The various health systems set up in sub-Saharan Africa perfectly illustrate the context of underdevelopment in which this part of the continent is plunged. This observation applies to both equipment and the transmission of health information. To improve the efficiency of these deficient health systems, it is urgent to carry out a comprehensive study to define areas for improvement. So what are the different perspectives to consider?
Africa in the grip of endemic diseases
Despite very encouraging growth, the African continent still has to contend with the fragile health of the entire population. To compensate for the inadequacy of health systems, more and more digital initiatives aimed at fighting recurrent infections are gradually appearing. Will e-health make it possible to positively change the current situation?
Indeed, for decades, Africa has been confronted with many endemic diseases: fever, yellow fever, malaria, trypanosomiasis. These seriously and lastingly affect the health of several million Africans. To a lesser extent, pathologies such as leprosy, cholera and tuberculosis are still present in Africa.
New viruses have also appeared: Ebola and AIDS. At the start of 2017, more than 26 million people, including 2.3 million children, were living with HIV. Sub-Saharan Africa is the area most affected by this disease. Ebola fever, meanwhile, recently claimed the lives of more than 10,000 people in West Africa.
These endemic diseases are all the more deadly as they come on top of the energy and protein deficiencies that afflict several million Africans. These health issues weaken the continent.
Is the health sector considered a priority?
The health sector represents a strategic issue for the development of Africa. Despite everything, spending to improve health systems represents, according to WHO, around 4% of GDP (4.7% in Senegal).
Unfortunately, the bulk of this health spending is allocated to private providers. 60% of health sector funding comes from private donors (NGOs, associations, companies, etc.).
Public investment turns out to be very low. This finding seems alarming in the face of the many health challenges that Africa faces.
What about health insurance?
Until a few years ago, 80% of the population in Africa did not have any health care system. Despite the establishment of CMU (Universal Health Coverage), millions of people do not have any insurance.
Only the wealthiest populations are able to afford health insurance from private providers. The poorest and most vulnerable populations, unable to take out this type of insurance, are often denied access to care in public and private hospitals.
This situation, in favor of an elitist and unequal system, sustains the spiral of poverty and lack of access to healthcare that the poorest people face.
Under-staffed nursing staff
To better understand the deficit in terms of available medical personnel in Africa, it is interesting to compare the situation in Africa with that of Europe. In Europe, there are 32 doctors for a population of 10,000 people. In Africa, you have two doctors for every 10,000 people.
In terms of nurses and midwives, the difference between Europe and Africa is equally impressive. In fact, for Europe, there are around 79 nurses and midwives per 10,000 people, while in Africa, there are only 11.
However, the African population currently represents 1.2 billion inhabitants. This figure is expected to double by 2050. This demographic boom will inevitably lead to a massive rural exodus.
According to the WHO, the deficit in terms of health workers in 2030 will be 6.1 million people. This shortage of qualified health workers will further widen the gap between rich and poor populations.
A lack of infrastructure and equipment
Africa has a low density of hospitals. In addition, in some areas, getting to hospitals can be a real journey. The virtual existence of passable roads that do not facilitate access to health facilities.
In addition, the dilapidation of hospitals is a reality. Heavy equipment such as scanners, for example, is not available in all hospitals. Many of them are simple dispensaries that do not offer serious care. According to the WHO, more than 550,000 additional beds must be provided to hospitals by 2020 to meet the needs of the populations.
Unfortunately, access to medicines is another issue facing African populations. Procurement in private hospitals can be a complex process. This phenomenon favors the illegal trafficking of fake medicines. In Africa, between 30 and 70% of the drugs available on the market are fake drugs.
Digital as an alternative solution?
Many African health systems have shortcomings and dysfunctions. To overcome this problem, new initiatives are flourishing in terms of health. Digital projects therefore the optic is to allow everyone to benefit from telemedicine are deployed. Mobile phones are at the very heart of this new type of innovation.
The GiftedMom application created by a Cameroonian doctor provides care and monitoring for pregnant women and young mothers. This solution works using a mobile phone. The Mos @ n initiative in Burkina Faso aims to improve coverage of maternal, child and HIV care.
Himore Medical company launched the Cardio Pad. This instrument, in tablet form, can be used to perform complete electrocardiograms on patients. The objective of the Cardio Pad is to limit the death rate due to cardiovascular failures.
The Faso Soap project is behind the creation of a soap that keeps mosquitoes away for more than 6 hours after application.
E-health, unfortunately, will fail to resolve and address all of the failings presented by African health systems. Nevertheless, this solution makes it possible to target and provide support to people who are rural and more prone to suffer from disease. African governments must therefore rapidly reform the health sector.