How Poverty Affects PregnancyWomen living in poor rural communities have a higher risk of maternal mortality. An astounding 99 percent of maternal deaths take place in developing countries. More than half of these victims lived in sub-Saharan Africa and one-third lived in South Asia.

The number one cause of death for adolescent females in developing countries is complication in reproduction. The risk of death is higher in girls of the age 15 years and younger. Their country’s health systems often fail to provide adequate health services to survive pregnancy and childbirth.

An estimated 75 percent of maternal deaths are caused by:

  • High blood pressure: during pregnancy preeclampsia should be detected and can be remedied with magnesium sulfate.
  • Infections: when recognized in a timely manner, they can be treated, and good hygiene following childbirth can prevent it.
  • Excessive bleeding after childbirth can kill a healthy woman in a matter of hours. To reduce this risk, oxytocin is injected immediately after birth.
  • Diseases such as malaria and AIDS (during pregnancy) account for all other maternal deaths.

Poor Health Systems

In developed countries, it is typical for women to have at least four prenatal care visits. Postpartum care is also recommended and received by high-income countries. Unfortunately for millions of poor mothers, there is no access to skilled providers to help them.

The lack of access to health workers can be due to lack of information or an issue of distance. At times, cultural practices prevent women from getting the care they need, and most often the nearest health facility is in another community.

The World Health Organization is contributing to the Global Strategy to improve health for women and children. Their goal is to ensure access to a better health system with effective treatments, trained health workers, and health coverage programs. Without access to quality health care during these critical times of development, this is another way in how poverty affects pregnancy.

Food Insecurity Impacts Female Health

Food insecurity is another way in which poverty affects pregnancy. Creating a new life requires a lot of energy from a woman’s body. This is why women facing food insecurity are at risk of health problems. A poor diet can cause:

  • gestational diabetes
  • iron deficiency (the mother becomes anemic)
  • low birth weight.

If women do not intake the appropriate amount of nutrients, the baby will take the vitamins and minerals from their mother’s body. This weakens a woman’s immune system which is needed to fight off disease and infection.

The Importance of Nutrition for Child Development

A healthy diet when creating a new life is consuming 1,800 calories a day in the first trimester, 2,200 in the second trimester and 2,400 in the third trimester. Essential nutrients include:

  • calcium for healthy growth
  • iron for a baby’s blood supply and
  • folic acid, which reduces the risk of spina bifida and anencephaly (a brain defect).

Without proper nourishment, a child will suffer from chronic malnutrition. This leads to impaired brain development, a weakened immune system and shorter stature. This could mean that some children will be unable to complete schooling. This is yet another factor in how poverty affects pregnancy.

The USAID study shows that girls with stunted growth have their firstborn at approximately four years younger than non-stunted girls. Additionally, these girls who are not fully developed to give birth to a child contribute to the maternal death rate.

It does not stop there. UNICEF estimates the under-performance of these victims will cost their generation’s global economy $125 billion. The five countries where nearly half the population of children under age five are chronically malnourished include Madagascar, Papua New Guinea, Eritrea, Burundi and Timor-Leste.

Overall, without access to a proper health system or proper nutrition, studies indicate the negative ways in how poverty can affect pregnancy. The health of a pregnant woman is vital for childbirth. Prenatal malnutrition stunts the development of children’s bodies and minds. Children can find themselves with learning challenges. This sets generations back from reaching their full potential to advance their communities, fueling the cycle of poverty.

-Crystal Tabares
Photo: Flickr

Located in Eastern Africa, Somalia continues to persist through political unrest. Withstanding colonialism until the late 1960s, civil war, authoritarian government, extreme poverty, environmental devastation and most recently, increased activity by jihadist fundamentalist group Al-Shabaab, educational opportunities may seem bleak, especially for girls. In the face of national struggle, the quest for education persists. Here are 10 facts about girls’ education in Somalia.

