Towards a healthier Africa, systems and innovations

Between March 7th and 9th, the Africa Health Agenda International Conference (AHAIC) was hosted by African Medical and Research Foundation (AMREF) and World Health Organisation (WHO) in Nairobi, Kenya. The conference brought together around 1000 health experts and leaders in government, private sectors and civil societies across Africa and beyond, to line Africa health agenda with global health agenda, exchange scientific knowledge and research findings and stimulate debates for strategies, ideas and innovations. Rwanda has contributed to the agenda, and was represented by young researchers from University of Rwanda. The three days of presentations and discussions offered a variety of perspectives on significance and uniqueness of Africa’s health agenda, and traced a roadmap to Sustainable Development Goals (SDGs). Panels discussions The Africa health agenda is made unique by its predominant role of preventable diseases in morbidity and mortality of Africa’s people and the gap that exists between communities and the health systems. With 11 percent of the world’s population, Africa accounts for 24 per cent of the global disease burden, has an emerging and high burden of infectious diseases, poor women’s and children’s health and an increasing burden of non-communicable diseases. Although community -based healthcare has the potential to contribute to better health outcomes, the gap between the community health and formal health systems remains wide and still 50 per cent of Africans do not have access to quality healthcare. Different panelists from governments, academia and various institutions addressed those problems and shed light on different issues. Some of the things addressed included, the existing bottlenecks that are hindering the attainment of universal health coverage in sub-Saharan Africa and achievements to date; threats to global health security in Africa where Africa’s preparedness for emerging and re-emergent health events and threats; public-private partnerships to address inadequacy of policies and broad frameworks on how public and private sectors can bettercollaborate to address the problems of health financing, access and quality. Discussions also centred on the implementation of the health SDGs in Africa, the role of innovations and technology in improving health services in Africa, burden of anti-microbial resistance on Africa, and above all, how to move towards universal health coverage. A number of different actions were suggested to empower weak and fragmented health systems and create a healthier Africa as outlines below; 1. Africans have to employ the ‘tools of our time’ to formulate and implement appropriate policies to mitigate the impact of the significant health worker shortage in Africa. This includes the issues of skewed distribution, brain-drain and migration. 2. Community participation and ownership must be at the center of primary health care and universal health coverage, given the critical role that the community health system plays in linking households to the formal health system. 3. Africa must meaningfully involve young people to co-create strategies, scientific approaches and investments to improve their health and implement policies that are youth-centered. Nothing for the youth without the youth! 4. For universal health access, integration of national Health Insurance Schemes and use of community health workers to increase enrolment are potential avenues for mitigating the challenges in access to national health insurance scheme funds. 5. Successful health systems require good systems for health. Africa must significantly increase investments in Primary Health Care as the backbone of global health security and universal health coverage. 6. Concerning public, private and community partnerships, governments in Africa need to engage in dialogue to build trust. The private sector has to embed PPPs in the main business of companies as opposed to their charitable foundations; and the civil society. 7. Africa is called to create the platforms that ensure that research and innovations are translated into evidence-based policy-making and actions. 8. Technology: We must harness the unlimited possibilities offered by technology in general, and particularly mobile technology and telemedicine, to address health challenges and achieve improved health outcomes. Governments must put in place policies and legislation for effective integration of technology in the health system. 9. For scale and sustainability, Africa must be bold and have confidence in home-grown, relevant innovations, bring them to scale and create more synergy. As Africans, we must ensure more of our continent’s great ideas reach the widest possible population. The outcomes of the conference are expected to revolutionise community health work in Africa, highlighting partner commitments to implementation of national community health strategies to tackle health threats and health systems weaknesses. This campaign emphasises the important role community health workers play in addressing health systems gaps like shortage of health professionals, poor uptake of health promotion and disease prevention interventions, poor data quality and inadequate use of data and evidence for decision-making at household, community and sub-national levels. Authored by: Blaise Ntacyabukura, NtambaraKanyangira Nelson, Uwineza Clarisse from University of Rwanda, and Kayiranga Phoebe from Michigan State University, US