African Water Development Report 2006 - United Nations Economic ...

African Water Development Report 2006AlgeriaAngolaBeninBotswanaBurkina FasoBurundiCameroonCape VerdeC. African RepChadComorosCongoCongo, Dem RepCôte d'IvoireDjiboutiEgyptEq. GuineaEritreaEthiopiaGabonGambiaGhanaGuineaGuinea-BissauKenyaLesothoLiberiaLibyaMadagascarMalawiMaliMauritaniaMauritiusMoroccoMozambiqueNamibiaNigerNigeriaRwandaSao Tome &SenegalSeychellesSierra LeoneSomaliaSouth AfricaSudanSwazilandTanzaniaTogoTunisiaUgandaZambiaZimbabweFig. 5.12: Per Capita Public HealthExpenditure in Africa0 200 400 600 8002001 2000Source: World Resources Institute – Earth Trends. The Environmental InformationPortal: http://earthtrends.wri.org/ Adapted from: World Health Organization(WHO). 2004. World Health Report: Statistical AnnexPer capita public health expenditure is stillvery low in most African countries irrespectiveof subregions. The countries with thehighest public health expenditure includeSeychelles, Tunisia, Botswana and South Africa;followed by Mauritius, Namibia, Libya,Swaziland, Zimbabwe, Gabon, Algeria andothers (fig. 5.12). The effect of such a situationcan be demonstrated through WHO’sHealth Adjusted Life Expectancy (Figs. 5.13and 5.14)EthiopiaEthiopia, a country with 58.1 million peoplein 1996, belongs to the lowest-incomegroup with a per capita GNP of only $ US110. Its social indicators are poor, even forlowest-income Africa: only 25% of adultfemale population is literate; 10% of thepopulation has access to safe sanitation; and27% access to safe water. However, ratingsof its legal framework (2.3) and governmentbureaucracy (1) are better than thoseof most other lowest-income African countries,and are about average for Africa as awhole. As a proportion of GDP, Ethiopia’spublic sector spending on health during theperiod 1990-1996 (1.2%) was at the 25thpercentile of African countries, and belowaverage for lowest-income Africa, eventhough it was increasing its levels over thistime. In real terms, this translates into lessthan $US 2 per capita, placing it near thebottom of the Africa table.In terms of health services, Ethiopia’s latestindicators show a mixed picture. It has someof the lowest levels of supervised deliveriesin Africa (14%; only Somalia is knownto be lower), its contraceptive prevalence(4%) places it below the 25th percentile,below average for lowest income Africa,whereas its DTP3 immunization coverage(39% during 1990–1996) varied considerablyfrom year to year, but was near theAfrican average by 1995. Among its healthoutcomes, Ethiopia stands out as havingone of the highest levels of malnutrition(48% of children were underweight) andfertility (total fertility rate 7 children) in Africa.Its infant mortality rate (116) is betterthan that of a quarter of African countries,but still higher than the average for lowestincomeAfrica.96