Reducing maternal and child mortality; improving access and quality of health care for all; keeping in check AIDS, tuberculosis and malaria: these are all major challenges for the 21st century. Health is an issue interwoven with many global problems – demographic, economic and environmental – and is today a priority of AFD action throughout the world.
  • logo linkedin
  • logo google plus
  • logo email
Nurse, Ngaliema Hospital, Kinshasa (DRC)
Lebanon, sciences, technologies, health, research

Promoting universal health coverage

health, Kabul, Afghanistan

Promoting universal health coverage

The world population will reach 8.5 billion in 2030. To guarantee quality of life for each person, it’s crucial to set up universal health coverage (UHC). This concept, supported by France, asserts that “all citizens should receive the quality services they need, without encountering financial difficulties”. UHC is now one of the most powerful drivers of social equality, especially within the framework of the SDGs.

AFD works with its partners in all aspects of their efforts aiming at health system strengthening (HSS): infrastructures, human resources, equipment, medicines, governance, etc.

We encourage the equity and financial protection that must shape the foundations of health systems. Our objective: to build – along with our partners – stable and sustainable societies that leave no one out.
To guarantee global health security and rapid resilience when disasters occur, we must also learn the lessons from the Ebola epidemic and recent global health crises. Incorporating the hygiene measures required to respond to the effects of climate change is also part of our action.

Improving maternal, newborn and child health

Health center Dar Naïm Post-childbirth consultation, Mauritania

Improving maternal, newborn and child health

In 2014, 220 million women were deprived of access to contraception. West Africa is the region of the world where adolescent pregnancy is most frequent. Lack of access to contraception is a major obstacle to the empowerment of young girls as well as to their access to education, employment and income. Sexual and reproductive rights are the foremost conditions for equality between women and men.

AFD’s action seeks to guarantee these rights and to ensure access by women and girls to suitable quality services. Our objective: to make it finally possible for women to no longer die during childbirth, to choose the number of children they will have, to have access to education and work, and to contribute to their country’s development and social progress.

In the countries that haven’t yet started their demographic transition, especially in the Sahel (where the population is expected to double by 2040 and triple by 2060), the priority of AFD is to work to reduce maternal and child mortality. Our teams and partners strive to eliminate malnutrition and to reach balanced demographics, which are essential for sustainable development.

Young people have a demographic weight that requires the development of responses whose impact will be felt in the long term. AFD supports investments in reproductive, maternal, newborn, child and adolescent health (MNCAH). These are decisive drivers for promoting more secure, equitable and inclusive societies.

Learning to deal with epidemics

technology, health,science, laboratory, Lebanon

Learning to deal with epidemics

Only epidemiological surveillance makes it possible to quickly detect epidemic threats and to thereby respond to them appropriately. It’s a powerful tool that can be used to promote not just public health, but also economic development – as SARS and Ebola showed the impact epidemics can have on growth.

The majority of emerging diseases among humans come from animals. AFD is promoting the extension of surveillance to animal health, as part of an integrated approach called “One Health”. In our globalized world, viruses and bacteria ignore borders. Epidemiological surveillance and health security must thus be considered as a “common good”, and this with a clear framework: international health tools.

Climate change is generating phenomena (droughts, flooding, etc.) that are modifying eco-systems and furthering the emergence of new diseases or epidemics. AFD is strengthening epidemiological surveillance in the most vulnerable regions, such as small island states. This aspect is an important policy of adaptation to climate change.

In this field, our priority actions are in the overseas France regions and in the places where our network of expertise possesses added value (for example the Pasteur Institutes in Southeast Asia and in French-speaking Africa). We give priority to regional approaches and to do so support integration bodies such as the Indian Ocean Commission and the Pacific Community.

Improving the care offer

Nurses, Ngaliema Hospital, Kinshasa

Improving the care offer

Strengthening health systems is a priority. That’s why AFD supports the hospital sector in around 30 countries. In all, more than 120 projects have been financed or funded, amounting to nearly 1 billion euros: hospital construction, reconstruction and extensions; capacity building for hospital personnel, etc.

Our financing benefits both the public and private sector. We can also take action from the project-design stage (strategic and/or technical feasibility studies, assistance in project management).

To round out these actions, we mobilize numerous public and private experts to reinforce projects and respond to beneficiary requests. We call on our French partners, who are healthcare operators, health agencies or professional federations, etc. They may take action for one-off support projects or for programs in capacity building and improving structures.

Investing in eHealth

La Réunion University Hospital – Bellepierre

Investing in eHealth

eHealth refers to digital services used in health systems. This field covers the information systems developed to steer and manage the sector (epidemiological surveillance and hospital activities), telemedicine and telehealth. New prospects currently deal with the micro (self-evaluation or “quantified-self” phenomenon) and the macro (“big data”) levels.

