Review Article | | Peer-Reviewed

From Policy to Practice: A Review of Africa’s Public Health Policy

Received: 26 September 2023    Accepted: 20 March 2024    Published: 2 April 2024
Views:       Downloads:
Abstract

Africa faces persistent health challenges, from infectious diseases to non-communicable illnesses, necessitating robust public health policies. However, the translation of these policies into effective practice remains a substantial challenge across the continent. This study employed a rigorous literature review, and policy analysis to shed light on the multifaceted factors impeding the successful transition from policy formulation to tangible health outcomes. Findings indicates that while Africa has made substantial progress in crafting health policies that align with global health goals, critical gaps persist in their execution. Major challenges include resource limitations, weak health infrastructure, insufficient capacity building, and complex socio-cultural dynamics that influence health behaviors and practices. In addition, bureaucratic hurdles, corruption, and lack of political will are identified as systemic barriers to policy implementation. The study highlights the need for adaptive and evidence-based policy making rigorous monitoring and evaluation mechanisms to track progress, and a multifaceted approach to bridge these gaps and address challenges. This includes strategic investments in healthcare infrastructure and workforce development, enhancing collaboration between governments and international partners, and fostering community engagement to ensure policies resonate with local contexts.

Published in Central African Journal of Public Health (Volume 10, Issue 2)
DOI 10.11648/j.cajph.20241002.14
Page(s) 90-99
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

African Public Health Policies, Health Policy, Public Health Policy, Workforce, African People

