Health in Commonwealth Africa


  • On average, the healthcare system in Commonwealth Africa is understaffed. The majority of these countries have 40 doctors or fewer and less than 300 nurses and midwives per 100,000 members of the population. Seychelles and Mauritius are notable exceptions, with more than 100 doctors and 350 nurses and midwives per 100,000 people, and South Africa has 77 doctors and over 400 nurses and midwives (2004).  Botswana has the highest proportion of public expenditure on health compared to the rest of the African member states, with 8% of its GDP or $612 in per capita terms spent on health in 2009. However, the rest of the Commonwealth Africa spends less than 5% of its GDP on health care and less than $500 per capita per annum – in fact, Kenya and Sierra Leone only spend 1% of GDP on health and Malawi spends less than $20 per capita for health care (2009).
  • A major health issue for Commonwealth member states in Africa is the high prevalence of HIV/AIDS among those aged 15-49, with a number of countries having a prevalence of over 20%. The prevalence of HIV/AIDS among those aged 15-49 is 25.9% in Swaziland, 24.8% in Botswana and 23.9% in Lesotho (2009). However, some African countries are showing a decrease in prevalence with Mauritius, Sierra Leone, Ghana and the Gambia having HIV/AIDS prevalence of 2% or less.
  • Sierra Leone has the highest rate of infant mortality in the Commonwealth, with 114 deaths per 1,000 live births. Seychelles has the lowest rate of infant mortality in Commonwealth Africa, with only 12 deaths per 1,000 live births. In addition, Sierra Leone also has the highest under-five mortality rate in the Commonwealth, with 174 deaths per 1,000 live births, while Seychelles again has the lowest rate at 14 deaths (2010).
  • Lesotho has the highest reported maternal mortality ratio, with 1,200 annual government-reported deaths of mothers per 100,000 live births (2006-10). Mauritius has the lowest reported ratio in Africa, with 22 deaths per 100,000 live births. Using the adjusted figures, taking into account both government figures and UN estimates, Sierra Leone has the highest maternal mortality ratio with 970 deaths per 100,000 live births in 2008. Mauritius, again, has the lowest ratio of 36 deaths.
  • The majority of member states in Africa have low rates of obesity. However, over 50% of the adult population in South Africa, Seychelles and Mauritius are overweight and over 30% of South Africans classified as obese (2008).
  • In comparison to other Commonwealth continents, African member states have lower rates of non-communicable disease risk factors, such as raised blood pressure, cholesterol and blood glucose. Of the 14 African Commonwealth countries with available data, all have a prevalence of raised blood pressure (hypertension) of over 30%. Almost 45% of the adult population of Mozambique have raised blood pressure while 36.4% of adults in Ghana suffer from hypertension (2008). However, most of the member states have a low prevalence of raised cholesterol, less than 30% of adults, with only Seychelles having a prevalence of over 50% (2008). Raised blood glucose, a key indicator in the presence of diabetes, is low in comparison to Pacific island and Caribbean nations. Seychelles has the highest prevalence in Africa of 12.9% while Malawi has the lowest at 5.4% (2008).
  • The prevalence of daily smoking in the adult population in African member states is relatively low compared to the rest of the Commonwealth; only Sierra Leone has a prevalence of over 20%. Indeed, in Ghana and Nigeria, less than 5% of adults smoke daily.
  • Within Commonwealth Africa, Seychelles has the highest income per capita at $9,760 for every Seychellois, while Malawi has the lowest income per capita at $330 (2010). Seychelles also ranks the highest in terms of human development in Africa, ranking 52 out of the 187 countries on the UN’s 2011 Human Development Index. Mozambique, at 184, ranks the lowest in Africa for human development. Mauritius and Seychelles have the highest life expectancies of African member states, both at 73 years. Sierra Leone has the lowest life expectancy at 47 years in 2010.