Healthcare Disparities in Africa Essay Example

scarce resources, and in some countries the sector is ranked below other development priorities. This has also lead to failure by governments to implement various commitment agreed upon in various African Union meeting like the Abuja Declaration of 2001. In this declaration , the head of states had committed to allocating 15 % of national budgets to the health sector , a commitment which has not be met to date by majority of the nations. For instance, average allocation of the budget in the Sub-Saharan Africa rarely go past 5 % with most these countries using less than US $10 for every person annual on health care instead of a minimum of the needed US $ 27 (Akukwe, 2008). This leads to the scenario where most of the African population in the rural areas cannot access modern and quality health facilities per head. The rural populations also cannot get safe sanitation and drinking water. Even where such facilities are available, they are usually congested and poorly staffed. Such services can only found in the major cities and towns which are inaccessible by the majority of the rural folks. The kind of neglect in the rural areas is evidenced by the high child, infant and maternal mortality levels and the low immunization rates in such regions (Thomson et.al, 2006). However, in the urban centers especially in the high end residential areas the rate of such incidences is quite low.

The high level of poverty is another factor that is associated with scarcity or mismanagement of resources and lead to the disparity in healthcare (Braveman, 2003). The UNDP report on Human development and World Bank report have been

estimating that, though the poverty level is gradually decreasing, the big part of the population lives in absolute poverty (Abdesslam, 2009). This kind of poverty means that most of the population has no access to quality health services and this in turn increase their vulnerability while affecting productivity directly. Disparity is thus seen between the poor and the rich. The poor of the nations do not have the resources to seek quality health services from the private hospitals which are out of reach (Thomson et.al, 2006).

Combined with policies that have crude cultural adjustments he poor always bear the brunt of this neglect. Moreover, financing of health care in Africa majorly depends on cash services payment. The only sources complementing the services are financial assistance from donors, both bilateral and multilateral. These results to a scenario where the ministries of health utilize much time attending workshops or seeking donors’ financing or responding to their inquiries with less time to ensure equitable distribution of the little healthcare resources available (Pieterse, 2014). This means that some countries have few non-state actors involved in the provision of public health services. In addition, the poor in these countries are normally exposed hazardous environmental risks and also have little information about such threats to their health. It also the poor who are most at the risk of being exposed to communicable diseases such as malaria , tuberculosis and HIV/Aids epidemic (Buseh, 2008). The disparities in the poverty and death are appalling in the continent and within the countries. The issue is further complicated by the loss of human capital resources through brain drain, civil wars in countries such as Congo and

training programs which are inappropriate (Akukwe, 2008). The African countries continue to suffer the consequences of an unjust world that, driven by capitalism, has seen imbalances in global trade and increasing burden in form of debts. The currently health care is being handled by free market strategies and structural adjustment has lead to reduction of health care involvement by the public sector. This can be related to the decrease of health care staff through retrenchments and various embargoes on recruitment whose possible effects have been deprivation of rural and poorer populations of quality health care services (Mason, Leavitt & Chaffee, 2012). This results to a great disparity between the healthcare for the communities living in rural areas or shanty towns and the few rich individuals who can access quality health care from modern private hospitals.

Many of the health care systems in African countries especially in the rural areas were inherited from the colonial governments. Most of such facilities are weighted unevenly towards the rich and the privileged people or elites in the urban areas. The colonial systems have been perpetuated so that just replacing the colonial governments did not solve the problem of uneven distribution of health care and health facilities (Thomson et.al, 2006). Although there have been an increase in spending over the years, no substantial progress has been made to ensure that equity in health care is achieved. The systems are organized in such a way that they do not evenly and adequately address the rising burden of various diseases. Any efforts to provide health care in the population in the lower income areas have been hampered by the recent reduction in health

budgets which continues to erode past advances in healthcare provision in such areas (Mason, Leavitt & Chaffee, 2012). The African governments also have weakened capacity to cope with the health crisis, which has made the low income areas to be disproportionately affected by the policies both national and international, which appear to serve only the financially able. These systems are also not flexible enough to cater for the scenarios that cause reversal of any gains. Thus, some people turn to traditional sources of care or faith based healthcare since they are more accessible and affordable but the authorities largely ignore them thus they are unregulated (Scher, 2011). Such health care services cannot be relied upon for quality since there no standards set in place to determine their effectiveness in the prevention and treatment of various tropical diseases.

There is lack of modern technology that can be used to diagnose diseases that are new or re-emerging. Such facilities are only available in the private hospitals and the few that are available in public health care facilities are old and congested which results to frequent breakdown and thus the majority of the population will have o wait in line or for the equipments to be functional after repair (Williams, 2011). This issue is complicated lack of proper treatment programs which means that patients do not follow up the prescriptions given resulting to drug resistance development. This is caused by high prices for drugs for diseases such as tuberculosis, which worsens the situations (Snell & White, 2011). In addition, most of the people in areas with no facilities seek healthcare when it is too late , and such scenarios

need sophisticated and quality treatment which is not easily accessible , more drugs and longer hospital visits whose end result is unsatisfactory recoveries (Shi, & Singh, 2011) . Lack of proper equipment in many public healthcare institutions leads to inability of analyzing various situations with credible data relating various diseases, healthcare performance and general public health status. This undermines the decision making process among the health professionals very difficult (Zondi, 2010).

