Decolonizing the African health systems; the required strategic shifts and leadership

Abstract

A health system refers to all organizations, people and actions whose primary intent is to promote, restore or maintain health. The key social goal of a health system is to increase the average level of health of the population and reduce health inequities. Decolonization is the change that colonized countries undergo when they become politically independent. Understanding the historical context of health helps us to respond more appropriately to the health challenges of today. All the African countries adopted Primary Health Care to improve their health outcomes. However lack of proper policy trust, insufficient political commitment, failure to achieve equity in access to primary care components, slow economic development, unbalanced resource distribution, poor inter-sectoral action for health, weak information systems, lack of accurate baseline data, rapid demographic and epidemiological changes, centralized planning and management with the exclusion of the communities and other stakeholders have accounted for its slow progress in Africa. Adoption of the global agenda for health has not seen translated gains for the masses. An African health system for Africans by Africans that responds to the needs of our people is what will bring gains for the masses. Attempts to improve the health status of African people must be linked to regaining political, cultural, economic independence and self-determination as individuals, families, communities and nations. The methodology used in this review involved identifying credible and relevant studies using multiple data bases and search engines such as Google search, PubMed and Medline search. Extensive notes were made during literature search and the sources and their references were noted. An unbiased and critical evaluation of every piece of evidence was under taken. The articles selected were those that met the scope and guidelines of the research such as the geography and period under consideration, from precolonial, colonial and postcolonial Africa. Another literature search was done after completing the writing of the study to ensure that no recent study was left out while the research was on-going. The paper concludes that, as a solution to Africa's health challenges, major strategic shifts including adopting systems thinking approach, engendering adaptive leadership, evidence-based policies, re-conceiving accountability and reducing vertical programmes among others are suggested.