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Fabric of Africa Trends Report Fabric of Africa trends report A Focus on Non-Communicable Diseases (NCDs), Maternal & Child Health, and Strengthening Healthcare Systems in Africa TABLE OF CONTENTS I. Background and Objectives 5 II. Introduction 6 III. Women’s Health – Non-Communicable Diseases 9 III.a – Breast Health 10 III.b – Breast Health in Selected Countries 12 Egypt 12 Ethiopia 13 Ghana 13 Kenya 14 Nigeria 14 South Africa 14 III.c – Cervical Health 15 III.d – Cervical Health in Selected Countries 16 Egypt 17 Ethiopia 17 Ghana 18 Kenya 18 Nigeria 18 South Africa 19 Uganda 19 III.e – Cardiovascular Health 20 III.f – Cardiovascular Health in Selected Countries 23 Egypt 22 Ethiopia 22 Ghana 22 Kenya 23 Nigeria 23 Page | 2 Philips Fabric of Africa TABLE OF CONTENTS South Africa 23 Uganda 23 IV. Maternal, Newborn and Child Health 24 IV.a – Maternal Health 25 IV.b – Maternal Health in Selected Countries 28 Egypt 29 Ethiopia 29 Ghana 30 Kenya 31 Nigeria 32 South Africa 32 Uganda 33 IV.c – Newborn and Child Health 34 IV.d – Newborn and Child Health in Selected Countries 39 Egypt 39 Ethiopia 39 Ghana 39 Kenya 40 Nigeria 40 South Africa 41 Uganda 41 V. The Need for Skilled Health Workers 42 VI. Looking Forward: The Role of Industry 43 VII. Conclusion 44 VIII. References 45 VIII. Appendix 47 Philips Fabric of Africa Page | 3 Page | 4 Philips Fabric of Africa BacKGROUND & OBJECTIVES Fabric of Africa is a collaborative campaign According to the World Health Organization to drive public-private partnerships and improve (WHO), deaths from NCDs in Africa will healthcare access across the continent. The surpass deaths from other conditions, including campaign focuses on women as the ‘fabric’ of communicable diseases, by 2030. Africa and uses this theme to highlight the importance of healthy women and the positive impact they have on the continent. The initiative Philips has a proven track reflects the post-2015 Millennium Development record in delivering solutions Goals (specifically goals 4 and 5), focusing on three key areas: Non-Communicable Diseases (NCDs) in the area of NCDs, (specifically breast, cervical & cardiac health), MNCH and strengthening Maternal, Newborn and Child Health (MNCH) and healthcare systems including infrastructure healthcare systems rehabilitation and clinical training. The following report has been commissioned Non-Communicable Diseases (NCDs), which to highlight current trends in relation to Non- include cancer, diabetes, cardiovascular disease, Communicable Diseases (NCDs), Maternal, and chronic respiratory disease, are projected to Newborn and Child Health (MNCH) and healthcare account for a quarter of all deaths in Africa by 2015. systems in Africa, with a specific focus on Kenya, By 2030 cancers alone are expected to result in Ghana, South Africa, Uganda, Nigeria, Ethiopia 1.6 million new cases with 1.2 million deaths. and Egypt. Philips Fabric of Africa Page | 5 INTRODUCTION In recent decades, there has been a noticeable NCDs were responsible for 40% of all deaths in the shift in the underlying causes of disease and death WHO African Region 3 and about half of all NCD- worldwide. While infectious disease is declining, related deaths in the region occurred in persons in many cases due to the current economic crisis, under the age of 70. [2] Furthermore, the region had countries are struggling with a double burden of the highest age-standardized NCD mortality rates disease i.e. NCD and infectious disease. for all ages: 844 per 100,000 for males and 724 per 100,000 for females. While global NCD-related Non-Communicable Diseases (NCDs), which deaths were projected to increase by 17% over the include cancer, diabetes, cardiovascular disease, and next 10 years, Sub-Saharan Africa (SSA) is expected chronic respiratory disease, are projected to account to see the greatest increase (27%). If current trends for a quarter of all deaths in Africa by 2015. By 2030 continue, the WHO projects that NCDs will exceed cancers alone are expected to result in 1.6 million communicable, maternal, perinatal, and nutritional new cases with 1.2 million deaths. 1 According to diseases as the most common cause of death in the World Health Organization (WHO), deaths Africa by 2025. [2] from NCDs in Africa will surpass deaths from other conditions, including communicable diseases, by 2030. 2 Sub-Saharan Africa (SSA) has continued to suffer the NCDs – typically viewed as “Western diseases” and, therefore, overshadowed by more sensational, highest levels of mortality headline-grabbing illnesses such as HIV/AIDS, in the world, with an overall Tuberculosis and Malaria – have become increasingly problematic in Africa yet have received low priority life expectancy at birth and few resources until very recently. [1] In 2010, of 46 years 1 Document prepared for the WHO/AFRO African Region Ministerial Consultation on Non-communicable Diseases. April 2011. http://www.who.int/nmh/events/2011/ africa_ncds_background_paper.pdf 2 World Health Organization Regional Office for Africa. African Health Monitor Magazine January- June 2008. Volume 8, Number 1. 