Health Affairs Web First: Assessing Health And Health Care Perceptions In sub-Saharan Africa

A large share of Western aid to developing countries goes to sub-Saharan Africa, a region where spending on health care is around $100 per person in 2005 price-adjusted terms. This region, which experienced large gains in life expectancy in the years following World War II, suffered health-related setbacks in the closing years of the twentieth century as a result of the HIV/AIDS epidemic.

The authors of a February 25 Health Affairs Web First study used data from the Gallup Organization’s 2012 World Poll to investigate health and health care perceptions in sub-Saharan Africa compared to other regions of the world. The poll found that sub-Saharan Africans’ overall evaluation of their well-being was lower than that of any other population in the world. Additionally, only 42.4 percent of residents in that region were satisfied with the availability of high-quality health care in their community, also the lowest level in the world. Even so, when sub-Saharan Africans were asked to name the issues that should be the highest priorities for their government, health care was not seen as the most pressing issue.

The Gallup Organization’s World Poll has been collecting data in sub-Saharan Africa since 2005. One of the controversial issues in the literature and the donor community is the effect of the HIV/AIDS epidemic on health care, both before and after 2004, after which there was a large increase in aid from PEPFAR and the Global Fund. When asked in 2012 whether their health care has improved over the previous five years, the poll found that public perceptions were positively related to the prevalence of HIV only in the countries with the highest prevalence. Study authors Angus Deaton and Robert Tortora conclude: “In these heavily affected countries, there may well have been positive spillovers [from HIV-related aid] into the more general health care system.

Deaton is affiliated with Princeton University; Tortora, now at ICF International in Rockville, Maryland, was at the Gallup Organization in Washington, DC, when the article was written. This study, which is supported by the Gallup Organization and the National Institute on Aging, will also appear in the March 2015 issue of Health Affairs.