Top 10 Facts About Girls’ Education in Somalia

  1. Somalia has one of the lowest school enrollment rates in the world. In 2018, 86 percent of Somalis between the ages of 15 and 24 received no education. Eighty-one percent of girls between the ages of 6 and 11 do not attend primary school and 79 percent of girls between the ages of 14 and 17 do not attend secondary school. The percentages for boys in the same age groups are slightly lower at 77 percent and 66 percent, respectively, showing a drastic disparity between genders. Only 1 percent of Somalis completed their post-secondary education in 2018.
  2. Poverty creates a huge barrier to girls’ education in Somalia. 1991 marked the end of a central school system due to political instability. Outside of Puntland and Somaliland (nearby states that offer more stability), private schools require parents to pay for their children’s school fees. However, almost 75 percent of the population lives under $2 per day. Consequently, 96 percent of Somalia’s poorest children never attend primary or secondary school while 50 percent of children belonging to Somalia’s wealthiest families receive primary education and 60 percent receive secondary educations.
  3. There is a huge need for resources for girls’ education in Somalia. Civil war combined with drought and flooding left school infrastructure in poor condition. Girls in particular lack adequate access to sanitation facilities and toilets, further disincentivizing girls from going to school. Additionally, there is a lack of qualified teachers in Somalia. Less than 20 percent of teachers are women.
  4. Close to 40 percent of children in Somalia between the ages of 5 and 14 are engaged in child labor. Almost 54 percent of these child laborers are girls, while 44.5 percent are boys. Nearly 40 percent of children between the ages of 5 and 14 work instead of going to school and 20.2 percent of children between the ages of 7 and 14 have jobs and go to school. Child laborers often endure dangerous conditions farming, herding livestock, mining, working in construction or selling goods and services on the streets. Children also face recruitment by groups like Al-Shabaab who force or coerce boys into becoming soldiers while they target girls for domestic and sexual slavery.
  5. Female genital cutting (FGC) affects between 95 and 98 percent of Somali women. Girls and women who aren’t cut are likely to face discrimination and can oftentimes have difficulty finding a husband to support them financially. As a result, families will often arrange the procedure when girls are between the ages of 4 and 11. The invasive procedure often leads to marriage and motherhood, resulting in higher drop out rates for girls in higher grades.
  6. More than half of Somali girls are married between the ages of 15 and 18. By the age of 18, the majority of girls have undergone FGC and are expected to take on the roles of wife and mother, leaving little opportunity to be a student. The combination of high poverty rates, political instability and high fertility rates, marrying daughters to husbands who can provide for them oftentimes seems like a viable option.
  7. Employment opportunities for women in Somalia are limited. Women in Somalia face an unemployment rate of 74 percent compared to 61 percent for men. Somalia’s economy is driven by agriculture, making a formal education seem unnecessary, especially for women who are more likely to perform domestic work or caring for livestock.
  8. The Africa Educational Trust is dedicated to girls’ education in Somalia. Since 1996, the AET has focused on increasing accessibility for girls and other marginalized communities to receive an education. The organization promotes “girl-friendly” spaces, training teachers, rebuilding the school system and supporting the national curriculum framework.
  9. The Somali Girls Education Promotion Programme helped increase student enrollment by more than 16 percent. Over the course of 4 years, the SOMGEP seeks to increase girls’ education in Somalia by shifting gender norms, increasing girls’ participation in school, improving learning conditions and developing girls’ leadership skills. Halfway through the project in 2016, the SOMGEP recorded increases in math and literacy rates along with increased religious support for girls’ education in Somalia
  10. Somalia drafted and approved its National Gender Policy. Over a 10-year period beginning in 2014, the policy seeks to build schools, improve access to schools, promote free primary education, increase enrollment and retention rates for girls and “facilitat[e] development and promotion of … gender-sensitive national curriculum that includes Women, Peace, and Security education.”

Increasing access to girls’ education in Somalia faces challenges such as limited access to schools, political uncertainty, widespread poverty and gender disparity. However, 2012 ushered in an attempt to implement a central authority, including newly elected parliament members and a president who is working towards political and national security, which will hopefully begin to eradicate some of the biggest challenges facing Somalis.

– Keeley Griego
Photo: Unsplash

Apps Help FarmersAccording to the Thinus Enslin, founder and owner of AgriPrecise, one of the biggest issues facing farmers is the high cost of over-fertilizing, leading to negative effects on the environment. The company’s AgIQ app aids the productivity of African farmers. With the help of the app, farmers can now use more efficacious methods to grow crops. The app aids farmers in using the right amount of fertilizer for crops to grow well. Because of the app, farmers can decrease the cost of growing crops and boost crop production.

AgriPrecise

The company AgriPrecise is located in Potchefstroom in South Africa. The primary purpose of the company is to gather and make sense of fertilizer and soil data. For 20 years, AgriPrecise has worked in agriculture, having worked in Zimbabwe and Zambia for 7 years. AgriPrecise has also worked in South Africa, Malawi, Mozambique and Ethiopia.

The company provides services in areas such as agronomy and consulting, data analysis, grid soil sampling, soil classifications, NDUI imagery and monitoring and data processing. Over the past 8 years, AgriPrecise has changed much of its work to IT. IT is helping in another part of its mission, which is to promote sustainable farming methods and practices.

