In early 2019, the government of Mali made an announcement that shocked the global health world: it would make healthcare free at the point of service to pregnant women and children younger than 5. The country had achieved universal healthcare in Mali.
The Situation
In a country where poverty and healthcare outcomes were in dire straits, the move to provide universal care for the most vulnerable demographic in Mali was welcome and necessary. Previous to the 2019 decree, Mali had disastrous health outcomes.
About 106 children out of 1,000 live births would not survive delivery. Adding to the issue was the fact that 587 per 100,000 mothers would not survive delivery either, one of the highest rates of maternal mortality in the world. Only malaria and digestive diseases claim more lives in Mali.
In order to diagnose the problems with Mali’s healthcare, a historical context is necessary. With that understanding, the new approach reveals itself to be necessary, positive and inclusive.
Post-Colonialism
After Mali’s liberation from France in the 1960s, the nascent country fell back on the healthcare system that was already in place. That system emerged 50 years prior and had not evolved with the needs of the populace. It would not change until the 1980s.
The Bamako Initiative
Launched in 1987, the initiative came under recommendation from both UNICEF and the World Health Organization (WHO). Named after the capital city of Mali, the initiative proved problematic, pushing Mali’s people into poor health outcomes.
The initiative called for patients to pay for things like health services and drugs to offset costs and insufficient funds. The system requirements led the impoverished to avoid seeking care.
Post-Implementation
The free to pregnant mothers and children younger than 5 policy has already yielded benefits. The new model re-centers care away from costly hospital services to community-based care.
Nurses can now travel door-to-door to service mothers and children younger than 5 without fees. The results have been stunningly effective, with infant mortality rates dropping by 95% in the Bamako district.
Dr. Ari Johnson, a professor of global health sciences at the University of California, San Francisco heralded the approach: “The ministry of health [in Mali] has taken a very brave and bold political move to make real, evidence-based healthcare change.”
The approach serves as a model example; One that Mali hopes will become the standard across Africa. Johnson continues with optimism, stating that he hopes the new approach will: “make Mali a leader in health sector reform on the African continent.” Universal healthcare in Mali was no longer out of reach.
The COVID-19 Pandemic
Although Mali has experienced strain due to the pandemic, U.N. Secretary-General António Guterres has noticed Mali’s new model of healthcare. He called on nations to implement Universal Health Care for all nations in order to beat COVID-19. He stated that “The pandemic has revealed utterly inadequate health systems, yawning gaps in social protection, and major structural inequalities within and between countries.”
Guterres continued on to make the connection between robust systems and access, stating that “… we cannot wait 10 years. We need Universal Health Coverage, including mental health coverage, now, to strengthen efforts against the pandemic and prepare for future crises.”
Foreign Aid
A number of Western nations have come to Mali’s aid. The impoverished nation, just starting on its new policy, has found itself hobbled by the current crisis. Experts see support for the nation, and its new health policy, as crucial.
The Netherlands
The Project to Accelerate Progress Towards Universal Health Coverage (PACSU) is a joint effort between the Dutch Embassy and the Global Financing Facility, the World Bank and the Ministry of Health in Mali. Learning from the impact of previous health crises in the region, the Netherlands’ support will focus on pregnant mothers and newborns.
When the Ebola crisis hit the region in 2014, a startling trend of infant and maternal mortality gripped Mali. Resources became scant and pregnant women were unable to secure the necessary health services to ensure a successful birth. PACSU will provide facilities, professionals, equipment and any other resources necessary to the ailing system during COVID-19.
USAID Takes Action
The United States Agency for International Development (USAID) will join the fight as well, supplying $45 million to Palladium, an international development firm. The organization will provide support to reinforce Mali’s health systems and financing, providing access to high-quality care. Two programs, the Human Resources for Health 2030 (HRH2030) and the Human Resources for Health Strengthening Activity (HRHSA), have not been successful and will undergo expansion.
These programs, in concert with Mali’s Ministry of Health, will focus on the decentralization of health services. Training, motivation and safety for new medical professionals, particularly in the prevention of illness among both patients and healthcare workers are crucial to the program’s success.
