Advertisement

Prioritising Health Systems to Achieve SDGs in Africa: A Review of Scientific Evidence

  • Colette Adhiambo WesongaEmail author
  • Benard Kulohoma
Chapter
Part of the Sustainable Development Goals Series book series (SDGS)

Abstract

The Sustainable Development Goals (SDGs) provide a framework for streamlining efforts towards achieving global development objectives. The SDG 3 on universal good health and well-being remains an international priority. Recent reports indicate that although progress has been made, most developing countries face health system challenges and are still far from achieving SDG 3. We examine scientific evidence to infer priorities for African states that could inform the direction and implementation of SDG 3 in Africa. The chapter focuses on shortfalls in health systems, particularly with health information systems and human resources for health. It also highlights strategies to strengthen these systems and promote sustainable capacity building. Health information systems (HIS) are important data sources for evidence-based health policymaking, research and evaluation, training and service delivery. However, inadequate provision of reliable, valid and comparable data in resource-poor settings threatens meaningful progress in realising SDG 3 targets. We review the literature and discuss progress and challenges in the collection, synthesis and use of health information, and give recommendations on improving HIS evidence in such settings. Human resource is a key component of strong and resilient health systems, without which implementation of evidence generated from HIS into meaningful practice is unachievable. We also discuss health workforce hurdles to health cooperation, coverage and training that may affect the attainment of SDG 3. Improvements in HIS and adequate capacity building will undoubtedly highlight key silences and obstacles in SDG 3 actualisation and inform health policymakers, practitioners and researchers on innovative strategies for better health in African countries.

