Politics ing primary health care , at the expense of tertiary services , has produced . The decisions which were taken to invest in lower-level health facilities were justified on the grounds that they served more poor people than tertiary , urban-based facilities which catered for the urban elite . This made a lot of sense . But then someone forgot that there were services which even the best lower-level facilities could not provide , such as specialized surgery .
With the increase in non-communicable diseases on the continent , demand for specialized services has grown tremendously . With very little investment in tertiary care , now Africans needing specialized care either simply die or they must find large sums of money to seek care from the local private sector , assuming it is sufficiently well-developed . Otherwise they must fly to India . In so doing , they boost India ’ s highly lucrative medical tourism .
And so , what seemed like a policy that made sense is now seen for what it really was : short-sighted . As non-communicable diseases become more common , the weak health systems of most African countries cannot possibly cope .
Nothing in the world of ‘ development ’ has boosted the careers of those working in philanthropy than poverty in Africa . The world is not short of people who want to reduce , alleviate , or eliminate poverty using all sorts of stratagems .
The thing about poverty in Africa , though , is that for decades it has remained pretty immune to most efforts seeking to enable the poor to free themselves from it . We may hear stories about countries that lift large numbers of their people out of poverty , but overall , poverty in Africa remains a fact of life for multitudes . One of the strategies for eliminating or reducing or alleviating it has been micro-finance .
It entails lending small amounts of money to the poor to enable them to invest in income-generating activities which , it has always been hoped , will lift them out of poverty . As with most things , there are many stories about micro-finance and how it works or does not work . The one that has struck me , nonetheless , is where the poor are given loans , only for them to channel the money into purposes other than the intended investment in income-generation .
Some invest , of course , only for their businesses to collapse without turning a profit . There are , however , others who squander the money on things that will never generate any income . The government of one East African country has invested millions of dollars in giving loans to young people to create their own jobs . Relatively few have used the money judiciously and paid it back . Many simply disappeared with it .
Others misused it , failed to pay back , and ended up in jail . The one thing that well-meaning advocates of micro-credit as a onesize-fits-all anti-poverty tool have disregarded and continue to disregard is that not every poor person has the aptitude for doing business .
We have all heard of the slogan “ education for all ”. Like all mantras which are meant to culminate in actions designed to benefit everybody or the greatest number of people , it is driven by the noble intention of getting as many school-going-age children into school as possible , and making sure that they do not drop out before they complete their studies . The thing about initiatives such as ‘ education for all ’ which pursue universal outcomes is that they must ensure zero exclusion of eligible beneficiaries .
Education for all , therefore , entails providing free education to those who would otherwise have the capacity to pay for it , and those who couldn ’ t possibly afford to do so . In practice it means that parents of children who qualify under the set criteria , are told that ‘ education is now free ’, which is usually understood to mean ‘ you do not have to pay anything ’. But anyone who has been to school knows that there is no such thing as education that is completely free of charge .
If parents are exempted from paying school fees , they will find that they have to buy requirements such as uniforms and supplies , and even food which their children will eat while at school . Because parents are told that ‘ education for all is free of charge ’, they usually resist or neglect or even refuse to pay for these things , after all “ the government told us that education is free ”.
This gap between what parents are told by governments and the reality they confront when schools ask them to pay for things , in many cases leads to children
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