How does healthcare work in Africa, and what travel insurance, health insurance or expat insurance do you need?

How does the healthcare system work in Africa?

The quality of healthcare in Africa varies greatly from country to country, depending on factors such as economic development, political stability, colonial history and urban infrastructure.
The best countries for healthcare are South Africa, Ghana, Kenya, Tunisia, Algeria, Nigeria, Egypt and Morocco. Countries where locals suffer greatly and where you cannot find good healthcare include the Central African Republic, DR Congo, Somalia, South Sudan and Chad.
Outside of popular international cities, it can be difficult to find English-speaking healthcare.
Most countries offer both public and private healthcare options.
Pharmacies are found in urban areas. Large international cities in particular have well-equipped pharmacies with all the necessary medicines. In rural areas and in many poorer countries, pharmacies are limited or non-existent.
In some countries, medical evacuation to South Africa, Europe or the Middle East is necessary for serious medical problems. Expats almost always opt for international health insurance, mainly because private healthcare is expensive and public healthcare often falls short.

Public healthcare is free or very cheap for residents in most countries, but of varying quality. For foreigners, this care is usually of limited use, unless they officially register with a local healthcare system.
The quality does depend strongly on the location: healthcare is better organised in urban areas than in rural areas.
Expats often have access to healthcare, but the quality and waiting times are a barrier.

Private healthcare is often used by foreigners and the local middle class. The care is often of better quality, with more extensive facilities and better trained doctors.
You can also find English-speaking staff more quickly here, especially in large cities.
Many countries have international private hospitals, for example Aga Khan Health Services (East Africa), Netcare and Mediclinic (South Africa), or private clinics in Nairobi, Accra, Tunis, or Rabat.
In countries such as South Africa, Morocco, Tunisia, Ghana, Kenya, Mauritius, Botswana you will find good private care.
In countries such as Niger, Eritrea and the Central African Republic even private care is difficult to find.

In many African countries the classic ‘general practitioner system’ does not exist as in Europe. People often go directly to clinics or hospitals.
In countries such as South Africa, Namibia, Mauritius and parts of North Africa (such as Morocco and Tunisia) general practitioners are part of the system.
In rural areas it is nurses, community health workers or traditional healers who fulfil the role of primary care provider.

In cities in some countries, private dental practices are easily accessible. In popular countries such as South Africa, Morocco, Egypt, Ghana, Kenya the quality of dental care is reasonable, especially in private clinics.
In rural areas or in conflict areas dental care is often limited or absent.
Prices are relatively low compared to Europe. Expats generally choose private clinics for reliability and hygiene.

Public maternity care is often free or cheap, but varies greatly in quality. In many countries, women depend on clinics with basic facilities or on help from NGOs.
In Rwanda, Ghana, South Africa, Kenya, Morocco, maternal and child care is relatively well developed, with prenatal care and vaccination programmes.
In countries such as Haiti, DR Congo, Chad, and Somalia, maternity care is limited or risky; giving birth is often dangerous here due to a lack of hygiene, emergency care and medical support.
Expats usually choose private clinics with international support, or fly abroad (e.g. South Africa or Europe) for childbirth and maternity care.

The safety situation also varies greatly per country in Africa. While you can expect some countries to be relatively safe - for example countries where many expats live, where the political situation is stable and where the economy is reasonable - other countries are sometimes extremely unsafe.
The relatively safe countries are Botswana, Namibia, Mauritius, Ghana, Cape Verde and parts of South Africa. Unsafe countries are mainly conflict countries such as DR Congo, Somalia, South Sudan and Burkina Faso. Here the risk of kidnappings and serious conflicts is much greater.
In general, you should be careful everywhere for pickpocketing, burglaries and car theft. Many foreigners live in guarded neighbourhoods.
It is also unsafe to walk the streets alone in the dark in many countries.
In countries where the government situation is stable, political unrest can lead to sudden unsafe situations.

You cannot avoid the risk of tropical diseases in Africa. These types of diseases, such as malaria, dengue, bilharzia, yellow fever and typhoid are widespread.
In many countries, tap water is not drinkable.
In high-altitude areas, altitude sickness can occur.

Driving in Africa actually also poses a considerable risk in terms of safety and health, although this also varies greatly from country to country. Roads are often poorly maintained, traffic is sometimes chaotic and you can get stuck in extremely remote places if you are looking for adventure.
In countries such as Kenya, Nigeria, Uganda, Ghana and Tanzania, traffic is busy and dangerous, with many accidents.
In South Africa, the road network is well developed, but there are risks of robberies on certain routes.
Public transport is usually limited or unsafe; many expats use private drivers, taxi apps or their own transport with local knowledge.

Is the trip to Africa and your return sufficiently covered? Are you sufficiently covered before, during and after your activities? Which insurance best suits your trip and your activity? Which insurance best suits your trip and your activity? Read more about insurances for abroad on JoHoinsurances.org.

A good, international health insurance is essential for almost all countries in Africa. There are many health risks, while the quality of care often leaves much to be desired. Insurance is therefore not only important to cover the costs of private care, but especially to prevent high costs for medical evacuation or repatriation.
Make sure your insurance covers medical evacuation as well as coverage in neighboring countries. Read more about insurances for abroad on Expatinsurances.org.

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