AgriPrecise’s software development partner is the Centurion-based technology solutions company Moyo Business Advisory. To assist farmers, AgriPrecise utilizes satellite imagery and conducts accurate soil sampling. The farmer will have access to a location-based visual display of his or her farm, fields and the conditions and will also be able to gather data on crops and pests. Then, data scientists carry out analytics and send the findings to the farmers.

AgriPrecise’s AgIQ App

Out of 1.166 billion people, more than 60 percent of people in Africa live in rural areas. Much of the economy in Africa is dependent on agriculture. In fact, 32 percent of its GDP is from agriculture. AgriPrecise’s AgIQ app meets a large part of Africa’s economy. The app aids the productivity of African Farmers through a number of steps. First, the app makes an assessment of the data and then finds the integral parts,  showing a farm, field and soil analysis. Lastly, it gathers information on all the kinds of crops ranging from vegetables to sugarcane.

The AgIQ app aids the productivity of African farmers through a sensor attached to a tractor that measures the amount of nitrogen needed to grow crops, so it can spread the right amount of fertilizer. The sensors on the tractor face down on each side of the bar on the roof of the tractor. The sensors measure the greenness of and the density of the crops below it. Facing up are the light intensity sensors that check the level of ambient light. The greenness measures plant health through analysis of the amount of chlorophyll in the leaves. This way the correct amount of nitrogen can be used to help grow crops.

One of the areas that the app helps gain information on is crop yields. The goal of AgriPrecise is to pick up patterns in growing crops to increase production, boost the quality of the crops and lower cost of growing them. The app has helped farmers increase their crop production by 2 percent, which has led to a 10 percent increase in profits.

One of the issues facing farmers that AgriPrecise’s AgIQ app aids the productivity of African farmers by helping farmers with is the cost of production and amount of crops grown. The app helps decrease the cost of growing crops and increase crop production. The app also diminishes negative effects on the environment by reducing over-fertilization. With the creation of the app AgIQ, farmers can take positive steps towards carrying out sustainable agricultural practices.

Daniel McAndrew-Greiner

Photo: Unsplash

CARE International

From Europe to Everywhere

CARE International is one of the foremost aid organizations in the world. It has a long and distinguished history, having been established in 1945 to help survivors of World War II in Europe. Today, CARE operates in more than 90 countries, runs 1,033 projects that serve more than 80 million people, and holds more than $584,161 in financial resources.

The beginnings of CARE were very different than the organization that exists today. Many people today may not realize that the term care package, now part of the everyday English lexicon, began as a registered trademark of CARE—an acronym that originally stood for “Cooperative for American Remittances to Europe.”

But CARE—which now stands for “Cooperative for Assistance and Relief Everywhere”—has changed dramatically over its more than 70 years of operation. Not only has it grown in size, but it has also changed focus. While CARE started by sending commodities to hungry people in Europe, it has evolved into an organization that is both more global and more local, both broader and more focused.

International and Local

One of the biggest changes CARE has undergone since its inception is a change in scale. In 1979, CARE changed its name to Care International and transitioned from a U.S. organization to an international organization with 14 branches around the world. While the largest branch is CARE USA in Atlanta, CARE International’s central headquarters is in Geneva.

At the same time, CARE International has moved away from one-size-fits-all aid, like the CARE package, and toward locally focused aid. It makes an effort to hire employees from the localities that receive the benefits of aid projects, so the people tasked with implementing programs have a deep understanding of local needs and obstacles.

In the words of CARE USA’s previous CEO, Helene Gayle, “Now instead of just focusing on the consequences of poverty and lack of access to basic needs, we also focus on the underlying causes… We look at how you have a longer-term impact on the lives of the communities in which we work… and we work not only on relief and emergency situations but continuing from relief to recovery to development, and building resiliency so communities that are affected from time to time by emergencies are able to respond and bounce back better.”

Helping Women and Girls

Gayle, as CEO of CARE USA, ushered in another major change, this one a change of focus. Under her leadership, CARE starting focusing its efforts on women and girls.

This is because, in Gayle’s view, “Girls and women bear the brunt of poverty around the world.” She explains elsewhere, “if women and girls have an opportunity, there’s this catalytic effect. A girl who is educated is more likely to marry later, have fewer children, have a greater economic future for her children, get them into school, etc.”

