Healthcare Systems In Africa


Healthcare systems in Africa favour neither patients nor healthcare workers.

With my heart in my stomach, I dropped the phone. Sister Ifeoma was still speaking. Then I picked it up again and mustered the little strength in me to ask her where she is and which hospital she was taken to, of which she informed me. 

The news alone changed my entire system, She has just informed me that mama has gotten into an accident and has been rushed to the only community hospital.

How could this be possible? It hadn’t been up to 3 hours mama left the house. Brushing my hair and wearing the closest cloth I could reach, I rushed out of the house.

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“Your mother needs blood and fast, else she may not survive it, fortunately, we have blood in our bank, you only need to pay for it”.

“Please, we don’t have any money now, can’t we use my brother he’s available”

“We can not use blood we haven’t tested. You just have to pay and save your mother”.

With this, I knew I had no choice, so I started making calls to all the persons I knew.

What I couldn’t understand is that if mama could wait for me to run around and get some money how about checking my brother in an even shorter time?

The above is just one of the many experiences patients have in public health facilities in Africa. Some persons have lost their loved ones through the laxity shown by health workers or through the unnecessary rigorous process involved in attending to patients in African health systems.

Overview Of Health And Challenges Of Healthcare Systems In Africa

The WHO defines health as a state of complete physical, mental, and social wellbeing and not merely the absence of disease or infirmity. The Healthcare system has to do with the general structure of health provision in a certain place, the entire process involved in maintaining the good health of citizens.

It is common knowledge that health is wealth and therefore improving health care is one of the most important issues that all countries actively engage themselves in. 

The WHO defined the basic building blocks or pillars of quality healthcare and they include;

Service delivery,

Healthcare workforce, 

Healthcare Information System, 

Medicine and Technologies, 


Leadership and Governance.

But unfortunately, the healthcare systems in Africa suffers from neglect and underfunding which leads to challenges across the WHO pillars of health care delivery. 

The majority of African countries are unable to meet the requirements for a quality health care system and the poor facilities in the health system have enhanced medical tourism.

Research reveals that an average of 5000 people leaves Nigeria for various kinds of treatment abroad causing a total of 1.2 billion U.S dollars lost t to medical tourism from Nigeria yearly.

Healthy citizens are the life wire of a country. If the percentage of a country’s healthy citizens is way below that of the unhealthy ones then there is a problem. The country would end up spending more than half of its economy on tackling health issues, after all only a healthy person can work and contribute to the economy. Countries all over the world seek daily to improve their health systems because they know the value of a quality health system. So despite the challenges and costs involved they try as much to put in the required work.

However, it’s not really easy to maintain a quality health system in a country and Africa is not left out. African countries face lots of challenges in creating standard health system for their nation and some key factors with their potential solutions include;

  • Inadequate Financing
  • Poor Leadership and Management 
  • Inadequate Human Resources for Health 

Inadequate Financing and allocation:

Research shows that the average Total Health Expenditure(THE) was 6.1% of total GDP in 2015, Yet it keeps increasing by the day. A study by Musango and colleagues found that scarcity of funds for healthcare is a chronic problem in major African countries and even the richest countries are finding it difficult to keep up with the increasing costs especially as the world economy is suffering a downturn.

In most countries, health care costs are financed through OOPs that is Out-of-pocket payments and this method ends up putting the poor masses at the receiving end. Also, a large percentage of the population does not have access to healthcare services as they cannot afford the cost. In a country where there aren’t even enough funds to provide standard equipment, how are they supposed to serve the patients?

Some of the countries in sub-Saharan Africa are implementing social health insurance schemes to cover the health cost but then most times they are not effective as OOPs still thrive, worst in emergency situations where you’ll be forced to provide money before you can be attended to just like the sample story above. 

The insurance schemes leave out the poor so they(poor) bear the brunt of the high level of diseases and expenditure and the government, in turn, finds it difficult to release adequate fund allocations to the health sector. 

Finance plays a key role in any sector that intends to thrive and maintain a growing world standard. 

On that note, increasing the budgetary allocation and funds for the health sector would really pave way for improved medical care and to a  great extent reduce the problems that come from insufficient funds.

Poor Leadership and Management:

A quality healthcare system is also dependent on the quality of personnel in charge of administering healthcare. Some of the personnel in our health facilities are often negligent of their duties and show laxity. 

The problem of leadership in our healthcare system is seen in the place of corruption among the leaders and management including the government. When there is bad leadership, it would affect all aspects of the economy, inability to disburse funds to the needing sector and even when the funds have been disbursed, corruption causes them to be found in private pockets.

The result is increased health costs, mismanagement of resources, poor work effectiveness which would then result to lower customer satisfaction and poor health outcome.

There should be periodic staff training and management courses which should be made compulsory even before admittance into leadership positions and administrators. Without good leaders within the health sector, all other efforts geared towards improving the health system will be in vain.

Unavailability of Human Resources:

This is a major challenge most African countries face in their health sector, Nigeria for example. Often times, the number of health workers being graduated every year is bigger than the positions available. Even the little spaces available for employment are being reserved for those with ‘connections’. 

Apart from this, most times, health workers engage in industrial action either due to internal issues or public campaigns, and during this period they are unavailable to attend to patients.

Some health workers engage in private practice instead of public, some who work both are often unserious with the public work making the public health facilities lacking in personnel. 

Most patients do not visit the facilities due to the unavailability of health workers, those who can’t afford the private hospitals end up in self-medication or care less about their health. This is even worse in the rural areas where there are more poor people who need prompt and easy access to healthcare but unfortunately can not help themselves.

All of these impede healthcare administration and services. If there happen to be an outbreak, there wouldn’t be enough personnel to help fight it which would lead to an increased mortality rate. 

Solutions To Some Of The Identified Challenges The Healthcare Systems In Africa

To mitigate against some of the challenges bedevilling healthcare systems in Africa the government should include strict laws guiding attendance to work and duty and also be more careful while recruiting workers. Besides this, it is said that the more you appreciate people for the work they have done the more they open up their hearts to do more, so from time to time, health managements should provide incentives for workers to encourage and motivate them.

Health sector should be among the top priorities of the government in terms of funding and infrastructural development and in training of medical and paramedical students.


The healthcare systems in Africa is facing so many challenges including weak training of healthcare workers, poor access to healthcare, poor healthcare infrastructure, and many others. Over the years, African countries have been actively making effort to address these issues with some improvement. 

Health is indeed wealth, if the health system is well managed, it would save a lot of added expenses and contribute largely to the economy.

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