Archive for category: Global Health

Information and stories about global health.

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4 Projects Expanding Health Care Access in Madagascar

A health worker assists a mother and child in a Madagascar clinic. Health Care Access in MadagascarFor many families living in Madagascar’s remote villages, reaching health centers can require hours of walking across rough terrain. For mothers with sick children, that journey can mean the difference between life and death.

State of Health Care Access in Madagascar

Madagascar is the world’s fourth-largest island, located approximately 400 kilometers off the eastern coast of Africa in the Indian Ocean. The island has a population of around 31 million people, many of whom live in isolated rural communities with limited access to health care. Nearly half of Madagascar’s population lives more than five kilometers from a health care center, a distance that creates major barriers to care. Despite these challenges, mobile clinics and community health programs now extend essential services to remote populations.

Madagascar’s health care system operates on four tiers: the central level sets national policy, the regional level coordinates implementation, the district level oversees hospitals and primary health centers, and the community level relies on health workers.

Despite this structure, access to health care remains limited across the country. Only one doctor serves approximately 11,000 people, and the life expectancy stands at 62.9 years, below the global average of 71.4 years. Just 4.4% of Madagascar’s population is over 65, reflecting this shorter life expectancy.

Madagascar suffers recurring humanitarian crises, including droughts, cyclones and famine, which place additional strain on the health care system. Disease is also a heavy burden, as malaria placed 28.9 million people at risk in 2022. This disease caused 4.9 million cases and killed more than 12,500 people in 2021. Contracting malaria keeps adults from working and children from attending school, reducing household income and reinforcing cycles of poverty. Tuberculosis incidence remains high, ranging from about 220 to 233 cases per 100,000 people. Under-five mortality stands at 66 deaths per 1,000 live births, while neonatal mortality reaches 24.1 deaths per 1,000 live births.

Rural Challenges

These challenges hit people in remote regions hardest, where distance and poor infrastructure make accessing health care extremely difficult. Geography poses one of the biggest barriers to health care access in Madagascar. According to the United Nations Children’s Fund (UNICEF), some residents must travel at least two kilometers just to reach the nearest health center, and many communities sit much farther away. Nearly half the population lives more than five kilometers from a health care facility, and roughly 75% of local health centers lack reliable electricity. These barriers to effective health care contribute considerably to cycles of poverty.

This lack of basic maintenance limits health centers’ emergency and nighttime care. Mobile clinics and outreach programs offer an important solution, bringing health care directly to isolated communities and helping to close the gap in access.

Reaching Remote Communities in Madagascar

Medair, founded in 1989, has implemented the “Tanan-kavana ho an’ny Fahasalamana” (TKF) project in Bevaho, Mahatsinjo, Anandravy, Antokonala and Ivato. This project aims to reduce morbidity in remote rural areas of southeastern Madagascar and provides free health care, especially for mothers and children. The TKF project, co-funded by the European Union (EU), began in May 2025 and is due to run until July 2026. In 2022, Medair impacted 2,716,365 people through its health and nutrition programs. The initiative shows how outreach health care can significantly support rural communities.

UNICEF’s Improved Nutritional Outcomes Project, known as PARN, has hired nearly 11,000 community health workers across Madagascar to provide care to mothers and children under 5 years old. With funding from the World Bank, UNICEF is providing assistance to strengthen the health system in regions where PARN is being implemented.

ACCESS Program

Management Services for Health and the United States Agency for International Development (USAID) operated the Accessible Continuum of Care and Essential Services Sustained (ACCESS) program across 78 districts and 14 regions. This project worked to ensure that quality health care services were available and accessible to all communities. Efforts include improving maternal and child health, treating malaria, increasing access to reproductive health and family planning services, combatting malnutrition and ensuring access to safe water, hygiene and sanitation. From 2018 to 2025, ACCESS covered more than 16 million people and supported nearly 1,900 health facilities. Maternal mortality decreased from 130 to 65 per 100,000 live births from October 2019 to September 2024 and neonatal mortality decreased from 5 to 3 per 1,000 live births from January 2021 to September 2024.

In southeast Madagascar, Sustainable Environment, Education and Development (SEED) is building community-led, sustainable initiatives in rural areas such as Ambinanibe. Project Votsira’s community education program fills gaps in health knowledge by running biweekly sessions at the local health center, with topics shaped by community needs. Topics include malaria prevention, breastfeeding, childhood illnesses, sexually transmitted infections (STI) and HIV awareness and nutrition. Between July and October 2024, the sessions drew more than 700 attendees in Ambinanibe, reflecting strong community demand for health support. Alongside this, SEED’s Water, Sanitation and Hygiene (WASH) and Solar in Health Centers project is improving physical health care infrastructure by installing solar power, building five gender-segregated latrines and a menstrual hygiene management facility and introducing a clean rainwater harvesting system.

Looking Ahead

Madagascar continues to face significant challenges to health care access, driven by geography and recurring climate disasters. However, mobile clinics and community health workers expand access to lifesaving care for rural communities. As these initiatives grow, they hold the potential to reduce preventable illness and offer a pathway to greater economic stability and stronger rural communities across Madagascar.

– Helen Turnbull

Helen is based in Cardiff, UK and focuses on Good News for The Borgen Project.

