Tag: jobs

Africa needs private sector growth and jobs.

If there is one thing that African economies are not good at, it is fostering the growth of the private sector and creating jobs. This problem, more than debt, more than global geopolitics, more than infrastructure deficits is holding the continent back.

As the last two centuries have shown in Europe, America and Asia, the greatest poverty reduction strategy is jobs. People getting regular incomes spend creating demand in the economy and driving growth. They save creating a pool of savings (something else Africa struggles to do) and that is invested in funding the growth fuelled by the growing demand. Africa needs jobs, and to get those we need a growing private sector. On top of this, private sector fuelled growth is indigenous, it is not reliant on cheap western credit, or Chinese largesse.

However, Africa does not benefit from this self-perpetuating driver of prosperity and poverty reduction. Wage employment in sub-Saharan Africa has barely risen 2% since 1991.

Figure 1: Wage and salaried workers, total (% of total employment) (modelled ILO estimate) – Sub-Saharan Africa | Data (worldbank.org)

In fact, we have become so bad at it we have fetishised entrepreneurship, micro-enterprise, and self-employment. Encouraging young people to become entrepreneurs, to hustle, celebrating those that make it while not acknowledging the high failure rates that they experience (estimates suggest that 70-80% of African startups fail within their first five years). More so, the policy makers, multilaterals and foundations that lead the entrepreneur and MSME cheerleading fail to acknowledge that the high cost of credit and capital that fundamentally undermines those same entrepreneurs and businesses is driven by the fact that we have low savings and thus low levels of native capital available for investment. More than that, everyone trying to be entrepreneur, whether they want to or not, does the wider economy little good.

To rekindle our private sector and create jobs. We must create the conditions in which businesses can thrive and hire more people. Today African businesses are strangled by an ever-growing web of regulations, a policy environment that is unpredictable and disconnected from their everyday realities. Africa needs to create its own prosperity, drive its own growth and for that we need jobs, and our policies need to be geared towards that outcome.

Regulation that works not hinders

Regulation is necessary and it is not evil. Standards agencies and food authorities ensure that the food sold to us is safe to eat, medical boards and bar associations ensure that our doctors are not quacks and lawyers are not hacks.

A well-regulated economy is a positive for the private sector, it ensures stability, enables competition by levelling the playing and most importantly protects citizens. Africa, in general does not have good regulatory systems, and as a result the private sector is hampered by old regulations, poorly written regulations, contradictory regulations and sometimes no regulations. What Africa needs is regulation that works and getting there will require regulatory reform that does three critical things, expand capacity, updates and Africanises regulations.

  1. Capacity – many African regulatory agencies are understaffed, under resourced and underfunded and struggle to enforce their mandates. Frustrating businesses that need licenses, permits, approvals, certificates, standards etc. and endangering the public. Regulations are a necessary public service and the agencies in charge of delivering that service should have the capacity to deliver that.
  2. Updates – a lot of regulation and legislation on the continent is old, dating back to decades some to the colonial era. To operate modern businesses and attract investment you need modern regulations that cater for modern world. Without that you get either chaos or stagnation. For instance, Kenya’s building code dates to colonial Kenya of the 1950’s it does not account for modern construction methods, or modern ways of covering up shoddy work. This has led to a chaotic construction sector dependent on the morals on the developer in question. Leading to a country of modern buildings side by side with collapsing buildings that kill people. African governments need to take a step back, assess their critical regulations and bring them up to date.
  3. Africanisation – we have a bad habit of adopting regulatory regimes from another part of the world, because it is ‘global best practice’ but never updating and adapting them for the African context. Thus, we end up with regulations that we don’t really understand, that are not fit for the African purpose. It is not enough to adopt global best practice, but African governments must ensure that they adapted to and fit their context.

Coherent predictable policy

I have written about this previously and will keep writing about it. The way most African governments make and implement policy lacks coherence and ends up creating a disjointed and unpredictable policy landscape. Sectors (and their ministerial departments) do not exist in isolation, policy in one sector must be connected to another. A packet of biscuits, that you find on the shelf of a shop utilises products from different sectors, wheat from agriculture, milled flour, and sugar in the manufacturing sector, it is transported in trucks on roads from the transport sector and sold in a shop from the trade sector. It is very likely that the farmer, manufacturer, or shop owner has utilised credit from a bank or insurance from the financial sector. If policy is made in any of those sectors it can affect the others and the costs of doing business, and when done so in isolation, the unfortunate biscuit manufacturer may find their business adversely affected by a choice made without the consequences on their sector in mind.

