![]() The United Nations describes a health system as a structure that includes “all actors, organizations, institutions, and resources whose primary purpose is to improve health…Their primary goal is to promote, restore or maintain health, but they also aim to be responsive to people’s legitimate expectations and financially fair” ( African Region Health Report 2013: 106). These hinge on a multiple of financial, social, economic, environmental, and workforce resources, and a leadership that is committed, with a vision that focuses primarily on the people, particularly the poor, the sick and the disabled, and, through various initiatives, encourages change in individual unhealthy behaviors-all factors that render health difficult and complex to manage. A health system that functions properly must have the necessary ingredients. Therefore, this section highlights and summarizes the overall successes and challenges of the health systems in Africa, and is followed by a discussion of the strategies needed to improve the health conditions of the Africans. Three of these, Goals 4, 5, and 6, child mortality, maternal health, and disease prevention, are related to health, without, however, minimizing the other goals because, as is clear with poverty, they all impact both national and global health. Discussed in this chapter are also the eight Millennium Development Goals (MDGs) which virtually all countries of the world and organizations, totaling 189 countries, including 147 heads of state and government in September 2000, pledged to reach by the year 2015. ![]() ![]() By being less expensive, primary health care is affordable and allows access to expected quality health care for the majority of the population and not only to the wealthy minority and its families. However, when all is said and done, primary health care still remains the best answer to disease as it provides the basic preventive strategies that render the system cheaper, reducing, in the process, the rate of child and maternal morbidity and mortality-two of the most preventable outcomes that can prolong life expectancy at birth. This chapter endorses the restrengthening of an uncompromised health care system to make it effective and efficient for both rural and urban areas one that finds ways of trimming financial and human resource waste revamps the institutions that train health care and service providers to make the system responsive to the real health needs of the people and not just the wealthy one that compensates physicians just as civil servants and aligns the educational system with targeted and expected measurable health outcomes. While many medical educational institutions on the continent tend to perpetuate, at times, skewed and irrelevant Eurocentric health training, the national pyramidal health structure, weakened at the village level, and disproportionately favoring the provincial and national hospitals, gives the illusion that rural areas are well-served, when in actuality they are not. As study after study has pointed out, the health care systems in Africa pay little attention to the critical interface between education and good health, especially when it comes to the education of women and mothers, who are the primary line of defense against child diseases, and perform simultaneously most domestic chores and critical agricultural activities.
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