Universal healthcare in Mali is critical from many standpoints. Not only does it provide relief for the historically impoverished Sahelian country itself but it serves as a model for the rest of Africa. The refocus on community health improves access and financing. Once again, Africa leads the way in methodology, access and care during the struggle against COVID-19.
– Christopher Millard
Photo: Flickr
Rise of Minimum Wage and Automation in Poland
Poland’s Increasing Minimum Wage
The Law and Justice (PiS) party, which rules Poland’s government, has vowed to increase Poland’s minimum wage to 4,000 zlotys monthly. In January 2020, Poland increased its minimum wage by 15% from last year to 2,600 zlotys. PiS plans to reach its goal of increasing Poland’s minimum wage by the end of 2023. This comes from PiS’s pledge in the “politics of dignity.” The pledge’s aim is to bring buying power into Polish hands so Poland’s economic model is similar to their western European neighbors.
Prime Minister Mateusz Morawiecki said the series of minimum wage hikes is an investment in Poland’s future as well as an effort to increase its prosperity. Yet, the minimum wage hike brings about unwelcome side-effects. Especially the rise of Poland’s automation. Industries are implementing automation in order to shed employees and the wage increase.
Aiding Poland’s Workers
Poland plans to spend EUR 247.2 million, a total of PLN 1.1 billion, on relief for firms investing in automation over the next five years. This plan includes a tax break for entrepreneurs, allowing a 50% reduction in costs for investments in Polish automation companies. A statistic of “42 robots per 1,000 employees is definitely not enough,” admits Development Minister Jadwiga Emilewicz. The level of industrial robots in Poland is lower than in the Czech Republic, Slovakia and Hungary.
The relief package looks to increase Poland’s automation levels as well as its economy, which Emilewicz believes is a condition for development. The rise of the minimum wage in Poland, its highest hike ever, will bring changes in wage dynamics among low-income workers. Companies will be expected to increase their remuneration to hold onto employees.
Krystian Jaworski, the senior economist at Credit Agricole CIB, mentions Poland’s minimum wage increase will impact inflation greatly. This remains true today as inflation came in at 3.4% in December last year, well above estimates in a Reuters poll. With the rise of Poland’s minimum wage, and PiS’s plan to further increase wages, Credit Agricole estimates the enterprise sector employment will be 3.5% lower in 2024. The loss equates to approximately 200,000 jobs.
Some companies are looking elsewhere in order to curb shedding their employees. Henryk Kaminski, who runs Kon-Plast, a manufacturing company, is “thinking of redesigning to get a better manufacturing cost” by limiting its use of plastic, which fulfills the factory sector’s aim on savings.
– Danielle Lindenbaum
Photo: Flickr
Conquering the Fall Armyworm in Uganda
Agriculture in Uganda and the Fall Armyworm
Approximately 22% of Uganda’s GDP comes from agriculture, with most Ugandans working in the agricultural sector, often engaging in subsistence farming. With the nation’s economic performance relying on successful agricultural harvests and the population’s everyday food sources coming from their own crop yields, any invasion of pests in Uganda can have serious consequences.
In 2016, Uganda experienced its first invasion of the fall armyworm pest, the larva of the armyworm moth. A native of the tropical regions of the western hemisphere, the fall armyworm pest eats through crops for nourishment before its transformation into a moth. By mid-2017, the fall armyworm had been detected throughout Uganda and estimations indicate that the infestation led to $192 million in maize crop losses alone. In some regions, farmers noted crop yield losses of up to 75%.
Despite the severe threat posed by the fall armyworm pest in Uganda, local developers have created a machine learning-based tool to assist Ugandan farmers with detecting the presence of the fall armyworm in their crops and preventing its spread.
Machine Learning to Protect Crops
In the aftermath of the arrival of the fall armyworm pest, Nazirini Siraji, a Ugandan woman from the city of Mbale, began work on a modern solution to the age-old problem of pest invasions. After attending one of Google’s Codelabs events, Siraji used Google’s TensorFlow platform to develop her Farmers Companion App. TensorFlow is an open-source machine learning tool that enables developers like Siraji to create digital solutions powered by artificial intelligence.
