Health

African Economic Development

Renata Serra – March 29th 2007

The African health crisis

Quantitative Qualitative Regress through time

• after painful progress

Lack of conditions for reverting the crisis in the short term

The worst areas

Infant mortality from preventable diseases and malnutrition combined

Maternal mortality (risk factor for African women is 500 times larger)

HIV/AIDS • See www.unaids.org for data and information,

especially on your country of choice

• http://www.theglobalfund.org/en/

• http://www.gatesfoundation.org/default

Supply constraints

Insufficient provision of health services Bias against rural areas and PHC Initiatives:

• 1978: Alma Atta Conference

• 1987: Bamako Initiative Despite commitments and reforms, the

supply of services remain inadequate quantitatively and qualitatively

“Demand” issues

Several constraints:• User fees

• Distance

• Perception of low quality

• Inability to buy medicines

• Patients’ feelings and pride hurt by providers “Access to PHC in Mali by women”

• Research shows that many poor women prefer alternative providers even when PHC facilities are in the near vicinity failure of the health reforms??

Men take decisions for their wife’s health

Source: Unicef, The State of the World’s Children 2007, Fig. 2.1 [online at: http://www.unicef.org/sowc07/docs/sowc07.pdf]

Challenges

Incorporate traditional medicine Train health personnel on provider-

patient relationships Take seriously specific cultural and

social barriers Language issue

Broader connections

Poverty Migration and trans-national movements Poor quality of water, hygiene and sanitation Low levels of education Political instability and wars Economic reforms International drug trade and IPRs agreements Brain drain

• Cause or consequence of lack of facilities?

The economic costs of poor health Lost days at work and lower productivity Poor children’s school attendance Increase in care activities by HH members and decrease

in productive employment Greater poverty (as income is spent on drugs and

treatment) Low levels of FDI All these factors amount to significant lower saving,

investment and growth rates: is there a measure of the lost growth potential for your own country?