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This paper was commissioned by N´weti and Wemos as part
of the project “Equitable health financing for a strong health
system in Mozambique”. Its purpose is to contribute to the
debate of th
...
e Mozambican Ministry of Health’s draft Health
Sector Financing Strategy (HSFS) 2025 – 2034
more
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 o
...
n 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
Achieving financial risk protection for the whole population requires significant financing for health. Health systems in low- and middle-income countries (LMIC) are plagued with persistent underfun
...
ding, and recent reductions in official development assistance have been registered. To create fiscal
space for health, the pursuit of efficiency gains and exploring innovative health financing for health seem attractive. This paper sought to synthesize available evidence on the nature of innovative health financing instruments, mechanisms and policies implemented in Africa. We further reviewed the factors that hinder or facilitate implementation, the lessons learnt on the structure, the development process and the implementation.
more
PLoS Med 10(1): e1001366. https://doi.org/10.1371/journal.pmed.1001366
Published: January 8, 2013
Drawing light from the pandemic: A new strategy for health and sustainable development (2021)
Available in English, French, German and Russian
Effectiveness of a diabetes program based on digital health on capacity building and quality of care in type 2 diabetes: a pragmatic quasi-experimental study
Moreas Morelli, D.; Rubinstein, F.; Santero, M.; et al.
BMC Health Services Research, part of Springer Nature
(2023)
CC2
Health systems in Latin America face many challenges in controlling the increasing burden of diabetes. Digital health interventions are a promise for the provision of care, especially in developing
...
countries where mobile technology has a high penetration. This study evaluated the effectiveness of the implementation of a Diabetes Program (DP) that included digital health interventions to improve the quality of care of persons with type 2 Diabetes (T2DM) in a vulnerable population attending the public primary care network.
more
Namibia has a two-tier health system: public health under the Ministry of Health and Social Services (MoHSS) and the private
...
health service. MoHSS‘ vision is to be the leading provider of quality health care and social services according to international set standards. Since Namibia’s independence, the government adopted Primary Health Care (PHC) as the approach to providing health service and as a key strategy in attaining the goal of health. Good health is also strengthened by the Sustainable Development Goals (SDGs). The SDGs provide a road map for human development and, among others, systematically address the social determinants of health. Notable is Goal 3, which focuses on good health and well-being.
more
Strengthening health financing to accelerate progress towards universal health coverage. Total Government Health Expenditure exceeds the commitmen
...
t by African Union member states to commit at least 15% of their budgets to the health sector. With a sector allocation of 16.6% of total budget in 2022/23 and average per capita spending estimated at US$407 (N$6,500.00), health spending in Namibia is one of the highest in SADC. The Government is thus encouraged to sustain this level of investment to safeguard the gains achieved and make progress towards SDGs. This could be achieved through the development of a national health financing strategy to mobilise additional and innovative resources for the sector.
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This guidance is intended to be one stop shop to improve the quality and effectiveness of health interventions in emergency, to respond to the most frequent scenarios and conditions.
The main document contains the most common elements to be found i
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n emergencies. As much as possible they are one page tables on one topic each with the key elements that ensure quality in column 2 of the table. Column 1 is about key information. Column 3 contains suggested indicators and column 4 helps decision making. This is a document to consult as needed, not really to read from front to last page
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Monitoring and Evaluation Toolkit: HIV, TB and Malaria and Health Systems Strenghtening
The Global Fund
(2011)
The TB section of the toolkit presents selected (a) programmatic output and (b) outcome and impact indicators for TB. In addition to recommended monitoring programs and measuring the outcomes and impact of TB programs, indicators for the strengthening of h
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ealth systems, strengthening of community systems and some indicators that measure quality of services are also included.
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Promoting and protecting health is essential to human welfare and sustained economic and social development. This was recognized more than 30 years ago by the Alma-Ata Declaration signatories, who noted that
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Health for All would contribute
both to a better quality of life and also to global peace and security
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Available in: English, French, Chinese, Spanish, Russian, Arabic, Thai, Korean, Tajik, Vietnamese, Uzbek
http://www.who.int/disabilities/cbr/guidelines/en/
The Health Literacy Toolkit For Low- and Middle-Income Countries
Sarity Dodson, Suvajee Good and Richard Osborne
World Health Organization - Regional Office South-East Asia
(2015)
A series of information sheets to help empower communities and strengthen health systems
This series of information sheets introduces health literacy, its
relevance to public policy, and the way
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s it can be used to inform
the promotion of good health, the prevention and management
of communicable and noncommunicable diseases, and the
reduction of health inequities. It provides information and links
to further resources to assist organizations and governments
to incorporate health literacy responses into practice, service
delivery systems, and policy.
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Malawi Health Sector Strategic Plan 2011 - 2016
recommended
Moving towards equity and quality
