Insight on Africa from the break room

For me, coffee breaks at work often lead to long sessions (after work, of course) on Google. This is because my officemates are all experts in their respective fields and even casual work-related conversations can become nuanced very quickly. I try to keep up but am usually relegated to later online searches for background info.

This happened recently after speaking with a colleague versed in African health system development. He spoke about the important role of the private sector in African health care and the challenge of enticing health sector investors. A few of these points surprised me, and the brief conversation showed me that my knowledge of health system development was limited. Resolved to learn more, I left the break room with inspiration for another online search. The African health expert not only provided inspiration but also gave me a starting point. He recommended the 'Health in Africa' report authored by the International Finance Corporation (IFC) with help from McKinsey & Company.

This IFC report clarifies the evidence behind the surprising points that my colleague offered in the break room. Here are some the items that I found most interesting:

-Encouraging investment African health infrastructure is difficult

This surprised me since I assumed that donors and investors would readily send money to African nations - especially those with noted epidemics like HIV/AIDS and malaria. With so many suffering decreased quality of life for lack of access to health resources, I estimated that the return on money spent for health clinics or education programming in the continent would be obvious. But this is not the case. Rather, investors look for quantifiable ROI. The Gates Foundation has propelled this trend of demanding accountability for their dollars. This means that measuring improvement has become one of the major challenges for those doing good health work in Africa.

-Non-government good work plays a big role

Despite federal investment in health infrastructure and system development, a recent International Finance Corporation (IFC) report says that non-government payers doled out over 60 percent of the continent's almost $17 billion in health-related expenditures. This is a surprise because many (myself included) assume that most private groups serve the rich while the public sector cares for the poor. One group gaining particular attention for good work in African health is the private insurance sector. With their interest in keeping health records these insurers are helping researchers track diseases and design interventions.

-The IFC's input is controversial (this was the least surprising of my findings)

The IFC and its sister group, the World Bank, aim to foster development in Africa and have invested significant funds in the region. While this seems like progress, some question the organizations' involvement. These critics cite another recent study showing that World Bank funded HIV/AIDS programs in Africa garnered a 25 percent success rate. Should the bank continue to fund health infrastructure development if this "good work" is failing?

The controversy over the World Bank is one of many surrounding health infrastructure in Africa. What are the controversies that interest you? What other lessons can you offer that might surprise me? Do you have other insights from development work or research? Please add comments below to continue the conversation.