African health ministers identify human resources as Africa’s biggest healthcare challenge, and that a focus on primary healthcare and public-private partnerships are necessary solutions for providing universal access to healthcare across the continent.
A panel of health ministers at the Africa Health Exhibition and Congress held at Gallagher Convention Centre discussed the challenges facing public healthcare in sub-Saharan Africa, and highlighted the solutions gained from experience in each of their countries.
Minister Dr Bernard Haufiku from the Republic of Namibia said that the most important factor that would contribute to achieving universal health coverage is human resources – behind infrastructure, equipment or financing.
“Wherever in the world I go, I have never been to a hospital where I don’t find an African working,” he said. “So we are having a brain drain. We need to reverse this trend. We need to train more, but we need to incentivise those we have trained to stay home.”
Dr Alex Makupe, a senior medical superintendent representing the Zambian Ministry of Health on the panel, added his voice to the call for healthcare human resources to stay in or return to their home countries. “Our need for surgeons is massively grave, our need for specialists is massively grave. Obstetrics and anaesthesia are even worse,” he said. “We need to be moving in the direction of mobilising more and more human resources.”
Minister David Parirenyatwa from Zimbabwe, said that a focus on primary healthcare has been key to strengthening his country’s healthcare provision. “What we have done is decentralised the healthcare system. We have a district hospital and around that there are health centres and around each health centre are village health posts.”
He says that healthcare workers are nominated by the communities themselves, and that these measures have gone a long way to reducing maternal death rates, improving responses to malaria and encouraging people to eat better. “The principle of primary healthcare is prevention first, second and third.”
However, Parirenyatwa added that as important as it is to focus on primary healthcare, it is also vital to ensure that innovation is taking place further up the healthcare chain as well. “We also have to focus on district, provincial and tertiary institutions. It’s a fine balance. We can do open heart surgery or separate conjoined twins, but we must still also look after primary healthcare.”
Dikgang Phillip Makgalemele, the Assistant Minister of Health and Wellness in Botswana, agreed that community involvement is critical to strengthen healthcare provision.
“We are working hard to sustain the participation of communities in our healthcare system,” he said. “Communities are acting together to control HIV, and this mobilisation at community level has resulted in people taking responsibility for their health. This model has proven very successful, so we are now looking at how best to broaden the model to accommodate the fight against other diseases and to enhance geographic coverage.”
He added that Botswana will also be focusing on strengthening public private partnerships.
Public private partnerships are also a key theme in strengthening healthcare in Namibia. “As far as health infrastructure is concerned, the public sector on its own will possibly never be able to cater to the entire required infrastructure on its own,” says Minister Haufiku.
He says that the private sector is well resourced and has all the necessary expertise. “Improving healthcare requires money, and the private sector could be a very important component in delivering infrastructure and providing human resource training.”
Of course, he pointed out that it is necessary to incentivise the private sector to invest in healthcare in African countries.
“Government has to incentivise the private sector to come on board, the same as if you want investors to come into your country. People do not put money there just for the sake of it, otherwise it’s not called investment; it’s called donation. We have to create conditions as regulators to make sure that the investor is protected and that he or she can earn profit on the dollar.”
The 7th annual Africa Health Exhibition & Congress 2017 is currently taking place from 7-9 June 2017 at the Gallagher Convention Centre in Johannesburg, South Africa. More than 10,000 regional and international healthcare professionals and medical experts are expected to attend the event during the course of the three days.