All these challenges are more acute in sub-Saharan Africa, which faces additional problems of financial and human resource constraints and low investment in health research ( 3, 4). Common shortcomings of contemporary health systems include fragmented, inappropriate, misdirected or poor quality care which mitigate against a comprehensive and balanced response to population health needs ( 1). These include: the changing burden and complexity of disease profiles the social, political, economic and environmental drivers of ill-health, unacceptable health inequalities between and within countries, and inadequate or poorly performing health systems ( 1, 3). Notwithstanding worldwide aggregate improvements in the health of individuals and communities, ( 1, 2) overall progress has been marred by a multiplicity of factors.
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