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1. Learning from experience: Are African governments prepared for another pandemic?

Author:
Tunde A. Alabi and Matthias Krönke
Publication Date:
06-2024
Content Type:
Policy Brief
Institution:
Afrobarometer
Abstract:
According to the Africa Centres for Disease Control and Prevention (CDC) (2020), Africa’s first case of COVID-19 was recorded in Egypt in mid-February 2020. Six months later, the continent’s death toll exceeded 19,000, representing 3% of global COVID-19 mortality. As the virus spread across Africa, governments began to enforce national lockdowns and other restrictions to minimise the impact of the pandemic. In addition to being a global health emergency, COVID-19 had other wide-ranging consequences. Many parts of government bureaucracies, as well as the private sector, shut down except for “essential” workers (Wickham, 2022). Children were unable to go to school for months, increasing dropout rates with knock-on effects on their nutrition and mental health (UNICEF Africa, 2022; Kidman, Breton, Behrman, & Kohler, 2022). Moreover, African governments’ responses to the pandemic affected trends in poverty on the continent. For example, Afrobarometer analyses found that “more restrictive government responses were associated with larger increases in lived poverty” (Mattes & Patel, 2022, p. 1). Faced with economic uncertainty and mobility restrictions, Africans turned to their governments for support and a coordinated public health response to the pandemic. The latest Afrobarometer surveys in 39 countries document how citizens experienced the pandemic, their views on how their governments handled the pandemic, and whether they think their governments are prepared for future health emergencies. Responses indicate that about one in seven households experienced a case of COVID-19, while more than a quarter suffered the loss of a primary source of income. Despite the severe economic effects of the pandemic, fewer than a quarter of households received pandemic related assistance from the government. Most respondents say that the distribution of relief was unfair and that corruption claimed funds intended for the pandemic response. Even so, most Africans say their government managed the pandemic well. When it comes to giving up democratic rights during a pandemic, a majority of Africans accept the use of the military or police to enforce public health mandates, but censoring the media and postponing elections are more controversial steps. Africans are divided in their assessments of their governments’ readiness for a future pandemic, and a majority say additional investments in such preparations are needed.
Topic:
Education, Health, Social Services, Pandemic, and COVID-19
Political Geography:
Africa

2. Health for everyone, everywhere?

Author:
Lionel Osse Essima and Matthias Krönke
Publication Date:
04-2024
Content Type:
Policy Brief
Institution:
Afrobarometer
Abstract:
The theme of World Health Day 2024 (7 April) is “My health, my right” (World Health Organization, 2024). A key component of the message is to encourage governments to deliver on citizens’ right to health by making health services “available, accessible, acceptable and of good quality for everyone, everywhere.” How close are African governments to meeting this ambitious goal? Since 1990, the burden of disease has decreased substantially in Africa (Roser, Ritchie, & Spooner, 2024; also see Figure A.1 in the Appendix). Between 2000 and 2019, Africa recorded the world’s greatest growth in healthy life expectancy, which rose from 46 to 56 years (Adepoju & Fletcher, 2022). Further, between 2015 and 2021, the under-5 mortality rate fell from 87 to 74 deaths per 1,000 live births across sub-Saharan Africa (United Nations, 2023). According to the World Health Organization, these gains were achieved through increased provision of essential health services and better access to care and disease prevention services (Adepoju & Fletcher, 2022). Despite these important advances, however, many Africans still do not have access to high quality health care. Compared to other world regions, the gap is particularly acute when it comes to communicable, neonatal, maternal, and nutritional diseases (as opposed to non communicable diseases and injuries) (see Figure A.2 in the Appendix). While sub-Saharan Africa saw the world’s fastest growth between 2015 and 2022 in the proportion of births attended by skilled health personnel, from 59% to 70%, the continent also recorded about 70% of the world’s maternal deaths (United Nations, 2023). At least part of the explanation is a lack of health workers; as of 2021, sub-Saharan Africa had an average of 2.3 medical doctors and 12.6 nursing/midwifery personnel per 10,000 people, compared to 39.4 and 89.5 in Europe (United Nations, 2023).
Topic:
Education, Public Opinion, Social Services, Public Health, and Healthcare System
Political Geography:
Africa

3. Can cities cope?

Author:
Francis Kibirige, John Martin Kewaza, Ronald Makanga Kakumba, Stevenson Ssevume Male, Muhammad Ssenkumba, George William Kayanja, Fred Male, and Pius Tibaingana
Publication Date:
05-2023
Content Type:
Policy Brief
Institution:
Afrobarometer
Abstract:
On 1 July 2020, less than a year before January 2021 presidential and parliamentary elections, Uganda’s minister of local government, acting under the Local Governments Act and with the approval of Parliament, elevated 10 of the 15 earmarked municipal councils across the country to city status (Parliament of the Republic of Uganda, 1997, 2020). City status, equal in stature to district local government status, is the highest level that local government units can attain under the current law and is synonymous with near-autonomy, including significant political influence and more control over resource mobilisation and use. Residents in the newly elevated city environs celebrated this administrative milestone amid surging expectations of immediate upgrades of public-services infrastructure and jobs. But the respective administrations awoke to the realities of over-stretched, outdated services infrastructure, and inadequate funding incapable of meeting the heightened level of demand. Can these new cities fulfil their mandate – even in the face of COVID-19-related impacts on the economy and personal living conditions – and cope with soaring public expectations? Evidence from the 2022 Afrobarometer survey suggests that it will not be easy, as the public mood, engagement with elected local leaders, and public service-delivery ratings are on the decline while mistrust, perceptions of official corruption, and resentment toward paying taxes are on the rise.
Topic:
Education, Health, Governance, Leadership, Institutions, Social Services, and Public Service
Political Geography:
Uganda and Africa

