The Role of Social Health Protection in Reducing Poverty: The Case of Africa

Abstract

This literature review aims to increase our knowledge of the potential that social health protection has in reducing poverty in sub-Saharan Africa. Of all regions in the world, sub-Saharan Africa ranks lowest in income per capita, life expectancy at birth, and highest in mortality. It is the only region with a negative growth for the period 1980-2000. Trapped in poverty and excluded from decent health care, the African poor have to face both the catastrophic costs of seeking health care and bear the burden of lost productivity. Evidence for the link between illness and poverty is particularly striking in the case of malaria and AIDS. Social protection is increasingly seen as a key strategy to contribute to poverty reduction and to sustainable development. But in Africa, where the informal economy sector remains huge and where poorly effective risk management strategies often prevail, there still is a long way to go. Community health insurance, however, appears to be an interesting option for meeting the goal of universal social protection. There is convincing evidence of its positive effect on access to health care. Moreover, community health insurance constitutes a promising channel to give voice to the poor. Today, this particular instrument of social health protection reaches only a small fraction of the African population, but enjoys a growing acceptance and is subject to increasing demands. Besides the ethical imperative of providing social protection, there is evidence today, albeit limited, indicating that the expansion of social health protection, by improving access to care, may increase people's participation in the labour market, improve their income and contribute to economic growth.