Photo: Flickr

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HPV Vaccination in Pakistan Reaches 9 Million Girls

HPV Vaccination in PakistanIn its first phase in 2025, Pakistan carried out the largest single human papillomavirus (HPV) vaccination campaign any country has ever conducted, reaching more than 9 million girls aged 9 to 14. The drive targets cervical cancer, a disease that kills eight women every day in Pakistan and falls hardest on the poor. HPV vaccination in Pakistan now stands as one of the most ambitious women’s health interventions in the country’s history, and a rare example of prevention reaching girls before a disease ever takes hold.

A Cancer of Inequality

Cervical cancer is one of the most preventable cancers, yet it remains one of the deadliest for women in low-income settings. Globally, cervical cancer caused about 350,000 deaths in 2022, and roughly 94% of those deaths occurred in low- and middle-income countries, a gap that reflects unequal access to vaccination, screening and treatment. The disease is driven by the human papillomavirus, and a vaccine given in early adolescence prevents most cases.

In Pakistan, the burden is heavy. Cervical cancer affects more than 5,000 women each year and kills around 3,200 of them. Screening and treatment remain concentrated in cities and private clinics, which places them out of reach for many rural and low-income women. For families living close to the poverty line, a late cervical cancer diagnosis can mean both the loss of a mother and catastrophic medical costs. Vaccinating girls early offers a way to interrupt that cycle before it begins.

The Largest Campaign of Its Kind

Pakistan launched the campaign on Sept. 15, 2025, through the Federal Directorate of Immunization, in partnership with Gavi, the Vaccine Alliance, United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO). The first phase covered Punjab, Sindh, Pakistan-administered Kashmir and Islamabad Capital Territory, with a goal of vaccinating at least 90% of 13 million eligible girls aged 9 to 14.

More than 49,000 health workers, most of them women trained with WHO support, delivered the vaccine in schools and communities. By early 2026, WHO reported that HPV vaccination in Pakistan had reached more than 9.6 million girls, although the agency notes that official coverage figures will not be confirmed until later in 2026. A single dose of the vaccine prevents most cases of cervical cancer, making the intervention one of the most cost-effective in global health.

Reaching the Hardest Places

Delivering the vaccine at this scale was not simple. Officials at the Federal Directorate of Immunization noted that severe flooding and displacement complicated the rollout, yet the campaign still reached close to 70% of its target. Vaccine hesitancy posed another barrier. To counter misinformation, Federal Health Minister Syed Mustafa Kamal had his own daughter vaccinated publicly, after which refusal rates fell and acceptance climbed in many districts.

The phased design reflects where the need is greatest. The poorest and most remote regions are scheduled for later rounds, with Khyber Pakhtunkhwa due in 2026 and Balochistan and Gilgit-Baltistan in 2027. Balochistan is Pakistan’s poorest province and Khyber Pakhtunkhwa also ranks well above the national average on poverty, and both carry limited health infrastructure. With about 22.5% of Pakistanis living below the national poverty line in fiscal year 2025, it is the households in these hardest-to-reach provinces that the later phases must serve.

What Comes After Vaccination

Vaccination is only the first of the WHO’s three targets for eliminating cervical cancer, known as the 90-70-90 goals: vaccinating 90% of girls, screening 70% of women and treating 90% of those who need it. Screening is where the gap is widest. In low- and middle-income countries, only about 19% of eligible women undergo screening, compared with far higher rates in wealthy nations. Pakistan has made a strong start on vaccination, but screening and treatment for the millions of women already past vaccination age remain limited, and sustaining the gains will require investment well beyond a single campaign.

Looking Ahead

HPV vaccination in Pakistan will not, on its own, eliminate cervical cancer. The country still needs accessible screening and affordable treatment, especially for poor and rural women who have the least access to both. Even so, protecting more than 9 million girls in a single campaign is a concrete step toward breaking a cycle in which a preventable cancer and household poverty reinforce each other. If the later phases reach the girls in Pakistan’s poorest regions, a disease that has long tracked inequality could begin to lose its grip.

– Amna Al Harrazi

Amna is based in Dubai, UAE and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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MedAdd: 3D Printing Project Improving African Health Care

Skulls and denture cast on white surface, related to 3D printing medical devices. MedAddMedAdd’s 3D printing project is giving South Africans access to life-changing medical devices that were once out of reach. For decades, South Africa has depended heavily on imported medical equipment, which is often unaffordable for public hospitals or poorly suited to patients’ individual needs. However, a homegrown initiative is now working to change that one patient at a time.

Despite a poverty rate of 37.9%, the country continues to grow, with 8% to 9% of its GDP coming from health care, which exceeds the World Health Organization’s (WHO) recommended spending by 4%. Statssa reports the public sector spends $30.59 on health care, contributing 44%. This increases the demand for 3D printing in South Africa, especially for custom-designed implants and prosthetics.

What Is MedAdd?

The Central University of Technology (CUT) and the Department of Science and Innovation (DSI) lead the innovative Medical Device Additive Manufacturing Technology Demonstrator Project (MedAdd), transforming health care across South Africa. MedAdd developed 3D printing, also known as additive manufacturing, of medical devices tailored specifically to the needs of the region.

Financial support of a R97 million (approximately $5.85 million) additive manufacturing (3D printing) project in Bloemfontein on April 8, 2022, provided a start-up.

