now the world’s fastest-growing mobile market, growing almost 20% each year and is likely to reach 735 million subscribers this year. It now has the opportunity to repeat this with its healthcare sector.
Due to a high linguistic diversity in Africa, it’s essential that when patients are educated, the use of their natural language be used as the challenge comes when patients need to be educated about disease prevention and management. Most doctors have little formal medical training and a lot of African pharmacies are often poorly stocked and remote. A creative approach is the only way to tackle such challenges and with the access to technology, mostly mobile phones this problem can be solved. Companies such as Novartis, are doing their part, in India Novartis works with local villagers and health workers, giving them the tools to lead information sessions on topics such as preventative health and nutrition. These villagers are trusted in their local communities and can best help spread awareness and adapt materials to meet local needs, overcoming logistical barriers.
As much as infrastructure is the cornerstone of the African economy, it’s also the key to driving public access to healthcare for many African patients. Governments who step up their investments in this sector can fast tract the elimination of poverty and open up investment opportunities within the heath sector. Access to roads, clean safe drinking water, transportation and agricultural and urban developments can lead to a decrease in communicable diseases, decrease in delayed responses to treatment due to bad roads, electricity outages affecting hospitals ect.
The average government investment in healthcare is about 6,5% of GDP, with most of the African population living on less than US$30 a month, that is clearly not enough. This means that for the majority of the population adequate high quality healthcare is far from reach. Government’s investment in this sector can see a turnaround with a focus on proper healthcare solutions in public healthcare, which include high-quality, low-cost generics, over the counter medicines, vaccines and innovative therapies. Government investments can also be channeled into increasing the amount of remote access facilities, meaning these solutions need to reach a large rural population spread over vast geographic areas that are often difficult to travel to, with poor roads and limited storage facilities.
Technology is unavoidable; almost every household in Africa, at least one family member has a mobile phone and is able to effectively use it irrespective of their level of education. It is only wise to tap into this technology as a form of improving the effectiveness of government’s efforts to improve healthcare. African patients are able to set reminders on their mobile phones about their medications, doctors visits, storage of emergency numbers. Healthcare workers and community aid workers are also able to communicate to African patients remotely on their healthcare needs and in the language of their choice or understanding. This method works instantaneously and the expansion of telecommunications in Africa very soon network issues will be a thing of the past. Pharmaceutical giant, Novartis, established teleconsultation centers in remote villages using mobile technology. Local health workers use closed-network mobile phones to speak with hospital staff to make treatment decisions. ‘We’ve also used mobile technology to capture assessment data, to help health authorities identify gaps in service and better allocate resources. These efforts have saved lives and lowered costs, while also reducing time waiting for treatment. Developing sustainable, long-term solutions – Efforts in Africa need to be sustainable to really make a difference.’ Novartis CEO, Joseph Jimenez.
COLLABORATIONS AND PARTNERSHIPS
The African culture is known for its spirit of community, togetherness and unity. It is essential then when looking at ways to address issues in Africa for Africans to look into fostering solutions collaboratively and inclusively. There are many international and local stakeholders, local and national government, NGOs, community leaders, etc. striving to improve the state of healthcare in African. The science behind healthcare and the details of an effective disease prevention and management plan are so complex; it is difficult for any one community to make a difference alone, all entities need to collaborate in order for solutions to be developed and implemented effectively and sustainably. Adapting solutions taking into account the diverse nature of Africa, its people, its culture, and its infrastructure, taking into account the use of emerging technologies – a huge difference and lasting impact can be made in the African healthcare sector.
TAKING A BRIEF LOOK AT KENYA
LEADING THE WAY TO IMPROVED HEALTHCARE
Kenya’s rise in healthcare expenses has pushed nearly 1million Kenyans below the poverty line. As access to affordable medical insurance remains a huge crisis in Africa, Kenya is no different. For many Kenyans, the cost of basic healthcare is a genuine concern when faced with life threatening illness. With nearly four out of every five Kenyan paying out of pocket for medical care, since medical insurance is out of financial reach, it means most Kenyans are excluded from quality healthcare services.
According to an article by a UN Resident Coordinator, in 2015, UN Member States endorsed the 17 Sustainable Development Goals (SDGs), expected to guide the development agenda through 2030. The endorsement of the SDG 3 ― Good health and wellbeing; formally enshrined Universal Health Coverage (UHC) as a development priority for all countries.
UHC has the potential to transform the lives of millions of Kenyans—guaranteeing access to lifesaving health services while helping individuals and families avoid crippling health expenses and the poverty trap. The situation is not unique to Kenya, but also a case in point for many other developing countries. As a result, UHC has been identified as a key development goal for enhancing countries’ health systems globally. It is an all-encompassing development issue, including as it does, the full spectrum of essential, quality health services from health promotion to prevention, treatment, rehabilitation as well as palliative care.
Another step in the government’s move to eliminate payments for primary and maternal health services in public facilities has led to tangible improvements in maternal and child health. The results saw maternal mortality ratio falling from 488 to 362 deaths per 100,000 live births between 2008 and 2014.
A partnership between the Kenyan Government with the United Nations, World Bank, and strong support from the governments of the United States of America, United Kingdom, Japan, Germany, Denmark and Norway, focused on the improvement of maternal and child health. Kenya’s First Lady also took to the stands, launching the Beyond Zero campaign in 2014, aimed at improving the maternal and child heath outcomes in the region.
Arnaud Bernaert, Head of Global Health and Health Care at the World Economic Forum, remarked that, “Kenya’s efforts has led to an innovative public-private partnership mechanism that has the potential of building business models that will offer the best of both public and private sector in scaling-up the delivery public health services in low-resource settings.”
In Siddharth Chatterjee’s article she highlights yet another positive direction is the devolution of health by the Kenyan Government – a constitutional change that shifted responsibility for healthcare provision to county governments. This seeks to achieve universal coverage by bringing health decisions closer to citizens, ensuring efficient and equitable resource distribution, thereby improving access to health facilities as well as services.
Recent changes to the National Health Insurance Fund (NHIF) has expanded the coverage for formal sector employees by adding outpatient care and a new initiative specially targeting the informal sector has recently been introduced. The new national scheme offers a comprehensive family cover for US$ 60 covering both outpatient and inpatient services. New initiatives such as health insurance subsidies for the poor, severely disabled and elderly will help to bring more vulnerable people under comprehensive health insurance cover.
Kenya is already a leader in technological innovation. This is a capability that must be harnessed to improve health systems to help bring down costs of delivering health care services through telemedicine, reducing inefficiencies in provider payment systems and generating better data.
These improvements could significantly help ameliorate the financial stress that is currently the most significant barrier to achievement of UHC. Some studies have shown that technical efficiency is a big flaw in Kenya’s health facilities, with one reporting that public dispensaries are operating at only 47 percent efficiency.
Kenya is part of various initiatives for developing sustainable financing for health services such as the Global Financing Facility, a partnership that will catalyse greater investments in health services, with a particular focus on women, adolescents and children.
The momentum is already with the country; Kenya must lead in the moral imperative of ensuring that none of the people who cannot pay for health care are left behind.