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Africa Health Systems Initiative
- Canada's commitment
- CIDA's approach: Making health care more accessible to mothers and children
- Getting to work on health care: Examples of CIDA's support
- Research underpins improvements in health systems
"It is health that is real wealth and not pieces of gold and silver."
Mahatma Gandhi
In many parts of Africa, people suffer from a variety of illnesses and diseases that lower their standard of living and set back development. Half of the world's child and maternal deaths occur in sub-Saharan Africa where, every year, thousands of newborns and mothers die. The majority of these deaths occur within days of childbirth, usually because of a lack of skilled care. More than half of them are preventable. Infection, premature birth, and asphyxia are the biggest newborn killers, with maternal malnutrition an underlying element in 60 to 80 percent of the cases.
The causes for these child and maternal deaths include:
- A shortage of health workers
- Long distances to the nearest health centre
- Supply shortages
- Poverty
There is a wide gap in the quality of health care received by people living in cities and those living in rural areas. In short, Africa's current health systems are unable to meet people's needs. Without action to strengthen health systems, many countries of sub-Saharan Africa will not meet the health-related Millennium Development Goals (MDGs) -not because they are unattainable but because current health systems and services in those countries are too weak to reach the beneficiaries and achieve the disease-reduction targets of the MDGs.
Canada's commitment
A the 2006 G8 Summit in Saint Petersburg, Russia, Prime Minister Harper committed Canada to contribute $450 million over a decade to support country-led efforts to strengthen health systems. The Africa Health Systems Initiative (AHSI) aims to help improve health outcomes and make solid progress toward the health-related MDGs, particularly those related to child mortality (MDG 4) and maternal health (MDG 5).
CIDA's approach: Making health care more accessible to mothers and children
AHSI specifically focuses on providing support to train, equip, and deploy new and existing African health workers to make health care more accessible for the most vulnerable, particularly for mothers and children. Most of the funding supports bilateral, country-led efforts in sub-Saharan Africa.
Through programming and policy dialogue at global, regional, and country levels, AHSI complements CIDA's regular health programming in three areas:
- Strengthening the production, mobilization, management, and retention of fully deployed, frontline health workers
- Improving health information systems, with a focus on better accountability and monitoring
- Strengthening equity in health service delivery
Getting to work on health care: Examples of CIDA's support
AHSI supports programming in eight countries (Mali, Mozambique, Sudan, Tanzania, the Democratic Republic of Congo, Malawi, Nigeria, and Zambia) and three regions (Pan-Africa, West and Central Africa, and Southern and Eastern Africa).
- In Mali, Canada has helped strengthen health programs in the Kayes region since 2003. This led to an increase in the proportion of deliveries attended by skilled health personnel from 24 percent in 2002 to 50 percent in 2007, consequently contributing to reducing maternal mortality. AHSI will build on those past efforts to expand essential health services for mothers and children. For example, AHSI programming will support regional health districts to ensure improved access to better quality health services in the four regions of Kayes, Tombouctou, Gao, and Kidal.
- In Mozambique, CIDA supports the Ministry of Health in implementing its health sector strategic plan, which has a strong focus on improving child and maternal health. A case in point: the Ministry of Health is using this support to increase the number of health posts that offer basic obstetrics care and youth-friendly health services.
A major component of AHSI is the Catalytic Initiative to Save a Million Lives launched by Prime Minister Stephen Harper in 2007. This multidonor initiative is increasing essential, proven, and affordable health services for women and children. Through this initiative, Canada supports UNICEF to train, equip, and deploy frontline health workers to deliver antimalarial bed nets, antibiotics, immunization, and other basic health services to vulnerable children and pregnant women in Ethiopia, Ghana, Malawi, Mali, Mozambique, and Niger. Canada's contribution to this overall initiative is expected to train over 40,000 community health workers and save an estimated 200,000 lives in sub-Saharan Africa.
Research underpins improvements in health systems
Through Canada's Global Health Research Initiative, CIDA is supporting African-led research teams in nine countries to provide solutions to issues related to health systems. Solutions are aligned with government priorities and link research, policy, and action.
- In Kenya, researchers from the University of Nairobi and the University of Manitoba are working with the national HIV/AIDS program to study whether educational text messaging using mobile phones can be effective in preventing mother-to-child transmission of HIV and in improving antenatal care and postpartum support.
Ethiopia: Nursing the sick in their own communities helps reduce the health care gap
Ethiopia has very few medical clinics; hospitals and existing health centres are at full capacity. A regional organization supported by AHSI, the African Medical and Research Foundation (AMREF), founded in Kenya in 1957, has helped build additional health clinics throughout Ethiopia, where it is training community members to provide home-based care. This is AMREF's approach in its work in Southern and Eastern Africa, where the organization helps improve the quality of medical services. In this way, people have more control over their own well-being, and the health gap that exists in these countries is reduced.
In Ethiopia, AMREF established a health clinic in the village of Kara Kebele, situated in one of the poorest neighbourhoods in the outskirts of the capital, Addis Ababa. There, Zenebeche Yededia, a resident of the area, says that the health clinic has played an important role in her village. "Before the centre was set up, people did not know what to do with critically ill patients. The hospital is far, and there are too many people in it. There are never enough drugs," says Zenebeche. "The health centre has helped a lot because it is near, and there are enough drugs there."
Two years ago, Zenebeche received training in home-based care that taught her how to care for the sick. She was also given a medical kit to treat fever and diarrhea. Zenebeche visits people in her community who are ill and provides care by making their beds, cleaning their homes, and teaching their family how to look after each other better. She gives limited medical treatment and takes gravely ill individuals to the local health clinic.
Through AMREF, more clinics have been established and more people have been trained to provide home-based care in the communities. CIDA's support has expanded access to health services and improved people's lives in Ethiopia.
