Holistic View of the Challenges of Healthcare in Africa
Discussions about the state of healthcare in Africa have sustained attention of actors in the private and public institutions, as well as expats and foreign investors that have all had at least one thing to say on the subject.What makes the subject so important? Perhaps the great potential assigned to the continent, as the fastest billion. However, one cannot neglect the socio economic impact of the continents failures, in matters of healthcare on other continents socio-political affairs. The case of Ebola, provides an excellent example.
The subject of healthcare in Africa has been covered from multiple angles, although, the full picture of the healthcare ecosystem in Africa remains challenging to grasp. Not only because the continent is made of multiple individual health systems, but even more so because the main pillars (challenges) common to most (if not all) of these individual systems cause so much dynamic that it becomes difficult to prioritise one over the other, or to fix the system by treating a single pillar.
The Main Challenges of the African Healthcare system
Along the lines of discussions held among experts at the Africa Healthcare Summit 2015, the challenges of the health system in Africa have been classified as follows;
- Policy & Leadership
Challenges linked to the lack of policies to regulate the system. Several actors (from NGOs, to foreign investors, private practitioners, to public institutions) provide input to the system, however there are no guidelines governing the interaction. No policies regulating the system? No dedicated leaders to assess the kind of policies required and follow up implementation of new policies to ensure change.
Challenges related to the sources of funding of healthcare, looking at the roles played by the public and private sectors, and the positioning of ‘out of the pocket’ funding.
- Access to medicine and equipment
Challenges associated with the identification of suppliers, creation of a reliable ecosystem (with policies and guidelines) to govern interaction with suppliers and combat counterfeiting, to list a few.
- Education & Infrastructure
Challenges associated with brain drain (how to incentivise medical professionals, how to overcome issues of insufficient infrastructure that have been closely linked with brain drain?) and brain gain (where role could the diaspora play a role, how to ease and facilitate the involvement of the diaspora to meeting the huge demand for care), how to educate healthcare seekers in ways that positively impacts the system?
How Technology should help consolidate the system. Hence gaps in the existing system should be identified to determine the type of technologies or technological solutions required to advance the healthcare system.
Which Pillars to prioritise to heal the broader system
The challenge as we may all know, has been to identify the starting point to fix the whole system. Although multiple initiatives have been launched, each addressing one or a few of the points above, let’s just acknowledge the fact that the complex nature of the situation results in a dynamic which makes no one pillar more important than the other.
Distinct roles for Public & Private actors
The real solution of dealing with this complex, multi-priority system is to acknowledge that the states funding around 80 per cent of the systems cannot do it all, and clearly identify its limitations, as well as the unique value that could be contributed by the private sector. After all, the private sector currently accounts for 50 to 60 % of healthcare delivery in developing countries. Their input is invaluable and should be strategically involved in the bigger picture.
Matching Actors’ capabilities to the various Pillars
The progress and sustainability of the system will depend on how relevant policies implemented are, and how well implemented the policies are. The government will play a critical role in controlling the institutional layers.
On the other side, the private sector with its entrepreneurial character, decision power over its own resources, has the required capabilities to manage the complex and multi-priority dynamics of the cited healthcare challenges.
Nonetheless, the public sector, will play an important role in prioritising private sector initiatives that support the development of the system in a thought and structured way.