Game-changer for health of Africans
View
ON A dusty road in Ghana’s bustling capital city of Accra, history was made recently. In a landmark first, world renowned African health experts, academics and health professionals converged under a single, newly formed African health organisation, African Forum for Research and Education in Health (Afrehealth), to map out solutions to tackle the continent’s health challenges – led by Africans, for Africans.
It was a defining moment as African health solutions have almost always been guided by “Western” experts. This was a game-changer. Health experts in Africa would be at the forefront, playing a leading role in global health solutions.
The continent’s leading health figures debated and discussed a continent-wide campaign to tackle key bottlenecks to health solutions in Africa.
At the heart of this was the clarion call to African governments to prioritise health care in their countries, to do more to retain local health professionals and curb the exodus of their skills to foreign markets, and for more investment in supporting African health research to ensure locally-relevant and led health solutions.
“An African-led think tank in health is the game-changer for the continent,” Ghanaian-born Afrehealth chairperson Professor Peter Donkor told delegates.
The excitement at an African-led package of solutions was etched on the faces of the more than 200 delegates attending the conference.
Nurses, doctors, community health workers, surgeons, professors, Health Ministry leaders, government ministers – they all came together for the first time, under one umbrella body with a common cause: improving the health outcomes in Africa as a continent, not country specific.
Interestingly, despite the differences in cultures, languages and governments, there was a common thread in the representing countries’ health direction: a growing shift to a primary health care (PHC) approach, a concept at the heart of South Africa’s new National Health Insurance (NHI) system expected to replace the current, curative health care approach over the coming nine years.
The PHC system relies heavily on community care and prevention of diseases, hence the need for more basic health care services at clinic level.
It’s a system aimed at raising awareness of health issues and driving prevention. For this approach to work, South Africa – like other countries on the continent – will need more nurses and doctors trained as family physicians, and willing to work in rural areas. It’s a formidable challenge. Latest reports indicate a rise – by almost 60% – in the number of doctors and nurses leaving Africa to work in Organisation for Economic Co-operation and Development countries, which include most of Europe.
Added to this are continued reports of more South African graduate doctors refusing to work in state health care facilities, while foreign doctors remain more willing to work in rural areas across South Africa.
A recent study by Econex revealed up to 80% of newly qualified doctors in the country chose not to work in public health facilities.
South Africa is already addressing this, through its Cuban health partnership, which sends hundreds of South African medical students to Cuba each year to train as family physicians.
The idea is to drive exposure of community health care, in line with the impending requirement of our new NHI system and to encourage retention at rural level. But there are no guarantees they will take the bait and remain loyal. And South Africa is not alone. The exodus of local health skills is a serious concern across the continent, as graduates leave for more lucrative markets.
It’s a key concern weighing heavily on the mandate of Afrehealth and one the organisation is well aware of.
“We know our continent faces a brain drain and while we will never be able to stop it, we can do more to manage it better,” says internationally renowned Ghanaian professor and key Afrehealth member, Francis Omaswa.
“One of the ways we can do this is to encourage the World Health Organisation Global Code of Practice on the International Recruitment of Health Personnel, which promotes voluntary principles and practices for the ethical international recruitment of health personnel, taking into account the rights, obligations and expectations of source countries, destination countries and migrant health personnel.”
Campaigning internationally for countries to adopt the code of practice while working towards creating an environment which retains health professionals locally are some of the plans being rolled out to combat the skills shortages on the continent.
“It won’t be easy. We will need to increase rural health experiences of our medical students and ensure they have an enabling and supporting environment to assist in their experience. But it has to be done,” says Afrehealth’s deputy chair and Stellenbosch University’s Professor Marietjie de Villiers.
Until now, collaborations in health on the continent have been largely driven by funding commitments to international donors. And, while this worked successfully, Africa remained hamstrung by not being able to set a local agenda, often frustrated by stringent international criteria.
“We must stop this reliance on international funding to resolve Africa’s problems. We need Africa to rise and not to look at Harvard and Oxford solutions to what is happening in Africa,” said Liberia’s Professor Vuyu Kanda Golakai.
With funding on the decline from international donors, African health leaders embarking on the mission to go it alone will need to drum up more support locally if they are to succeed.
The mission to “lead with African health solutions by Africans” cannot be left to them alone.
It’s a collective responsibility and an obligation on all African governments and educational institutions to support if the continent is to benefit.
Our resource-constrained environments where health workers often have to do so much with so little can only be understood by those who share similar experiences. Afrehealth will need Africa behind it if it is to truly become a global leader in African health solutions. It’s not an impossible feat.