CARE’s focus on the wellbeing of women and girls has generated impressive results. For instance, in one CARE program in Bangladesh designed to reduce malnutrition in children, aid workers realized that the program was most effective “when households also participated in activities that contributed to women’s empowerment.” CARE began by creating programs to increase educational access to women and fight domestic violence, and the nutrition benefits followed.

CARE International is a storied organization that could have continued along the path it started in 1945. In order to have an impact on a changing world, though, the organization decided to change. In the process, it has provided a lesson in flexible, dynamic global aid work in the 21st century.

-Eric Rosenbaum
Photo: Flickr

Fleeing El Salvator

Poverty, political instability, corruption and gang violence force many to uproot their families and flee their homes in El Salvador. The number of asylum seekers fleeing their country has increased dramatically since the 1980s. Below are eight facts about why so many are fleeing El Salvador and what/who can aid in this humanitarian crisis.

8 Facts about Fleeing El Salvador

  1. El Salvador has one of the lowest economic growth rates in Central America. While rates of poverty have slowly been decreasing in recent years, the high rates of crime and violence create challenges for a growing economy. According to the World Bank, crime and violence make doing business expensive, have negative impacts on investment decisions and also hinder the creation of jobs.
  2. Coffee rust intensifies the threat of poverty. Hemileia vastatrix, also known as “coffee rust”, is a fungus that many Salvadoran coffee farmers fear. This fungus can greatly decrease the amount of mature (sellable) coffee beans in a harvest. With coffee representing 7.5 percent of El Salvador’s exports and sustaining 650,000 jobs, “coffee rust” greatly threatens income and stability of many families.
  3. The threat of climate change also aggravates the cycle of poverty. More than one-third of Salvadorans live in rural areas and depend on agriculture. However, environmental disasters such as floods, droughts and volcanoes combined with changes in climate threaten harvests and income. Within the next few decades, increasing temperatures pose the possibility of declining crop yields by up to 30 percent. Thus, this creates even more worry for Salvadorans whose lives depend on the quality of their harvests.
  4. Uprisings, wars and extreme gang violence contribute to political instability. In 1932, the Salvadoran government massacred approximately 30,000 peasants. From 1979 to 1992, the Civil War (and the Salvadoran army) left another 30,000 dead. Today, gangs contribute to high levels of extortion and hinder an already weak economy. High trends of violence and corruption contribute to reduced trust in government. Furthermore, the government does not have institutions strong enough and prepared to combat rampant gang violence.
  5. Many flee El Salvador due to direct threats of gang violence. In a country with a total population just over 6 million, it’s estimated that there are approximately 60,000 gang members in El Salvador. That’s one gang member out of every 100 people. Between 2014 and 2017 alone, violent gangs are responsible for the deaths of nearly 20,000 Salvadorans. In a country with one of the highest homicide rates in the world, it make sense that there have been waves of migrants fleeing El Salvador for decades.
  6. Gangs particularly render women and children vulnerable. El Salvador has one of the highest rates of violent deaths of women in the world. More than 25 percent of Salvadoran women report intimate partner violence. Additionally, criminal gangs routinely target girls and women and force them into relationships with gang members or force them into sexual slavery. Some women will try to stay in their homes with their children, not even leaving for school or work in an effort to be safe from the violence.
  7. Save the Children is active in El Salvador. This nonprofit organization supports families by providing means of income for families. In addition, the organization is improving food security and providing health education and care that can deter preventable deaths for mothers and children.
  8. For years, the US gave foreign assistance to El Salvador. Claudia Ivette Canjura de Centeno, the Salvadoran Ambassador to the US, recently said in an interview that US foreign assistance funds to El Salvador are distributed among programs promoting safety, youth empowerment and security. This is done through creating jobs and opportunities and developing spaces of recreation. However, President Trump threatens to suspend economic aid to El Salvador. This will have a huge impact on the progress El Salvador has experienced.

You can do something to make an impact. Call and email your Congressional representatives. Encourage them to oppose cuts to foreign assistance to Central America. People have been fleeing El Salvador with their families and will continue to do so until they no longer feel the threats of poverty, political instability, corruption and gang violence.

El Salvador has a deep history of violence and corruption that contribute to the present situation where many are fleeing their country. For many, the grueling process of migrating and trying to start a new life is too challenging to try. Despite the challenges of that process, it might provide safety, security and opportunities. This outweighs trying to feed one’s family under constant threats of violence and governmental instability. While organizations like Save the Children provides essential aid to Salvadoran communities, addressing deep, systemic issues is what is going to create sustainable security. Please call your representatives and urge them to oppose the suspension of foreign assistance to Central America.

