Crippling budget cuts leave Africa’s public sector workers underpaid, overworked and struggling to make ends meet

• Teachers across Africa are buckling under the weight of brutal austerity measures, losing up to half of their income over five years   
• Nearly all health workers (97%) surveyed by ActionAid said their wages aren’t enough to cover food, electricity and household expenses.  
• 87% of teachers reported shortages of basic classroom materials, with three quarters of staff (73%) paying for equipment out of their own pockets  

A new study by ActionAid reveals that deep cuts to public spending in education and health across six African countries have seen workers struggling to afford essentials like food and resulted in overcrowded classrooms and failing healthcare.  

Published today, The Human Cost of Public Sector Cuts in Africa surveyed over 600 healthcare workers, teachers and community members in Ethiopia, Ghana, Kenya, Liberia, Malawi, and Nigeria. The study highlights that teachers' salaries have plummeted by between 10% and 50% over the past 5 years, with an alarming 97% of health workers reporting insufficient wages for basic needs like rent, food and household expenses. 

The study paints a bleak picture of failing public systems – especially for women and girls. It shows how governments’ inadequate investments in education and health sectors have left workers struggling to make ends meet and communities failing to access quality public services. 

ActionAid says the International Monetary Fund (IMF) is to blame for its advice to governments to cut spending on public services in order to service foreign debts. With the accelerating debt crisis in the Global South, over three-quarters of all low-income countries in the world are spending more on debt servicing than they spend on health. 

Andrew Mamedu, the Country Director of ActionAid Nigeria, said:   

“The debt crisis and the IMF's insistence on cuts to public services in favour of foreign debt repayments have severely hindered investments in healthcare and education across Africa. For example, in 2024, Nigeria allocated only 4% of its national revenue to health, while a staggering 20.1% went toward repaying foreign debt.  

“This is not only absurd but unsustainable in the long run. The time for change is now. Governments must shift from unsustainable economic policies based on cuts and debt repayments to those that prioritise human rights. The lives of millions depend on it.”   

The research highlights how insufficient budgets in the healthcare system have led to chronic shortages and a decline in service quality. Community members in all six countries revealed deep dissatisfaction with the public healthcare system and noted rising costs of services, shortage of healthcare workers, and poor infrastructure. What’s also clear is the disproportionate impact on women, as Maria*, a healthcare worker from Kenya, explains:  

“In the past month, I have witnessed four women giving birth at home due to unaffordable hospital fees. The community is forced to seek vaccines and immunisation in private hospitals since they are not available in public hospitals. Our [local] health services are limited in terms of catering for pregnant and lactating women, as a result, most women must seek services in Mombasa, which is expensive.” 

Medicines for malaria are now ten times more expensive at private facilities. Long travel distances, rising fees and a dwindling medical workforce are leaving millions without healthcare as Marym*, a community member from Muyakela Kebele, Ethiopia, reveals:  

“Now malaria is an epidemic in our area [because medication is now beyond the reach of many]. Five years ago, we could buy [antimalarial medication] for 50 birrs (USD 0.4), but now it costs more than 500 birr (USD 4) in private health centres.” 

Rose*, a community member from Taita Taveta in Kenya, said:  

“We are referred for diagnosis tests 40 km away from the [local] dispensary. Doctor’s consultation has [doubled] at the referral hospital, making it difficult for the community to access services.”  

In education, the toll is equally severe. Budget cuts have resulted in failing public education systems crippled by rising costs, a dire shortage of learning materials and overcrowded classrooms. Some 87% of teachers said they lacked basic classroom materials, with 73% shelling out for equipment themselves. Meanwhile, teachers’ incomes are falling: 84% of teachers surveyed reported a drop in real income of between 10 and 50% over the past five years.   

“I now believe teaching is the least valued profession. With over 200 students in my class and inadequate teaching and learning materials, delivering quality education is nearly impossible. Monitoring individual performance and supporting struggling students has become a daunting task,” said Maluwa*, a primary school teacher in Malawi’s Rumphi District.  

Four of the six countries covered by the research are spending less than the recommended one-fifth of the national budget on education and exceed the ratio of one teacher per 30 pupils, as reported by the UNESCO Institute for Statistics. 

Kasor, a teacher from Liberia, with 80 pupils in his class, said: “The ministry doesn’t provide teaching aids or textbooks. I feel stressed and hopeless. We need better infrastructure and resources to cope with these changes.”  

On a personal level, due to reduced income, Kasor said, “I often struggle to put enough food on the table.” 

The research shows that the consequences of these policies are multi-faceted and far-reaching. Workers are stretched beyond their limits and communities’ fundamental rights to healthcare and education are severely impacted. Governments and the IMF must work to reverse this damaging trend of cuts to essential services while prioritising debt repayment. 

Roos Saalbrink, the Global Economic Justice Lead at ActionAid International, said: 

“The debt crisis and drive for austerity is amplified for countries in the Global South and low-income countries, especially due to an unfair global economic system held in place by outdated institutions, such as the IMF.  

“This means the burden of debt falls on those most marginalised - once again. This must end. 

She added: “It’s crucial that governments agree on new international rules on global economic governance that shift important decisions away from the IMF and towards democratic institutions, such as the United Nations, to shape a fair and inclusive global economy for all.” 

ActionAid is calling on education and health ministries to work with finance ministries to allocate sufficient resources to meet global benchmarks, ensure fair remuneration for workers, and improve infrastructure to deliver quality services. 

Additionally, governments should explore fair and just ways of raising income, such as progressive taxation, rather than imposing spending cuts to essential public services.