As global health funding experiences unprecedented declines, governments across sub-Saharan Africa face mounting pressure to mobilize and allocate domestic resources to sustain essential healthcare systems.
A new CHAI assessment covering nine countries (Burkina Faso, Eswatini, Ethiopia, Kenya, Malawi, Nigeria, Rwanda, South Africa, and Zimbabwe) reveals significant gaps in the technical expertise needed to execute this vital healthcare financing work. These gaps stem from systemic weaknesses in existing training programs and institutional arrangements.
The assessment also highlights opportunities to close these gaps. It provides a clear roadmap for building a skilled workforce capable of driving sustainable, gender-equitable health financing reforms.
Key recommendations
- Establish government-academia partnerships to counter funding cut impacts
- 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 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
While the global health community rightly focuses on supporting governments, communities, and patients in addressing the immediate fallout from external funding cliffs—ensuring medicine availability, paying nurses and doctors—we must simultaneously build long-term capacity.
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.