How This Works

MedAdd aims to reduce South Africa’s dependence on imported devices. The Centre for Rapid Prototyping and Manufacturing (CRPM) at CUT is doing groundbreaking work in the design, development and manufacturing of medical devices. This makes the university a leading institution in South Africa in the field of customized medical production.

MedAdd’s 3D printing solution provides a groundbreaking approach for South Africa’s dependence on medical device imports. With the health care budgets, hospitals and clinics lacking vital equipment, will receive immense support through this initiative, as it will also help with the costs of imported devices.

MedAdd aims to:

  • Enhance the existing equipment and capabilities at CUT
  • Enable CUT, academic partners and local companies to demonstrate reproducibility and increase innovative medical device products
  • Be available for up-and-coming companies to industrialize new products, taking out the risks of innovative development prior to commercialization
  • Enable students, including researchers and personnel, to develop the required skills necessary for the development of the new technology and industry

MedAdd Is Changing Lives

The importance of health innovation, which is the focus of the DSI, is already enhancing the impact of science in society. Rebecca Maserumule, Acting Deputy Director-General for Technology Innovation at the DSI, emphasized the importance for African countries to proactively invest in medical research and health innovation.

She says, “Our overall objective in this space is to help grow the health economy by providing locally developed and relevant diagnostics and medical devices with a view to boosting their manufacturing.”

Maserumule adds that enhancing existing capacity to manufacture active pharmaceutical ingredients, vaccines, biopharmaceuticals, diagnostics and medical devices will address the disease burden and ensure the security and sustainable supply of essential therapeutics and prophylactics.

Currently, more than 1,000 patients have been assisted through the CRPM’s efforts, which are supported by state and private hospitals and funding from the DSI, TIA and other partners. Among these cases are Princess Moshona and Luan Adams.

BBC covered a MedAdd success story emphasizing how the 3D printing medical devices changed the life of a gunshot survivor, Princess Moshona, who was shot in the jaw by carjackers, deforming her face. Thanks to a 3D metal implant treatment, her face is restored.

Another success story follows Luan Adams, whose face was disfigured by sinus cancer affecting his speech and breathing. Currently, a facial prosthetic implant made of silicone at the CRPM has helped both his breathing and his speech. The CRPM 3D-printed the titanium frame implant used to hold the prosthetic in place. Thanks to this, Adams shares that he is more than grateful to be alive.

MedAdd’s Future and Impact

South Africa’s leadership in 3D printing is projected to reach a market size of $70 million by 2030, setting a benchmark for other African nations. The emergence of technology hubs and fab labs, like the Togolese fab lab Woelab Lomé, reflects a growing ethos of innovation across the continent, which is instrumental in adopting new technologies for societal needs.

Looking further ahead, the broader Africa 3D printing medical devices market is projected to reach $1,065 million by 2025, with a compound annual growth rate of 17.04%.

A Model for the Continent

MedAdd shows that Africa does not wait for imported solutions to meet its health care needs. By investing in local manufacturing capability, accredited research infrastructure and partnerships across government, academia and industry, South Africa is building a model that other African nations can follow. As 3D printing technology becomes more available and accessible, initiatives like MedAdd offer a blueprint for how developing nations can close the medical device gap affordably, sustainably and on their own terms.

– Joy Kohol

Joy is based in Muncie, IN, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Pexels

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How Somalia’s Vaccination Program Reaches Vulnerable Children

Somalia's Vaccination ProgramYears of drought, conflict and economic hardship have displaced thousands of families from Somalia’s Bakool and Hiraan regions. Many families have sought safety in communities such as Kahda District in Mogadishu, where humanitarian organizations continue expanding access to essential services. Through Somalia vaccination efforts for children, health care workers are helping vulnerable families access lifesaving immunizations and build healthier futures for children who might otherwise face preventable diseases.

Displacement Crisis in Somalia

Somalia continues to face one of the world’s largest displacement crises. According to the United Nations High Commissioner for Refugees (UNHCR), millions of Somalis have experienced displacement due to conflict, climate-related disasters and food insecurity. Families arriving in communities such as Kahda often struggle to access health care services, increasing children’s vulnerability to diseases such as measles and polio. Malnutrition and limited health care access can further increase health risks for young children.

Challenges and Progress

Health officials classify many of these children as “zero-dose” children because they have not received even one routine vaccine. A 2025 study found that approximately 60% of Somali children remain zero-dose, with the highest concentrations located in rural, nomadic and conflict-affected regions. Limited health care infrastructure, transportation barriers and workforce shortages continue to prevent many families from accessing immunization services. Reaching these children remains one of Somalia’s most important public health priorities.

Partnerships Driving Success

Vaccination efforts for children continue achieving remarkable progress through partnerships led by Gavi and the International Rescue Committee (IRC). Established in 2000, Gavi works to increase vaccine access in lower-income countries, while the IRC, founded in 1933, provides humanitarian assistance in more than 40 countries worldwide. Through the REACH consortium, led by the IRC, health care workers have delivered more than 30 million vaccine doses and reached more than 1 million children across Somalia since 2022. The initiative also expanded humanitarian access from 16% of targeted communities to 100%, allowing health care workers to reach children who previously lacked access to routine immunizations.