Coherent, predictable policy is the bedrock of a growth environment for the private sector. We must keep demanding this from African governments until it becomes a reality.

Public Private Engagement, Accountability and Action.

One of the key lessons I take from the rise of the Asian tigers is the constant dialogue and collaboration between the public and private sector. Taiwan’s semi conductor industry, now the most important in the world would never have become a reality unless the industry and government were constantly talking and acting in pursuit of shared goals.

In Africa much the government and private sector have either an adversarial reaction where they are fighting each other or an ambivalent one where they talk but don’t listen. Significant sustained private sector and job growth requires genuine engagement and understanding between the public and private sectors.

Government and private sector must not only talk to each other but listen to each other. This requires both sides to recognise and understand that the motivations and goals of the other are legitimate and beneficial. Once that understanding is in place then shared goals can be developed. The growth of the private sector is an inherent goal of business, but it must also be one of government, tied to that the government goals of job growth and key issues like worker conditions, training and education, environmental sustainably must also be private sector goals.

When an honest dialogue and shared goals are established then, plans with key actions and milestones can be developed and the public and private sectors can hold each other accountable to those plans, and thus take real action.

Right now, Africa has an overwhelming number of vision 2030/35/40/60s etc. strategic plans, manifesto’s and blueprints. All of them developed largely by public sector and highly paid consultants with token input from the private sector. The core of their ineffectiveness stems from the fact that these documents are disconnected from and largely meaningless citizens and private sector they are being enacted on. Honest dialogue to establish shared goals and a shared plan will lead to real action and accountability because both the public and private sectors have something to gain from effective implementation.

So long as we continue the ambivalent and adversarial relationship between the public and private sectors, their engagement shall continue to be ineffective.

Jobs and growth

Without private sector growth and jobs, much of our development discourse is meaningless. With jobs come incomes, savings, investment, demand, and tax revenue. With jobs individuals and households have incomes, the ability to pay for housing, healthcare, recreation and invest in the future. In short with jobs come agency and dignity both for people and the nation, and dignity is at the core of my definition of development.

Without private sector growth and jobs, we will be stuck in our perennial cycle of economic growth that is meaningless to the vast majority of African’s, followed by debt crises as African governments attempts to invest and spark growth with debt (on the advice of consultants or multilaterals) falls flat yet again.

If we want indigenous self reinforcing growth, that enables people to live dignified lives out of poverty, then the lesson of the industrial revolution and rise of Asia is that you need a growing private sector and jobs. Our governments need to get serious about providing an environment that can foster that and collaborating with the private sector to create a shared vision for the future with jobs at its heart that both the public and private sector have a stake in achieving.

 

Losing Our Mind: Reversing Africa’s Brain Drain

Africa has a migration problem. Not only are thousands of the continents young men and women risking life and limb to try and make it to Europe, we are also losing some of our best minds. A 2013 report from the United Nations and the Organization for Economic Co-operation and Development found one in nine Africans with a tertiary education (2.9 million people from the continent) were living and working in developed nations in North America, Europe and elsewhere. Over the last 10 years this number has grown by 50% more than any other part of the world. Since 1990, Africa lost 20,000 academic professionals who left their countries and 10 percent of the continents highly skilled information technology professionals. The loss of Africa’s best and brightest is most keenly felt in the health sector, a study by Canadian scientists found that Sub-Saharan African countries that train doctors have lost $2 billion as the expert clinicians leave home to find work in the developed world.

The beneficiaries of this migration are the developed world. The findings of the study suggested that Britain was around $2.7 billion better off, the USA $846 million, Australia $621 million and Canada was $384 million better off. Yet in the developed world, particularly in the West a nativist, anti-immigration sentiment has taken hold. The places that have benefitted most from migration are becoming more hostile to it. This presents a perfect opportunity for Africa to tempt its doctors, engineers, artists, academics and other skilled professionals home. These people offer an unparalleled opportunity to boost our economies and enrich our societies, with the skills, capital, knowledge, networks and experience they could bring back home.

What is needed are the right pull factors to entice the diaspora to move back home. We need policies that make moving back to the continent more attractive.

 

Why the diaspora?

Development needs a skills and knowledge base. Healthcare systems need doctors and nurses to staff them. Infrastructure needs engineers to build them. The IT sector needs talented software and hardware engineers. And the private sector needs people with experience and global business networks if African business are to grow in a global economy. Africa could and should grow these capabilities, but that will take time, valuable time that we can ill afford to lose.