Keywords

Sustainable development Health systems Health information Health workforce 

References

  1. Abuya T, Ndwiga C, Ritter J, Kanya L, Bellows B, Binkin N, Warren CE (2015) The effect of a multi-component intervention on disrespect and abuse during childbirth in Kenya. BMC Pregnancy Childbirth 15(1):224CrossRefGoogle Scholar
  2. Ahanhanzo YG, Kpozehouen A, Sopoh G, Sossa-Jerome C, Ouedraogo L, Wilmet-Dramaix M (2016) Management of information within emergencies departments in developing countries: analysis at the National Emergency Department in Benin. Pan Afr Med J 24:263CrossRefGoogle Scholar
  3. Akanbi MO, Ocheke AN, Agaba PA, Daniyam CA, Agaba EI, Okeke EN, Ukoli CO (2012) Use of electronic health records in Sub-Saharan Africa: Progress and challenges. J Med Trop 14(1):1–6Google Scholar
  4. Ambikile JS, Iseselo MK (2017) Mental health care and delivery system at Temeke hospital in Dar es Salaam Tanzania. BMC Psychiatry 17(1):109CrossRefGoogle Scholar
  5. Aminpour F, Sadoughi F, Ahamdi M (2014) Utilization of open source electronic health record around the world: a systematic review. J Res Med Sci 19(1):57–64Google Scholar
  6. Amouzou A, Kachaka W, Banda B, Chimzimu M, Hill K, Bryce J (2013) Monitoring child survival in ‘real time’ using routine health facility records: results from Malawi. Trop Med Int Health 18(10):1231–1239CrossRefGoogle Scholar
  7. Armah-Attoh D, Selormey E, Houessou R (2016) Despite gains, barriers keep health care high on Africa’s priority list. http://www.afrobarometer.org/publications/pp31-despite-gains-barriers-keep-health-care-high-on-africas-priority-list. Accessed 25 July 2017
  8. Atun R (2012) Health systems, systems thinking and innovation. Health Policy Plan 27(Suppl 4):4–8CrossRefGoogle Scholar
  9. Atun RA, Bennett S, Duran A (2008) When do vertical (stand-alone) programmes have a place in health systems? http://www.who.int/management/district/services/WhenDoVerticalProgrammesPlaceHealthSystems.pdf. Accessed 3 Jan 2018
  10. Bailey PE, Andualem W, Brun M, Freedman L, Gbangbade S, Kante M, Keyes E, Libamba E, Moran AC, Mouniri H, El Joud DO, Singh K (2017) Institutional maternal and perinatal deaths: a review of 40 low and middle income countries. BMC Pregnancy and Childbirth 17(1):295CrossRefGoogle Scholar
  11. Bhatia A, Ferreira LZ, Barros AJD, Victora CG (2017) Who and where are the uncounted children? Inequalities in birth certificate coverage among children under five years in 94 countries using nationally representative household surveys. Int J Equity Health 16(1):148CrossRefGoogle Scholar
  12. Bonaventure A, Harewood R, Stiller CA, Gatta G, Clavel J, Stefan DC, Carreira H, Spika D, Marcos-Gragera R, Peris-Bonet R, Pineros M, Sant M, Kuehni CE, Murphy MFG, Coleman MP, Allemani C (2017) Worldwide comparison of survival from childhood leukaemia for 1995-2009, by subtype, age, and sex (CONCORD-2): a population-based study of individual data for 89 828 children from 198 registries in 53 countries. Lancet Haematol 4(5):e202–e217CrossRefGoogle Scholar
  13. Brown JB, Ramaiya K, Besancon S, Rheeder P, Tassou CM, Mbanya JC, Kissimova-Skarbek K, Njenga EW, Muchemi EW, Wanjiru HK, Schneider E (2014) Use of medical services and medicines attributable to diabetes in Sub-Saharan Africa. PLoS ONE 9(9):e106716CrossRefGoogle Scholar
  14. Chichom-Mefire A, Nwanna-Nzewunwa OC, Siysi VV, Feldhaus I, Dicker R, Juillard C (2017) Key findings from a prospective trauma registry at a regional hospital in Southwest Cameroon. PLoS One 12(7):e0180784CrossRefGoogle Scholar
  15. Congo B, Sanon D, Millogo T, Ouedraogo CM, Yameogo WME, Meda ZC, Kouanda S (2017) Inadequate programming, insufficient communication and non-compliance with the basic principles of maternal death audits in health districts in Burkina Faso: a qualitative study. Reprod Health 14(1):121CrossRefGoogle Scholar
  16. de Savigny D, Riley I, Chandramohan D, Odhiambo F, Nichols E, Notzon S, AbouZahr C, Mitra R, Cobos Munoz D, Firth S, Maire N, Sankoh O, Bronson G, Setel P, Byass P, Jakob R, Boerma T, Lopez AD (2017) Integrating community-based verbal autopsy into civil registration and vital statistics (CRVS): system-level considerations. Glob Health Action 10(1):1272882CrossRefGoogle Scholar
