THE STATE OF HEALTH in the WHO African Region: An analysis of the status of health, health services and health systems in the context of the Sustainable Development Goals

A complex picture of the African Region emerges from the ›ndings of this analysis. Looking at the level of
funding available for countries to produce the results observed (using the €‡ per capita THE in USµ PPP),
one sees a mixed situation: only nine countries in the Region are spending above USµ ‡ per capita (all, with
the exception of Eswatini, are upper middle or high-income countries), and half the countries (š) have a total
health expenditure of less than USµ €š per capita.
Analysing the linkage between health expenditure and healthy life expenditure shows a weak association between
the two areas. Further analysis of associations shows that healthy life expenditure is more strongly associated
with health system performance, as opposed to all other areas of the Framework of Actions. Countries need to
place monitoring of performance of their systems at the centre of their eorts to move towards SDG  .
Countries in the Region are diverse, due to cultural, economic, governance and political dierences, which
makes a ‘one size ›ts all’ approach in addressing health in the   Agenda not possible. To move forward,
countries need to:
Find means to extend their health services to currently unreached populations, including urban
informal settlements;
Increase their focus on improving the process of care, not only its availability;
Proactively identify and increase services to all age cohorts, including the adolescents and the elderly;
Anticipate and mitigate health and governance security challenges, as they have the potential to
undo any progress made; and
Develop country-speci›c mechanisms to engage all health-related stakeholders to ensure that social,
economic, environmental and political SDG targets are on track.