Community-Based Efforts

Somalia’s vaccination program for children succeeds because health care workers actively bring immunization services directly to families. Mobile health teams travel to remote villages, displacement camps and underserved communities to vaccinate children and connect families with health care resources. Community health workers educate parents about vaccine safety, identify children who missed vaccinations and encourage families to complete immunization schedules. These efforts help health care workers protect more children from preventable diseases and strengthen community health.

Broader Impact of Vaccination

Vaccines provide benefits that extend beyond individual health. Immunization reduces child mortality, prevents disease outbreaks and lowers health care costs for families already facing financial hardship. When children stay healthy, they are more likely to attend school, participate in their communities and achieve better long-term outcomes. Public health experts consistently identify vaccination as one of the most cost-effective investments countries can make to improve health and reduce poverty.

Continuing Efforts and Future Outlook

Coordinated investments and expanded humanitarian access continue improving vaccination coverage across Somalia. Organizations such as Gavi, the United Nations Children’s Fund (UNICEF), the World Health Organization (WHO) and the IRC work alongside local partners to strengthen health care delivery systems and expand access to immunization services. These partnerships help ensure that children living in remote and underserved communities receive the same opportunities for healthy development as children living in more accessible areas. The continued growth of Somalia’s vaccination program for children offers hope to families seeking better health outcomes, according to WHO and UNICEF immunization coverage estimates.

Challenges remain, particularly in regions affected by insecurity, climate shocks and displacement. However, Somalia’s vaccination program for children continues demonstrating what targeted investments, strong partnerships and community-based health care can accomplish. Health care workers have already delivered more than 30 million doses and reached more than 1 million children through the REACH consortium. As health care teams continue serving families in Bakool, Hiraan and communities such as Kahda, they are protecting children, strengthening local health care systems and creating healthier futures across Somalia

– Kianna Hines

Kianna is based in Brooklyn, NY, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Mental Health Support in Bangladesh After Natural Disasters Strike

Mental Health Support in BangladeshBangladesh ranks among the top countries in the world in terms of deaths and home displacements due to natural disasters. Between 1970 and 2005, half a million people died from natural disasters, primarily cyclones, floods, riverbank erosion and droughts. While the main responses to such devastation have been to the physical well-being of citizens and to rebuild infrastructure, another key issue is addressing the mental health concerns of those impacted.

Eastern Floods

In August 2024, more than 500,000 were forced from their homes and 71 were killed by devastating floods. The rivers and overall water levels in cities like Feni threatened to cover the rooftops of many buildings as the water levels reached up to 30 feet in some places. Citizens directed traffic to allow emergency vehicles to arrive faster. Acts of kindness included giving out hot meals and helping evacuate stranded individuals by boat.

Besides being impacted by the flood, people in such an altered environment are at greater risk of experiencing different forms of violence. To help mitigate this problem, the government provided women experiencing gender-based violence with safe shelters. Many of these women also received psychological first aid to help manage their trauma.

Psychological first aid is not a formalized therapy session. It provides a safe space for affected individuals to process trauma and helps connect people with additional disaster relief resources. The Bangladesh Red Crescent Society (BDRCS) provided medical support for more than 83,000 individuals. Thousands also received psychological aid in the same place where medical support was provided.

People living in poverty can have their situations exacerbated by various circumstances, with extreme floods being one of the worst. About three-quarters of impoverished households see their economic situations worsen after a flood. Bangladesh lost over a million metric tons of food due to the 2024 floods, primarily rice and vegetables. This caused food prices to rise and led to increased inflation. Sixty-two percent of households regularly had scarce meals as a result.

Cyclone Sidr

A devastating Category 4 storm hit Bangladesh in November 2007, killing over 3,400 people, injuring 55,000 and displacing 500,000 from their homes. Beyond the physical damage, a quarter of those impacted by the storm suffered from post-traumatic stress disorder (PTSD).

The BDRCS organized a psychological first aid program to provide mental health support in Bangladesh after the storm. It included staff members as well as community volunteers, including 20 psychology students from Dhaka University. Over 400 additional volunteers were trained to help in highly affected areas. As part of the immediate recovery goals after the cyclone, the BDRCS aimed to help 20,000 people with psychosocial support.

The BDRCS also provided funding for individuals impacted by the storm to help them improve their situations. A woman named Misti built her own boat for a ferry service thanks to a grant from the BDRCS. She uses this boat to have a self-sustaining career and to help people escape dangerous situations when another major storm is on the horizon. There are many more success stories of people achieving financial independence thanks to BDRCS funding.

A Preemptive Plan of Action

In 2024, the World Health Organization (WHO) in Bangladesh developed a preemptive plan to mitigate the effects of future natural disasters. The WHO will increase mental health support in Bangladesh before, during and after disasters and will also seek feedback from people in refugee camps to determine how they can be better supported.

At least 16% of people in Bangladesh experience a mental health challenge due to various circumstances beyond natural disasters. However, the actual number is estimated to be much higher due to many remaining undiagnosed or untreated. Since there is a predisposition toward worsening mental health after a natural disaster, it is helpful for care in some form to be set in place every step of the way.