References
[1] Public health policy: Definition, examples, and more. Columbia University Mailman School of Public Health. (2022, October 3).
[2] Azevedo, M. J., & Azevedo, M. J. (2017). Public health in Africa: Theoretical framework. Historical Perspectives on the State of Health and Health Systems in Africa, Volume I: The Pre-Colonial and Colonial Eras, 1-77.
[3] Katoue, M. G., Cerda, A. A., García, L. Y., & Jakovljevic, M. (2022). Healthcare system development in the Middle East and North Africa region: Challenges, endeavors and prospective opportunities. Frontiers in public health, 10, 4937.
[4] Vearey, J., Luginaah, I., Magitta, N. W. F., Shilla, D. J., & Oni, T. (2019). Urban health in Africa: a critical global public health priority. BMC public health, 19(1), 1-4.
[5] Ruger, J. P., & Yach, D. (2009). The global role of the World Health Organization. Global health governance: the scholarly journal for the new health security paradigm, 2(2), 1.
[6] Boutayeb, A. (2010). The impact of infectious diseases on the development of Africa. Handbook of disease burdens and quality of life measures, 1171.
[7] National Academies of Sciences, Engineering, and Medicine. (2017). Addressing continuous threats: HIV/AIDS, Tuberculosis, and Malaria. Global health and the future role of the United States.
[8] Church, K., Kiweewa, F., Dasgupta, A., Mwangome, M., Mpandaguta, E., Gómez-Olivé, F. X.,... & Zaba, B. (2015). A comparative analysis of national HIV policies in six African countries with generalized epidemics. Bulletin of the World Health Organization, 93, 457-467.
[9] Van de Ruit, C. (2020). HIV/AIDS politics and policy in sub-Saharan Africa. In Oxford research encyclopedia of politics.
[10] Mills, E., Cooper, C., & Kanfer, I. (2005). Traditional African medicine in the treatment of HIV. The Lancet Infectious Diseases, 5(8), 465-467.
[11] The cost of South Africa’s misguided AIDS policies. (2014, February 19). News.
[12] Roberts, D., & Matthews, G. (2016). Risk factors of malaria in children under the age of five years old in Uganda. Malaria journal, 15(1), 1-11.
[13] Nalinya, S., Musoke, D., & Deane, K. (2022). Malaria prevention interventions beyond long-lasting insecticidal nets and indoor residual spraying in low-and middle-income countries: a scoping review. Malaria journal, 21(1), 1-13.
[14] Feachem, Sir Richard. "Roll Back Malaria: an historical footnote." Malaria Journal 17 (2018): 1-3.
[15] Narasimhan, V., & Attaran, A. (2003). Roll back malaria? The scarcity of international aid for malaria control. Malaria Journal, 2(1), 1-8.
[16] Akoria, O. A., & Arhuidese, I. J. (2014). Progress toward elimination of malaria in Nigeria: Uptake of artemisinin. based combination therapies for the treatment of malaria in households in Benin City. Annals of African medicine, 13(3), 104-113.
[17] Jamison, D. T., Breman, J. G., Measham, A. R., Alleyne, G., Claeson, M., Evans, D. B.,... & Musgrove, P. (Eds.). (2006). Disease control priorities in developing countries.
[18] Knight, G. M., Dodd, P. J., Grant, A. D., Fielding, K. L., Churchyard, G. J., & White, R. G. (2015). Tuberculosis prevention in South Africa. PLoS One, 10(4), e0122514.
[19] Ogbuabor, D. C., & Onwujekwe, O. E. (2019). Governance of tuberculosis control programme in Nigeria. Infectious diseases of poverty, 8, 1-11.
[20] Audu, A. M., Otorkpa, O. J., & Eniola, O. L. Prevalence of Mycobacterium Tuberculosis and Dermatophytes Co-Infection in Human Immunodeficiency Virus (HIV) Patients.
[21] Onambele, L., Ortega-Leon, W., Guillen-Aguinaga, S., Forjaz, M. J., Yoseph, A., Guillen-Aguinaga, L.,... & Guillen-Grima, F. (2022). Maternal Mortality in Africa: Regional Trends (2000–2017). International Journal of Environmental Research and Public Health, 19(20), 13146.
[22] Ogbuabor, D. C., & Onwujekwe, O. E. (2018). Implementation of free maternal and child healthcare policies: assessment of influence of context and institutional capacity of health facilities in South-east Nigeria. Global health action, 11(1), 1535031.
