Health

Aug 24th, 2008 by UNDP

A nurse helps a patient in a clinic The healthcare system in the Central African Republic (CAR) can best be described as dysfunctional. The pillaging and destruction of public services during the previous years of crisis have severely reduced the government’s ability to ensure and coordinate the provision of healthcare. There are inadequacies in every area and at every level of the heath sector including a lack of doctors, nurses, infrastructure, equipment, medicines and financial resources that could help ameliorate the situation.

The statistics tell a frightful story of a deeply neglected health system: At last count, only 37% of people lived within 10km of a health center. Administering care is further complicated by a lack of qualified professionals: there is only one doctor for every 3,000 people and one nurse for every 1,000. A functioning healthcare system requires six times the number of doctors and nurses that are currently working in the Central African Republic, a country the size of France.

With such a limited availability of care, those Central Africans that are least able to fend for themselves are hit the hardest: more than 10% of babies die during childbirth or shortly thereafter, and almost 20% of children die before the age of five. The maternal mortality rate is a staggering 1,102 per 100,000 births: in Sudan it is 450 and the UK it is 8. Overall, the average life expectancy at birth is less than 43 years.

CAR also has the highest HIV/AIDS prevalence in the region: 6.2% of all Central Africans between 15 and 49 years old are infected. Malaria, however, remains the leading cause of premature death in CAR, causing 13.8% of deaths.

Taken together, these numbers do not bode well for achieving the Millennium Development Goals in 2015. For example, a three-quarters reduction in maternal mortality rate, bringing the number to 276 per 100,000 births will be virtually impossible to achieve. Similarly, providing universal access to treatment for HIV/AIDS by 2010 in CAR will also be an enormous challenge.

The problems stem partly from a severe funding gap: currently the Central African Government spends only 1.5% of GDP on public health. Recently, targets have been set to raise that to 15%, a ten-fold increase. However, even with a substantial increase in government funding, much of this increase will require substantial outside aide from partners.

The main areas in need of attention are in providing greater access to health, maternal and infant care, reproductive health and services for adolescents, the fight against HIV/AIDS and gender-based violence, safe blood transfusions, mental health, coordination of organizations providing health care, assessment of gaps and monitoring of the health situation, epidemic outbreak control, data management, logistics and communication, and capacity building in the Ministry of Health and other national structures of the health system.