– Logan Hessek

Logan is based in Northglenn, CO, US and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Behind the Statistics: Poverty in the Dominican Republic

A street vendor sells fruits from a cart in the Dominican Republic.Poverty in the Dominican Republic continues to affect many families despite economic growth in recent years. The World Bank states that although the Dominican Republic has experienced rapid economic growth over the past two decades, inequalities and limited access to quality jobs and public services continue to affect underserved populations. Limited access to stable employment, reliable infrastructure, affordable health care and higher education creates ongoing challenges for low-income families.

A former resident of a low-income community in the Dominican Republic, who requested anonymity for privacy reasons, described growing up in a household where survival depended on constant work. According to the source, every member of the family began working at a young age to help cover necessities such as food, clothing and utility bills.

“Every day was spent working to pay for clothes and food and keep the bills up to date,” the source said. They also stated that in a household of five children and two parents, financial pressure shaped nearly every aspect of daily life.

Economic hardship also affected social relationships and community life. Long work hours left little time for friendships, recreation or personal development. “It was just to focus on work and get money to pay bills and get food to continue living,” the source explained.

Education and School Dropout Rates

Financial hardship often creates long-term educational barriers for children living in poverty in the Dominican Republic. Families struggling to meet daily needs frequently depend on children and adolescents to contribute financially, increasing the likelihood of school absenteeism and dropout rates.

UNICEF reported that many children in the Dominican Republic continue to face educational exclusion due to poverty and limited resources. The organization found that 60% of Dominicans ages 18 to 40 had not completed school during the 2014-2015 academic period.

According to a UNICEF report, 9.9% of adolescents aged 15 to 17 were not attending school during the 2014-2015 academic period. The report also found that 24.1% of secondary students were enrolled with an overage of two or more years, increasing the risk of school abandonment and educational exclusion.

The report additionally noted that students living in rural and underserved communities face greater barriers to completing secondary education and accessing equal educational opportunities. Researchers also found that many adolescents who left school would have needed to return to primary education if they reentered the school system.

The anonymous source explained that balancing work and education created constant stress and exhaustion during childhood. Although education was valued within the household, financial hardship often took priority over long-term academic opportunities.

“In the Dominican Republic, the school systems were not the best, but it is what we had,” the source said. Financial limitations eventually prevented the individual from attending university after graduating from high school, forcing full-time entry into the workforce instead.

Education Quality and Access

Educational inequality in the Dominican Republic extends beyond school attendance to learning quality and student achievement.

According to UNICEF, education challenges in the Dominican Republic include low learning outcomes, school exclusion and unequal access to quality education, particularly among vulnerable communities. Despite increased investment in education, many students continue struggling to complete school due to poverty and limited educational resources.

UNICEF reported that only 12% of third-grade students achieved satisfactory results in Spanish language studies, while only 27% achieved satisfactory results in mathematics during the 2017 National Diagnostic Assessment. The organizations also identify school violence and unequal educational opportunities as major barriers affecting learning outcomes throughout the country.

According to UNICEF’s All Children Learn in the Dominican Republic initiative, educational programs currently focus on improving literacy and mathematics instruction, supporting vulnerable students and increasing inclusive learning opportunities for children and adolescents with disabilities. UNICEF has also worked with schools and communities to strengthen programs for peaceful conflict resolution and improve inclusive classroom practices.

These educational challenges are often closely connected to broader housing and infrastructure issues that affect low-income communities daily.

Housing and Infrastructure Challenges

The effects of poverty in the Dominican Republic also extend to housing and infrastructure. According to the source, the family lived in a crowded home where multiple people shared rooms and privacy was limited. Daily routines were often disrupted by unreliable electricity and inconsistent access to water.

“The light would always go out and there was not much access to water,” the source explained. They also described poor infrastructure in the community, including constant construction and difficult road access, which disrupted daily life.

The World Bank states that inequalities in infrastructure and access to public services continue to affect underserved populations throughout the Dominican Republic, particularly low-income communities. Limited infrastructure can also contribute to educational and health-related challenges, especially for families already struggling financially.

Health Care and Community Support

Health care expenses created major financial burdens for families living paycheck to paycheck. Instead of relying on larger pharmacies, many residents turned to smaller local “boticas,” which offered more affordable medicine options.

“When it came to someone who was ill, we would have to skip out on work or school to take them to the hospital,” the source said. Missing work to care for a sick family member often meant losing income needed for food, rent or utility bills.

In many underserved communities, churches remain one of the only reliable forms of local support. The source explained that families often depended on churches for food, clothing or emergency assistance because few organizations or social programs were available in the area.

“There were only churches; there were no types of support or organizations that would help,” the source explained.

Looking Beyond the Statistics

UNICEF continues to support educational initiatives in the Dominican Republic to improve learning opportunities and school accessibility for vulnerable children and adolescents. The organization’s programs focus on strengthening early education, improving inclusive learning opportunities and helping students remain in school. UNICEF has also supported programs designed to reduce school violence and improve educational accessibility for children with disabilities.

Although poverty in the Dominican Republic continues to limit opportunities for many families, educational initiatives and community-based support programs may help reduce long-term inequalities. Personal accounts from individuals directly affected by poverty highlight the realities behind economic statistics and underscore the importance of continued efforts to improve living conditions across the country.

