Global Health Africa blogger – Ifeoma Ozodiegwu – shares some of her reflections on improving health outcomes in Africa. She is currently based in Zambia.
Here in Zambia, I have spent the past 5 months observing, reading and reflecting on how best to improve the health outcomes in Africa. I am currently obsessed with learning and highlighting best practice ideas to tackle preventable diseases.
It appears to me that part of the answer lies not in solely improving the health sector but in improving all sectors in a country. The death of a hypothetical young mother from undiagnosed HIV is strongly associated to the economic, financial and social structures prevalent within a nation. I am viewing this problem from the angle of poverty and the lack of safety nets that prevented this hypothetical lady from being educated and led her into impoverishment. At this point, she is unable to afford care and consequently, her first point of call when she is ill is the traditional medicine man, who may attribute her illness to spiritual forces.
Health outcomes have deeper roots than an individual’s decision or the state of a health sector. In the words of Dr. Margaret Chan, the WHO Secretary General, “……the threats to health are more numerous, the causes more ominous and the burden more onerous”. Echoing the same sentiment in their treatise on the evolution of health in all policies, IIona Kickbusch and Kevin Buckett write about “wicked problems” in the context of health systems. They define these problems as “difficult to define, may be socially complex, are often multicausal with many inter-dependencies, have no clear solution and are not the responsibility of any one organization or government department”
Consequently, to address the present day health challenges calls for a broader and more collaborative approach by stakeholders – African Governments, donors, health ministries, international and local NGOs. Governments in the region need to create the enabling environment for multi-sectoral collaboration to thrive. Policy-makers can see the results of such collaboration from the Singaporean experience as documented by William Haseltine in his book – Affordable Excellence. In the book, Haseltine writes about an “unusual degree of unity” that existed within the country’s ministries as far back as the 1980s. This unified front created room for discussion and collaboration on multi-sectoral issues and development of policies that “reaches across ministries”. In its 2000 World Health Report, the World Health Organization ranked Singapore as sixth on its overall health system performance ahead of several developed countries.
Involving other sectors to work in public health has the potential to bring about exponential improvements in the health of citizens in African countries. For example, collaborations between ministries of transportation and health could be the first step in addressing the high mortality rate from accidents in Africa. See more about accident statistics in Africa.
Such alliances could result in improved availability and response time of emergency care at frequent accident sites. In addition, research collaboration between both ministries can help determine accident risk factors and develop programs to address them. Indeed, one of the proverbs we are fond of in Africa goes: “If you want to go fast, go alone. If you want to go far, go together”.