Working to Advance
Health Equity in Africa

SRHR in East and Southern Africa

SRHR in East and Southern Africa

A new reality is now emerging. In many countries on the continent there is evidence that expanding health care coverage does not necessarily result in better health outcomes, even for conditions that can be treated by health care. After several decades of gains in reducing child mortality and deaths from infectious diseases, the residual mortality in sub- Saharan African countries consists of more complex and multimorbid conditions that cannot be addressed simply by expanding access to low-quality health systems. Expansion in coverage must also be accompanied by improvements in quality health care.

Both the UHC and SRHR agendas explicitly position access to services and quality of care as fundamental human rights. A key step for improving health outcomes is to understand where the various constraints lie and the degree to which each constraint matters. While the UHC agenda provides a key vehicle for achieving key SRHR outcomes, measuring progress remains a challenge. Improving quality should be at the core of UHC initiatives, alongside efforts to prioritise the poor and their health needs from the start, especially in the case of sexual and reproductive health and rights. Aiming for quality includes several elements: adopting a national strategy for quality, improving the management capacity at all levels, strengthening regulation and accountability, and collecting data and learning from it.

This report examines the evidence around progress on access to SRHR services and quality of care.

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