3 The WHO African Region includes the following countries: Algeria, Angola, Benin, Botswana, Burkina Faso, Burundi, Cameroon, Cape Verde, Central African Republic, Chad, Comoros, Congo, Côte d’Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Eritrea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Mauritius, Mozambique, Namibia, Niger, Nigeria, Rwanda, Sao Tome and Principe, Senegal, Seychelles, Sierra Leone, South Africa, Swaziland, Togo, Uganda, United Republic of Tanzania, Zambia, and Zimbabwe. Page | 6 Philips Fabric of Africa Now, with the increasing emergence of NCDs, the Organization’s 2009 “Women and Health: health systems in SSA have begun to operate on Today’s Evidence, Tomorrow’s Agenda” report, what the WHO calls a “double burden of disease”: said that the health status of girls and women high mortality and morbidity rates due to both in SSA was the lowest in the world. For women communicable and NCDs. The most common aged 20 to 60 years in the region, the risk of and modifiable risk factors linked to NCDs – high premature death is 42%, seven times higher than blood pressure, high cholesterol levels, tobacco that of their counterparts in affluent countries. use, excessive alcohol use, inadequate intake of In addition, she noted that maternal health fruit and vegetables and being overweight, obese issues such as complications due to pregnancy or physically inactive – have increased in the and childbirth were the leading cause of death WHO African Region (WHOAFRO) and can be and disability among 15 to 19 year old girls in attributed to urbanization and globalization. [1] developing countries. [4] Overall, the health and well-being of African men, In the past 20 years, continent-wide health women and children has been cause for concern. sector reforms in Africa have prioritized primary According to World Bank statistics, Sub-Saharan healthcare in attempts to provide accessible Africa (SSA) has continued to suffer the highest healthcare to rural communities while containing levels of mortality in the world, with an overall costs. While such strategies have been primarily life expectancy at birth of 46 years. While all focused on MNCH, the provision of acute care other regions have experienced uninterrupted remains a challenge in all areas. [3] increases in life expectancy since the 1960s, life expectancy in SSA peaked in the early 1990s at As Philips Healthcare is committed to improving 50 years and has fallen back by 4 years. [3] the health of women in Africa, the following report provides a review of trends in maternal Women’s health, in particular, has represented a and child health as well as women’s health issues challenge for the region. WHO Director-General related to NCDs such as breast cancer, cervical Margaret Chan, commenting on the findings of cancer, and cardiovascular disease. Philips Fabric of Africa Page | 7 Page | 8 Philips Fabric of Africa WOMEN’S Health – NON-COMMUNIcable DISEASES The urbanization and globalization of African Summary 15: Non-Communicable Diseases”, countries in recent decades have led to increasing there were more NCD-related deaths among levels of incidence in risk factors typically women aged 15 to 59 years in Africa in 2004 (2.2 associated with NCDs, including obesity, physical deaths per 1,000 women) than in high-income inactivity, and tobacco smoking. countries (1.1 deaths per 1,000 women). 5 [5] • Breast and cervical cancers are the leading Certain NCDs specifically affect women. One forms of cancers for women in Africa, and such NCD is breast cancer, the leading cause of associated mortality rates are high. cancer death among women worldwide. Despite • Cardiovascular diseases (CVDs) have become the availability of methods for early detection and the second most common cause of death treatment, breast cancer caused an estimated after infectious diseases. 458,000 deaths in women in 2008. Of the 1.4 million new cases of breast cancer identified in 2008, about The key challenges in tackling these health issues half were in low- and middle-income countries. include low levels of awareness and the taboo nature of breast and cervical cancer in most Cervical cancer is another NCD affecting African countries. Poverty and rural living also female mortality rates. Certain types of human compound these health issues. To overcome papillomavirus (HPV) have led to both pre- these challenges, efforts to raise awareness and cancer and cancer of the cervix. Around 88% promote early screenings for women are needed. of the 275,000 women who died from cervical cancer in 2008 were living in low- and middle- CURRENT StatUS AND income countries. KEY ISSUES The risk factors associated with cardiovascular health Beyond the pressing maternal health issues, have also been shown to contribute to the onset of women worldwide are faced with several other other NCDs, such as cervical and breast cancer.
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