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Key findings
  • On average across 34 countries, more than half (53%) of Africans said they went without needed medicines or medical treatment at least once during the 12 months preceding the survey, including about one in five (18%) who did so “many times” or “always.” This form of deprivation was rare in Mauritius, but more than one-third of citizens went without needed care many times/always in Gabon (37%), Togo (35%), Niger (34%), and Guinea (34%)
  • Health ranks second among the most important national problems that Africans want their governments to address, trailing only unemployment
  • Africans were divided as to whether their countries have made progress in providing medical care. Fewer than four in 10 (38%) said their ability to get care is “better” or “much better” than it was “a few years ago,” while a majority said that things are either unchanged (31%) or have even gotten worse (30%). The greatest improvements were reported by respondents in Botswana (64%), Kenya (60%), and Burkina Faso (60%). But about half of citizens said things have deteriorated in Malawi (51%), Gabon (50%), and Niger (49%)
  • More than half (57%) of Africans have a health clinic within easy walking distance.3 Countries vary widely in the availability of clinics, from fewer than four in 10 in the Gambia (31%), Lesotho (34%), and Namibia (36%) to three-fourths or more in Mauritius (88%) and Sudan (75%)
  • Overall, governments received mixed scores for their performance on improving basic health services: On average, half (51%) of Africans said their governments are doing “fairly well” or “very well,” but almost as many (46%) rated them as performing fairly/very badly. In some countries, citizens overwhelmingly approved of their government’s efforts, including eSwatini (83%), Botswana (72%), Kenya (68%), Burkina Faso (67%), and Namibia (67%). But fewer than one-third of respondents agreed in Morocco (18%), Sudan (27%), Gabon (28%), and Tunisia (32%)

More than half of all Africans go without needed medical care at least once in a given year, a new analysis of Afrobarometer survey data shows. Across the continent, citizens identify health as the second-most-important national problem they want their governments to address.

Even before the threat of overwhelming demand due to COVID-19, about one in five Africans faced a frequent lack of needed health-care services, including almost two-thirds of the poorest citizens.

These findings from national surveys in 34 African countries, released in advance of World Health Day (April 7), provide a pre-COVID-19 snapshot of Africans’ experiences and assessments of public health-care systems committed to the United Nations Sustainable Development Goal (SDG) No. 3 of “good health and well-being” for all.

While experiences vary widely across countries, among those who had contact with a public health facility in the past year, almost half said it’s difficult to obtain care. Four in 10 said they experienced long waits or never got service, and about one in eight reported having to pay a bribe to get the care they needed. Only a minority said health-care provision in their country has
been improving. And governments received decidedly mixed performance reviews on health, especially from citizens who went without needed medical care, encountered difficulties in obtaining care, or had to pay a bribe.

Brian Howard

Brian is the head of publications at Afrobarometer