– Keeley Griego
Photo: Flickr

Disparity Affecting Australia's Indigenous

Australia is the largest landmass in Oceania. This place was once home to 750,000 Aboriginal and Torres Strait Islander peoples who made up more than 500 indigenous groups. Today, Australia’s total population is just over 25 million. But, only approximately 3 percent of the population consists of Aboriginal and Torres Strait Islander peoples. Overall, Australia’s indigenous population faces widespread disparity in comparison to its non-indigenous counterpart. Below are ten facts about disparity affecting Australia’s indigenous population.

  1. Socioeconomic disadvantages Socioeconomic disadvantages contribute to developmental vulnerability among indigenous children. In 2015, the Australian Institute of Health and Welfare estimated that 42 percent of Indigenous children in their first year of full-time schooling was considered developmentally vulnerable in one or more of the five key areas of early childhood development. These key areas are physical health, social competence, emotional maturity, language and cognitive skills, communication skills and general knowledge. In comparison, 21 percent of non-indigenous children were considered developmentally vulnerable.
  2. Poor test performance – Indigenous students have lower literacy and numeracy scores than their counterparts. Aboriginal and Torres Strait Islander students achieve lower test scores throughout primary and secondary schooling on the National Assessment Program than their non-Indigenous peers. This certainly highlights educational disparity affecting Australia’s indigenous population. The farther away indigenous children live from cities and regional areas, the lower the test scores.
  3. Negative over-representation –There is over-representation of the indigenous population in the child-protection and justice systems. Indigenous children between the ages of 10 and 17 make up less than 6 percent of the population within that age range. However, 48 percent of those under youth justice supervision and 59 percent of those in youth detention centers are indigenous youths. Indicators of prior familial involvement with the criminal justice system, such as unemployment, can increase the chances of an indigenous child going into one of these two systems.
  4. Indigenous adults in the justice system – The adult justice system over-represents Indigenous individuals. For instance, 27 percent of the prison population in Australia consists of indigenous peoples, but only contribute to 3 percent of Australia’s total population. Socioeconomic factors and institutional discrimination are key factors that contribute to more 25 percent in the adult justice system being of Aboriginal or Torres Strait Island descent.
  5. High unemployment and low wages – Aboriginal and Torres Islander Strait populations face higher rates of unemployment and lower wages. In fact, just under 50 percent of Australia’s indigenous population is employed. However, over 70 percent of the non-indigenous population is employed. Lower income is associated with poor health, crime and violence, poor education and substance abuse. Consequently, these associations reflect a cycle of poverty and lack of opportunities.
  6. Increased risk of poor health – Indigenous populations are more likely to have poor health than their non-indigenous counterpart. Aboriginal and Torres Strait Islanders are approximately two times more likely to have a high risk of complications such as long-term hearing problems, passing away before the age of 50, being born underweight, experiencing high levels of psychological distress or having a disability or long-term health condition.
  7. Poor living conditions – There are regional disparities affecting Australia’s indigenous population. Aboriginal and Torres Strait Islands who live in remote areas are more likely to live in overcrowded communities or having substandard living accommodations. This is compared to those who live in major cities or regional areas.
  8. Beneficial cultural impacts – Although there are detrimental factors with living removed from cities and regional areas, indigenous communities living remotely experience beneficial cultural and communal impacts. They are more likely to speak an indigenous language, identify with a specific clan or tribe, be involved with cultural events and ceremonies. In addition, they are less likely to abuse substances (excluding alcohol and tobacco) and less likely to experience homelessness.
  9. Closing the education gap – There has actually been an improvement in recent years to close the gap in education. For example, indigenous individuals between the ages of 20 and 24 with a 12-year education (or equivalent) increased from 45 percent to 62 percent between the years of 2008 and 2015. Although the statistics for the non-indigenous population is higher at 86%, this is a great start at tackling educational disparity affecting Australia’s Indigenous population.
  10. NACCHO – The National Aboriginal Community Controlled Health Organization (NACCHO) is dedicated to representing Australia’s Indigenous population in regard to their needs and interests. The NACCHO’s main goals are to alleviate poverty, advance spirituality, provide constructive educational programs and deliver holistic and culturally appropriate health services to Aboriginal populations.

Though unfortunate, the history of Australia’s indigenous population includes foreign disease, massacres and violation of rights to their land. The present situation of educational, income and other types of disparity affecting Australia’s indigenous communities stems from the complex colonial history of the continent. Despite centuries of inequity, the Council of Australian Governments and other organizations have committed themselves to raise this marginalized group and decreasing disparity affecting Australia’s Indigenous population.

