Africa Healthcare
The healthcare sector in Africa has historically lagged with limited access, low quality of healthcare services and a scarcity of skilled manpower resources. However, as the continent experiences rapid demographic transitions, economic growth, and advances in technology, the demand for accessible, affordable, and high-quality healthcare has surged.
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While some regions have advanced medical facilities and skilled healthcare professionals, others face enduring challenges such as inadequate infrastructure, a scarcity of medical staff and restricted access to essential medications. Communicable diseases such as malaria, HIV/AIDS and tuberculosis are still prevalent in the Sub-Saharan African region, in addition to the growing concerns about non-communicable diseases and maternal health issues. The World Health Organization has reported that Africa bears more than 22%-24% of the global disease burden and accounts for less than 1% of global healthcare expenditure, creating a major healthcare infrastructure deficit. Additionally, underinvestment puts considerable strain on health workers, contributing to an annual loss of USD 2bn as African doctors emigrate to high-income countries.
Despite strides made in improving healthcare continent-wide, including broadening primary care access and embracing telemedicine and health data management technologies, there persists a gap that emphasises the ongoing necessity for sustainable investments, innovative solutions and collaborative partnerships to cater to the diverse healthcare demand of Africa’s population.
Bed Density
Access to adequate healthcare infrastructure is a critical determinant of public health outcomes. Among the fundamental components of healthcare infrastructure, hospital bed density serves as a key indicator of a country's preparedness to address health crises and provide essential medical services. Countries such as Mauritius and Ethiopia have a higher bed density at 3.9 and 3.3 beds per 1,000 population, respectively, in comparison to the global average of 2.9 indicating optimum bed capacity to cater to the current needs of the population. Meanwhile, countries such as Nigeria, Uganda, Egypt and Morocco have a relatively low bed density compared to their respective population. Several factors contribute to the challenges associated with hospital bed density, such as limited financial resources, inadequate infrastructure development and rapid population growth. Strategic investments in infrastructure development, coupled with robust healthcare financing mechanisms, are essential for expanding bed capacity and improving healthcare access. Moreover, further leveraging technological innovations, such as telemedicine and mobile health clinics, can augment healthcare delivery in underserved areas, alleviating pressure on traditional hospitals. Collaborative efforts involving governments, international organisations, and the private sector are paramount in addressing Africa's multifaceted challenges of hospital bed density.
Demographic impact on healthcare
Africa's demographic profile indicates a comparatively youthful population compared to other global regions. Currently, 50.8% of the population is below the age of 19 years. The population above the ages of 40-59 years and above 60 years is expected to grow by 1.4x in the next decade. This increase in population within the different age groups indicates demand for specialised services focusing on paediatrics, chronic care management, rehabilitation and so on.
Overview of Africa Healthcare
Current Health Expenditure (CHE)
- Current health expenditure (CHE) as a % of GDP provides an indication of the level of resources channelled into health and determines the importance of the health sector in the overall economy.
- Over the past decade, health expenditure in Africa has been on the rise, reflecting growing investments in healthcare infrastructure, services and personnel. Mozambique has the highest CHE at 9.1%, whilst Zimbabwe has the lowest at 2.8%.
- In Africa, private funding is the primary source of financing, followed by government and external funding. However, long-term financing solutions are required to address infrastructure gaps, strengthen the healthcare workforce and build resilient health systems to improve the quality of care
Real Estate Investment
Taking into consideration the global average bed density of 2.9 beds per 1,000 population, the gap in the healthcare infrastructure and the total real estate investment required has been identified. With the exception of Ethiopia and Mauritius, the majority of the countries fall short of the global average and require a significant investment in healthcare infrastructure. To put this into perspective, Nigeria, for example, requires 415k beds costing over USD 498 bn*, and Egypt requires 177k beds with an infrastructure investment of USD 213 bn*.
The identified gap in healthcare infrastructure presents both challenges and opportunities for investors, governments and healthcare stakeholders.
On one side, bridging this gap demands significant financial investments and strategic foresight to construct, enhance, and modernize healthcare facilities. On the other hand, it opens avenues for real estate developers, investors, and healthcare providers to engage in infrastructure projects that can have an impact on public health and overall welfare.
Disease Burden
- Deaths and DALY are key indicators to analyze the disease burden of a country.
- Disease Adjusted Life Years (DALY) is known as the total years of potential life lost due to premature death and the years of productive life lost due to disability. It is used as a measure for the quantity and quality of life of the population.
- Northern African countries such as Egypt Morocco and Tunisia, have non- communicable diseases as the primary causes of deaths and DALY which includes cardiovascular, neonatal, respiratory disorders etc and could be attributed to sedentary lifestyle, urbanization and unhealthy diet.
- Sub Saharan African countries such as Uganda, Cameroon, Nigeria and Malawi have a higher burden of communicable diseases such as malaria, HIV/AIDS, TB which could be attributed to factors as such poverty, inadequate healthcare infrastructure and limited access to essential medicines and preventive care.
Health Insurance In Africa
Only 17% of Africa’s population currently has access to health insurance (either covered by government or private insurers). The coverage varies significantly from one country to another within Africa and therefore majority of them still make out of pocket payments.
The health insurance is provided by the following stakeholders:
By investing in health insurance and strengthening healthcare financing mechanisms, African countries can work towards building more resilient and equitable health systems that meet the needs of their populations.
Going forward, some countries in Northern Africa that have relatively well-developed healthcare and have made significant improvements over the years by placing strong emphasis on preventive care and primary health services should focus on investing in the following areas:
1) Tertiary care facilities
2) Specialised outpatient clinics such as IVF, nephrology, dialysis etc
3) Pharmaceuticals
4) Diagnostic services
The majority of the Sub-Saharan African countries (with the exception of South Africa, Ghana, and Ethiopia) that are still grappling with communicable diseases should focus on the following:
1) Strengthening primary healthcare
2) Better access to essential medicines
3) Tele-health services, especially in the rural areas.