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THE STATE OF HEALTH IN THE WHO AFRICAN REGION THE STATE OF HEALTH in the WHO African Region An analysis of the status of health, health services and health systems in the context of the Sustainable Development Goals Where we are Where we need to go on no e b g e in h v i n a d d e e L L i n A AFRIC SUSTAINABLE DEVELOPMENT G ALS 30 30 25 6% 6% 25 20 20 8% 7% 4% 2% 15 15 4% 6% 2% 10 14% 14% 3% 2% 10 11% 3% 9% 5 8% 5 6% 0 0 Courts Police Public Public clinic/ school service hospital Once or twice A few times Often The peoples of Africa aspire to a future of good health and well-being. The health and health-related Sustainable Development Goals (SDGs) build on this hope, providing guidance to ensure that no one is left behind as the continent progresses towards sustainable and equitable health. To achieve this, a coherent and logical approach to the adaptation of the SDGs is needed, to ensure that the health dividend accrued in the coming years is enjoyed equitably and plays its role in accelerating the development of the continent. The WHO Regional Oce for Africa has set up a process to ensure that countries walk together as they march towards sustainable and equitable health. This report is a recognition of the complexity of actions needed. It aims to provide guidance on where countries need to focus as they plan their work towards attaining the SDGs. It will also serve as a benchmark for future comparison of progress. This report is not a country scorecard. Rather, its purpose is to act as a compass to guide progress towards health in the SDGs. The Regional Oce aims to regularly provide such information to countries, so that they can attain their health goals in the most ecient and eective manner. ISBN 978-929023409-8 WHO Regional Oce for Africa Cité du Djoué, Brazzaville, Congo www.aho.afro.who.int THE STATE OF HEALTH IN THE WHO AFRICAN REGION An analysis of the status of health, health services and health systems in the context of the Sustainable Development Goals Where we are Where we need to go on no e b g e in h v i n a d d e e L L i n A AFRIC The state of health in the WHO African Region: an analysis of the status of health, health services and health systems in the context of the Sustainable Development Goals ISBN 978-929023409-8 © WHO Regional Oce for Africa 2018 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. 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More information about this publication can be obtained from: WHO Regional Oce for Africa Cité du Djoué, Brazzaville, Republic of the Congo www.aho.afro.who.int Printed and bound in the WHO Regional Oce for Africa, Brazzaville, Congo Contents Foreword ........................................................................................................................................................................... vii Acknowledgments ....................................................................................................................................................... viii Preface ................................................................................................................................................................................. ix Abbreviations and acronyms ...................................................................................................................................... x Executive summary ........................................................................................................................................................ xi Introduction and context 1 The 2030 Agenda for Sustainable Development ....................................................................................................1 2 The unnished business of the Millennium Development Goals .........................................................................2 3 Health within the SDGs .........................................................................................................................................2 4 Expectations of the country health sectors in implementing the SDGs ...........................................................3 5 Role and focus of WHO in supporting the implementation of the SDGs ..........................................................4 6 Purpose, methodology and structure of this report ...........................................................................................7 Part I – Regional report 1 The status of health in the African Region .........................................................................................................13 Attributes of a good state of health in the context of the SDGs ................................................................................13 1.1 The state of healthy life in the WHO African Region ........................................................................................14 1.2 Morbidity and mortality causes inuencing healthy life in the African Region .................................................16 1.3 Risk factors inuencing healthy life in the African Region ................................................................................18 2 The status of health and health-related population outcomes in the African Region ...................................19 Attributes of eective health and health-related outcomes in the context of the SDGs .............................................19 2.1 Availability of essential services across the life course .....................................................................................23 2.2 Coverage of essential health interventions .....................................................................................................25 2.3 Levels of nancial risk protection ...................................................................................................................29 2.4 Levels of appropriate health security ..............................................................................................................31 2.5 Responsiveness of essential services to population needs ..............................................................................34 2.6 Coverage of health-related SDG targets .........................................................................................................38 3 Health systems performance in the African Region..........................................................................................42