Africa is continuing to make progress in meeting its Universal Health Coverage (UHC) targets (part of the United Nations’ Sustainable Development Goals). Countries like Rwanda and Ethiopia are two examples of African countries making exemplary progress. Kenya, Ghana and South Africa are also among those making significant progress towards realising this dream. However, there is still a long way to go if the continent is to achieve its target on the Service Coverage Index by 2030. The continent’s average on the scale of UHC rose from 23 in 2000 to 44 in 2021, still only halfway to its projected goal.

Accelerated progress toward UHC is possible, however, it requires an initial step; resilient primary health care (PHCs) systems.

Why primary health care systems matter

Those who are most vulnerable across our continent – women, children, and under-resourced communities – continue to be at risk. Each year, approximately  70% of global maternal deaths occur in sub-Saharan Africa, with an estimated 178,000 mothers and 1 million newborns dying each year, many from preventable illness.

For too long Africa has focused on addressing individual diseases, largely a result of international donors and their priorities. The result is a fragmented system that misses the opportunity to provide more streamlined, holistic care through robust primary care systems.

Primary health care (PHC) systems provide essential services ranging from prenatal care and child vaccines to other life-saving treatments. They are frequently the only times many people and communities receive health care. Over 60% of the continent’s population lives in rural areas, where primary healthcare facilities are often the only available health service. Put simply, without strong PHC systems, universal health coverage will not be achievable.

This week, Africa’s leading health experts have convened at the 4^th International Conference on Public Health (CPHIA) in Durban, South Africa to explore the theme: “Moving towards self-reliance to achieve universal health coverage and health security in Africa”. In those discussions, health leaders are sharing ideas to support and shape more innovative, dynamic, and visionary PHC systems in Africa.  See related story.

Africa Seeks More Self-Reliance Amid Disease Outbreaks and Decline in Donor Funds

Supporting PHC infrastructure through innovation

The 2020 pandemic exposed a critical gap in the public health sector: the infrastructure needed to support resilient primary health systems. Countries buckled under the clinical demands of COVID-19, which were exacerbated by the lack of basic commodities in many healthcare facilities.

A 5-year study conducted in Sub-Saharan Africa from 2013 – 2018 found that over 40% of PHC facilities lack clean water. Some 15% of Sub-Saharan health facilities have no electricity at all while an estimated 50% lack reliable electricity services. Another study of health facilities across 18 sub-Saharan African countries also found that only 74% of health facilities had basics like soap, running water, or alcohol-based hand rub. The result is that only 17% of facilities could ensure infection prevention protocols. These are the same facilities that were on the frontlines of the deadly pandemic two years later. And beyond these infrastructure issues is a human resources crisis: Africa has only 1.3 health workers per 1,000 people, which sits well below the WHO minimum threshold of 4.5.

To ensure everything from surgeries to childbirth can occur safely, investing in robust PHC system infrastructure is a must. We are starting to see the deployment of African-made technology, from solar-powered clinics to smart water systems. Our technology can power the pathway forward.

The private sector can step up as a partner

This is where the business community has a critical role to play. Across the continent, the private sector is increasingly stepping up as a partner in delivering stronger and more resilient primary health care systems. Businesses are investing in digital tools, data systems, and supply chain innovations that help extend quality services to communities that public facilities alone cannot always reach. In Kenya, for instance, the rapid growth of homegrown telehealth platforms and mobile-based health insurance models has expanded access to consultations and coverage, particularly for peri-urban and rural areas. Similar collaborations are emerging in Nigeria, where private logistics companies are supporting vaccine delivery to last-mile clinics. These examples show how Africa’s business community can be an active force for progress – bridging gaps, driving innovation, and strengthening partnerships that make universal health coverage and health security truly attainable.

Primary health clinics with digital health record systems have been shown to deliver higher quality care. For example, a study at Festac Primary Health Centre in Lagos, Nigeria, found that introducing electronic health records significantly reduced paperwork and improved service delivery, freeing health workers to spend more time on patient care.

African innovation can further power PHC infrastructure by supporting the training demands of the health workforce today and in the future. The WHO estimates a shortfall of 6.1 million healthcare workers in Africa by 2030. This gap poses a major barrier to achieving universal health coverage. Remote medical training distributed through mobile devices can help make opportunities for frontline health more accessible and affordable. These tools can help incentivise young professionals to pursue health careers and close this critical workforce gap in PHC systems. Another example is Kenya’s M-JALI platform, which has trained thousands of community health workers via mobile devices, improving service delivery and making health careers more attainable.

CPHIA 2025 and beyond

We stand at a time where innovation and necessity are converging, giving Africa the chance to rewrite its health story and build a future where all Africans have access to quality healthcare. Achieving this demands bold, cross-sector partnerships that strengthen primary health systems to meet Africa’s evolving health challenges. Universal health coverage isn’t some far-off goal. It’s something we must start working toward today.

Dr. Amit N. Thakker, is executive chairman, Africa Health Business, which facilitates collaborations acros sAfrica between governent, businesses and communiites on the development of better tools for community health care.

Image Credits: G Lontro/ NCD Alliance, WHO/Lindsay Mackenzie, DC Studio on Freepik.