– Keeley Griego
Photo: Flickr

Tuberculosis in Southeast AsiaTuberculosis is a bacterial infection caused by Mycobacterium tuberculosis. This bacteria usually attacks the lungs, but TB can also affect any part of the body, including the kidneys, spine and brain. Tuberculosis is highly contagious and spreads through the air from person to person. It is most infectious when it is in a person’s lungs, not in their kidneys or other organs.

Southeast Asia’s Member States Goal to End TB by 2030

Worldwide, 10 million people contract TB annually, killing 1.6 million people. Tuberculosis in Southeast Asia accounts for 44 percent of cases and 50 percent of the deaths from this disease. This region only makes up a quarter of the world’s population.

In 2017, the WHO Southeast Asia Region’s Member States issued a call for action to accelerate the progress that is being made to exterminate tuberculosis around the globe. A year later in 2018, the same group released a Statement of Action to further increase these efforts.

To that end, domestic budgetary allocations have more than doubled. There has been a concerted effort in technology and medicines. The region has adopted a people-centered approach so that they can find more cases. For the first time, case finding has become a core focus, particularly in high-risk groups. Patient-centered policies are being implemented, including direct cash transfers and nutritional support for persons for tuberculosis. Governments are also including civil society organizations in decision making, and more people are joining the effort to combat TB as a result.

Further Efforts to Fight Tuberculosis in Southeast Asia

By 2020, at least 1.8 million tuberculosis-infected patients need to diagnosed and treated, 1.5 million of these should be children. Efforts are also being made to address the 500,000 people with drug-resistant TB. Overall, the plan is to ensure that 12 million people currently at risk receive preventative medicines and vaccines.

Adequate access to low-cost TB drugs via South-South cooperation is also an important policy objective. The goal is that more drugs will be produced with enhanced diagnostics so that more people can be reached.

These countries are working together to make great strides in ending tuberculosis in Southeast Asia. They are working with organizations, like WHO and USAID, to increase local advocacy and communications, to mobilize people to do their part. In Thailand, the Thailand TB Active Surveillance Network was established to strengthen the capacity to watch with outbreaks and cases throughout the region.

In addition, USAID has helped to strengthen regional-specific TB training modules, increasing infrastructure and training across the region so that more laboratories can be created and staffed.

Regional leaders have joined forces to combat tuberculosis in Southeast Asia, with the goal of ending preventable deaths. While there is still a long way to go, with the progress and action that the governments and their people are taking every day, the goal of ending tuberculosis in Southeast Asia by 2030 will be achieved.

– Michela Rahaim
Photo: Flickr

maternal mortality mozambique

Maternal health in Mozambique is a constant concern as the nation’s maternal mortality rate is one of the highest in the world. While some progress has been made, there is still much that needs to be done to ensure that mothers in Mozambique have to access high-quality healthcare. Recently, two initiatives have been created, the Mozambique-Canada Maternal Health Project and a project by the Maternal and Child Survival Program. They are working to improve maternal health in Mozambique.

The Current State of Maternal Health

In 2015, the maternal mortality rate was 489 deaths per 100,000 live births. Approximately one-fifth of these deaths are women under the age of 20. Maternal mortality has declined since 1990 when there were approximately 1390 deaths per 100,000 live births; however, maternal deaths remain high. It is clear that continued efforts are needed to improve the quality of maternal health in Mozambique. Each day, approximately 800 pregnant women die from preventable causes.

One of the primary factors determining maternal mortality rates is the availability of antenatal care. In regions where more women receive four or more antenatal visits, the maternal mortality rate is generally lower. Globally, 62 percent of pregnant women have at least four antenatal visits with a skilled health professional, while 86 percent of women have at least one. In Mozambique, only 51 percent of expectant mothers have at least four antenatal visits.

Additionally, only 54 percent of births are attended by skilled health personnel. Age is also a factor, with 40 percent of women 20-24 years old reporting that they gave birth before the age of 18. Younger mothers have an increased risk of death during childbirth, particularly if there is not someone with medical training present.

Early marriage logically leads to childbirth at a younger age and improving maternal mortality rates in the nation relies on protecting young women. In response to this, the government of Mozambique created the National Strategy to Prevent and Combat Early Marriage in 2016. This program includes better education about sexual and reproductive rights with the goal of empowering women to seek out appropriate care and understand their legal rights. For poorer women, this knowledge is often not enough, however, as they may not have the autonomy to make a legal case or have a healthcare facility readily available to them.

