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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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Donor funding for family planning: levels and trends between 2003 and 2013

Grollman, C.; F. L. Cavallaro; D. Duclos et al. Health Policy and Planning (2018) C1

The International Conference on Population and Development in 1994 set targets for donor funding to support family planning programmes, and recent initiatives such as FP2020 have renewed focus on the need for adequate funding to rights-based family planning. Disbursements supporting family planning ... more

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Considerations for adoption and use of multidisease testing devices in integrated laboratory networks

World Health Organization (2017) C_WHO

Information note.
This information note provides a strategic overview of key implementation considerations for diagnostic integration using these devices, and is primarily intended for use by national laboratory services and TB, HIV, and hepatitis programme managers.
It may also be of inte... more

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Financing Global Health 2013: Transition in an Age of Austerity

Institute for Health Metrics and Evaluation (2014) CC

Financing Global Health 2013: Transition in an Age of Austerity, IHME’s fifth annual report on global health expenditure, depicts financing trends that underline the resilience of development assistance for health. This year’s updated estimates show that despite lackluster economic growth and fi... more

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Economic Evaluation of Community Based Practitioners In Low-And Middle-Income Countries - A literature review, country case studies and a generalized cost-effectiveness model

global health workforce alliance World Health Organization (2015) C_WHO

Community-based strategies play a significant role in many health systems in low- and middle-income countries, especially in light of critical shortages in the health workforce. The term community health worker has been used to refer to volunteers and salaried, professional or lay health workers wit... more

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La prise en charge communautaire intégrée des maladies de l'enfant (Sénégal)

Maternal and Child Health Integrated Program, US Aid du peuple americain (2012) C2

Documentation des meilleures pratiques et des goulots d’étranglement à la mise en œuvre du programme au Sénégal .

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Madagascar: Curriculum de formation des agents de santé: prévention des hémorragies du postpartum - Carnet du participant

USAID Maternal and Child Health Integrated Program (MCHIP) (2012) C1

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Madagascar: Curriculum de formation des agents de santé: prévention des hémorragies du postpartum - Cahier du formateur

USAID Maternal and Child Health Integrated Program (MCHIP) (2012) C1

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Zambia National Maternal and Neonatal Services. Referral Guidelines

Ministry of Health, Zambia (2018) C1

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National Guidelines for Maternal and Perinatal Deaths Surveillance and Response in Nigeria

Federal Ministry of Health, Nigeria; WHO; UNFPA et al. (2015) C_WHO

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National Tools for Maternal and Perinatal Deaths Surveillance and Response in Nigeria

Federal Ministry of Health, Nigeria (2015) C1

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mother & child health booklet kenya | Afya ya mama na mtoto

Ministry of Public Health and Sanitation and Ministry of Medical Services, Republic of Kenya (2010) C2

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Improving access to maternal health care in Senegal: WAHA International’s mHealth programme

World Health Organisation (WHO) (2014) C_WHO

WAHA International’s mHealth programme addresses several barriers to maternal and neonatal care, including: a lack of information at the community level about locally available services; a large distance from services and a lack of affordable transport for patients; and ineffective communication b... more

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Comprehensive Evaluation of the Community Health Program in Rwanda (FINAL REPORT)

Centre for Maternal and Newborn Health (CMNH), from the Liverpool School of Tropical Medicine (LSTM) (2016) C2

The objective of the evaluation is to understand whether the CHW program has achieved its intended objectives, thus contributing to the overarching objectives defined in the HSSP III of improving the health status of the population by “Ensuring universal accessibility of quality health services fo... more

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Kangaroo mother care: a transformative innovation in health care

World Health Organisation (WHO) (2023) C_WHO

This document puts forward the joint position and vision of an expert, global, multistakeholder working group on implementing Kangaroo Mother Care (KMC) for all preterm or low birth weight (LBW) infants as the foundation for small and/or sick newborn care within maternal, newborn, and child health p... more

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Santé maternelle et neonatale au Sénégal - Succès et Défis

Touré, L.; D. Wane, S. Alford et. al. USAid du peuple americain, Maternal and Child Health Integrated Program (2012) C2

Après une description de la méthodologie utilisée, le rapport présente le contexte de l’exécution des programmes de santé maternelle et néonatale au Sénégal, les acquis enregistrés, les défis relevés et réponses apportées, avant d’aboutir aux conclusions et recommandations.

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Ghana 2017 Maternal Health Survey

Ghana Statistical Service (GSS), Ghana Health Service (GHS), and ICF (2018) CC

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Giving life, risking death - Maternal mortality in Burkina Faso

Amnesty International Publications (2020) C2

Accessed on 20.10.2020 In its fight against maternal mortality, the government of Burkina Faso is supported by the donor community which contributes to the health budget and also supports specific projects aimed at improving access to health care. This report acknowledges the efforts to address ... more

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Guidance Note on Youth Integration into the Women Friendly Health Spaces (WFHS)

United Nations Population Fund UNFPA (2023) CC

UNFPA has been implementing programming for women and girls through Women Friendly Health Spaces (WFHSs), which provide access to critical services, information and support. The WFHS is providing: psychosocial counseling services; awareness raising sessions on PSS in the community; and life skills &... more

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An Analytical Report on National Survey of Female Community Health Volunteers of Nepal

Government of Nepal USAID, MOH (Nepal) (2007) C1

The FCHV program focuses on family planning, maternal/neonatal and child health. Vitamin A distribution program. The activity of FCHV is contributing to Nepal’s goal of reducing the total fertility rate and under five mortality and maternal mortality rates.