Making the public health system work…

Three years ago, more than 5.2 million people in Africa died from causes which could have been prevented or easily cured, given access to the right health facility. Given Africa’s plagued history of such deaths, these numbers don’t appear alarming as they should.

Put in perspective, the number of deaths recorded in 2015 are enough to wipe out the entire populations of Seychelles, Sao Tome & Principe, Cape Verde, Comoros, Djibouti, Mauritius and Equatorial Guinea. When put this way, it appears alarming but perhaps that is what is needed to bring urgency into Africa’s approach to enhancing its health system.

As if the 5.2 million deaths mean little, maternal and infant mortality rates coupled with deaths resulting from road traffic crashes are about the highest in Africa than anywhere else in the world.

There is no denying that good health yields economic dividends; that is, a healthy nation is more productive and ultimately contributes to a country’s economic growth.

According to the World Health Organization’s Africa Health Regional Report (AHRR), 2014, an increased investment in health would translate into hundreds of billions of dollars per year of additional income, which could be used to improve living conditions and social infrastructure in poorer countries.

The report estimates that for every 10 percent increase in life expectancy at birth, there is a corresponding rise in economic growth of 0.4 percent per year. The United Nations Sustainable Development Goals rightfully recognizes the importance of good health in its Goal 3 – Good Health and Wellbeing.

Basically, achieving this goal would mean that Africa’s health system must be more responsive than it currently is in order to, for instance, reduce the burden of communicable diseases, maternal mortality as well as other preventable deaths.

It is a fact that strong health systems are fundamental to maintaining good health and managing threats to health. All over the continent, especially during the last ten years, efforts have been made by governments and donors among other stakeholders to generally reduce the disease burden on the continent.

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These investments have paid off in one way or the other but statistics from WHO shows that indeed the continent has more to do if it indeed can achieve the SDG 3. Despite the role international agencies have played in the eradication of polio and the near eradication of guinea worm, buruli ulcer and co, it is about time Africans owned the healthcare system and put their money where their hearts are.

While the role of the Melinda Gates Foundation and the likes in Africa are invaluable, it is time governments put in the requisite strategic framework to ensure that some of its wealthy corporates can also take active roles in enhancing its health system as well.

Africa is clearly the richest continent, in terms of natural resources and thus always being at the receiving end of charity, is a blot on the conscience of its leaders which must not be passed on to the next generation.

The piecemeal philanthropy approach exhibited by some multinationals in Africa must be properly aligned to the SDGs and companies that dedicate their resources to this must be rewarded, whether in a form of tax rebates or any other means that would encourage more companies to come on board.

The Africa Health Regional Report, 2014, said the role of governments [public officials] is to direct resources, health system performance and stakeholder activities towards achieving health system goals, in a transparent, accountable, equitable manner responsive to population needs. To achieve this, strategic frameworks combined with effective oversight must be put in place.

One innovation that can boost Africa’s public health system which has not been properly explored is the commitment of elected officials sticking to the use of the public health system when they are in need of health care services.

In most African countries, there seems to be a general lack of belief in the public health care system by elected officials who typically seek care services in other private health institutions, whether home or abroad.

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The public health system, whether in urban or rural areas, widely accessed by the majority of the population in any given African country, is dogged by either shortage of personnel, basic medicine or breakdown of equipment, among other petty issues which contribute to preventable deaths.

A crucial system like this cannot be fully functional when those public officials who are directly or indirectly responsible for the efficient running of it seek healthcare, together with their immediate family, outside the very public health system they are expected to improve.

Those who make decisions for the public health system must be proud enough to access it when they are in need of it – not abandon it to seek care elsewhere which is outside the reach of the people who voted them into office.

Elected officials exist at various levels, starting from grassroots, regional and all the way to the national level. Once people accept to stand for leadership positions, there must be commitment to improve the public system, be it health, transport or education and their use of this system across all the levels will give them firsthand opportunity of witnessing the shortfalls or gaps within the healthcare delivery chain.

Eight years ago, the wife of a then ruling MP and a Deputy Minister in Ghana, Inusah Fuseini, died in a public health institution while in labour. The country at the time had a maternal mortality rate of 350 deaths per 100,000 live births. But the uproar generated by unfortunate news and circumstances leading to the death was enough to trigger a review of protocols at that particular hospital.

Clearly, Africa needs a new breed of leaders who believe in its systems and are prepared to make them work. There is no better way to show that a system is efficient than to subject one’s self to it; after all, a large majority of citizens trust themselves into the hands of these systems every day.

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