Young Africans call for changes to health systems and jobs

Young people during discussions.  The meeting also highlighted a wider employment challenge facing young Africans.

More than 80 young African health professionals, researchers, innovators, entrepreneurs and higher education representatives have called for major changes in how the continent trains, employs and involves young people in its health systems.

The call emerged from Ubuntu Rising 2026, a meeting convened by the Africa Health Collaborative and hosted by the University of Cape Town, where participants developed nine recommendations covering leadership, innovation and employment.

The recommendations come as Africa faces a shortage of 5.5 million health workers, even as nearly one million trained health professionals remain without meaningful work, according to figures from the World Health Organisation’s Regional Office for Africa cited during the meeting. 

The meeting also highlighted a wider employment challenge facing young Africans.

Figures from the Mastercard Foundation’s Africa Youth Employment Outlook 2026 show that 90 per cent of employed young Africans work in the informal economy, while only 10 per cent of jobs are formal. The report also says 34 per cent of employed young Africans live in households below the $2.15-a-day international poverty line, while only nine per cent have completed tertiary education. 

Prof Brandon Collier-Reed, Deputy Vice-Chancellor for Teaching and Learning at the University of Cape Town, said the continent needs to look beyond simply counting how many young people are employed.

“Employment, on its own, is not the goal we should be measuring ourselves against. The question before us is not whether young Africans are working. It is whether the systems we have built are working for them.”

The nine recommendations are grouped into three areas, leadership, innovation and employment.

On leadership, participants called for stronger links between young professionals and health policy and systems. They want learning and networking opportunities that help young people understand how health systems operate and give them greater opportunities to contribute to decision-making.

They also called for youth leadership to be measured by influence and system-level outcomes rather than simply the number of young people who attend programmes or receive training.

The participants further recommended that institutions create environments where young people can take meaningful leadership roles.

On innovation, they called for leadership, problem-solving and entrepreneurship to be integrated into existing higher education and training programmes instead of being treated as separate interventions.

They also proposed structured programmes to help young people turn ideas into viable health innovations and businesses, while connecting young innovators to existing expertise and infrastructure.

On employment, the group called for harmonised curricula across Africa to make skills more transferable and improve opportunities for young people to work across borders.

They also urged governments and institutions to create stronger pathways into paid and dignified health employment, including internships, while giving young people a greater role in health policy and decision-making.

Training programmes should also be more closely linked to entrepreneurship and the needs of communities, the participants said.

The recommendations reflect the findings of the Mastercard Foundation report, which says Africa’s youth employment is largely informal and that low educational attainment and poverty remain major barriers to better jobs. The report estimates that 304 million young Africans aged 15 to 35 were employed in 2025, but 90 per cent were in informal jobs. 

Dr Nathina Pakade, a Public Health Medicine Registrar at the University of Cape Town and the Western Cape Department of Health and Wellness, said young people should have a role beyond simply attending meetings.

“There is a difference between asking young people what they think and giving them a meaningful role in deciding what happens next. For me, meaningful participation is moving beyond simply being present in the room to having the opportunity to influence what happens in that room.”

She said education and training alone were not enough and called for systems that allow young people to gain experience, receive mentorship and progress into leadership.

Young people should be able to “enter, learn, contribute, progress and lead”, she said, moving from “holders of potential to instruments of influence.”

Prof Tracey Naledi, Deputy Dean for Social Accountability and Health Systems at the University of Cape Town and host of Ubuntu Rising, said young people should be involved in designing the future of health systems.

“If we're building a world we won't be part of, then those who will inherit it must help create it. At the Africa Health Collaborative, everything we do is done with young people and informed by young people — and increasingly, led by young people, with us in a supporting role. For us, this is more than participation or consultation. It's co-creation of the future we all want to see,”

The nine recommendations will feed into the Africa Health Collaborative’s Youth Agenda and are expected to inform its future programmes, partnerships and engagement with the wider health sector.

The Africa Health Collaborative is a partnership involving the Mastercard Foundation, Amref Health Africa, Addis Ababa University, African Leadership University, African Institute for Mathematical Sciences, Ashesi University, Kwame Nkrumah University of Science and Technology, Moi University, the University of Cape Town and the University of Toronto.

The partnership focuses on strengthening primary healthcare systems through health workforce development, education, innovation and entrepreneurship. It is also part of the Mastercard Foundation’s Young Africa Works strategy, which aims to help 30 million young people, particularly women, access dignified and fulfilling work by 2030.

The recommendations come against the backdrop of the 18th World Congress on Public Health, held in Cape Town from September 6 to 9 under the theme “Health Without Borders: Equity, Inclusion, and Sustainability”.