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A new report says sub-Saharan Africans rate their health and health care systems among the worst in the world. Nevertheless, improving health is not their top priority.
The report’s been released as Guinea, Liberia and Sierra Leone continue to fight the Ebola outbreak – a situation that was made worse by the poor state of their health systems.
Angus Deaton, co-author of the study, said, “I think most of us thought these episodes burnt out very quickly and this one didn’t. And I think that was surprising to a lot of people. But – and this is relevant for our work – health care systems in sub-Saharan Africa are very poorly organized and very badly done. And of course that certainly contributed to the difficulties of bringing it under control.”
Deaton is Dwight D. Eisenhower Professor of Economics and International Affairs at Princeton University’s Woodrow Wilson School. It’s important, he said, to understand what Africans list as their top priorities.
“People in Africa don’t think of health as their highest priority, at least for the government -- whereas most aid agencies have been prioritizing health pretty heavily.”
He summarized the views of sub-Saharan Africans based on the findings of Gallup’s annual World Polls.
He said, “They perceive their health pretty badly. They perceive their overall well-being pretty badly. Well-being is broader than just health. So, you know, many people sort of think, well, if you lived in a poor country all your life you’re used to it by now. And you’d be just about as happy as everybody else. But if you ask people how their lives are going sub-Saharan Africans rate those very poorly. So, they know that life could be better.”
The same is true, Deaton said, of their perceptions of health care.
“Can you imagine a health care system that spends about $100 a year per person? That’s not going to deliver very much health care.”
So, if improving poor health care systems is not the top priority among Africans, what is?
“If you asked them what government should be doing for them, they want money and jobs more than they want health, which is interesting. And I think it has something to do with the fact that there’s a lot of morbidity and mortality in Africa,” he said.
During the early years of the HIV/AIDS epidemic in Africa, health workers say many infected people wanted food more than medical care. They knew the disease would take years to kill them, but a lack of food could do it much sooner.
The findings show jobs are more important because they have an immediate effect on people’s well-being.
“Some countries less than half of the population has ever had any contact whatsoever with a health professional. That’s pretty amazing. And there are certainly differences in that across countries. So, you get a country like Sudan or Somaliland, where it’s less than half – and then you places like Benin or Madagascar where 90 percent – or Senegal where more than 90 percent of the people -- have had some contact with health systems somewhere in their lives. So, there’s a huge amount of variability across Africa,” he said.
After an initial slow response to the West Africa Ebola outbreak, the international community poured in a lot of money and resources. Some observers say this will allow Guinea, Liberia and Sierra Leone, not only to get better health care systems, but to maintain them. Deaton doubts this and said they could easily slip back to pre-Ebola conditions.
“I don’t think just very easily. I’d be stunned if it didn’t happen. The fundamental problem is just incapacity of the state,” he said.
The Princeton professor said donors and aid agencies should take the study’s findings seriously. They show that 31 percent chose jobs as their top priority, while 21 percent picked improving agriculture. Nearly 14 and a half percent chose tackling corruption, while 13 and a half percent decided on education and health care. Just over six percent chose electricity as the top priority.
The study said those who chose jobs and agriculture shared an underlying factor – better livelihoods.
词汇解析：
critic
难度：3星常用词汇，属常用6000词
英汉解释
n.评论家；批评家
参考例句
用作名词 (n.)
She is a very discerning art critic.
她是位眼光敏锐的艺术评论家。
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separate
难度：5星基本词汇，属常用1000词
英汉解释
adj.分开的；不同的；单独的；各自的
v.分开；隔开；区分；分居；脱离
n.分开；抽印本
参考例句
用作形容词 (adj.)
Can these two definitions be conflated, or must they be kept separate?
这两个定义可以合成一个呢，还是必须分开?
用作动词 (v.)
We should never separate from the masses.
我们绝不应该脱离群众。
用作名词 (n.)
It's hard for me to separate the two fighting boys.
我很难把这两个打架的孩子分开。
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finding
难度：5星基本词汇，属常用1000词
英汉解释
n.调查(或研究)的结果；[律] 裁决
find的现在分词.
参考例句
用作名词 (n.)
The finding is based on such an inquiry.
基于如上调查所得出的发现
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fairly
难度：2星扩展词汇，属常用10000词
英汉解释
adv.公正地；相当地
参考例句
用作副词 (adv.)
This company deals fairly with every client.
这家公司公正地对待每位客户。
We're not rich but we're fairly comfortable.
我们并不富有,但生活还较宽裕。
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joint
难度：4星核心词汇，属常用3000词
英汉解释
adj.联合的；共同的；连带的；合资的
n.关节；接头；接合处；接缝；夜总会
v.贴合；连接
参考例句
用作形容词 (adj.)
They covenanted with us for establishing a joint venture.
他们就建立合资公司的事和我们签了合约。
用作名词 (n.)
The joint isn't quite done yet.
这一大块肉煮得不太熟。
用作动词 (v.)
Does any one know who can joint sales calls?
谁知道谁可以做联合销售拜访?
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lower
难度：5星基本词汇，属常用1000词
英汉解释
adj.低的；下级的；下层的
v.降低；减弱；跌落
参考例句
用作形容词 (adj.)
The lower level is subordinate to the higher level.
下级服从上级。
用作动词 (v.)
Examinations also lower the standards of teaching.
考试也使教学水平降低。
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protest
难度：4星核心词汇，属常用3000词
英汉解释
n.抗议；反对
v.抗议；反对；申明；断言
参考例句
用作名词 (n.)
Half a million people held a mass protest against racism last night.
昨晚50万人举行了大规模的抗议活动反对种族歧视。
用作动词 (v.)
They protested to the mayor that the taxes were too high.
他们向市长提出抗议说税款过高。
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