Developing Sustainable Healthcare Infrastructure in Africa


“The success or failure of any government, in the final analysis, must be measured by the well-being of its citizens. Nothing can be more important to a state than its public health; the state’s paramount concern should be the health of its people.”

Franklin Delano Roosevelt

1) African healthcare infrastructure in a nutshell

Healthcare infrastructure is the backbone of any public health system (Linda Luxon). It has several components including the human resources; the information systems (to help collect data for evidence-based decision and for monitoring the population health needs); and the public health agencies, laboratories and hospitals (Baingana & Bos). In sub-Saharan Africa, despite the fact that we bear about a quarter of the global diseases burden (pre-COVID-19 WHO’s statistic), these components remain largely inefficient, ineffective and of a low standard or quality; lagging behind our western counterpart.

This can partly be attributed to poorly trained medical doctors and nurses (Africa has only between 1-2% of the world’s trained public health workforce for 17% of the world’s population – WHO), a large health data gap and underfunded laboratories and hospitals. As regards the latter, the World Health Organisation reported that Africa’s share of global health expenditures is less than 1%; and that sub-Saharan Africa spends only between 6 – 7% of its GDP on health. This is less than half of the 15% of GDP suggested as good by the WHO (Human Rights Watch).

Moreover, in terms of the percentage of the State’s budget allocated to health, most countries spend significantly less than the 15% advised in the Abuja declaration (Babalola & Moodley). Covid-19 pandemic has further shown the importance of increasing health’s budget sooner; by revealing more healthcare infrastructure deficiencies such as poor testing capability, lack of protective equipment, and a deficit in intensive care beds and ventilators (HRW). For example, we have less than 1 intensive care bed and ventilator per 100 000 people across the continent (Reuters).

2) A need to develop sustainable healthcare infrastructure

World Bank-IFC estimated that over the next 10 year, Africa will need $30 billion to meet its healthcare demand. So far, the African Development Bank in February of this year allocated the equivalent of 0.03% of this amount or $10 million towards healthcare infrastructure while planning to mobilise up to $100 million (AfDB). As a result of the poor investment into African healthcare infrastructure, a staggering 410 million people in sub-Saharan Africa don’t have access to affordable and quality healthcare (UNDP). This also suggests that without a sustainable healthcare infrastructure (that’s adding value to the patients and saving costs, in addition to reducing carbon emissions -Linda Luxon), it will be difficult for Africa to achieve Sustainable Development Goal #3 on good health and well-being for all by 2030.

3) Some sustainable initiatives to improve African healthcare infrastructure

a) Leveraging on existing technology

For example, by taking advantage of relevant technology such as a smartphone (Joseph Jimenez); to update patients on medicine’s and vaccine’s availability and or pharmacies that have remained open at night or during the weekend.

b) Deliver world-class medical education

Improving the quality of medical education in sub-Saharan Africa should be given a priority in terms of resources allocation. For example by building state-of-the-art hospitals with modern equipment, managed by well-trained healthcare workers. The latter is so relevant as they are involved in the training of medical school students.

c) Improving the working conditions of health care personnel

Efforts should be made to improve the working conditions of medical doctors and nurses and thus increase their retention rates. For instance, by making sure hospitals and clinics have access to reliable electricity from solar PV especially in rural areas; promoting early conflict resolutions in high-risk areas (Baingana & Bos); and offering staff members better economic proposals to avoid expatriation.

d) Closing the health data gap

This will promote both evidence-based decision and targeted intervention within the healthcare sector.

This article was written by Hugue Nkoutchou

For more information on Africa’s Healthcare Infrastructure investment, please reach out to us.

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