Gabon has one of the highest urbanization rates in Africa with 1 in 5 of its citizens living in the urban areas. 3% of its GDP accounts for its total health expenditure. [1] [2] The life expectancy at birth is 66 years [3] and a half of its population is aged under 20. [2] The most prevalent mortality causing diseases in Gabon in 2019 were mainly cardiovascular disease, neoplasms, respiratory infections and HIV/AIDS, as compared to Malaria, respiratory infections and maternal/neonatal disorders which were the highest causes of mortality in the nineties. [4]
Even though the HIV/AIDS prevalence in Gabon is estimated to be down to 3.0% in 2021 [5] from 5.9% in 2007 [6] in the adult population (ages 15–49), HIV/AIDS remains a public health challenge in Gabon. HIV/AIDS contributes to 44.21% of total deaths of females in the reproductive age (15-49) and accounts for 15.47% deaths in females of all age groups. [4]
As of 2021, about 47,000 people were living with HIV/AIDS. [1] The UNAIDS 2025 target for HIV/AIDS is for 95% of persons living with HIV to know their HIV status, 95% of those who know their status are to have started with treatments while 95% of those on treatment should have suppressed viral loads. [7] In Gabon 73% of people living with HIV (PLHIV) know their HIV status, 54% are on antiretroviral treatment while there is an absence of data on the percentage of PLHIV with viral load suppression. [1]
Sub-Saharan Africa has the highest rates of HIV in the world. [8] Lesotho has the highest death rates(33.32%) due to HIV/AIDS followed closely by Eswatini(28.92%), Equatorial guinea(27.77%) and South Africa(27.53%). [4] The burden of disease of HIV/AIDS in Sub-Saharan Africa is the highest in the world as it is the number one cause of death of people in the reproductive age bracket(15-49). [4] Globally, the number of people living with HIV has increased over the span of two decades, however deaths secondary to HIV have reduced significantly. [9]
YEAR | NMR(/1000 live births) | U5MR(/1000 live births) | MMR(/100,000 live births) | stillbirth rate |
---|---|---|---|---|
1990 | 31 | 92 | 380 | |
2000 | 28 | 84 | 249 | 18 |
2021 | 19 | 40 | 227 | 14 |
SDG3 2030 targets | 12 | 25 | 70 | 12 |
Gabon has come a long way in improving its maternal and neonatal healthcare services and thus in reducing the number of deaths from maternal and infant related diseases, however maternal mortality ratio and U5MR is still quite high. The maternal mortality ratio per 100,000 births for Gabon is 227. This is comparable with the world average of 223 per 100,000 livebirths. [12] Gabon's U5MR per 1,000 livebirths is 40, also almost at the same level as the global average of 38 deaths per 1000 livebirths. [10] Neonatal mortality rate in Gabon is 19. [10] In Gabon the number of midwives per 1,000 live births is 12 and the lifetime risk of death for pregnant women is 1 in 110. [11]
This encompasses the availability of basic health care services to all people of a country with the aim of limiting out of pocket payments for health services thereby protecting people from financial ruin. Universal health coverage explores basic ethical principles that guide what services are provided with consideration to:
A 10% levy on the revenues of mobile phone companies and on mobile phone usage, introduced by Gabon's government in 2008, has helped to more than double the funds for a health insurance program that now covers 99% of the equatorial nation's poor, giving them access to critical health services such as care during pregnancy. This levy is one of a set of measures that increased enrolment in health insurance plans in Gabon to 45% of the population in 2012 from less than 20% in 2007. [14]
The Human Rights Measurement Initiative [15] finds that Gabon is fulfilling 62.2% of what it should be fulfilling for the right to health based on its level of income. [16] When looking at the right to health with respect to children, Gabon achieves 84.7% of what is expected based on its current income. [16] In regards to the right to health amongst the adult population, the country achieves only 78.1% of what is expected based on the nation's level of income. [16] Gabon falls into the "very bad" category when evaluating the right to reproductive health because the nation is fulfilling only 23.9% of what the nation is expected to achieve based on the resources (income) it has available. [16]
There were 542 medical facilities in Gabon in 2019. Government and other notable hospitals are listed below. [17]
Name | Location | Type facility | Ref |
---|---|---|---|
George Rawiri Hospitalier Regional | Lambaréné, Moyen-Ogooué Province | Regional Hospital | [17] |
Koulamoutou Centre Hospitalier Urbain | Koulamoutou, Ogooué-Lolo Province | Centre Hospitalier Urbain | [17] |
Paul Moukambi Hospitalier Regional | Koulamoutou, Ogooué-Lolo Province | Regional Hospital | [17] |
Mouila Hospitalier Regional | Mouila, Ngounié Province | Regional Hospital | [17] |
Bongolo Hospital | Lébamba, Ngounié Province | Hospital | [18] |
Makokou Hospitalier Regional | Makokou, Ogooué-Ivindo Province | Regional Hospital | [17] |
Agondje Centre Hospitalier Universitaire | Libreville/Owendo, Estuaire Province | University Hospital | [17] |
Egypto Gabonaise Hopital Cooperation | Libreville/Owendo, Estuaire Province | Hôpital Coopération | [17] |
