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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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Training Needs Assessment of Health Workers on Health Care Waste Management in Kenya

UNDP (2018) CC

This report contains the results of an in-depth Training Needs Assessment (TNA) of Health Workers in the 4 project counties of the republic of Kenya – Nakuru, Kisumu, Nairobi and Bungoma. The assessment, facilitated by the UPOPs Project in close collaboration with the Ministry of Health and Minist... more

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Community Health Worker Training Materials for Cholera Prevention and Control (Worldwide Edition)

Centers for Disease Control and Prevention CDC (2011) CC

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Community Health Worker Training Materials for Cholera Prevention and Control
recommended

Centers for Disease Control and Prevention CDC (2010) CC

Training manual

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Haiti: Community Health Worker Training Materials for Cholera Prevention and Control

Centers for Disease Control and Prevention (CDC) (2015) C_CDC

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What Works for Children in South Asia: Community Health Workers

UN Children's Fund UNICEF (2004) CC

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Priority activities in public health, WASH, shelter and settlements for preparedness and response to COVID-19 in UNHCR operations

UNHCR; reliefweb (2020) C2

The following is a breakdown of key considerations to guide planning and resource allocation for COVID-19 preparedness and response to support UNHCR regional and country operations in Public Health, WASH, Shelter and Settlements programmes. While some of the activities are more relevant in camps or ... more

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Revised WHO classification and treatment of childhood pneumonia at health facilities

World Health Organization (2014)

The revised guidelines present two major changes to existing guidelines: (A) there are now just 2 categories of pneumonia instead of 3 (“pneumonia” which is treated at home with oral amoxicillin and “severe pneumonia” which requires injectable antibiotics) and (B) oral amoxicillin replaces o... more

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2021 WHO health and climate change global survey report

World Health Organization (WHO) (2021) CC

The 2021 WHO health and climate change global survey report provides a valuable snapshot of the overall progress governments have made in addressing the health risks of climate change. The findings on key health and climate change indicators aim to empower policy makers to: make informed decisions o... more

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Resource package for strengthening countries’ health systems response to violence against women

World Health Organisation (WHO) (2021) C_WHO

o support and guide countries and partners to strengthen a health systems response to address violence against women, WHO has produced several tools, including: • clinical and policy guidelines; • implementation handbooks and manuals; • training curriculum; • evidence-based polic... more

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Climate-resilient water safety plans: Managing health risks associated with climate variability and change

World Health Organization (2017) C_WHO

Long-term planning for an adequate and safe supply of drinking-water should be set in the context of growing external uncertainties arising from changes in the climate and environment. The water safety plan (WSP) process offers a systematic framework to manage these risks by considering the implica... more

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Mental health policy development in Africa

O. Gureje & A. Alem Bulletin of the World Health Organization (2000) C_WHO

Mental health issues are usually given very low priority in health service policies. Although this is changing, African countries are still confronted with so many problems caused by communicable diseases and malnutrition that they have not woken up to the impact of mental disorders. Every country m... more

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Community health workers in Lesotho: Experiences of health promotion activities

T. Seutloali; L. Napoles; N. Bam African Journal of Primary Health Care & Family Medicine; AOSIS (2018) C2

African Journal of Primary Health Care & Family Medicine ISSN: (Online) 2071-2936, (Print) 2071-2928

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Where did all the aid go? An in-depth analysis of increased health aid flows over the past 10 years

Piva P., Dodd. R. Bull World Health Organ (2009) CC

To examine how health aid is spent and channelled, including the distribution of resources across countries and between subsectors. Our aim was to complement the many qualitative critiques of health aid with a quantitative review and to provide insights on the level of development assistance availa... more

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Strengthening community mental health resources by training refugees as peer counselors - A manual for trainers

Josi Salem-Pickartz Al Himaya Foundation for Trauma Recovery, Growth and Resilience (2008)

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Rapid assessment of Ebola impact on reproductive health services and service seeking behaviour in Sierra Leone

Government of Sierra Leone, Department for International Development, UN Population Fund, Irish Aid (2015)

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Water, Sanitation and Hygiene Situation in Health Care Facilities in Tanzania Mainland and Way Forward

National Institute for Medical Research (2016) C1

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Adolescent Sexual and Reproductive Health Toolkit for Humanitarian Settings

UNFPA, Save the Children USA (2009)

This Toolkit is intended to guide humanitarian programme managers and healthcare providers to ensure that sexual and reproductive health interventions put into place both during and after a crisis are responsive to the unique needs of adolescents.

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Home visits versus fixed-site care by community health workers and child survival: a cluster-randomized trial, Mali

World Health Organisation (WHO) (2024) C_WHO

Despite recent global declines, under-five mortality remains high in many of the poorest countries. Barriers to timely quality care, including user fees, distance to facilities and the availability of trained health workers and medical supplies, hinder progress in further reducing morbidity and m... more

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Building on Community-based Health Insurance to Expand National Coverage: The Case of Ghana

Nathan J. Blanchet and Osei B. Acheampong USAID, Health Finance & Governance (2013) CC

Community Health Worker Training Materials for Cholera Prevention and Control recommended

Community Health Worker Training Materials for Cholera Prevention and Control
recommended