[23] Keats, E. C., Ngugi, A., Macharia, W., Akseer, N., Khaemba, E. N., Bhatti, Z.,... & Bhutta, Z. A. (2017). Progress and priorities for reproductive, maternal, newborn, and child health in Kenya: a countdown to 2015 country case study. The Lancet Global Health, 5(8), e782-e795.
[24] Rono, J., Kamau, L., Mangwana, J., Waruguru, J., Aluoch, P., & Njoroge, M. (2022). A policy analysis of policies and strategic plans on Maternal, Newborn and Child Health in Ethiopia. International journal for equity in health, 21(1), 73.
[25] Kana, M. A., Doctor, H. V., Peleteiro, B., Lunet, N., & Barros, H. (2015). Maternal and child health interventions in Nigeria: a systematic review of published studies from 1990 to 2014. BMC public Health, 15(1), 1-12.
[26] Pugliese-Garcia, M., Radovich, E., Campbell, O. M., Hassanein, N., Khalil, K., & Benova, L. (2020). Childbirth care in Egypt: a repeat cross-sectional analysis using Demographic and Health Surveys between 1995 and 2014 examining use of care, provider mix and immediate postpartum care content. BMC pregnancy and childbirth, 20(1), 1-14.
[27] ten Hoope-Bender, P., Martin Hilber, A., Nove, A., Bandali, S., Nam, S., Armstrong, C.,... & Hulton, L. (2016). Using advocacy and data to strengthen political accountability in maternal and newborn health in Africa. International Journal of Gynecology & Obstetrics, 135(3), 358-364.
[28] Serbanescu, F., Goldberg, H. I., Danel, I., Wuhib, T., Marum, L., Obiero, W.,... & Conlon, C. M. (2017). Rapid reduction of maternal mortality in Uganda and Zambia through the saving mothers, giving life initiative: results of year 1 evaluation. BMC pregnancy and childbirth, 17(1), 1-14.
[29] Gurusamy, P. S. R., & Janagaraj, P. D. (2018). A success story: the burden of maternal, neonatal and childhood mortality in Rwanda-critical appraisal of interventions and recommendations for the future. African journal of reproductive health, 22(2), 9-16.
[30] Nganabashaka, J. P., Ntawuyirushintege, S., Niyibizi, J. B., Umwali, G., Bavuma, C. M., Byiringiro, J. C.,... & Tumusiime, D. K. (2022). Population-Level Interventions Targeting Risk Factors for Hypertension and Diabetes in Rwanda: A Situational Analysis. Frontiers in Public Health, 10, 882033.
[31] Immurana, M., Boachie, M. K., & Iddrisu, A. A. (2021). The effects of tobacco taxation and pricing on the prevalence of smoking in Africa. Global Health Research and Policy, 6(1), 1-10.
[32] Bader, P., Boisclair, D., & Ferrence, R. (2011). Effects of tobacco taxation and pricing on smoking behavior in high risk populations: a knowledge synthesis. International journal of environmental research and public health, 8(11), 4118-4139.
[33] Wisdom, J. P., Juma, P., Mwagomba, B., Ndinda, C., Mapa-Tassou, C., Assah, F.,... & Kyobutungi, C. (2018). Influence of the WHO framework convention on tobacco control on tobacco legislation and policies in sub-Saharan Africa. BMC Public Health, 18(1), 1-10.
[34] Olatona, F. A., Onabanjo, O. O., Ugbaja, R. N., Nnoaham, K. E., & Adelekan, D. A. (2018). Dietary habits and metabolic risk factors for non-communicable diseases in a university undergraduate population. Journal of health, population and nutrition, 37, 1-9.
[35] Booth, A., Barnes, A., Laar, A., Akparibo, R., Graham, F., Bash, K.,... & Holdsworth, M. (2021). Policy action within urban African food systems to promote healthy food consumption: a realist synthesis in Ghana and Kenya. International journal of health policy and management, 10(Special Issue on Political Economy of Food Systems), 828-844.
[36] Juma, P. A., Mohamed, S. F., Matanje Mwagomba, B. L., Ndinda, C., Mapa-Tassou, C., Oluwasanu, M.,... & Mbanya, J. C. (2018). Non-communicable disease prevention policy process in five African countries authors. BMC public health, 18(1), 1-12.
[37] Chabrol, F., Albert, L., & Ridde, V. (2019). 40 years after Alma-Ata, is building new hospitals in low-income and lower-middle-income countries beneficial?. BMJ Global Health, 3(Suppl 3), e001293.
[38] Kango, M. (2018). Sustainable financing to fight HIV/AIDS, TB and malaria: lessons learned from the African Union’s Abuja Declaration. MalariaWorld journal, 9.
[39] Houéto, D., & Valentini, H. (2014). Health promotion in Africa: history and prospects. Santé publique, (HS), 9-20.
