On a dusty road in Ghana’s bustling capital Accra, history was made recently.
In a landmark first, world-renowned African health experts, professionals and academics converged under a single, newly-formed 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.
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.
Nurses, doctors, community health workers, surgeons, professors, health ministry leaders, government ministers – came together for the first time, under one umbrella body with a common cause: improving the health outcomes in Africa as a continent.
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 National Health Insurance (NHI) system expected to replace the curative health care approach in the next nine years.
The PHC system relies heavily on community care and prevention of diseases, hence the need for more basic services at clinic level.
It is a system aimed at raising awareness of health issues and driving prevention. For this approach to work, South Africa will need more nurses and doctors trained as family physicians, and willing to work in rural areas.
It is a formidable challenge.
Latest reports indicate a rise – 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 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.
A recent study by Econex revealed up to 80% of newly-qualified doctors chose not to work in public health facilities. South Africa is addressing this, through its Cuban health partnership, which sends hundreds of its 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 the NHI system and to encourage retention at rural level. But there are no guarantees they will take the bait and remain loyal. “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 stop it, we can do more to manage it better,” says 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 deputy chairperson 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. While this worked, 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 is a collective responsibility and an obligation on all African governments and educational institutions to support if the continent is to benefit.
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 become a global leader in African health solutions. It’s not an impossible feat
* Teke is a communications consultant.