Access to health care gained the spotlight on national and international development agendas when the 1978 Alma Ata Declaration outlined a strategy for achieving universal access to primary health care by the year 2000 (World Health Organization, 1978). The Millennium Development Goals (MDGs) set targets for improving health-care delivery by 2015, and the United Nations’ new Sustainable Development Goals (SDGs), which took effect in January 2016, extend and supplement those with ambitious targets aimed at ensuring healthy lives for all.
Despite significant gains under these initiatives, Africans fully support health care’s continued prominence on development agendas: In Afrobarometer surveys across 36 African countries in 2014/2015, citizens rank health as the second-most-important problem (after unemployment) that their governments need to address, as well as the No. 2 priority (after education) requiring additional government investment.
While the proportion of Africans going without needed health care has decreased over the past decade, citizens’ perceptions highlight some of the challenges that still stand between current reality and “health for all,” including:
- In many areas, a continued absence of basic health-care facilities
- Shortages of needed medical care experienced by almost half of all Africans
- Widespread difficulties encountered in obtaining care, sometimes compelling patients to pay bribes
- Poor government performance, according to citizen ratings, in improving basic health services
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