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Africa’s Health Financing in a New Era

Africa Centres for Disease Control and Prevention (Africa CDC) (2025) CC

Africa’s health sector is facing an unprecedented financing crisis, driven by a sharp decline of 70% in Official Development Assistance (ODA) from 2021 to 2025 and deep-rooted structural vulnerabilities. This collapse is placing immense pressure on Africa’s already fragile health systems as ODA ...is seen as the backbone of critical health programs: pandemic preparedness, maternal and child health services, disease control programs are all at risk, threatening Sustainable Development Goal 3 and Universal Health Coverage. Compounding this is Africa’s spiraling debt, with countries expected to service USD 81 billion by 2025—surpassing anticipated external financing inflows—further eroding fiscal space for health investments. Level of domestic resources is low. TThe Abuja Declaration of 2001, a pivotal commitment made by African Union (AU) member states, aimed to reverse this trend by pledging to allocate at least 15% of national budgets to the health sector. However, more than two decades later, only three countries—Rwanda, Botswana, and Cabo Verde—have consistently met or exceeded this target (WHO, 2023). In contrast, over 30 AU member states remain well below the 10% benchmark, with some allocating as little as 5–7% of their national budgets to health. In addition, only 16 (29%) of African countries currently have updated versions of National Health Development Plan (NHDP) supported by a National Health Financing Plan (NHFP). These two documents play a critical role in driving internal resource mobilisation. At the same time, public health emergencies are surging, rising 41%—from 152 in 2022 to 213 in 2024—exposing severe under-resourcing of health infrastructure and workforce. Recurring outbreaks (Mpox, Ebola, cholera, measles, Marburg…) alongside effects of climate change and humanitarian crises in Eastern DRC, the Sahel, and Sudan, are overwhelming systems stretched by chronic underfunding. The situation is worsened by Africa’s heavy dependency with over 90% of vaccines, medicines, and diagnostics being externally sourced—leaving countries vulnerable to global supply chain shocks. Health worker shortages persist, with only 2.3 professionals per 1,000 people (below the WHO’s recommended 4.45), and fewer than 30% of systems are digitized, undermining disease surveillance and early warning. Without decisive action, Africa CDC projects the continent could reverse two decades of health progress, face 2 to 4 million additional preventable deaths annually, and a heightened risk of a pandemic emerging from within. Furthermore, 39 million more Africans could be pushed into poverty by 2030 due to intertwined health and economic shocks. This is not just a sectoral crisis—it is an existential threat to Africa’s political, social, and economic resilience, and global stability. In response, African leaders, under Africa CDC’s stewardship, are advancing a comprehensive three-pillar strategy centered on domestic resource mobilization, innovative financing, and blended finance. more

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The distinctive role of the Catholic Church in development and humanitarian response: 7 ways the Church makes a difference

Catholic Agency for Overseas Development CAFOD (2021) CC

7 Febr. 2021 As COVID-19 continues to wreak havoc in countries – decimating people’s livelihoods, and leaving health systems struggling to provide healthcare and vaccines for the entire population - governments and donors should look to the Church as a partner. The essential Church networks, tr... more

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A Checklist for Implementing Rural Pathways to Train, Develop and Support Health Workers in Low and Middle-Income Countries

O'Sullivan, B.; et al. (2020) CC

Front. Med., 27 November 2020 | https://doi.org/10.3389/fmed.2020.594728. The Checklist included eight actions for implementing rural pathways in LMICs: establishing community needs; policies and partners; exploring existing workers and scope; selecting health workers; education and training; workin... more

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The role of health extension workers in improving utilization of maternal health services in rural areas in Ethiopia: a cross sectional study

A. Medhanyie, M. Spigt, Y. Kifle, et al. (2012) CC

BMC Health Services Research 2012, 12:352 http://www.biomedcentral.com/1472-6963/12/352

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The roles, training and knowledge of community health workers about diabetes and hypertension in Khayelitsha, Cape Town

Tsollekile, L.P.; H. Schneider and T. Puoane Curationis (2018) CC

CONCLUSIONS: The roles performed by CHWs are broad, varied and essential for diabetes and hypertension management. However, basic knowledge about diabetes and hypertension remains poor while training is unstandardised and haphazard. These need to be improved if community-based NCD management is to b... more

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The Role of Communities in Mental Health Care in Low- and Middle-Income Countries: A Meta-Reviewof Components and Competencies

Brandon A. Kohrt,Laura Asher, Anvita Bhardwaj, et al. (2018) CC

Int J Environ Res Public Health. 2018 Jun; 15(6): 1279. Published online 2018 Jun 16. doi: 10.3390/ijerph15061279

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How Do Community Health Workers Contribute to Better Nutrition in Nepal? (Presentation)

SPRING and APC USAID (2016) C1

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Context Analysis: Close-to-Community Health Care Service Providers in Bangladesh

M. SHOWKAT GANI et al. Reach Out; European Union (2014) C1

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Kenya - Strategy for Community Health 2014-2019

Ministry of Health, Kenya; Community Health Services Unit USAID; PEPFAR; FANIKISHA (2014) C1

Transforming health: Acclerating the attainment of health goals

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The Current State of CHW Training Programs in Sub-Saharan Africa and South Asia: What We Know, What We Don’t Know, and What We Need to Do

C. Redick; H. S. Faich Dini; L.-A. Long One Million Community Worker Campaign; mPowering Frontline Health Workers (2014) C2

July 2014 This report was made possible through support provided by the One Million Community Health Workers Campaign, mPowering Frontline Health Workers, Intel, and USAID. This report was authored by Cindil Redick for mPowering Frontline Health Workers under the terms of Contract No. GHS-A-00-08... more

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Training and deployment of Key Informants (KIs) for case finding for children with severe visual impairment and blindness and Improving the follow up of children after cataract and other surgeries

Kilimanjaro Centre for Community Ophthalmology KCCO (2022) CC

The WHO estimates that 19 million children aged 15 years or younger are visually impaired. Of these, 1.4 million are irreversibly blind and need visual rehabilitation interventions for full psychological and personal development. The remainder have visual problems that could be prevented or treated.... more

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Country profile: Bangladesh community health programs

Arlington, VA: Advancing Partners & Communities Advancing Partners & Communities (2013) C1

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COVID-19 & Community Health Workers
recommended

African Union; Africa CDC Centres for Disease Control and Prevention (2021) CC

2-Day Orientation training Orientation Training, 1 Febr. 2021 Community Health Workers (CHWs) are an essential part of the Partnership to Accelerate COVID-19 Testing (PACT) Initiative • Africa CDC set up PACT to drive forward the Africa Union Joint Continental Strategy for COVID-19 Available in ... more

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The contribution of female community health volunteers (FCHVs) to maternity care in Nepal: a qualitative study

Panday, S., P. Bissell , E.van Teijlingen, et al. (2017) CC

BMC Health Services Research (2017) 17:623 DOI 10.1186/s12913-017-2567-7

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Global Experience of Community Health Workers for Delivery of Health Related Millennium Development Goals

Zulfiqar A. Bhutta, Zohra S. Lassi, George Pariyo and Luis Huicho World Health Organization WHO; Global Health Workforce Alliance (2010) C_WHO

A Systematic Review, Country Case Studies, and Recommendations for Integration into National Health Systems Alliance Report Participation of community health workers (CHWs) in the provision of primary health care has been experienced all over the world for several decades, and there is an amount ... more