The diaspora offers the perfect way to jumpstart development with human capital. They could bring these much-needed skills, knowledge and networks into the economy while we continue to train more people. In addition, if they came home the diaspora would not only bring back the soft assets of skills and knowledge, they would bring back hard assets, money (in the form of savings and investment funds) that they would use to settle back at home, as well start and invest in businesses. In South Africa it is estimated for every skilled person who returns home to South Africa, nine new jobs are created in the formal and informal sectors. In China, educated skilled professionals, who left China to study and work, are returning. These “sea turtles” have come back with desirable skills, a network of international business contacts and new ideas to boost the economy. Elsevier (the publisher of scientific journals) has used its data to show that India is enjoying a brain gain of scientists returning to and moving to India (the study also shows a similar effect in China).

Thus, the question becomes, how does Africa turn its brain drain into a brain gain. What policies and measures are needed to make African professionals living in other countries want to move back home.

Making moving back easier

If the African diaspora are to be enticed to move back, then we must make it easer for them to do so. This means a smart mix of incentives that make it easier and attractive to move back to Africa.

Moving countries can be a complicated affair, not only do you have to move your stuff, but you also have to register with tax authorities, set up bank accounts and move assets, get all your documentation, insurance, get your children into school etc. Governments can do a lot to make this easier. First by making all of this tax free, the amount of money that governments would make from African migrants coming home and paying taxes on their fridge or money transfers is tiny in comparison to the value they would produce over years. Furthermore, these tax incentives should be extended to those who start new companies within a year of returning and to investments such as buying stocks, bonds and real estate. Second, allow for dual citizenship, this would allow diaspora migrants to become fully fledged citizens without facing the prospect of having to completely leave behind the lives they have built abroad. Coupled with this should be a fast track to citizenship, no one will migrate if they will be in an uncertain situation subject to the whims of an immigration officer, full citizenship will give them security. Third, making reintegration painless. Which means aiding migrants and their families settle in as painlessly as possible, such as helping parents find schools for their children, purchase health insurance and a one stop shop for getting all their official paperwork and documents. Ideally these are services governments should provide to all citizens, and trialling with diaspora migrants may be a way to pilot such a scheme before rolling it out for all. Finally, we must make it clear that we want our diaspora to come back home, that we value them beyond their jobs and financial assets. That our people are our greatest resource and the contributions they could make to our societies would help make economic, social and cultural development a reality. This can only be done by clear unequivocal statements from political leaders backed by policies which make the rhetoric reality.

Reversing Migration

Incentivising high skilled migration is something done by developed countries around the world such as the UK, Canada and Australia, now China is getting in on the game as well. All of them are seeking to attract high skilled migrants to fill gaps in their own labour markets and ensure they remain globally competitive. They all have policies aimed at attracting highly skilled, high earning migrants which fast track their migration and ease their integration into society.

Africa is not only not attracting highly skilled migrants, we are our losing our own highly skilled people, it is a situation that we should be actively looking to stop and reverse. Our hospitals lack the doctors and nurses they need to provide adequate care, our universities lack the professors and researchers they need to produce the next generation of leading minds and research, our governments lack expertise in any number of areas and our private sectors could desperately use people with high level skills, experience and networks. It will not be easy we are in a global competition for the worlds best and brightest, but we must start somewhere, and having the right policies to attract our diaspora brothers and sisters home is a good place to start.

Africa can and should have universal healthcare.

WE ALSO COMMIT OURSELVES to take all necessary measures to ensure that the needed resources are made available from all sources and that they are efficiently and effectively delivered. In addition, WE PLEDGE to set a target of allocating at least 15% of our annual budget to the improvement of the health sector – Abuja Declaration 2001

In April 2001, the heads of state of African Union countries met and pledged to set a target of allocating at least 15% of their annual budget to improve the health sector. Yet almost decade later, not only have just a handful of African nations allocated the pledged amount of money to their healthcare systems, but Africa still has the worst health outcomes in the world (figure 1). The poor and vulnerable still have limited access to healthcare, the insurance and coverage schemes that do exist usually miss out those in the informal sector who make up a sizable portion of the African workforce. Despite some marked improvements since 2001 too many Africans are still falling victim to diseases that could be prevented, too many Africans are being made bankrupt paying medical bills for friends and family and far too many Africans are going without the care they need lowering their quality of life.