4. Trash Sorters: Entrepreneurs in Africa

Author:
Carl Manlan
Publication Date:
01-2020
Content Type:
Journal Article
Journal:
Cairo Review of Global Affairs
Institution:
School of Global Affairs and Public Policy, American University in Cairo
Abstract:
Africa is on the cusp of a community-led socioeconomic transformation, but this cannot happen without fully integrating the informal economic dynamos of young trash sorters.
Topic:
Economics, Youth, and Social Services
Political Geography:
Africa

5. The politics of social protection in Eastern and Southern Africa: Actors, institutions and dynamics

Author:
Sam Hickey, Tom Laver, Miguel Niño-Zarazúa, and Jeremy Seekings
Publication Date:
12-2019
Content Type:
Policy Brief
Institution:
United Nations University
Abstract:
Since the mid-1990s, there has been in Africa something of a ‘quiet revolution’ in poverty reduction strategies with the proliferation of social assistance programmes that entail cash transfers to the poor. The past two decades have also been characterized by a series of important political developments that have reshaped both state–society relations within sub-Saharan Africa and its relationship with transnational actors. What lies behind these changes?​​​
Topic:
Development, International Organization, Poverty, and Social Services
Political Geography:
Africa, South Africa, and East Africa

6. The Political Economy of Testing in Latin America and Sub-Saharan Africa

Author:
Barbara Bruns, Maryam Akmal, and Nancy Birdsall
Publication Date:
09-2019
Content Type:
Working Paper
Institution:
Center for Global Development (CGD)
Abstract:
Most countries in sub-Saharan Africa have not implemented testing of children’s learning that can be benchmarked regionally or globally. In contrast, in the last two decades, almost all countries in Latin America have participated in regionally and globally benchmarked testing initiatives. Our analysis of the political economy of cross-national learning measurement in Latin America suggests that policymakers perceive the risks of exposing their education system’s performance by joining cross-national assessments, but they also value the quality of the data generated, the strengthening of domestic technical capacity, and the political benefits in using comparative results to argue for reforms or to advertise progress. We document that in Ecuador and Peru cross-national tests played an important role in both stimulating and justifying reforms that have produced major improvements in learning. In sub-Saharan Africa, no cross-national test has been implemented as consistently or widely as the Latin American regional test. The context in Africa makes regional cooperation on cross-national testing more daunting—countries are poorer and more linguistically diverse than in Latin America, raising the relative costs of developing and administering cross-national tests. The experience of Latin America suggests that a coordinated and efficient application of resources in implementing cross-national tests in Africa, on the part of countries and with support of the international community, could help build countries’ national capacity, strengthen focus on learning, support better research, and help diffuse reforms that raise learning.
Topic:
Education, Political Economy, Children, and Social Services
Political Geography:
Africa, South America, Latin America, North America, and Sub-Saharan Africa

7. Following the Money in Ghana: From the Grassroots to the Hallways of the IMF

Author:
Abdulkarim Mohammed
Publication Date:
12-2017
Content Type:
Special Report
Institution:
Accountability Research Center (ARC), American University
Abstract:
Between 2011 and 2014, Ghana went from boasting the world’s fastest growing economy to requiring a bailout from the International Monetary Fund (IMF). While a global downturn in commodity prices precipitated the fall, a lack of accountability in how public finances have been managed has been at the heart of the problem. Fiscal indiscipline, fueled by a lack of oversight and rampant corruption, left the government unable to mount an effective response during lean economic times. Oxfam and its civil society partners in Ghana were worried that everyday Ghanaians would be left shouldering the burden of the economic crisis. Moreover, Ghanaians worried that their concerns and aspirations would not be represented in the high-level negotiations on the bailout between the Government of Ghana and the IMF. To address these concerns Oxfam and its partners coordinated a multi-level advocacy campaign. The campaign drew together a diverse coalition of civil society—from community activists to globally influential think tanks—able to represent and articulate local level concerns and project a united voice at the national and global levels. This novel approach proved highly successful in driving important changes in policy and practice that have enhanced accountability, fiscal responsibility, and citizens’ participation. The campaign not only contributed to improving the laws governing how public finances are managed in Ghana, but also helped to increase pro-poor spending and protect crucial social services.
Topic:
Civil Society, Corruption, Accountability, Social Services, Participation, IMF, Oversight, and Public Spending
Political Geography:
Africa and Ghana