The Farmers Companion App enables farmers to use mobile technology to identify this specific pest on their crops and their lifecycle stage. Using this information, the app notifies the users about the threat level their crops face and the extent to which the fall armyworm has the potential to spread. The app also recommends specific pesticide treatments that farmers can use based on the level of threat to the farmers’ crops.
According to Google, the app has already been deployed in the agricultural lands surrounding Mbale where Siraji partners with local farmers to put the Farmers Companion App to use.
Big Tech Meets Local Developer
The global expansion of the internet is accompanied by a rise in local innovation aiming to solve local issues. In Africa, pest invasions have been responsible for countless crop shortages and famines, which exacerbates problems of instability and poverty. While invasions from pests like the fall armyworm will inevitably occur in the future, they will not happen again without opposition from new technology.
– John Andrikos
Photo: Flickr
Prosper Africa Helps Address Global Poverty
Africa’s Economic Potential
Despite having struggled with chronic poverty issues, Africa is home to six of the 10 fastest growing economies in the world. With one billion potential consumers, Africa has the potential to become an economic powerhouse that can provide any international trading partner with a valuable destination for exports and a significant source of imports.
Seeing this opportunity, in 2018, the United States federal government launched the Prosper Africa initiative, which developed out of increasing requests by U.S. companies to have easier access to African markets.
With the oversight of the U.S. State Department and International Trade Administration, Prosper Africa offers U.S. and African businesses a wide-ranging set of economic tools such as access to financing, loan guarantees, insurance and business strategy advising. The program facilitates deals between U.S. and African businesses to foster a stronger two-way economic relationship between the United States and Africa.
Prosper Africa Shows Promising Signs of Success
According to a 2019 analysis by the Congressional Research Service, Prosper Africa has been implemented across the continent. Each U.S. embassy in Africa has created a team designated to fostering ties between U.S. and African businesses. Furthermore, the U.S. Development Finance Corporation has also launched an online point of access to the array of business tools that the initiative offers.
These efforts have had noticeable results across the continent. Since June 2019, Prosper Africa has facilitated more than 280 deals valued at roughly $22 billion in more 30 African countries, including Cameroon, Namibia, Sudan and Madagascar. These deals have been struck in sectors as diverse as healthcare, aerospace and financial services.
Prosper Africa helps countries in that it has also led to government reforms aimed at fostering a more transparent and efficient business environments in 10 African countries. These reforms ensure that small and medium-sized African businesses can access financial services and that governments can effectively implement necessary regulatory frameworks to govern business environments.
Ending Global Poverty is Beneficial for All
Prosper Africa helps Africa and the entire world because the fight against global poverty does not solely consist of one-way foreign aid investments. These investments have the potential to be the beginning of a healthy economic relationship between a developed nation and emerging economies. Once the United States takes the lead on an issue, the rest of the world follows. From addressing drug trafficking to addressing terrorism, the United States has shaped the focus of the international community on countless issues. Through Prosper Africa, the United States has the potential to lead the way once more and uplift the lives of billions in Africa.
– John Andrikos
Photo: Flickr
The Good News: Greek Startups Are Helping the Economy
Augmenta
Founded in 2016, Augmenta has been helping farmers decrease their costs while increasing production. The video device uses machine learning to analyze tractor movements, increasing yields by 15%, reducing chemical field inputs by 20% and improving field end production by 15%. Another advantage of this innovative technology is that the more the farmer uses the device, the more data will become available to the other farmers. Augmenta’s benefits are promising for farmers and the agricultural industry as a whole.
Neos Beyond Payments
With the increasing demand for contactless payment due to COVID-19, Greek startup Neos Beyond Payments is finding its place in the economic market. The wearable device has now taken off in the European market and continues to expand into Scandanavian markets as well. In partnership with a Swedish technology firm, Fidesmo, Neos makes it possible for you to tap and pay on any contactless terminal, the same way you do with your payment card, by using the Neos wearable bracelet. With more demands for contactless payment options, the Neos wearable device will be useful in all markets.
Inagros
Inagros is another one of the Greek startups helping the economy by creating innovative technologies for farmers and agronomists. Inagros’ innovative web platform delivers data through satellites and sensors to enhance crop production and reduce the consumption of water, fertilizer and energy. This new technology is expected to be a pillar in the development of the smart farming revolution, with innovations expected to significantly impact automatization and sustainable management in particular.