Figure 1 source: Angus S. Deaton and Robert Tortora, People in Sub-Saharan Africa Rate Their Health And Health Care Among The Lowest In The World 2015, Health Affairs

 

If we are to think of development as being people centred, then the health of the people is crucial. Quality of life (not to mention length of life) improves significantly when everyone has access to quality healthcare at an affordable cost (which is the WHO’s definition of universal healthcare[1]). If Africa is serious about development we must get serious about healthcare, and the best way to do that is through pursuing universal healthcare. Many will say this isn’t possible, it is too expensive, or African countries simply do not have the resources, however both Botswana and Rwanda show that not only can universal healthcare be done in Africa, but there is more than one way to do it. Thus, the question African policy makers should be pursuing is what do we have to do create quality, affordable healthcare with access for all.

Lessons from Botswana and Rwanda

Rwanda and Botswana have slightly different ways of implementing universal healthcare. Botswana operates a fully public system where the governments owns over 95% of healthcare facilities. The system is built around the delivery of primary healthcare which is available through an extensive network consisting of;

  • 844 mobile stops and 338 health posts which deliver primary preventative care to all it is citizens;
  • 272 clinics (101 of which have beds) which provide outpatient and general inpatient care;
  • and finally, there are the district hospitals and the two referral hospitals which provide long term and complex care and procedures.[2]

Almost all services are free except people between the ages of 5 and 65 pay 5 pula (‘USD’ or ‘$’ 0.50) for general check-ups.

Rwanda pursues universal health through a mandatory health insurance system called Mutuelles de Sante. The scheme is community based, residents of a particular area pay about ‘USD’ or ‘$’ 6 into a community insurance pool, richer citizens are charged higher premiums and for those who can pay a 10% service fee is paid for each visit to a health centre or hospital. Like Botswana Rwanda’s system is decentralised and built around providing primary care through;

  • 34 health post which do outreach activities such as immunisations, antenatal care and family planning;
  • 18 dispensaries and 442 health centres which provide preventative and primary care, out and inpatient services and maternity care;
  • 48 district hospitals which provide inpatient and outpatient care and 4 referral hospitals which provide specialised complex care.[3]

In both countries over 90% of the population have access to affordable healthcare whose quality has seen significant improvement over the last decade.

Botswana and Rwanda hold valuable lessons for policy makers on the continent. The first and most important being that universal healthcare is possible. Secondly multiple funding models are available and there is no reason that you cannot mix match payment, insurance and tax revenue to pay for it. Third, to be effective, primary and preventative health must be at the centre of the system. Primary healthcare focuses on people and their communities, by providing preventative and early continuous care and education, treatment of illnesses before they become life threatening and the early identification of serious health issues that require specialist treatment. Fourth you need appropriate infrastructure, specifically clinics, dispensaries and health posts/centres that are situated in communities around the country and are just as important as big hospitals. If you only invest in big hospitals they will end up being crowded with patients who could have been more effectively treated in facilities in their own communities. Investing in community health centres and facilities ensures that everyone has access to healthcare close to home and that large hospitals can take care of those who need the most help. Finally, we need to invest in people, and this strikes me as part of the solution to an existing problem. Africa has far too many young men and women who are educated but unemployed, to me this presents an untapped pool of administrators, doctors, nurses, pharmacists and clinical technicians who would be needed staff a universal health care system.

Health as development

Universal healthcare in Africa is achievable but only if our governments begin to think of healthcare as just as important to development as roads, power, jobs and education. Fundamentally healthier people are happier people. Universal healthcare will significantly improve the quality of life for hundreds of millions of people, it would take away the spectre of going broke because you, or a relative got sick and it could provide millions of meaningful jobs for young men and women who would jump at the prospect.

In 1948 Great Britain was broke and had just come out of two devastating world wars in the space of three decades, yet it was in that year that they launched the National Health Service which was and still is based on 3 principles; ‘That it meet the needs of everyone, that it be free at the point of delivery, and that it be based on clinical need, not ability to pay.’[4] Today, the NHS is the institution that the British are most proud of. Today, like Britain in 1948, Africa is not rich and faces a myriad of challenges, but we can and should dream big, that all Africans should all have access to quality affordable universal healthcare. If development in Africa is to mean anything surely it must mean that Africans can live full and healthy lives, it is time to bring the Abuja declaration to life.

 

 

 

[1] http://www.who.int/health_financing/universal_coverage_definition/en/

[2] http://www.gov.bw/en/Ministries–Authorities/Ministries/MinistryofHealth-MOH/About-MOH/About-MOH/

[3] http://www.hrhconsortium.moh.gov.rw/about-rwanda/health-system/

[4] https://www.nhs.uk/nhsengland/thenhs/about/pages/nhscoreprinciples.aspx