Health Care Systems in Africa: Achievements, Challenges and Policy Implications for Achieving Sustainable Development Goal 3

Abstract

The overall objective of the study is analysis of the health outcomes and the challenges of the health care systems in Africa under the dominant neoliberal regimes. Despite the limitations of neoliberal policies, the health care outcomes in Africa have been encouraging: infant, under five, and maternal mortality rates have declined significantly, while access to maternal and child health care services, family planning and to skilled birth attendants has improved. However, African countries still have faced several challenges (i)rising non-communicable disease burden, (ii) inadequate governments' budgetary expenditures, (iii) high out-of-pocket payments, (iv) shortage of health professionals, (v) low quality health care services (vi) low client satisfaction with the services provided.

In commercial-oriented health care systems of Africa, there is inverse health care in which the poor with the highest health care needs receive the lowest while the rich with the lowest health care needs but with the highest means receive the highest. In order reverse the situation and to achieve the health-related SDG 3by 2030, the following interventions are suggested (i)A shift from neoliberal policy stance to developmental state approach and ensure ownership   and management of health programs that will enhance effectiveness of the health care systems and achievement of SDG3 by 2030. (ii)  Enhancement of inclusive economic growth through increased investments so that African countries' governments will be able to allocate at least 5% GDP to the health care services which are accessible by all. (iii) Publically financed health care is the only means to achieve universal health coverage. To this end, expansion of fiscal space and increased budgetary expenditure on health care through mobilization of adequate domestic resources will eventually ensure achievement of SDG3.(iv) Introduction of mandatory health insurance to protect individuals from catastrophic expenditures while paving the way towards universal health coverage (v) Strengthening primary health care and ensure cost-effective and high impact interventions (vi) Increase public investment in health-related education to create awareness and as part of preventive measures for desired behavioral change among the public.(vii) External debt cancelation and rechanneling the proceeds to health care.