– Grelby Santos

Grelby is based in Boston, MA, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Unsplash

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Persistence in Health Care: Polio Vaccines in Nigeria

Polio Vaccines in NigeriaNigeria, often referred to as having the highest “zero-dose population in the world,” is moving away from fragmented health campaigns toward an integrated vaccination campaign aimed at protecting about 106 million children from measles, rubella and polio.

Though Nigeria was certified polio-free in 2020 due to its approach to implementing routine immunization, health care workers continue to provide treatment and care for children who have slipped through the cracks.

Integrated Health Campaigns

Nigeria has launched 20 health campaigns annually, with fewer than 15% integrated during this period. This strained resources, stretched health care workers thin and caused communities to lose faith in preventative care, opting instead for palliative care rather than seeking proper treatment for polio.

This began to change when Nigeria launched one of its largest vaccination campaigns in 2025, combining a variety of vaccines and child health care services to ensure treatment for children across the nation.

The campaign targets children ages 0-14 and 0-59 months for polio and was implemented in two phases:

  • 20 high-risk northern states and Oyo state in the southwest
  • In January 2026, the remaining southern states will follow

In addition to vaccines for measles and rubella, the integration of routine immunization and necessary health services will reinforce Nigeria’s “Primary Health Care Under One Roof” strategy and advance its Health Campaign Effectiveness in the direction of universal health coverage.

By the end of 2025, Nigeria achieved a 31% reduction in polio cases through persistence and constant vigilance.

Building Trust

With these campaigns shifting into routine immunization, Nigeria is prioritizing the health of its new generation while also addressing distrust.

In northern states like Sokoto, vaccinations were not readily accepted due to religious and cultural beliefs. Trust is part of the solution. Without it, polio vaccines in Nigeria go unused.

During Nigeria’s polio campaigns, communities and their religious leaders built community networks, called majalisa, where they assured families that the vaccines were safe and crucial for their children’s health. This partnership bridged the gap between hesitant families and health care workers, increasing the intake of not only polio vaccines but also treatments for other childhood diseases.

The same health workers who helped control polio initially convinced communities to bring in their children for continual treatment. This communication and connection have paid off as health care workers can identify households, plan outreach routes and record how many children are vaccinated, improving their reach.

Ongoing Efforts

It takes many components to create a solution, but once they come together, they work in harmony. Polio vaccines in Nigeria are now reaching children and households that were often underrepresented or out of the health system’s reach. Nigeria’s efforts will continue to pay off and even as challenges arise, persistence will increase the number of children receiving polio vaccines.

– Kianna Phosouvanh-Sythong

Kianna is based in Upper Darby, PA, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Reducing Maternal Deaths in CAR

A community midwife in CAR assists a pregnant woman during a check-up. Maternal Deaths in CARThe Central African Republic (CAR) has one of the highest maternal mortality rates in the world, at 835 deaths per 100,000 live births. A shortage of skilled health care providers and an unequal distribution of health services drive these high maternal deaths. Preventable conditions such as postpartum hemorrhage, hypertension and sepsis fuel the risks. These challenges explain why helping community midwives reduce maternal deaths in the CAR remains essential, especially in communities facing rapid population growth and limited services to support them.

Rural areas record only 28% of deliveries assisted by a skilled worker and just 2% of deliveries receive surgical assistance. The World Health Organization (WHO), UNICEF and the International Medical Corps expand access to maternal health care, train community midwives and strengthen rural health systems.

Training Community Midwives to Deliver Safer Births

WHO trains and deploys community midwives to expand access to skilled care. Fewer than half of pregnant women in CAR attend fewer than the four recommended antenatal consultations, with most deliveries occurring at home. By placing midwives directly within communities, WHO reduces the distance and cost barriers that prevent many women from seeking care.

Community midwives build trust and encourage families to seek skilled delivery services. In 2024, WHO equipped 30 maternity wards with essential medical equipment and medicines to improve the safety and dignity of maternal care. These improvements ensure that midwives can manage complications more effectively and women receive specialized and emergency care.

Community midwives help lower maternal deaths in the CAR.

Improving Access to Maternity Services

Rural communities in CAR face significantly higher risks during pregnancy and childbirth. Although understanding of midwifery care is increasing, many women still cannot reach health facilities.

UNICEF works to reduce delays in antenatal consultations and ensure that women receive timely and appropriate care. This support operates in five of the country’s 35 health districts. Bossangoa, a district of 176,688 people, shows the impact of this initiative. The regional hospital sits more than 90 kilometers from the farthest village, which makes access difficult. These long distances often force women to give birth at home without skilled assistance, increasing the likelihood of preventable complications.

In Nodokota, a local matron, Adele, received hands-on obstetric and neonatal training supported by UNICEF and donor funding. These practical skills improve conditions in remote communities and contribute to helping community midwives reduce maternal deaths in the CAR.

Establishing New Midwife Training Schools

To strengthen maternal health care, the Ministry of Health and Bangui University partnered with the International Medical Corps to establish the Bria Auxiliary Midwife Training School in 2024. The school serves a remote region of more than 150,000 people and offers a two-year certification program based on French Red Cross curriculum adapted to national and international standards.

