Similarly, many countries are characterised by a dualism in education and health, distinguished by the coexistence of expensive, private and public elite institutions situated in the capital, and a core sector (primary schools and health centres) lacking personnel, poorly stocked, and unevenly spread out across the region. 
Hivyo hivyo, nchi nyingi za Afrika zinasifa ya upacha wa elimu na afya, zinazotofautishwa na uwepo wa taasisi ghali, za binafsi na zile za umma zoete zikiwa mijini, na sekta kubwa (shule za msingi na vituo vya afya) vikikosa wataalamu, vifaa duni, na kutokuwepo maeneo yote ya nchi.