When it comes to health system strengthening, eHealth has strong potential. For example, ICT ensures better information circulation so that patient care can be ensured in a more reliable and coordinated way. In access to health care, telemedicine helps to redesign the health map, carry out territorial rebalancing for low-density medical areas, and facilitate the healthcare circuit. Management of the sector can also be strengthened, along with a health watch and a more detailed and instantaneous regulation of activities. Finally, by offering the possibility of optimizing health systems, ICT includes an essential economic dimension.

AFD provides guidance for around 20 projects incorporating the development of ICT. These initiatives may take place as support for public policies (Tunisia, Morocco, Colombia) or as more targeted investments (computerized medical file in Mali, regional information system in Martinique, etc.). We are also involved in a partnership with the Fondation Pierre Fabre to develop an eHealth observatory in the Global South.

million people with better access to health care in 2016
projects financed in 10 years
countries supported in the last 10 years

In the last 15 years or so, historic progress has been made: reduction of child mortality as well as improvement in maternal health and in the fight against HIV/AIDS and malaria, etc. But with 8.5 million people on the planet in 2030, health is one of the major challenges for the coming years. How can each person be guaranteed quality care? How can maternal mortality be reduced? How can avoidable deaths of newborns be eliminated?

AFD’s Health and Social Protection Strategy is perfectly consistent with the SDGs. In it, health development is considered in close relation with demographic, economic and environmental challenges.

More broadly, health challenges are incorporated into AFD’s policy of carrying out projects that are 100% climate-compatible. For instance, epidemiological surveillance and nutrition are repositioned into States’ policies for adaptation to the effects of climate change. More generally, we consider health – including financial accessibility to care – as a factor of resilience, especially for the most vulnerable populations.

AFD supports the sector through grants, long-term loans, guarantees and capital investments. It also manages grants that stem from European funds. These may round out a loan to finance our technical support program, for example. In 2016, our health-related commitments in foreign countries and in Overseas France amounted to 245 million euros.

Interactive map
This map is for illustrative purposes only and does not engage the responsibility of the AFD Group
Funding type


Tout cocher
Tout décocher

Funding type

Tout cocher
Tout décocher


Display local antennas


Launch search
See map of all projects


Evaluation document

Going Beyond Adverse Selection: Take-up of a Health Insurance Program in Rural Cambodia

Standard insurance theory predicts that households that anticipate high insurance costs are those that are willing to purchase health insurance (adverse selection). However, there are also several other reasons why ...
Dec 2012
Evaluation document

Adverse selection based on observable and unobservable factors in health insurance in rural Cambodia

High health care expenditures following a health shock can have long-term economic consequences. Health insurance has the potential to avert economic difficulties following health shocks, increase health care utilization and ...
Oct 2012
Evaluation document

Insuring Health or Insuring Wealth? An experimental evaluation of health insurance in rural Cambodia

High health care expenditures following a health shock can lead to long-term economic consequences. Health insurance has the potential to avert economic difficulties following health shocks. If uninsured individuals forgo ...
Mar 2012
Evaluation document

SKY Impact Evaluation Cambodia, 2010 Village Monographs

The SKY health microinsurance programme, run by the GRET is an innovative attempt to extend health insurance to Cambodians, with special initiatives reaching out to both the rural and urban ...
Aug 2012
Research document

DNDi, a Distinctive Illustration of Commons in the Area of Public Health

Following many years of structural adjustment programmes, the last decades of the 20th century saw drastic reductions in the public health resources of developing countries. The failures of the liberal ...
Feb 2019
Research document

Linkages between Education and Fertility in Sub-Saharan Africa

This paper explores linkages between women’s education and fertility in sub-Saharan Africa, using DHS data from about 30 countries. There are three substantive sets of analyses. First, we shed light ...
Nov 2017
Research document

Prevention or treatment? The introduction of a new antimalarial drug in Angola

In spite of massive efforts to generalize efficient prevention, such as insecticide-treated mosquito nets (ITN) or long-lasting insecticidal nets (LLINs), malaria remains prevalent in many countries and ITN/LLINs are ...
Sep 2017
Research document

An Application of the Alkire-Foster’s Multidimensional Poverty Index to Data from Madagascar: Taking Into Account the Dimensions of Employment and Gender Inequality

In this study, we build what we call the Malagasy Multidimensional Poverty Index (MALAMPI), which is an augmented-MPI. Here, in addition to the standard MPI dimensions (health, education and living ...
Apr 2017
Institutional document

Southern Africa: Social inclusion

Access to education, healthcare, decent housing and employment are fundamental to human dignity, and are key to achieve poverty eradication. In Southern Africa, although poverty rates fell by almost half ...
Sep 2018

Sahel Alliance: Aïssata

Facilité Santé Nord-Mali In North Mali, Aïssata, like 62,000 other women, will be able to give birth under good conditions thanks to the strengthening of health services within the framework ...
Jul 2018

Mobisan : Mobiles phone for healthcare services

Since January 2015, the MobiSan project in Burkina Faso has been improving the use of good health and nutritional practices and mother and child health services by populations in Gourma Province, ...
May 2018