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Africa’s Health Financing in a New Era

Africa Centres for Disease Control and Prevention (Africa CDC) (2025) CC

Africa’s health sector is facing an unprecedented financing crisis, driven by a sharp decline of 70% in Official Development Assistance (ODA) from 2021 to 2025 and deep-rooted structural vulnerabilities. This collapse is placing immense pressure on Africa’s already fragile health systems as ODA ...is seen as the backbone of critical health programs: pandemic preparedness, maternal and child health services, disease control programs are all at risk, threatening Sustainable Development Goal 3 and Universal Health Coverage. Compounding this is Africa’s spiraling debt, with countries expected to service USD 81 billion by 2025—surpassing anticipated external financing inflows—further eroding fiscal space for health investments. Level of domestic resources is low. TThe Abuja Declaration of 2001, a pivotal commitment made by African Union (AU) member states, aimed to reverse this trend by pledging to allocate at least 15% of national budgets to the health sector. However, more than two decades later, only three countries—Rwanda, Botswana, and Cabo Verde—have consistently met or exceeded this target (WHO, 2023). In contrast, over 30 AU member states remain well below the 10% benchmark, with some allocating as little as 5–7% of their national budgets to health. In addition, only 16 (29%) of African countries currently have updated versions of National Health Development Plan (NHDP) supported by a National Health Financing Plan (NHFP). These two documents play a critical role in driving internal resource mobilisation. At the same time, public health emergencies are surging, rising 41%—from 152 in 2022 to 213 in 2024—exposing severe under-resourcing of health infrastructure and workforce. Recurring outbreaks (Mpox, Ebola, cholera, measles, Marburg…) alongside effects of climate change and humanitarian crises in Eastern DRC, the Sahel, and Sudan, are overwhelming systems stretched by chronic underfunding. The situation is worsened by Africa’s heavy dependency with over 90% of vaccines, medicines, and diagnostics being externally sourced—leaving countries vulnerable to global supply chain shocks. Health worker shortages persist, with only 2.3 professionals per 1,000 people (below the WHO’s recommended 4.45), and fewer than 30% of systems are digitized, undermining disease surveillance and early warning. Without decisive action, Africa CDC projects the continent could reverse two decades of health progress, face 2 to 4 million additional preventable deaths annually, and a heightened risk of a pandemic emerging from within. Furthermore, 39 million more Africans could be pushed into poverty by 2030 due to intertwined health and economic shocks. This is not just a sectoral crisis—it is an existential threat to Africa’s political, social, and economic resilience, and global stability. In response, African leaders, under Africa CDC’s stewardship, are advancing a comprehensive three-pillar strategy centered on domestic resource mobilization, innovative financing, and blended finance. more

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Trends and mortality effects of vitamin A deficiency in children in 138 low-income and middle-income countries between 1991 and 2013: a pooled analysis of population-based surveys

Stevens, Gretchen; Bennett, James et al. (2015) CC

Vitamin A deficiency is a risk factor for blindness and for mortality from measles and diarrhoea in children aged 6–59 months. We aimed to estimate trends in the prevalence of vitamin A defi ciency between 1991 and 2013 and its mortality burden in low-income and middle-income countries.

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Feeding Practices and Nutritional Status of Children Age 6-23 Months in Myanmar: Further Analysis of the 2015-16 Demographic and Health Survey

Mya, Kyaw Swa, Aung Tin Kyaw, and Thandar Tun The DHS Program (2018) C1

DHS Working Paper No. 136
A total of 1,222 children age 6-23 months were included in this analysis. Twenty percent of children were stunted and 43% were moderately anemic. Regarding IYCF practices, only 16% of children received a minimum acceptable diet, 25% received diverse food groups, 58% were... more

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Vitamin A Supplementation Programs and Country-Level Evidence of Vitamin A Deficiency

Wirth, James P.; Petry, Nicolai and others (2017) CC

Vitamin A supplementation (VAS) programs targeted at children aged 6–59 months are implemented in many countries. By improving immune function, vitamin A (VA) reduces mortality associated with measles, diarrhea, and other illnesses. There is currently a debate regarding the relevance of VAS, but a... more

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Interim Guidelines Integrated Management of Severe Acute Malnutrition

Government of Southern Sudan, Ministry of Health (2009) C1

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Cost-effectiveness of a Community-based Rehabilitation Programme in Nepal

Kelsey Vaughan & Aradhana Thapa Disability, CBR & Inclusive Development Journal (DCIDJ) (2015) CC

This study aimed to estimate the cost-effectiveness of a community-based rehabilitation (CBR) programme known as Inspire2Care (I2C), implemented in Nepal by Karuna Foundation Nepal. In the absence of any gold standard methodology to measure cost-effectiveness, the authors developed a new methodology... more

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Management of Severe Acute Malnutrition in children: Working towards results at scale

United Nations Children’s Fund (UNICEF) (2015)

The objectives of this guidance document are to:
1. Strengthen the capacity of country teams to effectively scale up and manage programmes to address severe acute malnutrition
2. Extend the geographic reach of quality treatment for SAM to all vulnerable communities in need
3. Maximize... more

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Severe Acute Malnutrition Update: Current WHO Guidelines and the WHO Essential Medicine List for Children

Williams, Phoebe CM.; Berkley, James A. (2016) C1

This document was prepared in response to a need to review and potentially update the current recommendations for the antibiotic treatment of both inpatient and outpatient management of severe acute malnutrition (SAM). The current recommendations (Table 1) are based on guidelines published in 2013 i... more

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Trends in Child Health in Nigeria, 2003– 2013

Winter, Rebecca, Akinlo, Ambrose, and Lia Florey ICF International (2016) C2

DHS Further Analysis Reports No. 103

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Undernutrition in Myanmar. Part 2: A Secondary Analysis of LIFT 2013 Household Survey Data

Zaw Win; Cashin, Jennifer Leveraging Essential Nutrition Actions to Reduce Malnutrition (LEARN) (2016) C1

In order to better understand the contributing factors of undernutrition in LIFT program areas and the links between child nutritional status and independent variables of programmatic importance to LIFT (such as income, livelihoods, food security, and water, sanitation and hygiene [WASH]), LEARN com... more

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Prisoners - The gap report 2014

UNAIDS; UNHCR; Unicef (2014) C2

External Link

Training Works! What You Need to Know About Managing, Designing, Delivering, and Evaluating Group-Based Training

Jhpiego, Population Leadership Program, IntraHealth International, TRG, Family Health International (2003)

Document on key points needed to design, manage, deliver and evaluate training You can also find a spanish and french version here: http://reprolineplus.org/resources/training-works-what-you-need-know-about-managing-designing-delivering-and-evaluating-group

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Update of the WHO recommendations for vaccination against COVID-19 - Infographic

World Health Organisation (WHO) (2023) C_WHO

The updates are based on evidence emerging from the: Ongoing monitoring of the disease. Protection that the population already developed against COVID-19 through previous infection or vaccination. Epidemiological situation, availability of diagnostic tests and access to therapeutic options.

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Confronting the gender impact of Ebola virus disease in Guinea, Liberia, and Sierra Leone

UN Development Programme (2015)

UNDP Africa Policy Note

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Systematic screening for TB disease

World Health Organization WHO (2021) C_WHO

Systematic screening for TB disease is the systematic identification of people at risk for TB disease, in a predetermined target group, by assessing symptoms and using tests, examinations or other procedures that can be applied rapidly. Systematic screening can benefit people who are at risk of get... more