Rebuilding the Greek Economy
The bailout in 2010 was just the beginning of the collapse of Greece’s’ financial economy. By 2015, the country had borrowed more than €289 billion, the largest bailout a country has ever received. As a result of which, entrepreneurs, scientists and professionals fled due to the dying economy. Entrepreneurs in Greece that persisted during these years created momentum and paved a path for future entrepreneurs to continue to contribute to rebuilding the fallen economy. While Greece continues to fight through financial barriers, a booming economy may be on the horizon, with Greek startups helping the economy by creating innovative market opportunities that steadily bring life back into a fragile economy.
– Brandi Hale
Photo: Flickr
Sweden’s Foreign Aid
Tanzania
Tanzania and Sweden have been partners for more than half a century. The relationship between the two nations started back in 1963. Since then, Sweden has achieved multiple substantial successes in Tanzania. For example, Sweden has helped deliver electricity to about 20% of the newly powered areas since 2006. Sweden also provided financial assistance to 1 million small businesses. In this case, women and youth accounted for more than 50% of those beneficiaries. Additionally, in 2013, Sweden provided Tanzania with $123 million in official development assistance (ODA). It also provided $103 million in 2015.
According to the website Sweden Abroad, Sweden’s foreign aid in Tanzania intends to help the country achieve sustainable growth and to give impoverished people opportunities to care for themselves, either by providing them with employment or by helping them to start small businesses. Looking to the future, Sweden will decrease its aid as poverty decreases in Tanzania.
Afghanistan
Afghanistan has also received a tremendous amount of support from Sweden’s foreign aid. One of the core focuses of Swedish aid in Afghanistan is in promoting gender equality for women. Unfortunately, literacy among women in Afghanistan is around 18%. Sweden works tirelessly to improve that statistic, which has led to an increased number of women attending school. In 2001, 1 million women attended school in Afghanistan. By 2016, there were 8.2 million children in school, with girls making up 40% of these students. Sweden has increased the number of girls in school, in part, through the implementation of schools run by the Swedish Committee for Afghanistan. Currently, these schools teach about 70,000 Afghan children. Of that number, 62% are girls.
Sweden has also made strides in protecting women from violence. The Swedish International Development Cooperation Agency, U.N. Women and Women for Afghan Women (WAW) have teamed up to ensure the protection of Afghan women. These agencies have established refuges within 20 provinces of Afghanistan. These refuges offer services including legal assistance and guidance following gender-based violence incidents.
Mozambique
Similar to Tanzania, Mozambique has received Sweden’s foreign aid for many years; Swedish aid to Tanzania began in the 1970s. Sweden has aided Mozambique in many ways, including by preventing child marriages, promoting gender equality and renovating hydroelectric plants. The Pungwe Programme is one specific example of Sweden’s aid in Mozambique. This program takes care of the Pungwe River. More than 1 million people use the Pungwe River, including Mozambicans in addition to some Zimbabweans.
Hopefully, other countries will follow Sweden’s example and increase their investments in the global community. Sweden’s work in Tanzania, Afghanistan and Mozambique is commendable; however, it will take more aid to bring developing countries into the modern era.
– Jacob E. Lee
Photo: Flickr
Mobile Applications Aiding Mental Health in Africa
Since traditional one-to-one basis mental health care methods are not always available in developing countries, the World Health Organization states that mobile health technologies are beneficial resources for underserved individuals without access to mental health resources in developing countries such as Africa. With such a large variety of apps, varying from patient self-assessment to virtual sessions with healthcare specialists, support is offered to those who have access to any mobile devices. Here are three mobile applications aiding mental health in Africa.
3 Mobile Applications Aiding Mental Health in Africa
These three mobile apps, and many others alike, are convenient forms of technology that have the potential to improve mental health conditions in Africa and other regions around the world. The implementation of mobile applications into psychiatric practice can provide patients with the utmost care by utilizing thorough assessment, open communication and careful supervision, which can ultimately save lives.
