Close to 60% of Africa’s frontline doctors and nurses have admitted to seeing patients die in wards and hospital waiting bays against a global average of 33%, finds a newly-released report by global trade union federation Public Services International (PSI).
The survey analyzed experiences of more than 2,200 unionized medical staff from 12 African countries—including Nigeria, Ghana, South Africa, Uganda, Malawi, and Zimbabwe—and found that staff shortages was the leading reason patients die under preventable circumstances.
Governments are asking for more, but offer very little in support
Some 71% of the respondents said they handle twice as many patients than they can adequately care for. Consequently, 86% of respondents say they have witnessed patients experience “unnecessary pain or suffering.”
More than three-quarters said they were compelled to accomplish more tasks with fewer resources, while 80% complained working longer hours than agreed in job contracts. “Staff shortages mean nurses fail to live their lives,” Bertha Kabali, a nurse in Zambia, told Quartz. “We don’t have time to spend with our families, and we are stressed because we don’t have enough time to rest away from work.” To adjust to the shortage, Kabali said she only prioritizes tasks that have life-or-death stakes. “Instead of giving the quality delivery of services in full, you find that you just deliver half of it, or maybe a quarter of it,” she added.
African health workers are decrying poor compensation
Staff shortages aren’t the only factor with lives at risk: Poor pay has also been linked to preventable deaths. Many practitioners have quit their jobs in search of better perks, while a bigger percentage emigrates to developed economies. Even those who just graduated in medical studies feel uninspired to join the public sector in their home countries as rich countries keep outsourcing solutions for their health challenges from Africa—all at the expense of the continent’s poor population.
Anonymous testimonies from workers from African nations in the report paint a picture of a continent whose healthcare staff are suffering through unpaid dues, delayed salaries, illegal contract terminations and “constant harassments” from law enforcers.
“For the past eight years, I was denied my financial entitlement after they terminated my appointment unlawfully which I worked for,” one medical practitioner from Nigeria’s Borno state says in the report. In the capital Abuja, one health worker revealed that their “hazard allowance approved in 2021 was finally implemented last month,” but they were still owed outstanding wages after the federal government paid arrears for only one year. A nurse in Zimbabwe testified to financial hardship, with pay “below the poverty datum line” and poor working conditions. Meanwhile, many Nigerian health workers have left the country to work in the UK, the US, Canada, and the Gulf.
In Zimbabwe, one respondent disclosed that “underpaid workers take out their frustrations on the sick, leading to deaths.” Many African governments underprioritize investment in mental health care, according to the World Health Organization (WHO). The result: mental and emotional health needs of medical workers go unmet, while funds allocated for better equipment, drug supplies, and construction of more dispensaries are often embezzled.
Africa is yet to achieve WHO’s health worker threshold
The WHO projected last year that the shortage of health workers in Africa will hit 6.1 million by 2030, a 45% rise from 2013. Meanwhile, the PSI report finds that “supply of health workers remain significantly below the WHO threshold of 4.45 workers per 1,000 population,” a benchmark it says is needed to achieve universal health coverage in Africa. A 2022 study surveying 47 African countries shows that the region has just 1.55 health workers per 1,000 people. At least 37 countries on the continent are suffering from insufficient health workers.
If world governments fail to invest more in the health sector, the World Bank estimates the globe will face a 15 million health worker deficit (pdf) by 2030. Daniel Bertossa, PSI’s assistant general secretary, added in a press release that “insufficient public investment in our healthcare systems is creating life threatening risks for both patients and staff.” To frontline workers, the impact has already arrived: Over the covid pandemic period, PSI’s survey finds, 70% of health workers in Africa felt betrayed by their governments.