This program covers prenatal care, labor and delivery, postpartum care, family planning and newborn care. Enrollment reached 51 students by November 2024, with graduates expected in 2026. These trained auxiliary midwives will return to their rural communities with the skills needed to support mothers and newborns. By expanding the midwifery workforce, the program advances helping community midwives reduce maternal deaths in the CAR.

Strengthening Midwifery Leadership

In 2024, African midwives gathered in Ghana to discuss a new advisory body to represent midwifery across the continent. The summit brought together midwifery associations and young midwives and emphasized leadership development and equitable representation.

With 70% of the population under 30, investing in young midwives strengthens the future of maternal health. The movement also focuses on shaping maternal care around African realities and ensuring midwives closest to communities guide decision-making. This approach shifts influence toward local practitioners who understand the community needs and the barriers women face when seeking care. It also helps build a new generation of midwifery leaders who can advocate for stronger policies and more equitable health systems.

This regional collaboration supports long-term progress in helping community midwives reduce maternal deaths in the CAR.

Final Thoughts

These initiatives transform maternal health in the CAR by expanding access to health care, strengthening midwife training and improving services in rural areas. This support is especially important because most medical personnel work in urban centers, which leaves rural communities underserved. Through the efforts of WHO, UNICEF, the International Medical Corps and regional midwifery leaders, community midwives are increasingly equipped to provide safe, skilled care and continue helping community midwives reduce maternal deaths in the CAR.

– Flora de Leeuw

Flora is based in Bath, UK and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Environmental Risks to Children’s Health in Central Asia

Industrial smokestacks emitting pollution under cloudy skies, highlighting environmental risks to children's health.Every year, billions of children suffer from illnesses related to environmental risks. Ambient air pollution and mercury poisoning are linked to a shocking 1.7 million child deaths under the age of 5 each year. Reducing environmental risks to children’s health in Central Asian countries, like Mongolia, through changing energy usage practices and reducing child exposure to mercury and other toxic materials would prevent an estimated one in five child deaths annually.

Household Air Pollution (HAP)

An annual 2.9 million deaths are attributed to HAP worldwide. Some common conditions include ischaemic heart disease, stroke and lower respiratory infections, which cause a total of 76% of HAP-related deaths per year. In Mongolia, where coal is the predominant energy source for those living in poverty, indoor and outdoor air pollution cause 132 out of every 100,000 people to die prematurely each year.

Ulaanbaatar is the capital city of Mongolia. With 60% of the city’s population living in ger districts and many living in traditional felt tents, known as “gers” and small houses, a large number of children are exposed to extreme levels of HAP every day.

The country’s harsh climate, which can cause temperatures to plummet to as low as -20°C, forces Mongolians to heavily rely upon coal to survive, with three to six tons being burned annually in order to cook and provide warmth to their homes.

A study by Zaiyou Dai and colleagues in 2025 investigated the effects of HAP on the health of 1,279 infants by monitoring their health at 7, 13 and 36 months. They found the following results:

  • A positive correlation between the HAP score and the hazard ratio for pneumonia, which increased by 2% for every HAP score increase.
  • A positive correlation between HAP score and height for age (HAZ) score, which decreased as exposure to HAP increased.

The incomplete combustion caused by burning other materials, such as wood and charcoal, can also result in the emission of toxic gases like carbon monoxide. As one of the biggest environmental risks to children’s health in Central Asia, it is critical that energy production shift permanently away from burning these fossil fuels.

Mercury Poisoning

Mercury can be extremely harmful if consumed or inhaled. Central Asia has some of the most mercury-contaminated countries on the planet. For example, China contributes more than 600 tons of Hg to global emissions.

Toxic to humans, most people who experience mercury poisoning have come into contact with the chemical element by eating contaminated fish or inhaling vapors during industrial processing. Exposure can cause difficulties in child development both in utero and early life, as well as the following issues:

  • Toxic and damaged kidneys
  • Dysfunctional motor and cognitive skills
  • Impaired neuromuscular functions.

Due to fish being a key food source for lower-income families, children all over the world are put at risk of mercury poisoning. A study by Zhen-Yan Gao and colleagues in 2015 found that more than 14,000 Chinese children aged 0 to 6 years old had higher mercury levels than normal, with concentrations rising significantly if their diets included the frequent consumption of fish. These levels are an extreme cause for concern.

Ultraviolet Radiation

Ultraviolet rays, which individuals are vulnerable to during any exposure to sunlight, can be a useful source of much-needed vitamin D, but they can also have some disastrous and harmful effects. Because they are immunosuppressive, UV-B rays can cause skin damage and autoimmune diseases like lupus.

Sufferers of lupus, otherwise known as systemic lupus erythematosus, often experience:

  • Joint and muscle pain
  • Rashes caused by sun exposure
  • Weight and hair loss.

A long-term condition, lupus is life-changing and, while rare, about 15-20% of lupus patients are diagnosed as children. As the ozone layer slowly thins due to the changing climate, it is more critical than ever to protect children’s skin and their health from ultraviolet radiation.

While new environmental issues arise every day, it is also important to acknowledge the progress being made toward protecting children’s health. People from hundreds of nations are collaborating to find solutions to the many environmental risks to children’s health in Central Asia.

