Research On China-Africa Health Cooperation Strategies In Achieving Universal Health Coverage

ObjectivesThis study aims to reflect on the proceedings of African countries achieving Universal Health Coverage (UHC), and to summarize China’s practice that may apply to Africa, thus to identify the potential areas for China-Africa cooperation in supporting African countries achieving UHC. Through reviewing the needs of African countries, and principles of China-Africa cooperation, this study aims to propose the priority area and its cooperation strategy, in order to provide reference for China-Africa cooperation in UHC.Contents1 The states and obstacles impeded African countries toward UHC were analyzed.2 China’s practice towards UHC was summarized.3 The priority area of China-Africa health cooperation in UHC was identified.4 Suggestions of China-Africa health cooperation in Achieving UHC were proposed. Methods Methods employed in this study included quantitative and qualitative methods. Data were obtained from WHO Health Observation Database and descriptive statistical analysis was used to analyze the current states of African countries in achieving UHC. Fishbone diagram method was used to analyze obstacles impeded these countries toward UHC. Through literature review, this study summarized China’s experiences which might apply to Africa and then proposed potential areas for future cooperation. Expert consultation was conducted to identify the priority area and to analyze the challenges it might face in future cooperation, in order to provide reference for China-Africa cooperation in UHC.FindingsThe current unsatisfactory state of African countries towards UHC was attributed to:(1) lack of stable funding sources; (2) lack of risk sharing mechanism; (3) insufficient input, including infrastructure, personnel, drugs; (4) lack of an integrated service delivery system at all levels.China’s experiences that might apply to African countries were:(1) the leading role of government in promoting UHC; (2) the establishment of national health insurance system; (3) a strategy to focus on primary health care and rural health care system to improve accessibly in health service utilization; (4) emphasis on prevention, and efforts to improve public health system.The proposed potential areas for China-Africa UHC cooperation were:(1) to develop and implement national health financing strategy in order to provide financial protection for nationals; (2) to strengthen the health service system particularly primary and rural health service system, to improve health service access and equity.ConclusionsGiven the urgent needs for African countries, and guidelines of China-Africa cooperation, this study identified strengthening the health service system as the priority area for future China-Africa cooperation in achieving UHC, which is in accordance with African’s needs. However, there are some challenges it might face in future cooperation:(1) compared with the growing needs of the recipient countries, China’s capacity of mobilizing civil society to engage in international cooperation aid need to be improved;(2) lack of a clear vision and overall plan to guide future cooperation, and lack of specific country cooperation plans; (3) the inefficient governance capacity of African countries is the underlying cause that impedes the development of health systems; (4) failed to improve African countries’self-development capacity in strengthening health systems in past cooperation; and (5) relatively segmented health aid in supporting health service delivery in the past which impact on African countries was limited.Suggestions1 The goal of China-Africa cooperation should be promoting African countries to achieve UHC, and to improve their self-development capacity in health system strengthening.2 An overall strategic plan is need to guide the cooperation in general, while country specific cooperation plans will also be of great importance, which should be proposed based on full investigation and research.3 Using the health system strengthening as an opportunity to enhance the impact on health systems in Africa4 Current health aids to Africa need to be integrated into a stereo-aid models, to help African countries improve health service delivery, and to achieve the goal of UHC.5 The civil society should be more engaged in China-Africa cooperation, thus to improve the ability of international health aids and cooperation...