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Africa

Comment notre hôpital au bord de la faillite est devenu un modèle de gestion basée sur la performance ?

Also available in: English

En 2014 nous avons repris la direction de l’hôpital gynéco-obstétrique et pédiatrique de Yaoundé (HGOPY). Nous avons récupéré une institution confrontée à un endettement structurel chronique, avec de nombreux équipements et locaux vétustes. Aucun plan d’amortissement de la dette n’avait été mis en place et les dépenses non compressibles telles que les salaires et avantages des personnels étaient très élevés.

 



Ce genre de situation était malheureusement fréquent dans de nombreux établissements qui ont subi de plein fouet la crise économique et sociale qui a suivi l’ajustement structurel dans les pays africains. Le système de santé n’a pas été en reste. La décision d’augmenter les tarifs des prestations médicales a pénalisé les plus pauvres et limité leur accès aux soins de santé. Cela n’a pas tardé à avoir des conséquences sur les taux de mortalité maternelle et infantile qui ont augmenté.

Pour faire face à cette situation, les pays africains ont signé en 2000 la Déclaration d’Abuja, les engageant à consacrer au moins 15% de leur budget national à la santé. Au-delà de l’objectif de l’accès universel aux soins, le secteur devait améliorer sa performance, son efficacité et son efficience.

From the brink of bankruptcy to a model for performance-based management: The story of one Yaoundé hospital

Also available in: Français

We took over the management of the obstetrics, gynecology, and pediatric hospital in Yaoundé (HGOPY) in 2014, inheriting an institution that faced chronic structural debt, obsolete equipment, and dilapidated buildings. No debt repayment plan was in place and fixed expenses such as staff salaries and benefits were extremely high.

This situation was regrettably common in many institutions across Africa which were hit hard by the economic and social crisis that resulted from structural adjustment policies implemented in by several countries, including Cameroon. Furthermore, the decision to increase health care charges adversely affected the poorest, limiting their access to health care and leading to a rise in maternal and infant mortality rates.

In response, African countries signed the Abuja Declaration in 2000, committing to earmark at least 15% of their national budget to the health sector. In addition to the goal of providing universal health care, the sector was expected to enhance the performance, effectiveness, and efficiency of its services.

Realigning investment tax incentives to job opportunities

Sébastien Dessus's picture
Photo by: Gabriel/Flickr


The recent decline in global commodity prices is proving to be very costly for South Africa. The deterioration of South Africa’s terms of trade since 2012 cost at least four percentage points of gross domestic product (GDP) growth. This estimate does not account for some important indirect effects generated by the commodity price shock, including the heightened volatility of the rand and its impact on investment decisions. Instead of global monetary policy developments, commodity price volatility is now understood as being the main driver of exchange rate and capital account volatility in South Africa, and in emerging markets more generally. And 91% of European investors surveyed in the second half of 2014 identified the volatility of the rand as a major constraint to doing business in South Africa.

Will South Africa turn the corner in 2017?

Marek Hanusch's picture
Photo By: David Stanley/Flickr


The year 2016 was difficult for many countries. We estimate that global economic growth slowed from 2.7% in 2015 to 2.3% in 2016. High-income economies struggled with subdued growth and low inflation amidst increased uncertainty about policy direction in light of rising populism. Among emerging markets and developing economies, commodity exporters were most affected by the end of the commodity price boom, growing by only 0.3%—much in line with our estimate of 0.4% growth for South Africa, the lowest growth rate since the 2009 recession after the global financial crisis. By contrast, commodity importers carried the torch of global growth in 2016, expanding by 5.6%.

Afrique de l’Ouest : une vision commune au service d’un littoral résilient

Dahlia Lotayef's picture
Also available in: English
Au Togo, l’érosion du littoral menace les habitations et les moyens de subsistance. Crédit photo : Eric Kaglan, Banque mondiale

Au Togo, les familles placent souvent des talismans à l’extérieur de leurs maisons, face à l’océan Atlantique, espérant que leurs pouvoirs magiques ou spirituels supposés les protègeront des vagues qui pénètrent toujours plus loin dans les terres.
 