[40] Nyamwaya, D. (2003). Health promotion in Africa: strategies, players, challenges and prospects. Health Promotion International, 18(2), 85-87.
[41] Buseh, A. G., Stevens, P. E., Bromberg, M., & Kelber, S. T. (2015). The Ebola epidemic in West Africa: Challenges, opportunities, and policy priority areas. Nursing Outlook, 63(1), 30-40.
[42] Nkengasong, J. N., & Tessema, S. K. (2020). Africa needs a new public health order to tackle infectious disease threats. Cell, 183(2), 296-300.
[43] Oleribe, O. O., Momoh, J., Uzochukwu, B. S., Mbofana, F., Adebiyi, A., Barbera, T.,... & Taylor-Robinson, S. D. (2019). Identifying key challenges facing healthcare systems in Africa and potential solutions. International journal of general medicine, 395-403.
[44] Azevedo, M. J., & Azevedo, M. J. (2017). The state of health system (s) in Africa: challenges and opportunities. Historical perspectives on the state of health and health systems in Africa, volume II: the modern era, 1-73.
[45] Bakibinga, P., Kisia, L., Atela, M., Kibe, P. M., Kabaria, C., Kisiangani, I., & Kyobutungi, C. (2022). Demand and supply-side barriers and opportunities to enhance access to healthcare for urban poor populations in Kenya: a qualitative study. BMJ open, 12(5), e057484.
[46] Akhlaq, A., McKinstry, B., Muhammad, K. B., & Sheikh, A. (2016). Barriers and facilitators to health information exchange in low-and middle-income country settings: a systematic review. Health policy and planning, 31(9), 1310-1325.
[47] Clemens, M. A., & Pettersson, G. (2008). New data on African health professionals abroad. Human Resources for Health, 6(1), 1-11.
[48] Raufu, A. (2002). Nigerian health authorities worry over exodus of doctors and nurses. BMJ, 325(7355), 65.
[49] Duvivier, R. J., Burch, V. C., & Boulet, J. R. (2017). A comparison of physician emigration from Africa to the United States of America between 2005 and 2015. Human resources for health, 15, 1-12.
[50] Rosén, I. (2015). The impact of culture on health: A study of risk perception on unhealthy lifestyles in Babati town, Tanzania.
[51] Govender, R. D. (2005). The barriers and challenges to Health Promotion in Africa. South African Family Practice, 47(10), 39-42.
[52] Ensor, T., & Cooper, S. (2004). Overcoming barriers to health service access: influencing the demand side. Health policy and planning, 19(2), 69-79.
[53] Ibeneme, S., Ukor, N., Ongom, M., Dasa, T., Muneene, D., & Okeibunor, J. (2020, July). Strengthening capacities among digital health leaders for the development and implementation of national digital health programs in Nigeria. In BMC proceedings (Vol. 14, No. 10, pp. 1-12). BioMed Central.
[54] Ndokang, E. L. I., & Tsambou, A. D. (2015). Political instability in a country and health state in another country: the case of Central African Republic (CAR) and Cameroon using a mortality model. International Journal of Development and Management Review, 10(1), 13-29.
[55] Cook, C. T., & Kalu, K. (2008). The political economy of health policy in Sub-Saharan Africa. Med. & L., 27, 29.
[56] Nwankwo, O. N., Ugwu, C. I., Nwankwo, G. I., Akpoke, M. A., Anyigor, C., Obi-Nwankwo, U.,... & Spicer, N. (2022). A qualitative inquiry of rural-urban inequalities in the distribution and retention of healthcare workers in southern Nigeria. Plos one, 17(3), e0266159.
[57] Samuel, O., Zewotir, T., & North, D. (2021). Decomposing the urban–rural inequalities in the utilisation of maternal health care services: evidence from 27 selected countries in Sub-Saharan Africa. Reproductive Health, 18(1), 1-12.
[58] Sombié, I., Aidam, J., & Montorzi, G. (2017). Evaluation of regional project to strengthen national health research systems in four countries in West Africa: lessons learned. Health research policy and systems, 15(1), 89-99.
[59] Dodlova, M. (2020). International Donors and Social Policy Diffusion in the Global South. From Colonialism to International Aid: External Actors and Social Protection in the Global South, 189-220.