  17. Farahani M, Price N, El-Halabi S, Mlaudzi N, Keapoletswe K, Lebelonyane R, Fetogang EB, Chebani T, Kebaabetswe P, Masupe T, Gabaake K, Auld AF, Nkomazana O, Marlink R (2016) Impact of health system inputs on health outcome: a multilevel longitudinal analysis of Botswana National Antiretroviral Program (2002–2013). PLoS One 11(8):e0160206CrossRefGoogle Scholar
  18. Ferrand RA, Simms V, Dauya E, Bandason T, McHugh G, Mujuru H, Chonzi P, Busza J, Kranzer K, Munyati S, Weiss HA, Hayes RJ (2017) The effect of community-based support for caregivers on the risk of virological failure in children and adolescents with HIV in Harare, Zimbabwe (ZENITH): an open-label, randomised controlled trial. Lancet Child Adolesc Health 1(3):175–183CrossRefGoogle Scholar
  19. Ferreira-Borges C, Esser MB, Dias S, Babor T, Parry CD (2015) Alcohol control policies in 46 African countries: opportunities for improvement. Alcohol Alcohol 50(4):470–476CrossRefGoogle Scholar
  20. Flora OC, Margaret K, Dan K (2017) Perspectives on utilization of community based health information systems in Western Kenya. Pan Afr Med J 27:180CrossRefGoogle Scholar
  21. Gaafar T, Moshni E, Lievano F (2003) The challenge of achieving measles elimination in the eastern Mediterranean region by 2010. J Infect Dis 187(Suppl 1):S164–171CrossRefGoogle Scholar
  22. Gamell A, Glass TR, Luwanda LB, Mapesi H, Samson L, Mtoi T, Nyamtema A, Muri L, Ntamatungiro A, Tanner M, Hatz C, Battegay M, Letang E (2016) Implementation and operational research: an integrated and comprehensive service delivery model to improve pediatric and maternal HIV care in rural Africa. J Acquir Immune Defic Syndr 73(5):e67–e75CrossRefGoogle Scholar
  23. Ganfon H, Ekanmian G, Amoussou L, Daniel-Garcia E, Allabi AC (2017) Evaluation of the knowledge and attitude of pharmacists about the national malaria control policy in southern Benin. Malar J 16(1):231CrossRefGoogle Scholar
  24. Ghorbanoghli Z, Jabari C, Sweidan W, Hammoudeh W, Cortas G, Sharara AI, Abedrabbo A, Hourani I, Mahjoubi B, Majidzadeh K, Tozun N, Ziada-Bouchaar H, Hamoudi W, Diab O, Khorshid HRK, Lynch H, Vasen H (2017) A new hereditary colorectal cancer network in the Middle East and eastern mediterranean countries to improve care for high-risk families. Fam Cancer 17(2):209–212CrossRefGoogle Scholar
  25. Gies I, AlSaleem B, Olang B, Karima B, Samy G, Husain K, Elhalik M, Miqdady M, Rawashdeh M, Salah M, Mouane N, Rohani P, Singhal A, Vandenplas Y (2017) Early childhood obesity: a survey of knowledge and practices of physicians from the Middle East and North Africa. BMC Pediatr 17(1):115CrossRefGoogle Scholar
  26. Grady SC, Frake AN, Zhang Q, Bene M, Jordan DR, Vertalka J, Dossantos TC, Kadhim A, Namanya J, Pierre LM, Fan Y, Zhou P, Barry FB, Kutch L (2017) Neonatal mortality in East Africa and West Africa: a geographic analysis of district-level demographic and health survey data. Geospatial Health 12(1):501CrossRefGoogle Scholar
  27. Hanefeld J, Khan M, Tomson G, Smith R (2017) Trade is central to achieving the sustainable development goals: a case study of antimicrobial resistance. BMJ 358:j3505CrossRefGoogle Scholar
  28. Hendrickson C, Fetters T, Mupeta S, Vwallika B, Djemo P, Raisanen K (2016) Client-pharmacy worker interactions regarding medical abortion in Zambia in 2009 and 2011. Int J Gynaecol Obstet 132(2):214–218CrossRefGoogle Scholar
  29. Heunis JC, Kigozi NG, Chikobvu P, Botha S, van Rensburg HD (2017) Risk factors for mortality in TB patients: a 10-year electronic record review in a South African province. BMC Public Health 17(1):38CrossRefGoogle Scholar
  30. Iyer HS, Hirschhorn LR, Nisingizwe MP, Kamanzi E, Drobac PC, Rwabukwisi FC, Law MR, Muhire A, Rusanganwa V, Basinga P (2017) Impact of a district-wide health center strengthening intervention on healthcare utilization in rural Rwanda: Use of interrupted time series analysis. PLoS One 12(8):e0182418CrossRefGoogle Scholar
  31. Jobanputra K, Greig J, Shankar G, Perakslis E, Kremer R, Achar J, Gayton I (2016) Electronic medical records in humanitarian emergencies—the development of an Ebola clinical information and patient management system. F1000 Res 5:1477CrossRefGoogle Scholar
