Stories and podcasts WBW Stories A Wake Up Call To African Governments: Primary Health Care & Access To SRHR Services Still Remains Inaccessible For African Women & Youth Africa is one of the continents with the fastest growing population at a rate estimated at 2.5% every year. This continent currently has the biggest population of young people in its history. At no single time has Africa had such a majority of young people as now where 4 out of 10 among the 1.2 billion people are below the age of 15 years. A keen focus on the demographics of the African continent should be given to its population of women and girls of reproductive age between 10-35 years who comprise 23% of the total population. This explains why the population of Africa is growing at a fast rate, given most of these women do not have access to modern contraceptive methods. In many African families, women do not have the necessary knowledge about how to plan their family’s size despite the Cairo Declaration of 1994 on Population and Development giving women the right to determine the number and spacing of children. A regional conversation on harnessing the demographic dividend has sparked the debate on the preparedness of the African continent to handle the pressure that comes with a huge population in coming years. Will the scarce social resources, including health care services, be accessible to the people of Africa? Maybe I am jumping the gun. Let’s keep our focus on the current state of African people to access health care. My primary concern will be about the welfare of African women who cannot afford to access sexual reproductive health and rights services because of poor health systems infrastructure across the continent. Such is the issue: African leaders and the governments are not well- prepared to harness the demographic dividend by the year 2030 when healthcare is not their number one priority. The Maputo Call of Action is a commitment signed by many African nations outlining that at least 15% of the national budget will be for the health sector. This declaration had steps and strategies set to benefit the sexual reproductive health and rights of women in Africa, and was unveiled to signify a new dawn for African women. Some African states have pioneered the implementation of the Maputo declaration and are leading the pack in ensuring better sexual reproductive health and rights for women. Yet the majority of Africa’s 54 countries still lag behind and this translates to poor services in the health sector. In 2016, eight years after the Maputo Call of Action, the World Health Organization (WHO) convened the National Health System dialogue on Africa’s biggest health challenge held in Brazzaville, Congo in December 2014. In this forum, African leaders officially recognized: “No region needs to scale up its health systems more than Africa. By any measure of health system function – immunization coverage, skilled birth attendance, malnutrition, and maternal and child mortality – the region is in poor shape, despite recent improvements”. African leaders therefore resolved that health must be placed higher on the political and economic agenda of countries throughout the continent. The challenge was to make governments more aware that health has a crucial role to play in the social and economic development of their countries. Could this be the turning point of primary health care access to the people in all corners of the vast continent? Primary health care is crucial for our women and young people in Africa. It is the first point of contact for health care provided in the community. With the decline of traditional herbalists in Africa, where do people in rural Africa access the first medical support in case of need? How many kilometers do African expectant mothers have to walk to access antenatal care services? It is therefore important that these services be close to the African people. The aim is to provide an easily accessible health care service to those who need them most. Primary health care is based on caring for people rather than specific diseases. This means that African youth who are most vulnerable to HIV and STIs and African women who are at risk of maternal mortality and morbidity can access services whenever they need to. WHO has defined in clear guidelines what it means for African governments to provide primary health care. They have stated that the ultimate goal of primary health care is better health for all including the marginalized populations of Africa of youth, women and children. WHO has identified five key elements to achieving that goal, which are: 1. Reducing exclusion and social disparities in health (universal coverage reforms); 2. Organizing health services around people's needs and expectations (service delivery reforms) 3. Integrating health into all sectors (public policy reforms) 4. Pursuing collaborative models of policy dialogue (leadership reforms) 5. Increasing stakeholder participation. We therefore can boldly conclude that African governments have their work cut out. Their role now is to champion for health care access for their people through government led strategies and financial policies. It is only through ideal health legislation that there will be an enabling environment for African women and youth to enjoy their sexual and reproductive health – and the accompanying rights. 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