[60] Ejughemre, U. (2013). Donor support and the impacts on health system strengthening in sub-saharan africa: assessing the evidence through a review of the literature. Am J Public Health Res, 1(7), 146-51.
[61] Allen, T., & Heald, S. (2004). HIV/AIDS policy in Africa: what has worked in Uganda and what has failed in Botswana?. Journal of International Development: The Journal of the Development Studies Association, 16(8), 1141-1154.
[62] Pillay, Y., & Johnson, L. (2021). World AIDS Day 2020: Reflections on global and South African progress and continuing challenges. Southern African journal of HIV medicine, 22(1).
[63] Van Schalkwyk, C., Dorrington, R. E., Seatlhodi, T., Velasquez, C., Feizzadeh, A., & Johnson, L. F. (2021). Modelling of HIV prevention and treatment progress in five South African metropolitan districts. Scientific reports, 11(1), 5652.
[64] González-Alcaide, G., Menchi-Elanzi, M., Nacarapa, E., & Ramos-Rincón, J. M. (2020). HIV/AIDS research in Africa and the Middle East: participation and equity in North-South collaborations and relationships. Globalization and Health, 16(1), 1-18.
[65] Teferi, M. Y., El-Khatib, Z., Boltena, M. T., Andualem, A. T., Asamoah, B. O., Biru, M., & Adane, H. T. (2021). Tuberculosis treatment outcome and predictors in Africa: a systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 18(20), 10678.
[66] Adu, J., & Owusu, M. F. (2023). How do we improve maternal and child health outcomes in Ghana?. The International Journal of Health Planning and Management.
[67] Till, S., Mkhize, M., Farao, J., Shandu, L. D., Muthelo, L., Coleman, T. L.,... & CoMaCH Network. (2023). Digital Health Technologies for Maternal and Child Health in Africa and Other Low-and Middle-Income Countries: Cross-disciplinary Scoping Review With Stakeholder Consultation. Journal of Medical Internet Research, 25, e42161.
[68] Dahab, R., & Sakellariou, D. (2020). Barriers to accessing maternal care in low income countries in Africa: a systematic review. International journal of environmental research and public health, 17(12), 4292.
[69] Kassa, M. D., & Grace, J. M. (2022). Noncommunicable Diseases Prevention Policies and Their Implementation in Africa: A Systematic Review. Public Health Reviews, 42, 1604310.
[70] Nyaaba, G. N., Stronks, K., de-Graft Aikins, A., Kengne, A. P., & Agyemang, C. (2017). Tracing Africa’s progress towards implementing the Non-Communicable Diseases Global action plan 2013–2020: a synthesis of WHO country profile reports. BMC Public Health, 17(1), 1-13.
[71] African Development Bank. (2022). Strategy for Quality Health Infrastructure in Africa 2022-2030.
[72] Transforming Africa’s health system in wake of COVID-19 pandemic | WHO | Regional Office for Africa. (2023, August 18). WHO | Regional Office for Africa.
[73] Banke-Thomas, A., Wright, K., & Collins, L. (2019). Assessing geographical distribution and accessibility of emergency obstetric care in sub-Saharan Africa: a systematic review. Journal of global health, 9(1).
[74] Soyemi, T. S., & Aborode, A. T. (2022). Shortage of hospital bed capacity and overcrowding in emergency tertiary healthcare centers in Nigeria. Annals of Medicine and Surgery, 104675.
[75] Abu, T. Z., & Elliott, S. J. (2020). When it is not measured, how then will it be planned for? WaSH a critical indicator for universal health coverage in Kenya. International Journal of Environmental Research and Public Health, 17(16), 5746.
[76] Anugwom, E. E. (2020). Health promotion and its challenges to public health delivery system in Africa. Public Health in Developing Countries-Challenges and Opportunities.
[77] Govender, Romona D. "The barriers and challenges to Health Promotion in Africa." South African Family Practice 47, no. 10 (2005): 39-42.
[78] Female Genital Mutilation (FGM) Statistics - UNICEF Data. (2023, June 28). UNICEF DATA.
[79] Boboko, I., Bester, P., Kruger, I., Marais, S., & Marais, F. (2023). Health promotion workforce in South Africa: Direction from the Australian health promotion association. Health Promotion Journal of Australia, 34(2), 612-620.
[80] Public Health. (2023). What is Public Health Policy ? - Public Health. Public Health.
Cite This Article
  • APA Style

