Health in Equatorial Guinea

The Ministry of Health and Social Welfare, known as MINSABS, oversees the national health system. Public primary care includes 161 health posts and 46 health centres. Secondary care includes 11 district hospitals and 5 provincial hospitals, while two regional hospitals in Malabo and Bata provide the highest level of care in the country. These structural figures come from recent reporting but partly rely on older INEGE data, and a 2024 WHO assessment in ten districts found substantial staffing and management gaps. A person normally starts routine care, vaccination, antenatal care, family planning, malaria prevention, nutrition support, child care or basic treatment at a health post or health centre. District hospitals provide referrals and basic inpatient care. Provincial hospitals handle more complex cases, and regional hospitals receive patients who need specialist assessment or treatment. Interhospital transport is often the patient's responsibility, so distance and available transport can determine whether a referral is completed. Private clinics and pharmacies are also used, especially where public services are distant or crowded. INSESO polyclinics provide a parallel social-care channel for eligible users. Health care is not generally free across the country. Public and private facilities may request payment before treatment, and reliable nationwide tariffs are not consistently published. Antiretroviral treatment for HIV is provided free of charge through the national program. Public-sector artemisinin-based combination treatment for malaria is also free for all age groups. GeneXpert can provide a tuberculosis test result in about two hours where the equipment and service are functioning. Emergency telephone information is inconsistent: published guidance cites 3101 in one source and 112 or 115 in another, and both sources warn that emergency numbers may be unreliable. Confirm the local emergency pathway with the nearest facility and arrange transport where necessary. Malaria remains a major national health concern. Transmission is high, Plasmodium falciparum is reported as the dominant parasite, and the 2023 estimate was about 422,800 cases and 757 deaths. Free insecticide-treated nets and public malaria treatment support prevention and early care. HIV affects more than 6% of the population in the available evidence; antiretroviral coverage was about 49% in 2023. HIV services include testing, treatment and prevention of transmission from parent to child, with a start-of-treatment check after 14 days and medicine collection commonly organized every three months. Tuberculosis also requires prompt assessment: the estimated incidence was 275 cases per 100,000 people, and 95% of reported tuberculosis diagnoses in 2023 used a rapid test. Tuberculosis and HIV services are integrated in some facilities. Maternal and child health services include antenatal care, skilled birth attendance, postnatal care and emergency obstetric and newborn care. The available maternal mortality estimate was 212 deaths per 100,000 live births in 2020. Family-planning needs remain substantial, particularly among adolescents, and only nine facilities were reported to have the full basic emergency obstetric and newborn care package in 2024. Rural home births assisted by untrained traditional birth attendants continue to carry additional risk when emergency referral is delayed. Routine immunization is delivered through the national vaccination program, but coverage estimates vary and vaccine stock-outs and catch-up needs have been reported. WHO and UNICEF estimated 2023 coverage at 74% for the third DTP dose, 61% for the first measles dose and 28% for the second measles dose. Mental-health and non-communicable-disease programs exist, but specialist psychiatric and psychological services remain limited, including in larger cities. Traditional medicine is a locally relevant informal pathway. A national directorate and legal recognition have existed since 1985, but the degree of registration, standardization and integration with primary care is unclear. Traditional treatment should not delay assessment for severe symptoms, malaria, tuberculosis, HIV, pregnancy complications or other conditions requiring urgent medical care. The Constitution promotes primary health care, but the available legal review did not identify an explicit constitutional right to health that guarantees universally free treatment. Health professions are regulated by Ley 7/2006, while Ley 3/2003 regulates medicines and health products.