Libreville Centre Hospitalier Universitaire | Libreville/Owendo, Estuaire Province | University Hospital | [17] [18] |
Sino Gabonaise Hopital Cooperation Libreville | Libreville/Owendo, Estuaire Province | Hôpital Coopération | [17] |
Hôpital d’Instruction des Armées Omar Bongo Ondimba | Libreville/Owendo, Estuaire Province | Military Hospital | [18] |
Port Gentil Centre Hospitalier Regional | Port Gentil, Ogooué-Maritime Province | Regional Hospital | [17] [18] |
Port Gentil Hospitalier Regional | Port Gentil, Ogooué-Maritime Province | Regional Hospital | [17] |
Oyem Hospitalier Regional | Oyem, Woleu-Ntem Province | Regional Hospital | [17] |
Benjamin Ngoubou Hospitalier Regional | Tchibanga, Nyanga Province | Regional Hospital | [17] |
Tchibanga Hospitalier Regional | Tchibanga, Nyanga Province | Regional Hospital | [17] |
Amissa Bongo Hospitalier Regional | Franceville, Haut-Ogooué Province | Regional Hospital | [17] [18] |
Sino Gabonaise Hopital Cooperation Mpassa | Franceville, Haut-Ogooué Province | Hôpital Coopération | [17] |
Hôpital Albert Schweitzer | Lambaréné, Moyen-Ogooué Province | Private hospital | [18] |
The population of Africa has grown rapidly over the past century and consequently shows a large youth bulge, further reinforced by a low life expectancy of below 50 years in some African countries. Total population as of 2024 is about 1.5 billion, with a growth rate of about 100 million every three years. The total fertility rate for Africa is 4.7 as of 2018, the highest in the world according to the World Bank. The most populous African country is Nigeria with over 206 million inhabitants as of 2020 and a growth rate of 2.6% p.a.
In Nigeria, there has been a major progress in the improvement of health since 1950. Although lower respiratory infections, neonatal disorders and HIV/AIDS have ranked the topmost causes of deaths in Nigeria, in the case of other diseases such as monkeypox, polio, malaria and tuberculosis, progress has been achieved. Among other threats to health are malnutrition, pollution and road traffic accidents. In 2020, Nigeria had the highest number of cases of COVID-19 in Africa.
In terms of available healthcare and health status Sierra Leone is rated very poorly. Globally, infant and maternal mortality rates remain among the highest. The major causes of illness within the country are preventable with modern technology and medical advances. Most deaths within the country are attributed to nutritional deficiencies, lack of access to clean water, pneumonia, diarrheal diseases, anemia, malaria, tuberculosis and HIV/AIDS.
Tropical diseases, especially malaria and tuberculosis, have long been a public health problem in Kenya. In recent years, infection with the human immunodeficiency virus (HIV), which causes acquired immune deficiency syndrome (AIDS), also has become a severe problem. Estimates of the incidence of infection differ widely.
The Tajikistan health system is influenced by the former Soviet legacy. It is ranked as the poorest country within the WHO European region, including the lowest total health expenditure per capita. Tajikistan is ranked 129th as Human Development Index of 188 countries, with an Index of 0.627 in 2016. In 2016, the SDG Index value was 56. In Tajikistan health indicators such as infant and maternal mortality rates are among the highest of the former Soviet republics. In the post-Soviet era, life expectancy has decreased because of poor nutrition, polluted water supplies, and increased incidence of cholera, malaria, tuberculosis, and typhoid. Because the health care system has deteriorated badly and receives insufficient funding and because sanitation and water supply systems are in declining condition, Tajikistan has a high risk of epidemic disease.
Health problems have been a long-standing issue limiting development in the Democratic Republic of the Congo.
The current population of Myanmar is 54.05 million. It was 27.27 million in 1970. The general state of healthcare in Myanmar is poor. The military government of 1962-2011 spent anywhere from 0.5% to 3% of the country's GDP on healthcare. Healthcare in Myanmar is consistently ranked among the lowest in the world. In 2015, in congruence with a new democratic government, a series of healthcare reforms were enacted. In 2017, the reformed government spent 5.2% of GDP on healthcare expenditures. Health indicators have begun to improve as spending continues to increase. Patients continue to pay the majority of healthcare costs out of pocket. Although, out of pocket costs were reduced from 85% to 62% from 2014 to 2015. They continue to drop annually. The global average of healthcare costs paid out of pocket is 32%. Both public and private hospitals are understaffed due to a national shortage of doctors and nurses. Public hospitals lack many of the basic facilities and equipment. WHO consistently ranks Myanmar among the worst nations in healthcare.
According to the World Bank income level classification, Portugal is considered to be a high income country. Its population was of 10,283,822 people, by 1 July 2019. WHO estimates that 21.7% of the population is 65 or more years of age (2018), a proportion that is higher than the estimates for the WHO European Region.
