Achievements and challenges for health in africa: the importance of national health systems for MDGs

Many of the worst indicators of well-being and health are to be found in
sub-Saharan Africa: they include low existing levels of satisfaction of basic
needs, alongside worrying trends such as the sharp declines in life expectancy
in recent decades in some countries and striking failures to achieve the MDGs.
Such a situation seems to qualify the continent in the specialized literature as a
clear case of a ‘development failure’. The present paper, however, suggests with
the aid of evidence that the situation is more complex and variegated than the
one usually presented, even in the health sector, where some of those figures
are most disappointing. Greater attention should be paid to this heterogeneity
and thus to the wide range of resources and policies needed to meet Africa’s
Eduardo Bidaurratzaga
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