Cela n’a hélas pas sauvé ces dizaines de villages dévorés par les flots depuis le milieu des années 1990. Les coques de bateaux, remplies de souvenirs sur des côtes qui perdent chaque année jusqu’à 5 à 10 mètres de terrain, sont devenues impropres à toute activité rémunératrice. Les anciens habitants qui viennent en pèlerinage sur les lieux de leur enfance restent abasourdis en constatant que la mer a littéralement englouti des communautés entières.

West African countries commit to common vision for coastal resilience

Dahlia Lotayef's picture
Also available in: Français
Coastal erosion is threatening homes and livelihoods in Togo. Photo by: Eric Kaglan, World Bank 


Togolese families often place talismans, thought to contain magical or spiritual properties, outside their homes facing the Atlantic Ocean in hopes of protecting their dwellings from encroaching tides.
 
Unfortunately, dozens of villages have been devoured since the mid-1990s, leaving behind shells of houses, livelihoods and memories in the wake of a coast receding as much as 5-10 meters per year. When expatriates return to Togo’s coast to visit their childhood homes, they are astonished to see that communities have literally washed out to sea.

Building a regional solution to bridge Eastern and Southern Africa’s science and technology gap

Xiaonan Cao's picture
 Sarah Farhat/World Bank


Like much of Sub-Saharan Africa, the Eastern and Southern Africa region has seen significant economic growth in recent years, largely relying on agriculture and extractives. However, it hasn’t been able to keep up with the skilled labor demanded by the region’s required economic transformation for further growth. Surveys reveal that firms in the region now face acute challenges in developing research and development (R&D) capacity and filling technical and managerial positions – not just due to inadequate production of college graduates that have been rising over the years, but also due to low quality and relevance of current education and training at the tertiary level.

Sur la voie de la résilience : la réduction des risques climatiques et de catastrophes naturelles en Afrique

Ede Ijjasz-Vasquez's picture
Also available in: English
Alors que 60 millions de personnes en Afrique sont dans l’attente d’une aide humanitaire en raison du phénomène climatique El Niño, dont l’incidence cette année atteint un niveau sans précédent depuis plusieurs décennies, la Banque mondiale s’emploie activement à aider 14 pays à mettre en place des programmes de redressement, avec des engagements qui se chiffrent à plus de 500 millions de dollars. (Photo : Flore de Preneuf / Banque mondiale

Sécheresses, inondations, glissements de terrain, tempêtes : ces catastrophes naturelles liées aux conditions météorologiques se produisent régulièrement, mais leur fréquence et leur intensité sont vouées à augmenter sous l’effet du changement climatique. Depuis 1970, l’Afrique a connu plus de 2 000 catastrophes naturelles, dont près de la moitié au cours des dix dernières années seulement. Ces événements ont touché plus de 460 millions de personnes et causé le décès de 880 000 d’entre elles. Les estimations indiquent que 118 millions d’Africains vivant dans l’extrême pauvreté (avec moins de 1,25 dollar par jour) seront exposés d’ici 2030 à des sécheresses, des inondations et des vagues de chaleur extrême. Ces catastrophes à répétition entravent la croissance économique et privent encore davantage les populations démunies de la possibilité d’échapper à la pauvreté.

On the road to resilience: Reducing disaster and climate risk in Africa

Ede Ijjasz-Vasquez's picture
Also available in: Français
As 60 million people in Africa await humanitarian assistance due to the worst El Nino in decades, the World Bank is actively engaged in 14 countries to plan recovery programs worth more than $500 million. (Photo: Flore de Preneuf / World Bank)


Natural disasters—such as droughts, floods, landslides, and storms—are a regular occurrence, but climate change is increasing the frequency and intensity of such weather-related hazards. Since 1970, Africa has experienced more than 2,000 natural disasters, with just under half taking place in the last decade. During this time, natural disasters have affected over 460 million people and resulted in more than 880,000 casualties. In addition, it is estimated that by 2030, up to 118 million extremely poor people (living below $1.25/day) will be exposed to drought, floods, and extreme heat in Africa. In areas of recurrent disasters, this hampers growth and makes it harder for the poor to escape poverty.

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