The Quality of Health and Education Systems Across Africa
FIGURE 2.12 Percentage of health facilities with supplies of 14 basic medicines in six African countries, by country and type of facility Niger Mozambique Togo Sierra Leone Madagascar Tanzania 0
20
40
60
80
100
Medicine availability (% of essential medicines) Public average
Country average
Private average
Source: SDI (Service Delivery Indicators) health surveys. Note: Medicine availability is calculated as the share of 14 essential medicines available at a facility. The light green dots represent the average score at rural facilities, black dots represent the average score at urban facilities, and blue dots indicate the whole-country estimate. Country surveys were conducted in the following years: Madagascar (2016), Mozambique (2014), Niger (2015), Sierra Leone (2018), Tanzania (2016), and Togo (2013).
prevent spoilage, and only two-thirds of facilities (66 percent) report having a functional refrigerator.
Sterilization and waste disposal Patients seeking care would also hope that the facility follows best practices with regard to equipment hygiene and cleaning procedures. A patient would hope to be treated with clean equipment that has been sterilized and protected from avoidable infections. Measures to promote prevention and control of infections are always important but especially so during a pandemic. Hand hygiene and appropriate waste segregation and disposal, for instance, are necessary for the safety of both patients and health care workers. The necessity of appropriate water, sanitation, and hygiene techniques was demonstrated during the 2014 Ebola epidemic in Sierra Leone, where the rate of infection was several times higher among health care workers than among the general population, partly owing to lack of robust infection prevention and control measures in health facilities (Kilmarx et al. 2014). How do health facilities fare in terms of waste disposal and sterilization? Appropriate waste segregation and disposal practices are higher at hospitals (88 percent) than at health clinics (77 percent) or health posts (76 percent) and are also higher in urban areas and at private facilities. Similarly, equipment for 42