The paper begins with an overview of the economic and social trends in
Africa over the last decade, noting that the current period of economic
growth has not yielded commensurate improvements in key social indicators,
such as poverty and child nutrition. It builds on the work carried out by The
Cost of Hunger in Africa (COHA) studies that have estimated that between
70 and 90 per cent of the costs of care for malnourished children are borne
by families and not by public health systems. The proportion of children
who do not receive medical attention, particularly through births attended
by skilled personnel, or access to maternal child health programmes, and
therapeutic treatment for underweight children, are among the key drivers
of the costs of caring for underweight children, in addition to the time
dedicated by the primary caregivers in households. Yet, the issue of care,
performed mainly by women, has not featured in overall policy discussions
of actions and interventions. The paper also analyses trends in per capita
investments in health and proposes a research agenda to inform policy
makers on specific issues related to care.