– Isabella Socias
Photo: Flickr
Efforts to Eradicate Trachoma in South Sudan
The Government of South Sudan, The Carter Center and Sightsavers attempt to eradicate trachoma in South Sudan with universal health coverage, distributing antibiotics, providing corrective surgeries, promoting sanitation classes and building proper human waste disposals in the communities.
The Government of South Sudan
To help out the most vulnerable individuals, the Government of South Sudan provides free healthcare to all citizens. Since native and nomadic communities live in isolated areas and do not stay put in one place for too long, healthcare workers go into their communities to administer medical care. State employees learned to track the constant movement of the pastoralists to wait for their arrival. Consequently, 6,650 citizens who never visited a clinic in the village received treatment for trachoma in the safety of their communities.
Sightsavers
Sightsavers came to South Sudan in 2009 and strives to prevent vulnerable individuals from going blind. More specifically, the organization provides medication and corrective surgeries to citizens in South Sudan who suffer from trachoma.
First, Sightsavers partnered with the government to provide eye treatment to vulnerable individuals. Next, 5,100 citizens of these regions carried out the task of handing out medication to the locals. These volunteers went to rural and isolated places that do not have access to Western medication. In just 2018 alone, Sightsavers provided around 546,000 medications to cure trachoma and other eye conditions.
Next, the organization assists health professionals in visiting isolated areas. Once the workers arrive at their destination, they spend over a week providing around 200 corrective eye surgeries for individuals suffering from trachoma and cataracts. These surgeries changed the lives of citizens who dropped out of school or do not work due to their eye condition.
The Carter Center
The Carter Center began assisting South Sudan in 1986 before its independence. The Center strives to maintain peace in the nation, provide quality healthcare and teach the citizens how to produce more food. More specifically, the organization strives to eradicate trachoma in South Sudan with the implementation of the SAFE strategy.
The SAFE strategy signifies “surgery, antibiotics, facial cleanliness, and environmental improvement.” Beginning in 2000, the Center helped fund 10,000 corrective eye surgeries in South Sudan. Secondly, the organization provided close to four million doses of the antibiotic Zithromax. Next, the Center helped support sanitation classes in almost 4,000 communities and the erection of more than 6,000 bathrooms.
Final Thoughts
Many individuals living in remote areas in South Sudan suffer from the deteriorating effects of trachoma. With the help of the government and nonprofit organizations, citizens can access long-term relief from their symptoms and prevent future infection. The optimism and determination of the citizens to find a cure and get better forecasts a positive outlook for the eradication of trachoma in South Sudan.
– Samantha Rodriguez-Silva
Photo: Flickr
Efforts to Tackle Diabetes in Bangladesh
Diabetic Association of Bangladesh (BADAS)
Fortunately, the Diabetic Association of Bangladesh or Bangladesh Diabetic Somiti (BADAS) established in 1956 assists mostly lower-income individuals with the prevention, awareness and treatment of diabetes. BADAS helps reduce the prevalence of diabetes in three main ways:
Educating the healthcare sector on how to better treat diabetes during the coronavirus pandemic
Creating a study that organizes monthly community meetings and sending out weekly text messages on how to prevent and treat diabetes
Hosting an annual event for World Diabetes Day that offers free screenings, education and public awareness about the disease.
DMagic
BADAS helped organize a study called DMagic in the Faridpur District in Bangladesh that ran from 2015 to 2018. The study placed villagers in one of the following groups: engaging in community meetings, receiving text messages about how to prevent and treat diabetes, or attending a standard doctor for diabetes prevention and treatment. After the study finalized in 2018, researchers discovered that villagers in the community meetings group lowered their rate of diabetes by 20.7% in comparison to those who went to a regular doctor. However, the text messages proved to not be as effective in reducing diabetes among the participants. Therefore, researchers plan to organize more community meetings about how to prevent and treat diabetes in other rural areas of Bangladesh.
Teaching the Healthcare Sector to Handle Diabetes During COVID-19
BADAS recently implemented a new model to help the healthcare sector to continue to provide quality care for diabetic patients during the coronavirus pandemic. Firstly, BADAS urged the clinics and hospitals to remain open and to continue to offer services to diabetic patients. Secondly, medical professionals needed to wear appropriate gear, sanitize often, screen all patients and look out for individuals with potential COVID-19 symptoms to prevent the transmission of the virus. Next, BADAS encouraged doctors to offer free telephone and video call consultations to their patients. Lastly, healthcare facilities needed to provide sufficient medicine and supplies for diabetic patients.
