Shaping the AU-EU Partnership for Health Equity: The Role of African Civil Society

Challenges are vast when it comes to Africa’s fragile health care systems. All the more important is the role of civil society in this context, writes Cecilia Senoo, Executive Director of the NGO Hope for Future Generations. In her article, she assesses the status and challenges of health care in Ghana and emphasises the necessity of strong partnerships for quality health outcomes.

The fragility of Ghana’s health care system – and by extension Africa’s – was exposed by the emergence of the COVID-19 pandemic. Even though Africa’s health care systems are still advancing, the progress made over the years was aggravated by the disruption in the provision of health care services caused by COVID-19. Despite the low rates of infection as compared to other developed countries, the current health crisis has revealed the unpreparedness of the nation towards future pandemics as well as uncovered some compounded challenges facing the health sector.

Challenges in Africa’s health care systems are vast. In Ghana, the health care system is faced with poor governance, inadequate and unmotivated health workforce, limited infrastructure, lack of accurate data, inadequate domestic resources and a high dependency on donor funds. This shows a deficiency in all the dimensions of quality health as specified by the World Health Organisation (WHO).  A well-functioning health system is prepared and well-resourced with the right mix of health professionals, responds to the needs of people, defends communities and people against disease outbreaks, is inclusive and provides equitable access to care.

CSOs’ Role to Health Care in Ghana

Cognisant of the gaps and loose ends in the health care system, civil society organisations (CSOs) are one group that works in partnership with the government to address the health needs of the population. While there is a strong presence of CSOs in Ghana, the government’s inability to strengthen its partnership with CSOs has in many cases resulted in poor outcomes of health interventions by the state, especially at the community level. For instance, the recent high hesitancy in the acceptance of COVID-19 vaccines is one example of the poor partnership between the two sectors. Civil society organisations have demonstrated their capacity to work closely with the locals at the community and grassroots levels to achieve results. A partnership with CSOs during the rollout of COVID-19 vaccines would have ensured the delivery of community sensitization and engagements at the level of understanding for targeted groups to reduce misconceptions, misinformation and increase acceptance among the population.

Potential for AU-EU Partnership

While the contributions of CSOs to Ghana’s health care agenda are recognised, there are still some challenges being faced by the sector that – when addressed – can increase the potential for development and strengthen local and international partnerships for health.

One area for attention is the development of the capacities of CSOs to conduct evidence-based research in partnership with academia for accurate data to inform on health policies and reforms. For instance, Hope for Future Generations as an NGO encourages a periodic engagement with institutions like the University of Ghana for operational research and data review with the School of Public Health before the implementation of projects, especially on HIV/AIDS. There is the need to ensure a well-coordinated platform, where local and international governments can work with CSOs to provide evidence-based reports for knowledge production and management.

Likewise, building the capacities of CSOs can improve and well-equip them to monitor the use of resources allocated to health and demand accountability of services.

Again, it is important to strengthen partnerships with CSOs to ensure the promotion and delivery of quality health services at the grassroots level and deprived areas to reduce inequalities in access to health.

Expectations from the AU-EU partnership

Global partnerships for health have impacted health financing and created global platforms for engagement, health information and the development of new policies. While this is a significant improvement, there are still difficulties and new challenges that spring up every day.

Structural inequalities in relation to access to resources, technologies and innovations still persist in Africa and hinder the work of civil society. It is important to recognise the challenges of civil society in Africa as different from civil society in Europe and then strengthen partnerships to address them from the root causes.

Partnerships to effectively address gender gaps and strategise for women and youth empowerment is critical to achieving Universal Health Coverage.

Some essential ways to improve the AU-EU partnerships are through the exchange of knowledge, skills, resources and transfer of technologies and innovations necessary to augment the health needs of people as well as transform the works of civil society organisation in Africa. Since CSOs are pro-poor and actively involved in community-level activities, ensuring that they are well-resourced will increase the impact of Universal Health Coverage interventions among deprived communities and those who need them most to reduce inequalities.

In order to achieve Universal Health Coverage, investment in preventive health and partnering with CSOs to communicate positive behaviour and addressing inequalities will go a long way to reduce the high cost of curative health services in Africa. Prevention is always better than cure. CSOs are closer to the people, they speak the local languages and can explain issues better.

Concluding Remarks

The health of countries is known to be found in their wealth, but the real wealth of any country is in the health of its people. Civil society plays an equally important role just like the public sector in addressing the health needs of populations, and strong partnerships are essential to curb the challenges, improve and sustain quality health outcomes.

Cecilia Senoo is Executive Director of the NGO Hope for Future Generations (HFFG) in Accra, Ghana.