Africa’s health systems are poorly attuned to meet the healthcare needs of the poor, the disabled and other vulnerable groups putting the continent’s quest of achieving Universal Health Coverage (UHC) further out of reach, a recently released report revealed.
Achieving UHC will continue to be a challenge in Africa until customized, quality, and affordable essential health services are made available, the report states.
The independent Africa Health Agenda International Conference (AHAIC) Commission unveiled the State of Universal Health Coverage (UHC) in Africa Report, a comprehensive document that maps the progress of African countries towards their UHC goals.
The report was released on Monday at the opening ceremony of the AHAIC 2021 – a biennial convening of health ministers, private sector leaders, civil society and representatives from multilateral organisations.
AHAIC 2021 is holding between March 8 and 10 to advance the critical conversations initiated in Rwanda at AHAIC 2019 when calls were made for African countries to reinvigorate their quest for UHC.
The event which is considered one of the largest health gatherings in the continent is holding virtually due to the COVID-19 pandemic.
With a virtual format, AHAIC 2021 – co-convened by Amref Health Africa, Africa CDC, IFPMA, Johnson & Johnson, Roche and Takeda – will reach an even larger and more diverse audience, organisers say.
“The COVID-19 pandemic has pointed out the glaring gaps in African – and global – health systems and made a strong case for the urgent achievement of UHC”, Githinji Gitahi, Global CEO, Amref Health Africa said shortly after the launch of the report. “While progress towards achieving Health for All has been slow, the current reality has reinvigorated countries’ efforts to ensure better access to quality, affordable health care.”
“Through the State of UHC in Africa report and AHAIC 2021, we are hoping to provide a realistic roadmap that will guide African countries on their journeys to UHC and to ramp up support for greater multi-stakeholder collaboration across the continent, so that we can move from rhetoric to sustained action,” he said.
The report highlights the progress made by African countries towards realising Health for All and details the challenges and opportunities faced by countries on their journeys to UHC. It also provides key recommendations for transformative change, which African countries should adopt to accelerate progress towards UHC.
Compiled between November 2020 and March 2021, the State of UHC in Africa report takes stock of Africa’s progress in fulfilling commitments made by African leaders, such as the Abuja Declaration (2001), the Africa Health Strategy (2007-2015, 2016-2030) and the Addis Ababa Call to Action on UHC (2019).
It acknowledges the impact of colonial legacies, poor governance, and economic challenges on the continent’s health policies and outcomes and details the performance of African countries on key UHC indicators, including effective coverage with needed health services, financial risk protection and health outcomes.
According to the report, coverage of essential health care services in Africa is low: only 48 per cent of the population (approximately 615 million people) receive the healthcare services they need.
Quality of healthcare services provided in African countries is also low and is considered the poorest performing indicator of UHC. When quality of healthcare services is considered, service coverage scores across African countries are even lower, it states.
The report also reveals that coverage of essential services needed by women and girls in Africa is low, with data indicating that between 2015 to 2019, only 49 per cent of African women had their demand for family planning satisfied by modern methods.
Despite the dismal performance on some indicators, a number of data indications were positive. For example, although the proportion of individuals that are pushed into poverty due to out-of-pocket healthcare payments each year is high, at 15 million people (representing 1.4 per cent of the continent’s population), the number is gradually reducing.
Despite these challenges, the report concedes that the 21st century has seen African leaders show stronger political will to achieve UHC, creating an opportunity for countries to push the needle on change.
During Tuesday’s opening ceremony, participants of AHAIC2021 were immediately confronted with the stack reality that Africa is falling behind in achieving Sustainable Development Goal (SDG) Three, one of the 17 goals set by the United Nations General Assembly in 2015 for the year 2030.
Achieving UHC by 2030 is the central target of SDG 3.8.
Targets of SDG 3 include ending preventable deaths of newborns and children under five years of age by 2030.
Providing an affordable option for Africa’s poorest will determine whether countries achieve SDG 3, which is to “ensure healthy lives and promote well-being for all” by 2030, Mr Gitahi, CEO Amref Health, had explained in his first press briefing two years ago at AHAIC 2019 held in Rwanda.
Eleven million Africans are pushed into poverty every year by medical expenses, according to the WHO.
In Sub-Saharan Africa, health services are mostly paid for out-of-pocket and those gravely affected already live far below the poverty line.
In its recommendations, the AHAIC Commission proposes several actions to ensure steady progress towards UHC, including reorienting health systems and health system priorities to respond to population health needs; prioritising and strengthening primary healthcare as the foundation for UHC, boosting the number of skilled health workers especially in primary healthcare; investing in health technologies to enhance the performance of all health system functions and strengthening governance and accountability.
In addition to the report launch, the first day of AHAIC 2021 also saw attendance from Uhuru Kenyatta, President of the Republic of Kenya, who in his opening remarks acknowledged the progress made towards Africa’s vision of a continent free of poverty, ignorance and disease and urged African countries to consider seven priority areas to anchor their health policies and programmes, including giving greater priority to primary healthcare; increasing access to healthcare services; making healthcare more affordable; harnessing Africa’s innovative energy and creativity; strengthening health sector collaboration; improving health security and increasing political will towards UHC.
Also in attendance was the World Health Organisation (WHO) Director General, Tedros Ghebreyesus, who noted the COVID-19 pandemic’s role in highlighting the centrality of health to the social and economic wellbeing of African nations. He called on leaders to boost their nations’ capacities to enhance disease prevention and preparedness to mitigate the impact of disease outbreaks through greater political commitment.
The three-day conference will bring together a vast range of thought leaders in the health space, including government officials, private sector stakeholders, technical experts and grassroots organisers.
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