Health in Angola is rated among the worst in the world.
Botswana's healthcare system has been steadily improving and expanding its infrastructure to become more accessible. The country's position as an upper middle-income country has allowed them to make strides in universal healthcare access for much of Botswana's population. The majority of the Botswana's 2.3 million inhabitants now live within five kilometres of a healthcare facility. As a result, the infant mortality and maternal mortality rates have been on a steady decline. The country's improving healthcare infrastructure has also been reflected in an increase of the average life expectancy from birth, with nearly all births occurring in healthcare facilities.
A landlocked sub-Saharan country, Burkina Faso is among the poorest countries in the world—44 percent of its population lives below the international poverty line of US$1.90 per day —and it ranks 185th out of 188 countries on UNDP's 2016 Human Development Index. Rapid population growth, gender inequality, and low levels of educational attainment contribute to food insecurity and poverty in Burkina Faso. The total population is just over 20 million with the estimated population growth rate is 3.1 percent per year and seven out of 10 Burkinabe are younger than 30. Total health care expenditures were an estimated 5% of GDP. Total expenditure on health per capita is 82 in 2014.
The Human Rights Measurement Initiative finds that Cameroon is fulfilling 61.0% of what it should be fulfilling for the right to health based on its level of income. When looking at the right to health with respect to children, Cameroon achieves 81.7% of what is expected based on its current income. In regards to the right to health amongst the adult population, the country achieves only 70.5% of what is expected based on the nation's level of income. Cameroon falls into the "very bad" category when evaluating the right to reproductive health because the nation is fulfilling only 30.9% of what the nation is expected to achieve based on the resources (income) it has available.
Health in the Central African Republic has been degraded by years of internal conflict and economic turmoil since independence from France in 1960. One sixth of the country's population is in need of acute medical care. Endemic diseases put a high demand on the health infrastructure, which requires outside assistance to sustain itself.
The 2010 maternal mortality rate per 100,000 births for Tanzania was 790. This is compared with 449 in 2008 and 610.2 in 1990. The UN Child Mortality Report 2011 reports a decrease in under-five mortality from 155 per 1,000 live births in 1990 to 76 per 1,000 live births in 2010, and in neonatal mortality from 40 per 1,000 live births to 26 per 1,000 live births. The aim of the report The State of the World's Midwifery is to highlight ways in which the Millennium Development Goals can be achieved, particularly Goal 4 – Reduce child
Malawi ranks 170th out of 174 in the World Health Organization lifespan tables; 88% of the population live on less than £2.40 per day; and 50% are below the poverty line.
The WHO's estimate of life expectancy for a female child born in Guinea-Bissau in 2008 was 49 years, and 47 years for a boy. in 2016 life expectancy had improved to 58 for men and 61 for women.
Lesotho's Human development index value for 2018 was 0.518—which put the country in the low human development category—positioning it at 164 out of 189 countries and territories. Health care services in Lesotho are delivered primarily by the government and the Christian Health Association of Lesotho. Access to health services is difficult for many people, especially in rural areas. The country's health system is challenged by the relentless increase of the burden of disease brought about by AIDS, and a lack of expertise and human resources. Serious emergencies are often referred to neighbouring South Africa. The largest contribution to mortality in Lesotho are communicable diseases, maternal, perinatal and nutritional conditions.
Health in Mozambique has a complex history, influenced by the social, economic, and political changes that the country has experienced. Before the Mozambican Civil War, healthcare was heavily influenced by the Portuguese. After the civil war, the conflict affected the country's health status and ability to provide services to its people, breeding the host of health challenges the country faces in present day.
Zambia is a landlocked country in Sub Saharan Africa which experiences a burden of both communicable and non-communicable diseases. In line with WHO agenda for equity in health, it has adopted the Universal Health Coverage agenda to mitigate the challenges faced within the health sector. The Ministry of Health (MOH) provides information pertaining to Zambian health. The main focus of the Ministry of Health has been provision of uninterrupted care with emphasis on health systems strengthening and services via the primary health care approach.
The Health Sector in Eswatini is deteriorating and four years into the United Nations sustainable development goals, Eswatini seems unlikely to achieve the goal on good health. As a result of 63% poverty prevalence, 27% HIV prevalence, and poor health systems, maternal mortality rate is at a high of 389/100,000 live births, and under 5 mortality rate is at 70.4/1000 live births resulting in a life expectancy that remains amongst the lowest in the world. Despite significant international aid, the government fails to adequately fund the health sector. Nurses are now and again engaged in demonstrations over poor working conditions, drug shortages, all of which impairs quality health delivery. Despite tuberculosis and AIDS being major causes of death, diabetes and other non-communicable diseases are on the rise. Primary health care is relatively free in Eswatini save for its poor quality to meet the needs of the people. Road traffic accidents have increased over the years and they form a significant share of deaths in the country.