In the rationing of healthcare in indigent African populations, which services should come first?

Abstract

Governments, worldwide, have enormous difficul ties in affording adequate funds for healthcare and its maintenance. In developing populations, almost all of whom are indigent, the diverse health prob lems being faced with limited funds are insuffi ciently appreciated. Information is given, for both developed and developing populations, principally those in sub-Saharan Africa, regarding various countries' gross national product (GNP) per capi ta, the percentage of GNP devoted to health ser vices, and the allocation of health funds per capita. To illustrate the formidable health problems pre vailing, some data are given on the magnitudes of morbidity/mortality situations, both for communi cable and non-communicable diseases. Some examples are provided which exemplify opposing points of view regarding strongly contesting health claims for priorities in monetary support. Addi tionally, examples are given of some impoverished countries, which, despite highly adverse circum stances, have achieved enviable health statistics. In this respect it would be highly beneficial were the circumstances and means employed in these and similar contexts given wide publicity.