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The Role of the Private Sector in Healthcare Delivery

According to the World Health Organisation, Africa has one seventh of the world’s population yet carries almost one quarter of the global disease burden. Healthcare continues to be elusive for much of the continent’s population, particularly in Sub-Saharan Africa, a region considered to have the worst healthcare in the world. And what’s more, says WHO, despite the heavy disease burden, the majority of countries in the region are not on track to meet their Millennium Development Goals on Health.

Why is Healthcare in Africa so Poor?

The British Medical Journal highlights the following issues as being instrumental in impeding access to healthcare in Africa:

  • Almost half of all Africans live in abject poverty, being unable to pay for healthcare
  • Lack of funds – low government spend has been compounded by the lingering impact of the 2008 global economic meltdown, where funding from international governments and aid organisations has dried up
  • Governments are often weak, ineffective and tenuous
  • Service delivery is impacted, or disrupted by, corruption, conflict and war and a lack of education, infrastructure and appropriately skilled and trained human resources
  • The scourge of HIV/AIDS is placing enormous stress on an already strained system.

An Alternative Approach to Healthcare

Given that the traditional approach – funding from their own treasuries and from international donors – has seen limited success over the last few decades, it’s clear that a rethink to healthcare in Africa is in order. Health Partnership Africa points out that the private sector – both for-profit and not-for-profit – can be part of the solution to the current challenges faced by African healthcare systems. In a recent paper published in the International Archives of Medicine Drs. Luis Sambo – WHO’s Regional Director for Africa – and Joses Kirigia concur with this sentiment, arguing that the private sector can help accelerate action on the continent’s Millennium Development Goals on Health by:

  • Providing policy guidance – national departments of health should engage with private healthcare providers and tap into their knowledge base to develop integrated and inclusive policies
  • Supporting the delivery of health services through constructing and maintaining health facilities, supplying and maintaining equipment, providing utilities (power and sanitation systems, for example) and other ancillary goods and services (like cleaning, transport and catering)
  • Helping produce a health workforce – one of the most gripping problems is the lack of appropriately trained medical personnel. Public-private partnerships in education can go a long way to alleviating this skills shortage.
  • Producing and disseminating health information – the private sector can be a rich source of statistical and other data and the free flow of information of this nature between the public and private sectors should be encouraged. The private sector can also increase participation in health research and create and distribute educational materials.
  • Help promote equitable access to health care products and services, particularly by producing and distributing cost-effective vaccines and drugs (like antiretrovirals, TB and malaria treatments)
  • Help finance healthcare, through contributing funds for public-private initiatives, making health insurance schemes more accessible and contributing to national health insurance schemes (like South Africa’s soon-to-be-introduced NHI).
  • Help in the reduction of brain drain by incentivising African healthcare workers to stay and work in their communities, by providing them with greater career and training opportunities and better pay packages
  • Improving socioeconomic conditions – the environments in which people live and work can have a profound impact on their health. The private sector is uniquely positioned to achieve meaningful change by ensuring safe working conditions, addressing housing and sanitation needs and community health issues (like drug and alcohol misuse and abuse), promoting food security, health knowledge and investing in sport, recreation and leisure facilities in the communities in which they are active. 
David Okwara

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