Maternal and Child Survival Program (MCSP)

The Maternal and Child Survival Program (MCSP) has launched a project in Mozambique’s Zambézia Province focused on treating pregnant women with malaria. Malaria currently accounts for 9.6 percent of deaths in the nation, and the rate in the Zambézia Province higher than the average. This project seeks to improve maternal health in Mozambique by tackling maternal and newborn deaths due to malaria.

Malaria during pregnancy has many consequences, including higher rates of maternal anemia and low birthweight babies. These factors increase the likelihood of maternal death as well as stillbirth. A treatment known as IPTs-SP exists that can prevent malaria in expectant mothers, but fewer than 22 percent of women in Mozambique receive adequate dosages during their pregnancy.

The MCSP project is empowering healthcare providers in Mozambique to treat malaria cases in pregnant women regardless of their complexity. For example, a young pregnant woman who had malaria but was also HIV-positive could not receive IPTp-SP treatments because the drug is incompatible with her HIV treatment. However, a different medication was able to be prescribed by an MCSP-trained nurse who had been trained on how to handle a variety of malaria cases.

The project also implemented a Standards-Based Management and Recognition for Malaria program in 58 health facilities in the Zambézia Province. This program is working to collect better data about malaria cases and more effectively implement initiatives for prevention and treatment.

Mozambique-Canada Maternal Health Project

Improving maternal health in Mozambique is a priority for the University of Saskatchewan as well. Researchers from the university are working with Mozambique’s health ministry and the NGO Women and Law in Southern Africa (WLSA) to empower women in 20 different communities through the Mozambique-Canada Maternal Health Project.

Education is a key piece to this project, providing information on maternal, reproductive and sexual health to community members in a way that is participatory and engaging for adolescents and adults. The project is also prioritizing the education of health practitioners to improve the quality of care for mothers in Mozambique.

Additionally, the project seeks to improve resources in the community that can improve maternal and newborn health. They intend to provide local ambulances, establish maternal waiting homes nearby to clinics and support local midwives. The latter is the most important, as having locals who are trained health personnel can greatly benefit rural women who may not have the time or financial resources (particularly in situations of poverty) to travel to a clinic.

These efforts indicate that maternal health in Mozambique is continuing to be a priority. The work that these organizations are doing is focused on empowering women to make their own decisions about their sexual and reproductive lives, ensuring health personnel are properly trained and accessible and meeting the needs of poorer women.

Sara Olk

Photo: Flickr

radicalization in refugeesRefugees are a part of society in every country. Global interconnectivity has provided refugees more opportunities to escape the persecution they have experienced in their home countries. However, that same interconnectivity doesn’t always extend to the small communities where the refugees end up living. Isolation and poverty can sometimes lead to desperation and radicalization in refugees.

Social Cohesion

Social cohesion, as defined in BMC Medicine, “is the ability of a given society to be inclusive of all cultural and social groups, so that they work cooperatively.” A willingness to cooperate with one another has many benefits, including the promotion of healthier and more just communities with lower violent crime rates. Unfortunately, it is easier said than done. In a world that is so politically, culturally and historically diverse, these differences can sometimes seem to build barriers.

Indeed, many factors exist that can undermine social cohesion, including both social and economic isolation as well as discrimination. Marginalized members of society, specifically refugees and immigrants, are most commonly impacted. These populations often arrive in their host countries not able to speak the language and with limited support systems.  Social isolation frequently leads to economic isolation, meaning that refugees and immigrants are at a higher risk of falling into poverty.

Moreover, discrimination often faced by marginalized communities can further undermine social cohesion and is commonly linked with poorer health and unemployment. The negative impacts not only hurt these members but prevent them from contributing to the economy, affecting the community as a whole. Overall, communities that prioritize social inclusion and cultural understanding breed healthier societies and citizens.

Radicalization in Refugees

According to the 2017 IEP’s Global Terrorism Index, terrorism cost the world an estimated $84 billion in 2016. In addition, 77 countries reported at least one death as a result of terrorism, and 106 countries reportedly suffered at least one terrorist attack. Overall, Europe and other developed countries have seen a spike in levels of violence. With an ever-evolving terrorism landscape, more home-grown terrorists are perpetrating attacks using new methods. The nature of this ever-evolving threat means that terrorism persists as a major global issue. For this reason, the identification of isolation and discrimination as risk factors for violent radicalization is especially important in preventing violence.

