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Insight & Analysis - June 10, 2022

5 African Countries with the Worst Health Care System

The government structure in most African countries has encountered a number of issues in the area of health care. This includes embezzlement, a shortage of funding, and inadequate infrastructure. 

This is in addition to the pandemics, poverty, and the brain drain of indegenous doctors travelling overseas in pursuit of a higher income and a better standard of living.

Although public health care varies greatly from country to country and area to region, most expats will prefer to use the private sector, typically based in large cities and popular tourist destinations, or have international health insurance and cash to be evacuated to another country.

Here are the 5 African countries with the worst health care systems.


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1. Sierra Leone 

With a score of 0.00 on the WHO health systems performance index, Sierra Leone has the dubious distinction of being the worst African country at providing health care to its citizens. 

It is a small African country bordered by Guinea and Liberia, with a population of around 6 million people. Previously, civil war ravaged the country, but it is now steadily growing into a stable democratic state. 

Medical facilities in the country were looted and destroyed during the war. This, combined with the fact that most people in Sierra Leone live in rural regions, means that only a small percentage of the population has access to health care.

Pregnant women are entitled to free medical care under the law, but the country is unable to afford it.

There are only approximately 22 physicians in each area, and about 60% of the rural population lacks access to safe drinking water. At the moment, the average life expectancy in the country is 54 years. 

Around 42% of the population is under the age of 15. Malaria is a major public health concern in the country. Many collaborative initiatives with other countries are being made to improve health care and living standards.

2. South Sudan 

It is important to highlight how dependent on foreign aid South Sudan is. Without the intervention of international organisations, South Sudan will only have 380 facilities for a population of 11 million people that spans 249 square miles.

It is estimated that there are approximately 500 Southern Sudanese doctors with basic medical degrees but without postgraduate training. Most of these doctors either work in private practice or undertake administrative posts with non-government organisations in Southern or Northern Sudan.

3. Central African Republic

The Central African Republic (CAR) is the third-worst country in terms of health care, with a WHO health system performance score of 0.156/1. 

It is located in Central Africa and is also a landlocked country, enclosed by Chad, Sudan, South Sudan, the Democratic Republic of Congo, the Republic of Congo, and Cameroon. 

More than two years of sectarian warfare have wreaked havoc on CAR’s already precarious health systems. 

The average life expectancy has been reduced to 49 years due to political instability and overall lawlessness, as well as poverty and poor infrastructure. 

This circumstance has resulted in an increase in avoidable diseases like malaria among families still hiding in the jungle from armed groups. 

In this country, sanitation issues and a lack of clean water are primary sources of illness.

Diarrhoea is a leading cause of death in children under the age of five. On a more optimistic note, a forum for peace has been established. Its goal is to begin the arduous task of rebuilding the country and its systems.

4. Democratic Republic of Congo

The Democratic Republic of the Congo (DRC) has long been hampered by deep-seated flaws in its health-care system. 

It ranks fourth poorest in the WHO ranking of nations’ health system performance with a score of 0.171/1. The country has been in a state of near-constant strife. 

The majority of health clinics in the DRC are understaffed and underequipped, and medical supplies are scarce. According to WHO, there is just one doctor for every 10,000 people in the DRC.

The median age in the country is 17, with 43% under the age of 15 years old. Malnutrition is very common. 

Water-borne infections like diarrhoea and cholera are widespread since only about a quarter of the population has access to basic sanitation and clean water. Malaria, on the other hand, poses the greatest threat.

5. Nigeria 

This “African Giant” has a weak healthcare system, ranking fifth worst in the world. It has a WHO rating of 0.176/1. 

Nigeria is divided into 36 states and is governed by a central government. It is located in West Africa, between Benin and Chad to the west and east. With a population of over 174 million people, Nigeria is Africa’s most populous country. 

The country’s average life expectancy, which is roughly 52.3 years, has been badly impacted by the country’s extreme wealth inequality. 

Nigeria is experiencing a large outflow of nurses, doctors, and other health professionals who are leaving in search of better prospects abroad.

Infant mortality is also a problem, with over 20% of children dying before reaching the age of five.


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