Health systems and primary health care in the African Region

摘要

Equitable and sustainable access to properly functioning health systems, however, has not been attained across the Region. There have always been geographical disparities and these have worsened over the last decade. Many people, particularly those in rural areas, often have to travel long distances to receive basic health care. Once they reach a hospital or a clinic, they may only receive health care if they pay for it. Inevitably, many people may forego treatment because they cannot afford it, while those who pay may find the cost ruinous and the quality of service limited. Rapid turnover of people in key positions, lack of continuity in policy, lack of resources, poor management of available resources and poor implementation are seen in many countries as major constraints to improving the health systems. Most countries in the Region inherited a colonial, European model of health care that was primarily intended for colonial administrators and expatriates, with separate or second class provision made – if at all – for Africans.