Youth populations are most vulnerable to succumbing to violent ideologies since adolescence is an extremely formative period for identity. Living in poor social conditions can weaken links with socially inclusive networks, making way for new spheres of influence. Ideologically driven groups associated with violent radicalization often monopolize on this opportunity to offer an alienated member of society the chance to belong. For this reason, terrorist groups often target younger populations for new recruits, as they are the most vulnerable.

Thus far, most counterterrorism efforts have put an emphasis on the criminal justice system. This means focusing almost exclusively on those who are already planning on committing a crime and not on prevention. Not only may this partial focus be inhibiting success, but in some cases, it has further encouraged radicalization in refugees by singling out specific religious groups. If behavioral sciences like psychology and sociology are used in public health programs to prevent violence, couldn’t counterterrorism efforts similarly follow this example? 

Preventing Radicalization in Refugees

A new-wave of counterterrorism efforts can offer a new perspective on how to prevent violent threats through better comprehension of human complexity. Focusing on understanding individuals’ demographics, stories and culture in order to better employ protective factors, like social support programs, would be monumental. Furthermore, crafting programs that promote trust and integration is key. By creating safe environments for all demographics and cultures, risk factors for violent radicalization in refugees can be reduced and, hopefully, eradicated.

France is one of the first countries to apply this approach. In 2017 alone, 100,755 people requested asylum in France. For this reason, President Emanuel Macron’s administration has taken steps to aide new refugees and immigrants to integrate into their new host country through a community service program called Volont’r.

The program, launched in January 2019, aims to teach young refugees (between the ages of 16 and 25) about French values, language and culture through immersion. Refugees are given the opportunity to earn a living and to learn French through government-sponsored classes. The program also plans to recruit 1,500 French citizens to help guide 500 refugees to set and meet personal goals and to build networks.

Volont’r is an example of successfully addressing key risk factors for radicalization in refugees by using a public health approach. New refugees are no longer left in isolation because of a language barrier and a lack of social connections. Falling into poverty is prevented by providing tools for employment.

Learning Social Cohesion

Vulnerable populations must be given the opportunity to learn the codes of their new society, promoting integration into an environment where they are heard and understood. In an ever more globally connected world, France believes that building relationships, not walls, is the key to making the world a healthier and safer place. This is an important lesson all countries could benefit from not only for the health and safety of its refugee population but also to reduce the instances of radicalization in refugees.

Natalie Abdou
Photo: Flickr

Eye Care for Ebola SurvivorsWhile Ebola killed more than 11,000 people in just Western Africa in 2014-2015, the thousands who survived are now at risk of developing vision loss face issues caused by the infection. These survivors commonly face vision problems, ranging from uveitis (a form of eye inflammation) to optic neuropathy to panuveitis (inflammation of all the layers of the uveal tract).

One study found that nearly 40 percent of the people observed developed an ocular disease. The most common symptoms were blurry vision and photophobia — sensitivity to light — observed in 76 and 68 percent of patients, respectively. Tearing, pain, floaters and redness in the eyes were also prevalent. Many of those examined also had glaucoma and retinal detachment.

The Congo’s Reaction to the Latest Ebola Outbreak

Learning from previous outbreaks, the Ministry of Health in the Democratic Republic of the Congo recently set up a clinic in Beni to provide eye care for Ebola survivors. This is the first time that follow-up eye treatment has been offered so soon after patients have been released from care. A similar clinic has also been established in Butembo, another heavily affected area.

Survivors of Ebola have helped establish this clinic, providing aid and community outreach in this time of need. Emory University and the University of North Carolina have also donated ophthalmologists to help the effort get on its feet. Organizations, such as the WHO, are also working with the Ministry of Health to keep the clinics thriving.

So far, 250 people have been seen and examined. From their initial tests, complications like uveitis were low compared to previous outbreaks. Plans are also in place to train 10 Congolese ophthalmologists on Ebola-related issues in order to expand treatment options for patients. Over the following months, more clinics will be established to accommodate more than 300 patients who are on the waiting list.

The Need for Screening

While it remains unclear as to why Ebola affects people’s vision, it is clear that there is some correlation. Some studies show that Ebola may lead to uveitis because a higher viral load enables Ebola to enter the eye and establish viral persistence, which later leads to uveitis.

Doctors are finding that eye care for Ebola survivors relies heavily on early screening. One study showed that patients who were promptly screened for an initial assessment for the disease were easier to treat and at less risk for reduced vision. While more research is needed to determine the links between Ebola and visions loss, the establishment of clinics in disease-prone areas is a step in the right direction.

– Michela Rahaim
Photo: Flickr