Another factor resulting to disparity in healthcare provision is a crisis on human resources especially the medical staff (Maharaj, 2012). This crisis results from various factors like production of inadequate professionals in many countries especially in the sub-Saharan Africa, the lack of resources to hire adequate professionals which is caused by the mismanagement of resources or corruption (Scher, 2011). Moreover, there is high rate of brain drain where the health professionals are look for better terms of employment due to lack of motivation. These professionals work in poor conditions in public hospitals that have inadequate, outdated and non-functioning equipments and their payment is poor in relation to the large number of patients they have to care for (Pieterse, 2014). The results of these inadequacies is the high number of health professional seeking opportunities in other continents or turning to private sectors that can only be accessible by the financially able (Sultz & Young, 2011). Furthermore, many of the health workers are concentrated in the urban areas where it is only a small proportion of the populace lives. These professionals work in private hospitals that charge exuberant healthcare bills making them out of reach for the urban poor (Williams, 2011). The population in the rural areas

has to travel to the urban centers to access specialized care which is quite expensive.

The shrinking of human capital in health sectors due to decimation of the productive workforce by conflict or epidemics is a real situation in Africa (Thomson et.al, 2006). The conflicts also lead to few educated professionals and as aforementioned, the few ones available are search of greener pastures. While few of the African countries are dispatching many graduates in health disciplines, other countries in conflict or in reconstruction period after the conflict have a small learned workforce in the health sector leading to disparity among various nations (Turshen, 1999). Such population ends up depending on non-governmental organizations or United Nation’s institutions to offer health care services which are mostly unable to cater for all their needs.

The issue of this disparity is further complicated by the poverty burdens among various African countries (Thomson et.al, 2006). While few African countries can manage to provide food security and fully fund diseases control and prevention programs, most are stuck in inadequate budgets (Akukwe, 2008). The continent has continually been susceptible to economic and food crises that have been recurring since the early 80s’ (Kebede-Francis, 2011). Majority of the population is removed from the food supply chain and thus poor health and malnutrition. The governments have not adequately addressed the issue of constant food crisis meaning that most of the population is susceptible to various communicable and non-communicable diseases (Kosoko-Lasaki, Cook & O'Brien, 2009). Cases of severe famine have been recorded especially in the sub-Saharan Africa. A 2005 report recorded that more than 300,000 children died due to malnutrition by the end of the year. About

11 million people were reported to have faced starvation in Kenya, Somalia and Ethiopia with some surviving on a single meal each day (Zondi, 2010). Families had lost their crucial nutrient sources such as livestock due to recurring droughts. Lack of enough food reserves, weak food distribution systems and low application of agricultural inputs have also resulted to the disparities in nutrition provision among these countries. These issues are product of poor governance that fails to come up with policies aimed at ensuring food security across the whole populations (Turshen, 1999).

In order to correct these unacceptable disparities, the African Union must adopt systems that monitor or rather evaluate the commitments agreed upon in Abuja and other post-Abuja agreements (Akukwe, 2008). This will ensure that African governments allocate enough resources to health care sector. This will ensure health care centers are established in the rural areas to address the inadequacies and necessary equipments are stocked to provide equal healthcare services. In addition, the governments should provide better working conditions in public health facilities so as to prevent the incidents of brain drain (Klopper & Sigma Theta Tau International, 2013). The health care workers should be motivated through better terms of employment and hiring of more nursing and medical staffs to ensure that the patient-staff ratio is reduced. The African Union must persuade the member states to enhance the corruption fighting efforts so as to ensure that resources allocated for healthcare purposes is no looted or mismanaged (Zondi, 2010).

The governments must priorities the strengthening of systems for primary healthcare especially in rural areas and low-income urban centers where majority of the population is located. Efforts should also

be focused in reducing the cost of health care services among the public hospitals so that to make affordable to citizens most of whom are poor. The governments should establish effective and cordial partnership with other stakeholders who are non- state-actors in the healthcare sector (Falvo, 2011). Such partners will assist in providing health care services in places that are the governments are unable to reach due to financial constraints. There should also be co-operation with the players in the private sector so that they can regularize their services to the public by way of cost reduction. These actions will go a long way in reduction of the existing disparities health care between and within the African countries

References

1. Brach C & Fraser I. (2005).Can cultural competency reduces racial and ethnic health disparities?A review and conceptual model. Med Care Res Rev. 2005;57(suppl 1): 181–211
2. Braveman, P A.(2003) Monitoring equity in health and health care: a conceptual framework. 2003;21:181–192.
3. Falvo, D. R. (2011). Effective Patient Education: a guide to increased adherence / Donna R. Falvo. —4th edition.
4. Mason, D. J., Leavitt, J. K., & Chaffee, M. W. (2012). Policy and politics in nursing and healthcare (6th ed.) . St. Louis, MO: Elsvier Saunders.
5. Scher, D. L. MD (November 2011).How the crises of healthcare and education are related http://www.kevinmd.com/blog/2015/11/crises-healthcare-education-related.html
6. Snell, L., & White, L. (2011). A Sociocognitive Approach to Service Quality and Adherence Amongst Elderly Patients: A Pilot Study. Health Marketing Quarterly, 28(2), 99-115.
7. Sultz, H. A., & Young, K. M. (2011). Health care USA: understanding its organization and delivery (7th ed.). Sudbury, MA: Jones and Bartlett Publishers
8. Akukwe, C. (2008). Health services in Africa: Overcoming challenges, improving
   

outcomes.