World Diabetes Day Event
BADAS hosts an annual event in the region of Dhaka on November 14 to acknowledge World Diabetes Day. At the event, medical professionals offered free screenings and educated the public about diabetes. Also, doctors hosted a question and answer session to clarify any concerns and misconceptions about the disease. Next, artists sculpted clay models of healthy and unhealthy foods in an attempt to reduce the rate of diabetes among citizens. Then, the local religious leaders came forward and offered a special prayer for the public and those dealing with diabetes in Bangladesh. Lastly, hundreds of participants walked around Dhaka and carried a banner to spread awareness about diabetes.
Diabetes threatens the lives of millions of Bangladeshi citizens, especially those living in poverty. Although the fight of eradicating diabetes in Bangladesh continues, BADAS teaches many of the most vulnerable in society how to better recognize and prevent the disease.
– Samantha Rodriguez-Silva
Photo: Flickr
GreenShoots Foundation in the Fight Against HIV/AIDS in Asia
GreenShoots Foundation
GreenShoots Foundation is a London-based charity founded in 2010. For a decade now, it has been supporting people living with HIV/AIDS and working to alleviate poverty. It takes on international development with a holistic approach through three programs that are active in six countries across Asia.
The Education Loans & Social Entrepreneurship program aims to support children’s education in India. In the Philippines and Cambodia, the Food, Agriculture & Social Entrepreneurship program is bolstering rural economies by promoting sustainable farming as well as sustainable business practices. The Medical Assistance & Medical Education (MAME) program, which is active in Kyrgyzstan, Vietnam and Myanmar, is improving the lives of those with HIV/AIDS.
Medical Assistance & Medical Education (MAME)
The objective of the MAME program is to fight HIV/AIDS and other diseases that pose a threat to public health. It helps by providing greater access to treatment plans and equipping local healthcare workers with the knowledge they need to help people living with HIV/AIDS.
In Kyrgyzstan, the HIV infection rate has risen 21% since 2010. GreenShoots Foundation is working with the Kyrgyz National Infection Control Centre to provide local organizations with medical knowledge about HIV/AIDS through workshops and internships. It is also making efforts to change public opinion so that people living with HIV/AIDS in Kyrgyzstan are not stigmatized and know what resources are available to them. It has already trained 45 medical staff and 130 students, as well as impacted 350 patients directly.
What began as a health concern for sex workers and drug users in Vietnam has since grown to become a nationwide issue. While deaths related to HIV/AIDS have dropped 45% since 2010, there were still nearly 5,000 Vietnamese people who passed away from the disease in 2018. So while much is being done to address the epidemic, there is still room for improvement.
GreenShoots Foundation has been focusing on the province of Hoa Binh, where the government has taken steps to improve HIV/AIDS treatment, but the level of medical knowledge still needs to be improved. Through workshops, visits to hospitals and the media distribution of medical information, GreenShoots Foundation has been able to improve upon what changes the Vietnamese government has made. It hopes to host more workshops with a broader reach in the future.
Medical Action Myanmar has also been collaborating with GreenShoots Foundation. Similar to approaches used in Kyrgyzstan and Vietnam, the organizations have been focusing on workshops to provide medical workers with better knowledge as well as working with people living with HIV/AIDS on microfinance. Additionally, GreenShoots Foundation has sent 13 doctors and nurses to Yangon to support people living with HIV/AIDS. It has also dedicated nearly 7,000 hours toward mentoring medical staff.
Further Impact
Through its various workshops across Asia, GreenShoots Foundation has trained over 3,000 doctors and more than 1,000 medical students in HIV education. Through this, it has been able to contribute to the fight against HIV/AIDS in Asia and make for a healthier world.
– Evan Driscoll
Photo: Flickr
The Beginning of Universal Healthcare in Mali
In early 2019, the government of Mali made an announcement that shocked the global health world: it would make healthcare free at the point of service to pregnant women and children younger than 5. The country had achieved universal healthcare in Mali.
