McKinsey&Company

In recent decades, global attention to the harrowing state of health in sub-Saharan Africa has increased dramatically.
Funding to combat the major health problems there has reached unprecedented levels, and marked improvements have been made on certain fronts. In Zanzibar, for example, malaria deaths have been reduced substantially. And in Uganda, maternal mortality has dropped by more than half.
But despite the increased investment, the health of the vast majority of people in sub-Saharan Africa remains in jeopardy.
From 1990 to 2005, life expectancy slid by more than 2 years, to 47.1 years. Millions of Africans continue to suffer from diseases that are relatively simple to prevent or treat. And for most nations in the region, the United Nations’ health-related Millennium Development Goals (MDGs)—the targets for reducing child and maternal mortality rates and reversing the spread of infectious diseases by 2015—remain out of reach.
As the health systems in sub-Saharan Africa continue to struggle to meet basic standards of care, many experts have come to believe that system-wide barriers to care delivery are preventing greater progress from being made. If substantive improvements in health outcomes are to be achieved, a comprehensive approach is required to overcome these barriers.
But how can system-wide changes be made in countries that are struggling to provide even basic care delivery?
To address this issue, the Touch Foundation, a nonprofit organization active in Tanzania, and McKinsey recently conducted an intensive investigation of the health system in the Lake Zone, the northwest section of that country. This region is small enough that it could be studied in detail but large enough that it could serve as a suitable geographic proxy for Tanzania as a whole and, potentially, for the entire sub-Saharan region.

• A practical approach to health system strengthening in sub-Saharan Africa (PDF - 1166 KB)