A CHAI assessment covering nine countries (Burkina Faso, Eswatini, Ethiopia, Kenya, Malawi, Nigeria, Rwanda, South Africa, and Zimbabwe) reveals significant gaps in the health financing workforce needed to execute this vital financing work. These gaps stem from systemic weaknesses in existing training programs and institutional arrangements.
The assessment, originally produced in 2022, also highlights opportunities to close these gaps. The insights are more relevant than ever, given recent shifts in global funding to Africa: Governments will need people with expertise in priority setting to make even more difficult trade-offs based on the best available evidence.
Key recommendations
- Establish government-academia partnerships
- Create health economics and policy units that formally bridge academia and government
- Develop clear pathways for evidence-based research to inform policy decisions directly
- Prioritize female scholarships, hiring, and retention initiatives to improve gender equity in technical roles in government.
- Strengthen in-service training for the existing health financing workforce
- Create targeted training for specific skills gaps
- Establish mentoring and networking systems for knowledge transfer
- Improve collaboration with gender-equity focused ministries, departments, and agencies to operationalize pro-equity policies
- Reform institutional systems
- Eliminate bureaucratic barriers to hiring and retention of technical experts
- Implement policies limiting excessive health financing staff rotation to build sector expertise
- Create merit-based career progression pathways that retain top talent
- Leverage regional institutions and networks
- Support initiatives led by the African Union Africa Leadership Meeting (ALM), Africa CDC, Africa Health Economics and Policy Association, and other regional bodies.
- Facilitate cross-border knowledge exchange and standardization of approaches
- Make catalytic investments in regional initiatives that can support efforts at both government and educational levels
The Path Forward
This assessment provides an urgent call to action for governments, academic institutions, and development partners to collaboratively strengthen the technical foundations that will enable countries to effectively raise and allocate resources for health, not just during crisis, but well into the future.
