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Jun 12, 2023   |   Blog Post

Forging new partnerships to reorient health systems to primary health care in Africa

Ministers of Health from Malawi, Kenya and Zambia and DRC representative from the Ministry of Health and Population at the High level Ministerial Meeting on Community Health. (Photo Credit: Kat Tillman)

By Theo Chiviru

Director, Advocacy & Partnerships

As Dr Tedros, Director-General of the World Health Organization (WHO), and world leaders gathered in Geneva this May for the 76th World Health Assembly (WHA), the imperative remained to ensure that countries strengthen health care systems, deliver on the commitments of Sustainable Development Goal 3 and forge fit-for-purpose partnerships towards primary health care in Africa.

WHA is the decision-making body of WHO, which meets each year to discuss current and future priorities for public health issues of global importance. This year’s assembly was under the theme, “WHO at 75: Saving lives, driving health for all.”

This was a befitting theme for Africa as the continent grapples with the effects of COVID-19 on primary health care- which has become a dark reality. WHO estimates that about 670 million people in Africa, representing 48% of the continent’s population, still lack access to quality health care.

The assembly discussed the need to reorient health systems to primary health care as a resilient foundation for universal health coverage. Health ministers, civil society, academia and the private sector echoed the need to forge new partnerships to help countries improve primary health care delivery and achieve 2030 targets. An all-hands-on-deck approach that consists of the following:

Sustainable financing models

Fundamentally shifting primary health care priorities and creating a system that responds to people’s needs involves financial choices and sustainable financial streams. The shocks from COVID-19, the Ukraine war, the debt crisis and climate change have put health care systems in a more precarious position than a decade ago, creating significant uncertainties for African countries.

Redressing this situation will require building partnerships that help African countries develop sustainable financial models that fuel a more integrated, digitally-driven, and pluralistic system that can support, drive, and lead to financial independence. The African Union’s (AU) African Leadership Meeting (ALM) Declaration provides a starting point for dialogues on partnerships for health finance

Comprehensive health care framework

We need partnerships that support a comprehensive framework with a whole-of-government and whole-of-society approach that combines critical core components: multisectoral policy and action, empowered people and communities.

Malawi’s Health Minister shared how the Health Sector Strategy Plan 3 focuses implementation on ONE Plan, ONE Budget, ONE M&E. Comprehensive frameworks can help African countries equitably maximize scarce resources and guide investments from partners towards the same goals.

Enabling environment for local innovation

We need partnerships that take bold, transformative action, invest, and champion innovative local solutions to solve primary health care challenges. Local entrepreneurs face numerous challenges, including inadequate finance, an unfavourable policy environment, and competitive technologies.

Homegrown solutions should be the heart of primary health care in Africa. Local innovations leverage local knowledge, social norms, cultural characteristics, and political economy to solve problems. Local social enterprises are agile and can respond quickly to community needs and pain points. It enables health systems to absorb and roll out innovations through existing services with minimal disruption and maximum effect.

Health workforce

The assembly deliberated on the brain drain of African health professionals, which negatively affects the workforce. The Africa Union estimates that 90,000 health professionals emigrate from Africa every year.

To reverse these numbers will require an urgent collaborative effort. Africa’s Health Ministers called for partnerships to improve health professionals’ working conditions, such as equipment availability, remuneration and specialist training programs.

Accountability mechanisms

Many African countries need better governance systems, among other things. Corruption, mismanagement, absenteeism and inefficiency affect primary health care delivery.

Communities need to participate in decision-making and hold decision-makers accountable. We need partnerships that build robust accountability ecosystems that foster efficiency and effectiveness using mechanisms like feedback loops. Doing so empowers individuals, families, and communities to optimize their health as advocates for policies and better delivery that promote and protect health and well-being.

Strengthening supply chain

Health supply chain faces severe constraints that negatively impact primary health care delivery. These challenges include poor infrastructure, weak regulatory systems, disruptions, corruption, counterfeit and expired drugs, cold-chain shipping, and stock-outs.

Considering the complexity of the supply chain, we must build collaborative processes that enable transparency in supply chain data and the adoption of tech-enabled systems to expedite last-mile delivery. Efficient and effective health supply chains are vital in allowing access, quality, and affordability of services. VillageReach has built partnerships in the Democratic Republic of Congo, Liberia, Malawi, Mozambique and Côte d’Ivoire to make health products available when and where they are needed.

A more collaborative approach that involves governments, the private sector, civil society, multilateral institutions and communities is a non-negotiable pathway to reorienting health systems to primary health care in Africa. These new partnerships must rise to the challenges as a sustainable future requires bold action today.

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