Friday 7 April 2023

Financing Primary Health Care Systems in Africa

Photo by Ivan Samkov on Pexels

by Adetayo Adetokun

World Health Day is celebrated every year on April 7, and this year's theme is "Health for All." This theme emphasizes the need for universal health coverage, which ensures that everyone, regardless of their socio-economic status, can access quality healthcare services. One of the ways to achieve this is by integrating more funding for primary healthcare centres in Africa by African governments.

Primary healthcare centres are the first point of contact for most people seeking medical attention in Africa. These centres offer a wide range of services, from diagnosis and treatment of common illnesses to preventative care services such as immunizations and family planning. However, despite the critical role they play in the healthcare system, primary healthcare centres in Africa are often underfunded, understaffed, and lack the necessary equipment and supplies.

The Role of Governments in Primary Healthcare Funding

Governments have a crucial role to play in funding primary healthcare centres in Africa. They are responsible for providing healthcare services to their citizens and ensuring that they have access to quality healthcare services. Governments can provide funding for primary healthcare centres through various mechanisms, such as tax-funded health insurance schemes, public-private partnerships, and donor funding.

Research has shown that increased funding for primary healthcare centres can improve health outcomes and reduce healthcare costs. According to a study conducted by the World Health Organization (WHO), every dollar invested in primary healthcare can yield up to ten times the return on investment. This is because primary healthcare centres can prevent diseases, reduce hospitalization rates, and improve the overall health of communities.

Financing Primary Healthcare Systems in Africa 

Financing primary healthcare systems in Africa has been a challenge for many governments. However, there are several financing options that governments can explore to improve primary healthcare services in the continent.

  1. Domestic Financing: Governments can increase domestic financing for primary healthcare systems through taxes, user fees, and national health insurance schemes. These financing options can be used to build and maintain healthcare facilities, train healthcare workers, provide basic consumables, and purchase medical supplies and equipment. Many countries in Africa have introduced health insurance schemes to improve access to healthcare services.

  1. Donor Funding: Donor funding can also be an important source of financing for primary healthcare systems in Africa. Many international organizations, such as the World Health Organization (WHO), the United Nations Development Programme (UNDP), and the World Bank, provide funding for healthcare projects in developing countries. Donor funding can be used to support healthcare infrastructure, provide medical supplies and equipment, and train healthcare workers.

  1. Public-Private Partnerships (PPPs): Governments can also partner with private sector organizations to finance primary healthcare systems. This can involve the private sector investing in healthcare infrastructure or providing healthcare services in collaboration with the government. PPPs can be an effective way to leverage private sector expertise and resources to improve healthcare services.

  1. Community Financing: Community financing involves communities contributing to the financing of healthcare services. This can involve communities contributing financially, or through labor or other forms of in-kind support. Community financing can be an important source of funding for primary healthcare systems, particularly in rural areas.

  1. Innovative Financing: Innovative financing mechanisms involve using non-traditional sources of financing to support healthcare services. For example, governments can use a portion of revenue from natural resource extraction, such as oil or mining, to fund healthcare services. Other innovative financing mechanisms include issuing bonds, levying taxes on tobacco or alcohol, or introducing a tax on financial transactions.

While there are several financing options available, governments need to carefully consider the implications of each financing mechanism. For example, user fees can deter some people from seeking healthcare services, while relying too heavily on donor funding can be unsustainable in the long term. Governments need to balance the need for financing with ensuring that healthcare services are accessible and affordable for all citizens.

Impact of low funding on Primary Healthcare Systems in Africa

Low funding in primary healthcare systems in Africa can have a wide range of negative impacts on both the healthcare system and the population it serves. Some of the most significant impacts include:

  1. Limited access to healthcare services: When primary healthcare systems are underfunded, it becomes difficult to provide basic healthcare services to the population. This can result in limited access to healthcare services, especially for people living in rural or remote areas.

  1. Poor quality of healthcare services: Low funding can result in a shortage of healthcare workers, inadequate medical equipment and supplies, and poor infrastructure. This can lead to poor quality of healthcare services and a high risk of medical errors.

  1. Increased burden of communicable diseases: Low funding can result in poor disease surveillance, inadequate immunization programs, and poor prevention and control of infectious diseases. This can lead to an increased burden of communicable diseases such as tuberculosis, malaria, HIV/AIDS and a host of zoonotic diseases.

  1. Increased mortality rates: Low funding can result in a lack of preventive healthcare services, inadequate treatment of chronic diseases, and poor maternal and child healthcare. This can lead to increased mortality rates, especially among vulnerable populations such as women and children.

