By Winnie Osika
Africa should consider streamlining and financing its own health systems and work towards reducing its reliance on donor funding, experts now say.
A panel discussion that was held during the Medic East Africa in Kenya concluded that most countries in Africa are capable of financing their health systems if only resources are utilized effectively and domestic resources for health are increased.
The panel that was discussing ways of fostering innovative financing for Universal Health Care (UHC) in Kenya and East Africa as well as transformative partnerships for sustainable health financing observed that external funding partners who initially funded health programs have shifted to financing other areas like climate change.
One of the panelists, Ms. Regina Ombam, East African Community Health Financing Dialogue Facilitator said there is significant wastage of domestic health resources, and that even the resources available are not being utilized effectively.
“We are seeing a lot of wastage in the health sector. What we need in the East Africa community is a public finance mechanism that responds to what we need to do and what works for us. If we streamline this, we can take care of our health systems very well. “Said Ombam.
She further highlighted that specific health areas, such as Primary Health Care, development of Strategic Plans and collation of health Data should not be donor funded as it denies and undermines the control of beneficiary countries.
Her sentiments were echoed by another panelist, Dr. Margaret Lubaale Executive Director, Health NGOs Network (HENNET) who agreed that politicization of the health sector, a lot of wastage and not effectively utilizing what is available is causing over dependence on donor funding.
Lubaale stated, “Our focus should be on enhancing integrity and accountability within the health sector. By addressing systemic leakages, we can effectively utilize domestic resources to manage the health sector smoothly. However, once health issues become politicized, they are compromised entirely.”
The discussions on sustainable and resilient health financing in Africa happened after the just concluded meeting in Addis Ababa earlier in the year that sort to develop a roadmap to catalyse action to reshape the health financing ecosystem in Africa, and make it fit-for-purpose towards 2030 and beyonLu
More than 80 ministry of health experts, regional and global partners and civil society representatives attended the meeting that was convened by the World Health Organization’s (WHO) Regional Office for Africa, in partnership with the African Centres for Disease Control and Prevention (Africa CDC) and the African Constituency Bureau of the Global Fund.
The development of the roadmap marked an important step in the ongoing process of identifying ways to ensure that global health initiatives (GHIs) and other external funding partners are more effective, efficient and equitable in complementing domestic financing, to strengthen health system capacities, accelerate progress towards universal health coverage (UHC), and deliver health impact.
The declaration of the Addis leadership meeting undertook to increase domestic investments in health and improve health financing systems in a context-appropriate manner so that each country can pursue its own path to achieving and sustaining Universal Health Coverage and that the people of the African continent can receive qualitative, accessible and affordable prevention, diagnosis, treatment and care services they need without suffering financial hardships.
Additionally, it agreed to foster cooperation between public and private sectors to create synergies and deliver health for all.
In Kenya, The Health sector received Sh127 billion for Affordable Healthcare provision in the 2024-25 financial year. The amount represented a Sh14.2 billion budgetary cut from the Sh141.2 billion the sector was allocated in the 2023-24 fiscal year.
This is the third year in a row the health sector has received budget cuts. The trend reflects Kenya’s ongoing ‘habit’ of not allocating at least 15 percent of its budget to the health sector, as stipulated by the Abuja Declaration.
At county level, the experts said that most of these monies are not utilized fully due to late disbursement by the National government.
Another key problem that was pointed out at county level was the centralization of the procurement processes. It was argued that people who do not understand the dynamics and emergencies of the medical sector have been put at the fore front of handling and procuring medical equipment yet they do not understand the technicalities and urgencies of these equipment.
According to the Kenya Health Facility Census Report 2023, it was pointed out that there is a need to prioritize strengthening the capacity of health facilities to provide essential outpatient services through availing the requisite health personnel, health infrastructure/equipment and health products and technologies.
The report further mentioned that availability of basic equipment is especially a critical gap that needs to be bridged for quick gains.
In regards to health workforce, it was noted that access to health workers such as nurses and clinical officers was greater than other cadres such as pharmacists and dentists. In addition, health workforce was inadequate and below the WHO recommended norms per population.
This could have a negative effect on access to quality health care and more so for understaffed cadres such as dental and pharmaceutical staff, and hamper the formation of multidisciplinary teams for holistic care.