UNICEF and Its Fight Against Air Pollution

In 2021, UNICEF launched a program called UniSat, which was designed to help protect children’s health in Central Asia by educating youths. Girls from Kazakhstan, Uzbekistan and Kyrgyzstan were taught how to use nanosatellites and other technology that can be used to monitor air, so the future generation can make life-saving, progressive changes that will reduce air pollution in their country and consequently protect thousands of children’s health.

The staggering loss of 1.7 million lives each year emphasizes the significance of the environment and its impact on health, a harsh reality now catalyzing countless life-changing, innovative programs and policies, such as UniSat and the Minamata Convention. With the ever-changing climate and a surge in pollution worldwide, it is now more important than ever to rethink energy usage and direct attention toward achieving a safe environment where children can thrive, not just survive.

– Ruby Fraser

Ruby is based in Cannes, France and focuses on Global Health, Politics for The Borgen Project.

Photo: Pixabay

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Cuts to USAID and the Ebola Outbreak in the DRC

Health workers in protective gear walking on a street, highlighting USAID cuts impact on Ebola response. Ebola Outbreak in the DRCIn 2014, an Ebola crisis heavily affected West Africa. The U.S. government was deeply involved in the response. A Disaster Assistance Response Team (DART) was formed under the U.S. Agency for International Development (USAID) to oversee logistics and planning required to control the spread. Soon after, the U.S. committed nearly $1 billion toward fighting Ebola in West Africa.

At the time, this was the largest response by the U.S. government to a health crisis overseas. According to President Barack Obama, the response helped cut cases of the disease by 80%. There was a clear initiative to collaborate globally to recognize the threat this outbreak posed if not addressed appropriately. This contrasts starkly with the current response.

The Numbers

Since the start of May 2026, a similar Ebola outbreak has emerged, affecting regions in Africa, with the Democratic Republic of Congo (DRC) being most impacted. According to the International Rescue Committee (IRC), it could become the deadliest outbreak on record if not addressed appropriately.

So what do the numbers say so far? Despite the first case being confirmed only recently, it is already the third-largest outbreak of the disease, with the speed of its spread most alarming. According to the British Medical Journal, there have been 250 deaths and 1,200 cases recorded. These numbers doubled in just a week, from 551 cases and 136 deaths. These statistics were published on May 27, 2026. It is important to note that these numbers include both confirmed and suspected cases.

USAID Cuts’ Impact on Ebola Outbreak in the DRC

With these numbers growing daily, understanding the impact of USAID cuts on Ebola is essential. USAID has been a cornerstone of American foreign policy since President John F. Kennedy. In 2025, President Trump reduced it by 90% while also permanently cutting funding for thousands of projects that support development and health worldwide. The response to this outbreak has been directly affected by these cuts.

The outbreak was reported to the World Health Organization (WHO) nine days before U.S. officials became aware of it, a delay that occurred after cuts to USAID funding and the U.S. withdrawal from the WHO.

Dennis Carroll, an infectious disease specialist and former director of the Emerging Pandemic Threats program at USAID, said in a recent interview with NPR that the abolishment of USAID led to the disappearance of support for infrastructure. Simple logistics are not being met as before, such as personnel being able to reach critically needed hospitals and moving laboratories and samples swiftly for quick infection determination.

The experts who built a rapport with health workers in this region have largely been dismissed, so a significant amount of expertise and experience has vanished. This void left by the U.S. has not been filled by any other nation. Coordination with organizations like the WHO and the CDC was a key element in responding to outbreaks like this one.

Solutions

The data is clear on the impact of USAID cuts on the Ebola outbreak in the DRC. However, lessons from previous outbreaks can inform the current response.

Dr. Patrick Otim, WHO’s area manager for Africa, explained the importance of reacting quickly in a recent interview with the BBC. He detailed how delaying the detection of cases, engaging communities and isolating patients allows transmission chains to expand rapidly. He stresses the importance of community trust and engagement. Medical intervention alone is not enough to stop the spread effectively. Clear communication from local government and dignified, safe burials are as significant as medical supplies and test centers.

The U.S. is not inactive. It has committed more than $160 million in humanitarian and emergency funds to help fight the disease. The U.S. is also sending CDC personnel, along with a disaster-assistance response team, to the region. This, along with lessons learned from other outbreaks, gives locals hope that this crisis can be managed effectively.

Charities are also contributing to the effort. For example, UNICEF has personnel on the ground working to address the situation. So far, the organization has provided almost 50 tons of infection prevention and control supplies, including personal protective equipment, disinfectant, soaps and water purification tablets.

Conclusion

Bob Kitchen, the IRC’s Vice President Emergencies & Humanitarian Action, stated, “The warning signs are flashing red. Eastern DRC is confronting the outbreak more fragile and less prepared than during the 2018–2020 outbreak that killed more than 2,000 people and with fewer resources to fight it.”

The U.S. attitude toward foreign aid has changed significantly over the past few years. President Obama sought to reduce Ebola cases to zero, while President Trump emphasized an America-first message during his campaign and the results of those intentions are now evident. This outbreak serves as a case study demonstrating the impact of American foreign aid on global health.

Although the numbers may seem bleak, the solutions mentioned are making a difference, whether through lessons learned from previous outbreaks or through charities like UNICEF working on the front lines to slow the spread.

– Oisín Downes

Oisín is based in Galway, Ireland and focuses on Politics for The Borgen Project.

Photo: Unsplash