Tag Archives | healthcare in Africa
The African pharmaceutical industry is largely undeveloped, both from a manufacturing and innovation point of […]
The most important trend for positively impacting healthcare in Africa is already underway: the steady rolling out of primary healthcare into ever more remote areas, providing vaccinations, clean water, midwife assistance and basic health advice to ever larger numbers of people.
Another important trend is taking place in Africa’s cities, where new private hospitals are providing outpatient services and the reassurance of quality emergency care to the new middle class.
Healthy populations with access to high-quality health services lead longer and more productive lives, resulting in stronger and more financially secure families, communities, and countries. At KPMG, we are passionate about finding a solution for effective delivery of healthcare, to all people, across the continent.
Direct payment at point of use is the least-optimal way of financing healthcare, as in poor countries in particular, dramatic and expensive ailments can push the poor into bankruptcy, or else high costs can dissuade people from seeking desperately needed medical care. So, according to the WHO, two years after Burundi introduced user fees for healthcare in 2002, four out of five patients in that country were either in debt or had sold assets to pay for healthcare.
It is routine for more than 2% of the population of low-income countries to suffer ‘financial catastrophe’– defined as having to spend over 40% of income after food – because of healthcare costs. In the estimation of the WHO, reliance on direct payments has to fall to at most 20% of total health expenditures to bring the incidence of financial catastrophe down to negligible levels.
After effectiveness, the most important criterion in evaluating healthcare systems is probably expenditure. ‘Who pays how much for what’ determines how many people obtain treatment, and thus the overall health of a population. The world has been taking steps towards a better affordability of healthcare for the poor since 2005, when the (then) 192 members of WHO endorsed a resolution entitled ‘Sustainable health financing, universal coverage and social health insurance’.
To better understand why lives in Africa are so short, in relative terms, it is important to see what ends lives. (At 34 per 1,000 people per year, Africa’s crude death is by far the highest in the world and more than quadruple the global average.)
Africa’s mortality profile is almost the exact opposite of that of the world as a whole. Under a third of global deaths are caused by communicable diseases, maternal and perinatal conditions and nutritional deficiencies; in Africa the figure approaches two thirds. Only 28% of Africa’s deaths are caused by non-communicable conditions whereas the global figure is 64% (and in Europe the figure is 87%).
Africa is not a healthy continent. On all indicators of health, Africa lags behind the rest of the world, and behind poor countries of South-East and South Asia that were behind Africa when measured on these metrics a few decades ago. Much of this gap, which has widened since the 1980s is a consequence of the HIV/AIDS epidemic which has hit Africa harder than any region on Earth, but much of it (as well as the sometimes sluggish and ineffective responses to HIV/AIDS) can be blamed on other factors.