The Situation
In a country where poverty and healthcare outcomes were in dire straits, the move to provide universal care for the most vulnerable demographic in Mali was welcome and necessary. Previous to the 2019 decree, Mali had disastrous health outcomes.
About 106 children out of 1,000 live births would not survive delivery. Adding to the issue was the fact that 587 per 100,000 mothers would not survive delivery either, one of the highest rates of maternal mortality in the world. Only malaria and digestive diseases claim more lives in Mali.
In order to diagnose the problems with Mali’s healthcare, a historical context is necessary. With that understanding, the new approach reveals itself to be necessary, positive and inclusive.
Post-Colonialism
After Mali’s liberation from France in the 1960s, the nascent country fell back on the healthcare system that was already in place. That system emerged 50 years prior and had not evolved with the needs of the populace. It would not change until the 1980s.
The Bamako Initiative
Launched in 1987, the initiative came under recommendation from both UNICEF and the World Health Organization (WHO). Named after the capital city of Mali, the initiative proved problematic, pushing Mali’s people into poor health outcomes.
The initiative called for patients to pay for things like health services and drugs to offset costs and insufficient funds. The system requirements led the impoverished to avoid seeking care.
Post-Implementation
The free to pregnant mothers and children younger than 5 policy has already yielded benefits. The new model re-centers care away from costly hospital services to community-based care.
Nurses can now travel door-to-door to service mothers and children younger than 5 without fees. The results have been stunningly effective, with infant mortality rates dropping by 95% in the Bamako district.
Dr. Ari Johnson, a professor of global health sciences at the University of California, San Francisco heralded the approach: “The ministry of health [in Mali] has taken a very brave and bold political move to make real, evidence-based healthcare change.”
The approach serves as a model example; One that Mali hopes will become the standard across Africa. Johnson continues with optimism, stating that he hopes the new approach will: “make Mali a leader in health sector reform on the African continent.” Universal healthcare in Mali was no longer out of reach.
The COVID-19 Pandemic
Although Mali has experienced strain due to the pandemic, U.N. Secretary-General António Guterres has noticed Mali’s new model of healthcare. He called on nations to implement Universal Health Care for all nations in order to beat COVID-19. He stated that “The pandemic has revealed utterly inadequate health systems, yawning gaps in social protection, and major structural inequalities within and between countries.”
Guterres continued on to make the connection between robust systems and access, stating that “… we cannot wait 10 years. We need Universal Health Coverage, including mental health coverage, now, to strengthen efforts against the pandemic and prepare for future crises.”
Foreign Aid
A number of Western nations have come to Mali’s aid. The impoverished nation, just starting on its new policy, has found itself hobbled by the current crisis. Experts see support for the nation, and its new health policy, as crucial.
The Netherlands
The Project to Accelerate Progress Towards Universal Health Coverage (PACSU) is a joint effort between the Dutch Embassy and the Global Financing Facility, the World Bank and the Ministry of Health in Mali. Learning from the impact of previous health crises in the region, the Netherlands’ support will focus on pregnant mothers and newborns.
When the Ebola crisis hit the region in 2014, a startling trend of infant and maternal mortality gripped Mali. Resources became scant and pregnant women were unable to secure the necessary health services to ensure a successful birth. PACSU will provide facilities, professionals, equipment and any other resources necessary to the ailing system during COVID-19.
USAID Takes Action
The United States Agency for International Development (USAID) will join the fight as well, supplying $45 million to Palladium, an international development firm. The organization will provide support to reinforce Mali’s health systems and financing, providing access to high-quality care. Two programs, the Human Resources for Health 2030 (HRH2030) and the Human Resources for Health Strengthening Activity (HRHSA), have not been successful and will undergo expansion.
These programs, in concert with Mali’s Ministry of Health, will focus on the decentralization of health services. Training, motivation and safety for new medical professionals, particularly in the prevention of illness among both patients and healthcare workers are crucial to the program’s success.
Universal healthcare in Mali is critical from many standpoints. Not only does it provide relief for the historically impoverished Sahelian country itself but it serves as a model for the rest of Africa. The refocus on community health improves access and financing. Once again, Africa leads the way in methodology, access and care during the struggle against COVID-19.
– Christopher Millard
Photo: Flickr