Challenges in Reforming the Health Sector in Africa

About the Book

The book provides an insight and descriptive analyses of health sector reforms that are being implemented in African countries, with particular application to Zimbabwe. In some cases the Zimbabwean experience is blended with those of other countries in Africa. The book elaborates on the various elements of health sector reforms which include; health financing options, organizational restructuring, core health service packages, the introduction of market forces, hospital autonomy and the Sector Wide Approach to health development. These reform elements are described from a theoretical perspective; the rationale, implications, implementation modalities, their potential impact which the author provocatively links to the practical experiences of the selected country. The book highlights the fact that reforms in African countries have a different thrust to those in developing countries, though in both cases the ultimate objectives are the same.

Whilst each chapter is dedicated to an element of the reform process, other chapters provide the background to reforms, the interactions between reforms and the notion of equity and the monitoring and evaluation of health reforms. The last chapter attempts to consolidate the experiences of the reforms in Zimbabwe and their impact and propose a possible way forward for the troubled health sector.

The targeted readership includes students in community medicine, nursing programs, public health medicine students and practitioners, professional health managers and administrators and development workers in the health field in Africa.

About the Author

Dr. Sikosana is married with 3 children and his educational qualifications include a Medical Degree (MD) from the University of Dar es Salaam in Tanzania, a Masters in Public Health (Epidemiology) from the Johns Hopkins University in the USA, and a Masters in Business Administration (MBA, Health Executive) from Keele University in the United Kingdom.

Dr. Paulinus L.N. Sikosana has more than 20 years work experience in the public sector in Zimbabwe. He has worked as a District Medical Officer, Medical Superintendent, Provincial Medical Director and Principal Medical Director at the Ministry of Health headquarters. Dr. Sikosana left the Ministry of Health and Child Welfare in 2001 after heading the ministry for 5 years as the Secretary for Health to assume an advisory role to the Ministry of Health and the Public Service Commission as the National Coordinator for Health Sector Reforms in Zimbabwe.

In 2002 he joined Liverpool Associates in Tropical Health (LATH) as an independent Consultant assigned to the Ministry of Health of Malawi as a Technical Advisor on the Essential Health Package (EHP) and the development of the country's health Sector Wide Approach (SWAp).

Dr. Sikosana has worked on several consultancies with the World Bank, UNFPA, UNICEF, WHO, the University of Zimbabwe, etc. on program development, assessment and health systems development. He has experience in several countries which include, Botswana, Lesotho, Malawi, Zambia, Ethiopia and Mozambique. During the course of his work he has interacted with several bilateral and multilateral organizations and represented his country at several international forums.