Golden opportunity for countries in Sub Saharan Africa to scale up health finances

While the big news at 2013 United Nation General Assembly was, diplomatic breakthroughs on Iran and Syria, post-2015 got a pretty good airing as well.  At the Millennium Development Goals (MDGs) special event on September 25th the leaders discussed the substantial advancement that has been made in meeting several of the MDG targets. However, the key question for countries in Sub Saharan Africa is how to sustain the successes. Maximizing their capacity in health service delivery is vital and allocating more finances and combating corruption in health sector can do this.

The region is known for its weak health service delivery and as a result it became the experimental center for most of the MDG targets. According to the WHO ranking, countries in sub Saharan Africa perform the lowest in terms of health service delivery indicating that countries do not efficiently spend the financial resources that they do have for health services. For example, in 2009 countries in sub-Saharan Africa spent less than 9.5% of GDP that the middle and high-income countries spend on health[1]. Most MDGs goals can be addressed when health service delivery is effective for intervention to the problems. As populations rises, and chronic diseases burden increases the right number of trained health workers and well-equipped health facilities appear to be essential in delivery of adequate responses to any potential catastrophic health challenges ahead. Therefore, it is time for countries in this region to find alternative mechanisms to raise more finances to strengthen their health sector.

After decades of economic stagnation, economic growth across Sub-Saharan Africa is increasing by more than 5% per year and it is expected to accelerate moderately every year[2]. Such economic growth suggests potential additional funds for the health sector. Foreign and domestic private and public investments are the main attributers for the economic growth[3], thus introducing temporary additional taxes on most profitable sectors will generate additional funding for the government. Furthermore, the current economic growth will be expected to increase the household income, thus there is an opportunity for the government to introduce tax on purchase price. All the generated revenues can go directly into national health system to scale up the health finances. The additional finances will help to build more clinics and hospitals especially in rural areas, help to train more health workers, strengthening the health facilities, provide needed ambulance and emergency cares. Furthermore, as brain drain is a serious problem in the region, the introduction of additional funds will help to raise the salaries of health professionals to a competitive level, thus retain the manpower.

The governments need to take necessary measures to ensure that sufficient anti-corruption and good governance processes are in place prior to starting to reimburse own and donor funds. Many countries in this region are recipients of a large number of donor funds for health[4]. Since funding from donors may sometimes be higher than a national health budget, it is; therefore, highly vulnerable to corruption. As a result in the past there were many incidents of corruptions by officials at various levels. For instant, in 2009, Zambia’s high-level officials in the Ministry of Health and Social Welfare paid $1.4 million for consultants for workshops that did not take place [4]. In this regards the government and donors should introduce various mechanisms to control the health finances. In low resource setting, involving citizens in monitoring major funding will be a cost effective approach. For example, in Colombia the government and donors have set up a social control fund and because of this, the country was able to save as much as US$5.4 million from corruption [4]. Without a proper health finance control mechanisms and a surge of additional funds to the health sector, the quality of the health services will remain weak and as a result it will complicate the roads to achieve the MDGs and countries will be unable to cope with the challenges imposed by chronic disease and population rises. Therefore, now is the time for countries in Sub Saharan Africa to reform their health finance approaches.

[1] World Health Organization (2010) “Responding to the challenges of resources mobilization: Mechanisms of raising additional domestic resource for health”

[2] International Monitory Fund (2013) “World economic and financial surveys, regional economic outlook: Sub Saharan Africa”

[3] World Bank (2013) “An analysis shaping African’s economic future”

[4] United Nation Development Programme (2011) “Fighting corruption in the health sector, methods, tools, and good practices”


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