Seychelles



Africa

4.2%CHE/GDP

24.4%OOP/CHE

10.2%GGHE-D/GGE

2BGDP (USD)

125.5KPopulation

Seychelles has the highest health spending per capita in Africa, as shown in the Africa Scorecard on Domestic Financing for Health 2024. Still, out-of-pocket (OOP) health expenditure as a percentage of current health expenditure (CHE) was 22% in 2021, despite health services in public health institutions being free at the point of delivery. This OOP/CHE ratio exceeds the ratio of prior years, such as 20% in 2020.

The Constitution of Seychelles states that “the State recognizes the right of every citizen to protection of health and to the enjoyment of the highest attainable standards of physical and mental health …”. The constitution also addresses the measures the country will take to regarding these rights in the areas of free primary health care; prevention, treatment and control of disease; infant mortality and the healthy development of children; promoting individual responsibility for health; private medical services.

A Strategic plan and a national health promotion policy

To facilitate the implementation of the National Strategic Health Plan (NHSP) and a national health promotion policy, Seychelles has opted for the guiding principle of “health for all and health by all”. This plan, adopted in 2022, is built around six pillars:

SD1 Strengthen leadership, governance and administration
SD2 Protect and improve universal health coverage
SD3 Improve health security
SD4 Promote healthy populations
SD5 Invest for results
SD6 Improve data for impact

In 2023, Seychelles adopted a National health promotion policy, which states that during the few preceding years the country had found maintaining past health gains challenging. In this context, the policy promises to implement the NHSP by proposing “bold changes to maintain and build on health gains for all people in Seychelles throughout the life-course. It recognizes that promoting, protecting, and restoring health in the fragile and unpredictable post-pandemic social and economic situation requires bold and innovative approaches.”

This approach would help support the country’s efforts to advance universal health coverage (UHC). Indeed, the country’s annual Health sector performance report for 2019 states “Seychelles has achieved a high service coverage index (80)”. However, it also notes “some aspects of UHC, such as equity and quality of services, are not currently systematically measured at present”.

Universal health coverage in the coming years

To address this concern, the NHSP’s Strategic Direction 2 (SD2) aims to “provide people of all ages and all health needs with health services. Transform primary health care. Use a proactive approach to prevention, work on achieving all dimensions of quality care”.

To this end, Seychelles aims to meet four “specific objectives” listed and detailed in the NHSP 2022-2026 :

Improve health services across the life- course and address priority health conditions.
Champion Quality Improvement across the health system.
Improve collaboration with private health sector and health-related NGOs.
Mitigate risks and mainstream resilience across the health system.