8. Are Policy Reforms Enough to Improve Satisfaction with Health Care? Evidence from Benin

Author:
Richard Houessou
Publication Date:
11-2015
Content Type:
Policy Brief
Institution:
Afrobarometer
Abstract:
In 2009, the government of Benin embarked on a series of policy initiatives to increase public access to health services, especially for pregnant women, children under age 5, and the poor. While health coverage rates remained steady, attendance at health services increased sharply, and at first, public satisfaction with the government’s performance in improving basic health services increased as well. However, by 2014, public approval of the government’s efforts had dropped sharply. What explains this decrease in public satisfaction, despite the policy reforms? This paper uses Afrobarometer survey findings and other data to examine mechanisms that might contribute to dissatisfaction at the grass roots with how government is handling health services. Its finding that citizens’ negative experiences while visiting public clinics or hospitals are the main factor driving down public assessments of government performance in this area should alert policy makers that they must put in place more than policy reforms in order to satisfy public demand for high-quality basic health services.
Topic:
Health, Governance, Health Care Policy, and Social Services
Political Geography:
Africa and Benin

9. The quality of public services: An intrinsic factor in Ghanaian evaluations of government performance

Author:
Daniel Armah-Attoh
Publication Date:
07-2015
Content Type:
Policy Brief
Institution:
Afrobarometer
Abstract:
The provision of public goods and services is an important aspect of socioeconomic development. Access to basic services such as clean water and sanitation, health care, schooling, and transportation enhances citizens’ well-being. Access to roads and telecommunications systems lowers transaction costs, leading to improvements in trade and economic activities (Xu, 2013). In spite of the importance of public services to individuals and nations, the World Bank’s World Development Report (2004) found large variations in the quality and quantity of public goods and services across developing countries and within countries. In most African countries, including Ghana, providing public services is a huge challenge for the state, which is traditionally seen as solely responsible for the production and distribution of these services. In practice, given scarce resources and management challenges, the state alone often cannot provide these services at levels that match rapid population growth, development, and urbanization. In Ghana, attempts at adopting a public-private partnership approach for the delivery of some public services has met with apprehension by citizens who fear the consequences of profit-seeking private-sector entities producing or distributing these essential public goods. With the government left to play the primary provider role, citizens continue to have difficulties accessing vital public services because of a lack of service facilities or inadequate service quantity or quality. Quality has been an important focus of management models used by service providers in developed countries since the 1980s. Notable among these are the total quality management (TQM) and new public management (NPM) approaches (Mwita, 2000). These consumer-oriented models approach public service quality from the perspectives of the technical professional, the manager, and the client (Ovretveit, 1992; Curry & Herbert, 1998; Kadir, Abdullah, & Agus, 2000). Similarly, Joss & Kogan (1995) distinguish among technical, systemic, and generic (or interpersonal) aspects of quality, while Grönroos (1982) distinguishes technical from functional quality, the latter having to do with the way services are offered and received. Underlying these approaches is the idea that an essential part of public service quality is clients' evaluation of the level of service received, which is often founded on perceptions formed during service encounters (Parasuraman, Zeithaml, & Berry, 1988; Bitner, Booms, & Tetreault, 1990; Johnston, 1995). Recent Afrobarometer survey data from Ghana shows widespread public dissatisfaction with public services. The survey did not ask specifically about service quality, but analysis of the data points to the importance of service quality in citizens’ negative evaluations of government service delivery performance. This paper examines the hypothesis that the quality of public services is an intrinsic factor – and therefore an important indicator to monitor – in Ghanaians’ assessment of government service-delivery performance.
Topic:
Infrastructure, Governance, Leadership, Social Services, and Public Service
Political Geography:
Africa and Ghana

10. On the Primacy of Weak Public Service Provision in rural Africa: Malians Redefine ‘State Breakdown’ Amidst 2012 Political Crisis

Author:
Jaimie Bleck and Kristin Michelitch
Publication Date:
03-2015
Content Type:
Working Paper
Institution:
Afrobarometer
Abstract:
In 2012, Mali faced a dual state breakdown disrupting nearly 20 years of democratization – a coup and a secessionist insurgency. This paper provides the perspectives of rural Malians living on the border of state- and rebel-controlled territory. Our main finding is that villagers defined “the crisis” as one of unmet need for public services and infrastructure. State breakdown matters less where the state is not present in the first place. Rather than the state, villagers were largely reliant on local traditional authorities. The salience of villagers’ concerns about public services and infrastructure, as well as general basic needs insecurity, are echoed in cross-national Afrobarometer data (2012-2013) on public service provision across rural and urban citizens. In nearly all sub-Saharan African countries, the urban-rural gap is large, absolute levels of rural provision are low, and countries are inconsistent in provision across indicators. We conclude by drawing implications of weak state public service and infrastructure provision for citizenship in rural areas.
Topic:
Fragile/Failed State, Governance, Social Services, Political Crisis, and Public Service
Political Geography:
Africa and Mali