  1. Economic burden: Low funding can result in a lack of investment in healthcare infrastructure and human resources, leading to high healthcare costs for individuals and families. This can lead to a significant economic burden on households and the economy as a whole.

Low funding in primary healthcare systems in Africa can have a significant negative impact on the health and well-being of the population, as well as on the economy. Governments and international organizations need to prioritize adequate funding for primary healthcare systems in Africa to ensure access to quality healthcare services for all.


To upscale primary healthcare centres in Africa through funding, research, and technology, the government can consider the following solutions:

  • Increase funding: There should be an increase in funding for primary healthcare centres to improve their infrastructure, equipment, and staffing. This will help to improve the quality of healthcare services provided and increase access to primary healthcare services.

  • Research and development investments: Government should look into research development and investment to improve the quality of healthcare services provided at primary healthcare centres. This could involve research on new drugs, medical technologies, and treatment protocols to improve the diagnosis and treatment of diseases.

  • Training and capacity building: Governments should include the training and capacity building of healthcare workers in routine budget planning for health projects to improve their skills and knowledge. This could involve providing training in new medical technologies, treatment protocols, and disease prevention strategies.

  • Technology adoption: The adoption of new medical technologies should be fostered to improve the quality of healthcare services provided at primary healthcare centres. This could involve the adoption of electronic health records, telemedicine, and other digital health technologies to improve healthcare delivery and patient outcomes.

  • Public-private partnerships: Ministries of health should partner with private sector organizations to improve the quality of healthcare services provided at primary healthcare centres. This could involve collaborations with pharmaceutical companies, medical device manufacturers, and other healthcare organizations to provide funding, medical supplies, and expertise to support primary healthcare programs.

  • Monitoring and evaluation: Meticulous monitoring and evaluation of the performance of primary healthcare centres should be done to ensure they are providing quality healthcare services. This could involve setting performance targets and monitoring key performance indicators to track progress and identify areas for improvement.

  • Community involvement: Community members should be involved in the planning, design, and implementation of primary healthcare programs. This can help to ensure that primary healthcare centres meet the needs of the communities they serve and are culturally appropriate.

  • Health insurance schemes: Health insurance schemes should be introduced to help finance primary healthcare services. This can help to increase access to healthcare services and reduce out-of-pocket expenses for patients.

  • Strengthening supply chain management: Proper reinforcing and strengthening of supply chain management should be done to ensure that primary healthcare centres have access to essential medicines and medical supplies. This can involve the development of better inventory management systems and the use of technology to improve supply chain efficiency.

  • Quality assurance: Governments should facilitate the implementation of quality assurance mechanisms to ensure that primary healthcare centres are providing quality healthcare services. This can involve the development of quality standards and the use of accreditation processes to ensure that healthcare facilities meet these standards.

  • Addressing healthcare workforce shortages: Governments should address healthcare workforce shortages by developing policies to attract and retain healthcare workers in primary healthcare centres. This could involve offering incentives such as training opportunities, professional development, and better pay and working conditions.

  • Empowering patients: There should be measures in place to empower patients to take an active role in their healthcare by providing them with information and tools to manage their health. This could involve the development of patient education materials, health promotion campaigns, and the use of digital health technologies to support patient self-management.

Primary healthcare is the backbone of any effective healthcare system. African governments must recognize the importance of primary healthcare and prioritize funding to improve access to essential health services for their populations. Integrating more funding for PHCs can go a long way in improving health outcomes in the continent. It is crucial for African governments to take proactive steps to increase healthcare budgets, implement health insurance schemes, and partner with international organizations and donor agencies. By doing so, we can achieve the World Health Day theme of "Health for all" and ensure that every individual in Africa has access to quality health services.

Investing in primary healthcare is not only a moral imperative but also an essential step towards achieving universal health coverage and promoting the well-being of African populations. By prioritizing and allocating more resources to primary healthcare, African governments can improve the health and well-being of their populations, reduce healthcare costs, and contribute to sustainable development. Moreover, integrating more funding for PHCs can help address health inequalities and promote social justice by ensuring that vulnerable populations have access to essential health services. It is time for African governments to take bold and decisive action to improve primary health care and advance the health of their populations.


  1. I have visited over 100 PHCs in nigeria, all the points raised are very important.They" might "actually be good funding but is it utilised well?
    Do we bring in the best staffs?
    Do we care about training and research?
    Do we genuinely care?
    The answer to everything you raised is that nobody genuinely cares about the job.
    The just want another avenue to get what they can get to be able to feed themselves,zero passion,zero Will in doing anything progressive.
    The southwest however are miles ahead of other PHCs because there's a clear difference in the administrative discipline as regards other regions.

    1. You have raised such valid points. We agree: nobody in governance genuinely cares. Thank you for reading!