AFRICAN

Recommendations

Info

Figure 1. Total health expenditure (THE) on health per capita, 2012 US$ 1 200 1 000 800 600 400 200 0 1 138 645 384 397 444 473 521 259 279 15 15 18 18 18 20 25 25 26 30 31 32 33 37 38 38 41 41 42 44 45 51 52 59 65 66 83 88 94 96 96 100 109 138 144 190 Eritrea Democratic Republic of the Congo Ethiopia Central African Republic Madagascar Burundi Malawi Niger Gambia Guinea-Bissau Chad Guinea Benin Mozambique Comoros Burkina Faso Togo United Republic of Tanzania Mali Uganda Kenya Senegal Mauritania Cameroon Liberia Rwanda Ghana Côte d’Ivoire Nigeria Sierra Leone Zambia Congo Sao Tome and Principe Lesotho Cape Verde Angola Swaziland Algeria Botswana Gabon Mauritius Namibia Seychelles South Africa Equatorial Guinea of good quality services in all population groups while ensuring solidarity through financial protection against catastrophic OOP health payments. It is necessary to pool resources and to eliminate direct payments at the point of service in order to provide quality services equitably. UHC is much desired and progress in its implementation will result in improving health outcomes and tackling poverty, by increasing access to, and coverage of, quality health services, and by reducing the suffering associated with payment for health services. Health financing is central to providing the different components of health systems needed to make progress in UHC. However, there are several constraints militating against the financial resources for health that are essential to implementation of UHC in the African Region. 4,5 This article describes those constraints and potential measures to circumvent those challenges. Constraints in implementation of universal health coverage Insufficient financial resources The high-level Taskforce on Innovative International Financing for Health Systems 6 estimated that in 2009 a lowincome country needed to spend on average US$ 44 per capita, and US$ 60 as a target for 2015, to strengthen its health system and to provide an essential package of health services. In 2012 the data show that 26 countries were on or above US$44 per capita while 19 were below that amount (Figure 1). Unexpectedly, there is no positive correlation between health expenditure and health indicators – r²=0.17 for the maternal mortality rate (MMR) and 0.018 for the under-five mortality rate (U5MR). In addition, the countries with an average expenditure on health of more than US$ 60 per capita do not have improved health indicators; probably due to inefficiency in the utilization of the available resources including the prioritization of highimpact interventions. For example, Mauritania, Côte d’Ivoire and Sierra Leone are spending US$ 50–100 per capita on health, but their MMRs are 300, 700 and 1 100 per 100 000 live births, respectively. Algeria, Botswana and South Africa have low rates of MMR,
Figure 2. Total health expenditure (THE) per capita versus MMR and U5MR in the African Region, 2012 1100 Sierra Leone R-Squared=0,302063 Table 1. Total health expenditure against general government health expenditure (GGHE)/general government expenditure (GGE), 2012 MMR in 2013 U5MR in 2013 1000 Chad 900 Central African Republic 800 700 Côte d'Ivoire 600 500 Angola 400 300 Swaziland Zambia Equatorial Guinea Gabon 200 Sao Tome and Principe Botswana South Africa 100 Namibia Algeria Mauritius Cabo Verde Republic of 0 170 160 150 140 130 120 110 100 90 80 70 60 50 40 30 20 10 0 100 200 300 400 500 600 700 800 900 1000 1100 1200 THE/per capita in USD in 2012 R-Squared=0,133105 Angola Sierra Leone Chad Central African Republic Nigeria Lesotho Equatorial Guinea Swaziland Ethiopia Gabon Congo Namibia Botswana South Africa Algeria Mauritius GGHE/GGE >15% GGHE/GGE US$ 60 Liberia, Rwanda, Swaziland, Zambia (4 countries) Malawi, Togo (2 countries) Algeria, Angola, Botswana, Cape Verde, Congo, Côte d’Ivoire, Equatorial Guinea, Gabon, Ghana, Lesotho, Mali, Mauritius, Namibia, Nigeria, Sao Tome and Principe, Seychelles, Sierra Leone, South Africa (18 countries) THE per capita
Page 1 and 2: THE AFRICAN HEALTH MONITOR REGIONAL
Page 3 and 4: Editorial Universal health coverage
Page 5: e The critical role of health finan
Page 9 and 10: Table 2. Best practice in the imple
Page 11 and 12: Key requirements for strengthening
Page 13 and 14: Democratic Republic of the Congo. I
Page 15 and 16: Figure 1. Common support derived fr
Page 17 and 18: 3 Institutions and structural quali
Page 19 and 20: Principal component analysis was us
Page 21 and 22: Ashanti region than other regions,
Page 23 and 24: The study focuses on Senegal. Seneg
Page 25 and 26: BOX 2 Selected stakeholder quotatio
Page 27 and 28: of specialized economic and politic
Page 29 and 30: 5 Financing flows through private p
Page 31 and 32: Kenya Between 2006 and 2010, Kenya
Page 33 and 34: spending aligns with their stated s
Page 35 and 36: PHEs and CBOs), verification of res
Page 37 and 38: Figure 2. Differences between syphi
Page 39 and 40: 7 Piloting a performancebased finan
Page 41 and 42: Notes were taken during interviews
Page 43 and 44: Secondly, as encouraged during the
Page 45 and 46: 8 Estimating willingness to pay for
Page 47 and 48: stunted economic growth coupled wit
Page 49 and 50: seeking the services were from the
Page 51 and 52: a voucher programme and comparable
Page 53 and 54: 9 Fondements de la résilience et d
Page 55 and 56: Tableau 2. Principaux thèmes abord
Page 57 and 58:
les établissements publics (moins
Page 59 and 60:
de cet hôpital privé pour des rai
Page 61 and 62:
The decentralized health system in
Page 63 and 64:
CBHI application systems. The Healt
Page 65 and 66:
B L’impact des modalités d’all
Page 67 and 68:
ésultats dans la prise en charge d
Page 69 and 70:
News and events Renowned public hea
Page 71 and 72:
Abstracts RÉSUMÉS EN VERSION FRAN
Page 73 and 74:
separação de funções e a polít
Page 75 and 76:
The African Health Monitor Special
show all

AFRICAN

Create successful ePaper yourself

Delete template?

Save as template?