  32. Kickbusch I, Hanefeld J (2017) Role for academic institutions and think tanks in speeding progress on sustainable development goals. BMJ 358:j3519CrossRefGoogle Scholar
  33. Kingue S, Ba SA, Balde D, Diarra MB, Anzouan-Kacou JB, Anisubia B, Damorou JM, Ndobo P, Menanga A, Kane A, Kakou-Guikahue M, Kenfack M, Metogo B, Chelo D, Yangnigni E, Tantchou C, Bertrand E, Monsuez JJ (2016) The VALVAFRIC study: a registry of rheumatic heart disease in Western and Central Africa. Arch Cardiovasc Dis 109(5):321–329CrossRefGoogle Scholar
  34. Kirigia JM, Nabyonga-Orem J, Dovlo DY (2016) Space and place for WHO health development dialogues in the African Region. BMC Health Serv Res 16(Suppl 4):221CrossRefGoogle Scholar
  35. Lamri L, Gripiotis E, Ferrario A (2014) Diabetes in Algeria and challenges for health policy: a literature review of prevalence, cost, management and outcomes of diabetes and its complications. Glob Health 10:11CrossRefGoogle Scholar
  36. Likofata Esanga J-R, Viadro C, McManus L, Wesson J, Matoko N, Ngumbu E, Gilroy KE, Trudeau D (2017) How the introduction of a human resources information system helped the Democratic Republic of Congo to mobilise domestic resources for an improved health workforce. Health Policy Plan 32(Suppl 3):iii25–iii31Google Scholar
  37. Liu L, Oza S, Hogan D, Chu Y, Perin J, Zhu J, Lawn JE, Cousens S, Mathers C, Black RE (2016) Global, regional, and national causes of under-5 mortality in 2000-15: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet 388(10063):3027–3035CrossRefGoogle Scholar
  38. Manyazewal T (2017) Using the World Health Organization health system building blocks through survey of healthcare professionals to determine the performance of public healthcare facilities. Arch Public Health 75:50CrossRefGoogle Scholar
  39. Mbondji PE, Kebede D, Soumbey-Alley EW, Zielinski C, Kouvividila W, Lusamba-Dikassa PS (2014) Health information systems in Africa: descriptive analysis of data sources, information products and health statistics. J R Soc Med 107(Suppl 1):34–45CrossRefGoogle Scholar
  40. Moustaghfir A, Haddak M, Mechmeche R (2012) Management of acute coronary syndromes in Maghreb countries: the ACCESS (ACute Coronary Events—a multinational Survey of current management Strategies) registry. Arch Cardiovasc Dis 105(11):566–577CrossRefGoogle Scholar
  41. Mwinga S, Kulohoma C, Mwaniki P, Idowu R, Masasabi J, English M (2015) Quality of surgical care in hospitals providing internship training in Kenya: a cross sectional survey. Trop Med Int Health 20(2):240–249CrossRefGoogle Scholar
  42. Neal S, Ruktanonchai C, Chandra-Mouli V, Matthews Z, Tatem AJ (2016) Mapping adolescent first births within three east African countries using data from Demographic and Health Surveys: exploring geospatial methods to inform policy. Reprod Health 13(1):98CrossRefGoogle Scholar
  43. Nicol E, Bradshaw D, Phillips T, Dudley L (2013) Human factors affecting the quality of routinely collected data in South Africa. Stud Health Technol Inf 192:788–792Google Scholar
  44. Nunes AR, Lee K, O’Riordan T (2016) The importance of an integrating framework for achieving the Sustainable Development Goals: the example of health and well-being. BMJ Glob Health 1(3):e000068CrossRefGoogle Scholar
  45. Odekunle FF, Odekunle RO, Shankar S (2017) Why Sub-Saharan Africa lags in electronic health record adoption and possible strategies to increase its adoption in this region. Int J Health Sci 11(4):59–64Google Scholar
  46. Pantalone KM, Hobbs TM, Chagin KM, Kong SX, Wells BJ, Kattan MW, Bouchard J, Sakurada B, Milinovich A, Weng W, Bauman J, Misra-Hebert AD, Zimmerman RS, Burguera B (2017) Prevalence and recognition of obesity and its associated comorbidities: cross-sectional analysis of electronic health record data from a large US integrated health system. BMJ Open 7(11):e017583CrossRefGoogle Scholar
  47. Save the children (2015) A wake up call: Lessons from Ebola for the world’s health systems. https://www.savethechildren.net/sites/default/files/libraries/WAKEUPCALLREPORTPDF.pdf. Accessed 25 July 2017
