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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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Lancet Series on Women’s and Children’s Health in Conflict Settings
recommended

BRANCH Consortium; The Lancet (2021) CC

The Lancet Series on Women’s and Children’s Health in Conflict Settings aims to improve understanding of and address the special requirements of providing sexual, reproductive, maternal, newborn, child and adolescent health and nutrition services in conflict settings. The Series draws upon schol... more

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Peru − Progress in health and sciences in 200 years of independence

Carrillo-Larco; R.M.; Guzman-Vilca, W. C.; Leon-Velarde, F.; et al. The Lancet Regional Health - Americas (2021) CC

Peru celebrates 200 years of independence in 2021. Over this period of independent life, and despite the turbulent socio-political scenarios, from internal armed conflict to economic crisis to political instability over the last 40 years, Peru has experienced major changes on its epidemiological and... more

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Senegal DHS 2014 - Maternal Health flyer (French)

The DHS Program (2015) C2

Santé de la mère au Sénégal selon l’Enquête Continue 2014

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WHO recommendations on maternal health: Guidelines approved by the WHO Guidelines Review Committee

World Health Organization (WHO) (2017) C_WHO

Updated May 2017
This document is meant to respond to the questions:
■ What health interventions should be delivered during pregnancy, childbirth and the postnatal period?
■ What health behaviours should the women practise (or not practise) during these periods to care for ... more

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Influence of Service Readiness on Use of Facility Delivery Care: A Study Linking Health Facility Data and Population Data in Haiti

Wang, Wenjuan, Michelle Winner, Clara Burgert, and Josh Colston ICF International (2014) C2

DHS Working Papers No. 114

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mHealth intervention “ImTeCHO” to improve delivery of maternal, neonatal, and child care services—A cluster-randomized trial in tribal areas of Gujarat, India

Modi, D., N. Dholakia, R. Gopalan, et al. (2019) CC

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Maternal and Child Health in Nepal: The Effects of Caste, Ethnicity, and Regional Identity

Pandey, J. P., M.R. Dhakal, S. Karki, P. Poudel, and M.S. Pradhan Nepal Ministry of Health and Population, New ERA, and ICF International (2013) C2

Further analysis of the 2011 Nepal Demographic and Health Survey

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Levels and Trends in Maternal and Child Health Disparities by Wealth and Region in Eleven Countries with DHS Surveys

Shireen Assaf & Thomas Pullum ICF International Rockville, Maryland, USA (2016) C2

DHS Comparative Reports No. 42

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2015 Health Facility Assessment for Reproductive Health Commodities and Services

The Republic of the Union of Myanmar, Ministry of Health and Sports, Department of Medical Research, Department of Public Health, Department of Medical Services, UNFPA (2016) C1

The report is based on comprehensive information collected at representative sample health facilities all over the country by well-organized and trained teams during May and August 2015. This is a continuation of 2014 Assessment activities and findings also reflect comparison between two consecutive... more

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Basic Package of Health and Social Welfare Services for Liberia

Ministry of Health and Social Welfare, Liberia (2008) C1

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Assessing the Quality of Care in Family Planning, Antenatal, and Sick Child Services at Health Facilities in Kenya, Namibia, and Senegal

Wang, W., Do, M., Hembling, J. & Ametepi, P. (2014) C1

DHS Analytical Studies No. 44 Rockville, Maryland, USA: ICF International.

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Newborn Health Implementation Framework - STANDARDS FOR NEWBORN HEALTH CARE SERVICES

Ministry of Health, Republic of Uganda (2010) C2

This document is to guide policy makers, managers, districts, health workers, communities, NGOs and all other stakeholders on how to implement newborn health services.

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A Guide to Cancer for Health Service Providers

American Cancer Society; Federal Ministry of Health, Ethiopia; John Hopkins Center for Communication Programs; et al. (2016)

Introduces the GATHER approach to counseling, a patient-centered approach that improves patient satisfaction Has a chapter offering basic biomedical information on cancer, as requested by health workers Includes information about management of side effects Encourages health workers to take care o... more

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A Guide to Cancer for Health Service Providers (Amharic Version)

American Cancer Society; Federal Ministry of Health, Ethiopia; John Hopkins Center for Communication Programs; et al. (2016)

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Task-Shifting and Task-Sharing (TSTS) Policy for Essential Health Care Services in Nigeria

Federal Ministry of Health, Nigeria (2014) C1

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Essential care and practice mhGAP Training of Health-care Providers. Training manual and supporting material

World Health Organization (WHO) (2015) C_WHO

Key messages include Effective communication skills should be used for everyone seeking health care, including people with MNS conditions and their carers; Effective communication skills enable health-care providers to build rapport and trust with people as well as enabling health-care providers to... more

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Skills Lab Operational Guidelines

Maternal Health Division Ministry of Health and Family Welfare Government of India (2013) C1

Strengthening competency based training of health care providers for Reproductive Maternal Newborn Child & Adolescenct Health (RMNCH + A) services

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Guidelines for Maternity Care in South Africa - fourth edition 2016

Maternal Health Committee of the National Department of Health (NDoH) South Africa NDoH South Africa (2016) CC

These guidelines have been prepared by the Sub directorate: Maternal Health for the guidance of health workers (doctors and midwives) providing obstetric, surgical and anaesthetic services for pregnant women in district clinics, health centres and district hospitals. These guidelines are intended fo... more

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Rwanda: FAMILY PLANNING POLICY

Government of Rwanda: Ministry of Health, Maternal and Child Health (2012) C2

This policy will serve as a cornerstone from which to address the accessibility of Family Planning services and to encourage its integration with services for HIV/AIDS, maternal health, child health, and other development initiatives. This policy is timely, as Rwanda is embarking on the introduction... more

Lancet Series on Women’s and Children’s Health in Conflict Settings recommended

Lancet Series on Women’s and Children’s Health in Conflict Settings
recommended