Sub-Saharan Africa has made tremendous progress on health since the beginning of the 2000s. Mortality rates, for example, have decreased rapidly, and, as a consequence, the average life expectancy has increased from 50 to 60 years in the last 15 years.
Yet, our new study on border cities found that health infrastructure are very unequally distributed across the region. States tend to concentrate most of their top tier facilities in capital cities and as a result there are fewer health facilities in border areas.
The fact that border regions are less equipped than other regions is a matter of concern for national cohesion and regional integration. Each country distributes its health facilities based on its financial capacity without explicitly considering international patients.
Our study has identified several regions where health services could be improved through closer collaboration between the countries in the region. One of the regions is the Senegal river region, where most high-level facilities are located on the Senegalese side of the border.
To address this unequal distribution of health facilities, new centers could be constructed, as between Mali and Burkina Faso, where a cross-border health center was funded by the German Cooperation. Existing infrastructure could also be improved, as in the Liptako Gourma between Niger, Burkina and Mali, where a number of small health centers could be upgraded to better serve the local population.
Olivier J. Walther 