    Otorkpa, O. J., Otorkpa, C. O., Adebola, O. A., Emmanuel, S., Adamu, A., et al. (2024). From Policy to Practice: A Review of Africa’s Public Health Policy . Central African Journal of Public Health, 10(2), 90-99. https://doi.org/10.11648/j.cajph.20241002.14

    Copy | Download

    ACS Style

    Otorkpa, O. J.; Otorkpa, C. O.; Adebola, O. A.; Emmanuel, S.; Adamu, A., et al. From Policy to Practice: A Review of Africa’s Public Health Policy . Cent. Afr. J. Public Health 2024, 10(2), 90-99. doi: 10.11648/j.cajph.20241002.14

    Copy | Download

    AMA Style

    Otorkpa OJ, Otorkpa CO, Adebola OA, Emmanuel S, Adamu A, et al. From Policy to Practice: A Review of Africa’s Public Health Policy . Cent Afr J Public Health. 2024;10(2):90-99. doi: 10.11648/j.cajph.20241002.14

    Copy | Download

  • @article{10.11648/j.cajph.20241002.14,
      author = {Oche Joseph Otorkpa and Chinenye Oche Otorkpa and Onifade Adefunmilola Adebola and Stephen Emmanuel and Ahamed Adamu and Ololade Esther Olaniyan and Saizonou Zinsou Jacques and Okolo Martin Luther Oseni and Abdirizak Mohamud Yusuf and Maman Laminou Ibrahim and Zakariaou Njoumemi and Ruhaima Issah Zorro and Francis Ngemba Kiese and Abechi Andrew Alapa and Dechasa Adare and Adamu Usman Musa and Fatima Ahmed},
      title = {From Policy to Practice: A Review of Africa’s Public Health Policy
    },
      journal = {Central African Journal of Public Health},
      volume = {10},
      number = {2},
      pages = {90-99},
      doi = {10.11648/j.cajph.20241002.14},
      url = {https://doi.org/10.11648/j.cajph.20241002.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cajph.20241002.14},
      abstract = {Africa faces persistent health challenges, from infectious diseases to non-communicable illnesses, necessitating robust public health policies. However, the translation of these policies into effective practice remains a substantial challenge across the continent. This study employed a rigorous literature review, and policy analysis to shed light on the multifaceted factors impeding the successful transition from policy formulation to tangible health outcomes. Findings indicates that while Africa has made substantial progress in crafting health policies that align with global health goals, critical gaps persist in their execution. Major challenges include resource limitations, weak health infrastructure, insufficient capacity building, and complex socio-cultural dynamics that influence health behaviors and practices. In addition, bureaucratic hurdles, corruption, and lack of political will are identified as systemic barriers to policy implementation. The study highlights the need for adaptive and evidence-based policy making rigorous monitoring and evaluation mechanisms to track progress, and a multifaceted approach to bridge these gaps and address challenges. This includes strategic investments in healthcare infrastructure and workforce development, enhancing collaboration between governments and international partners, and fostering community engagement to ensure policies resonate with local contexts.
    },
     year = {2024}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - From Policy to Practice: A Review of Africa’s Public Health Policy
    
    AU  - Oche Joseph Otorkpa
    AU  - Chinenye Oche Otorkpa
    AU  - Onifade Adefunmilola Adebola
    AU  - Stephen Emmanuel
    AU  - Ahamed Adamu
    AU  - Ololade Esther Olaniyan
    AU  - Saizonou Zinsou Jacques
    AU  - Okolo Martin Luther Oseni
    AU  - Abdirizak Mohamud Yusuf
    AU  - Maman Laminou Ibrahim
    AU  - Zakariaou Njoumemi
    AU  - Ruhaima Issah Zorro
    AU  - Francis Ngemba Kiese
    AU  - Abechi Andrew Alapa
    AU  - Dechasa Adare
    AU  - Adamu Usman Musa
    AU  - Fatima Ahmed
    Y1  - 2024/04/02
    PY  - 2024
    N1  - https://doi.org/10.11648/j.cajph.20241002.14
    DO  - 10.11648/j.cajph.20241002.14
    T2  - Central African Journal of Public Health
    JF  - Central African Journal of Public Health
    JO  - Central African Journal of Public Health
    SP  - 90
    EP  - 99
    PB  - Science Publishing Group
    SN  - 2575-5781
    UR  - https://doi.org/10.11648/j.cajph.20241002.14
    AB  - Africa faces persistent health challenges, from infectious diseases to non-communicable illnesses, necessitating robust public health policies. However, the translation of these policies into effective practice remains a substantial challenge across the continent. This study employed a rigorous literature review, and policy analysis to shed light on the multifaceted factors impeding the successful transition from policy formulation to tangible health outcomes. Findings indicates that while Africa has made substantial progress in crafting health policies that align with global health goals, critical gaps persist in their execution. Major challenges include resource limitations, weak health infrastructure, insufficient capacity building, and complex socio-cultural dynamics that influence health behaviors and practices. In addition, bureaucratic hurdles, corruption, and lack of political will are identified as systemic barriers to policy implementation. The study highlights the need for adaptive and evidence-based policy making rigorous monitoring and evaluation mechanisms to track progress, and a multifaceted approach to bridge these gaps and address challenges. This includes strategic investments in healthcare infrastructure and workforce development, enhancing collaboration between governments and international partners, and fostering community engagement to ensure policies resonate with local contexts.
    
    VL  - 10
    IS  - 2
    ER  - 

    Copy | Download

Author Information
  • Sections