  48. Semeere A, Freeman E, Wenger M, Glidden D, Bwana M, Kanyesigye M, Asirwa FC, Rotich E, Busakhala N, Oga E, Jedy-Agba E, Kwaghe V, Iregbu K, Adebamowo C, Jaquet A, Dabis F, Phiri S, Bohlius J, Egger M, Yiannoutsos CT, Wools-Kaloustian K, Martin J (2017) Updating vital status by tracking in the community among patients with epidemic Kaposi sarcoma who are lost to follow-up in Sub-Saharan Africa. BMC Cancer 17(1):611CrossRefGoogle Scholar
  49. Sepanlou SG, Parsaeian M, Krohn KJ, Afshin A, Farzadfar F, Roshandel G, Karimkhani C, Bazargan-Hejazi S, Kiadaliri AA, Ahmadieh H, Djalalinia S, Ebrahimi H, Eshrati B, Esteghamati AR, Farvid MS, Fereshtehnejad SM, Hafezi-Nejad N, Hassanvand MS, Heydarpour P, Islami F, Karimi SM, Katibeh M, Khosravi A, Khubchandani J, Mahdavi M, Pishgar F, Qorbani M, Rahimi-Movaghar V, Safi S, Sahraian MA, Shahraz S, Sheikhbahaei S, Mohammadi A, Mokdad AH, Vos T, Murray CJL, Moradi-Lakeh M, Naghavi M, Malekzadeh R (2017) Disability-Adjusted Life-Years (DALYs) for 315 diseases and injuries and Healthy Life Expectancy (HALE) in Iran and its neighbouring countries, 1990–2015: Findings from global burden of disease study 2015. Arch Iranian Med 20(7):403–418Google Scholar
  50. Sousa-Figueiredo JC, Gamboa D, Pedro JM, Fancony C, Langa AJ, Magalhaes RJ, Stothard JR, Nery SV (2012) Epidemiology of malaria, schistosomiasis, geohelminths, anemia and malnutrition in the context of a demographic surveillance system in northern Angola. PLoS One 7(4):e33189CrossRefGoogle Scholar
  51. Steinhardt LC, Onikpo F, Kouame J, Piercefield E, Lama M, Deming MS, Rowe AK (2015) Predictors of health worker performance after Integrated Management of Childhood Illness training in Benin: a cohort study. BMC Health Serv Res 15:276CrossRefGoogle Scholar
  52. Topp SM, Chipukuma JM (2016) A qualitative study of the role of workplace and interpersonal trust in shaping service quality and responsiveness in Zambian primary health centres. Health Policy Plan 31(2):192–204CrossRefGoogle Scholar
  53. United Nations (UN) (2015) We can end poverty: Millennium Development Goals and beyond 2015. http://www.un.org/millenniumgoals/bkgd.shtml. Accessed 27 Jan 2018
  54. United Nations Development Programme (UNDP) (2015) A new sustainable development agenda. http://www.undp.org/content/undp/en/home/sustainable-development-goals.html. Accessed 26 Nov 2017
  55. World Health Organization (WHO) (2007) Everybody’s business, strengthening health systems to improve health outcomes: WHO’s framework for action. https://www.who.int/healthsystems/strategy/everybodys_business.pdf. Accessed 25 July 2017
  56. World Health Organization (WHO) (2010) Monitoring the building blocks of health systems: A handbook of indicators and their measurement strategies. http://www.who.int/healthinfo/systems/WHO_MBHSS_2010_full_web.pdf. Accessed 25 July 2017
  57. World Health Organization (WHO) (2017) World health statistics 2017: monitoring health for the SDGs, Sustainable Development Goals. http://www.who.int/gho/publications/world_health_statistics/2017/en/. Accessed 1 Feb 2018
  58. Witter S, Bertone MP, Chirwa Y, Namakula J, So S, Wurie HR (2016) Evolution of policies on human resources for health: opportunities and constraints in four post-conflict and post-crisis settings. Confl Health 10:31CrossRefGoogle Scholar
  59. World Bank (2007) Healthy development: the World Bank strategy for health, nutrition and population results. https://openknowledge.worldbank.org/bitstream/handle/10986/6843/409280PAPER0He101OFFICIAL0USE0ONLY1.pdf?sequence=1&isAllowed=y. Accessed 1 Feb 2018
  60. Yagos WO, Tabo Olok G, Ovuga E (2017) Use of information and communication technology and retention of health workers in rural post-war conflict Northern Uganda: findings from a qualitative study. BMC Med Inform Decis Mak 17(1):6CrossRefGoogle Scholar
  61. Ye Y, Wamukoya M, Ezeh A, Emina JB, Sankoh O (2012) Health and demographic surveillance systems: a step towards full civil registration and vital statistics system in sub-Sahara Africa? BMC Public Health 12:741CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.African Academy of SciencesNairobiKenya

Personalised recommendations