Healthcare in Africa is changing. While the continent still shoulders the greatest burden of communicable diseases, its economic growth is lifting millions out of poverty and creating an urban middle class which is demanding more from healthcare and government. Speaking at the Economist's recent 'Healthcare in Africa' event, I was struck by the importance of putting the patient's perspective at the heart of healthcare systems during this dynamic period of change and development.
Calls for universal health cover grow ever louder in Africa, and the NHS is seen as a beacon of what could be created. All over the African continent, countries are experimenting with new care models, often driven through a scarcity of health workers. For example, the number of nurses per 10,000 population in Africa is estimated by the World Health Organisation to be 11 compared to 68 across the European region. Africa carries 25% of the world's disease burden but accounts for only 1% of global health expenditure and 3% of the world's health workers.
Patient-centric care is important to all people and the focus, at this time, in South Africa is on access to care, starting with Universal Insurance. In South Africa, a comprehensive National Health Insurance (NHI) system is being developed to cover 48 million people. The NHI is part of a ten point plan to improve public hospitals, infrastructure, the quality and quantity of health workers and reduce HIV and maternal deaths. The government plans to introduce the NHI gradually, given the cost and logistical implications.
At the same time, there is significant scope to improve the delivery of care with a focus on quality and the patient experience. Making improvement part of daily work in health care - as opposed to a set of projects - is important. Supporting staff with on-the-job coaching, that provides them with the skills and confidence to challenge the status quo, is also crucial. The Aravind Eye Care System in India, the Narayana heart hospital in India and the delivery of obstetric care with Tecnicos in Mozambique are all examples of innovation in countries where health care is also developing at pace - examples that could help to inform and inspire innovation in countries such as South Africa. A key area of innovation in NHI policy is the re-structuring of primary healthcare. By taking advantage of outreach-type services that already exist, and creating news ones, I believe the rollout of NHI will see a far more community-centred, patient-centred approach to primary care that could improve patient education as well as patient health.
The further development of health care systems in Africa, such as NHI, will undoubtedly have a significant impact on the health of millions of people, for generations to come. Ensuring the patient experience is a core value in the development of these new, and maturing, health care systems is an opportunity to truly embed a patient-centric culture. A culture in which patients play an active role in planning their own treatment. A culture in which resources are used efficiently and patients have a voice. A culture in which patients are treated with the dignity and respect they deserve.