Archive for category: Global Health

Information and stories about global health.

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UNICEF’s Oxygen Plant-in-a-Box

Oxygen Plant-in-a-BoxPneumonia kills more children than any other infectious disease. Each year, more than 7 million children under 5 require oxygen as a means of treatment for this. In 2020, UNICEF launched its Oxygen Plant-in-a-Box Project. This cost-effective project supplies hospitals with life-saving gas, a means of preventing millions of deaths from pneumonia.

Before 2020 – The Situation

As of 2018, pneumonia was responsible for 16% of child deaths, with the majority amongst children below the age of 2. It killed more children than diarrhea and malaria combined. Almost all cases of pneumonia can be prevented through early diagnosis and access to antibiotics and oxygen treatment. The problem lay and continues to lie with access to this healthcare.

Pneumonia does not have a single cause, it is an acute respiratory infection of the lungs, developing from either viruses or bacteria in the air. Once infected lungs become inflamed which causes difficulty breathing. The most common symptoms are coughing, fever and difficulty breathing.

The Role of Oxygen

When pneumonia develops, inflammation of the lungs stops enough oxygen from entering the bloodstream and circulating through the body. Access to oxygen in these cases becomes lifesaving. However, it has previously been unavailable to those in countries without strong health systems, only available in higher-level facilities and hospitals.

As the leading cause of preventable child deaths, pneumonia is more deadly to children in 124 low to middle-income countries who have limited or no access to health care. It leaves around 4.2 million children under 5 with dangerously low oxygen levels. This group is more vulnerable due to exposure to polluted air and higher rates of malnutrition and diarrhea, which leaves immune systems weaker.

UNICEF’s Oxygen Plant-in-a-Box Project.

Since the COVID-19 pandemic, UNICEF and partners have worked to improve basic oxygen access, coming up with their innovative Oxygen Plant-in-a-Box Project. The Oxygen-Plant in a box produces enough oxygen to treat up to 100 children with severe pneumonia. The package contains everything necessary to install and operate a pressure swing adsorption (PSA) oxygen plant which is fully functional within days of being implemented at a health facility.

By December 2021, over 16 countries had ordered this product and were on the path to developing stronger health care systems. That month patients at the Soroti Regional Referral Hospital in Uganda were the first to receive life-saving oxygen from this project.

More about the Box

The package includes everything to produce large volumes of medical-grade oxygen for patients, with each plant holding the capacity to produce up to 720,000 litres of oxygen each day. These packages aim to support medium to large health facilities.

Kristoffer Gandrup-Marino, Chief of Product Innovation at UNICEF Supply Division, stated these plants could take up to six months to design and order, so they developed the pre-designed plants making the product cheaper and faster to manufacture and arrive, saving lives in the process.

Real Life Implementation

In Uganda, 6-month-old Constance suffered from a cough, fever and difficulty breathing. She went to her local hospital where they diagnosed her with pneumonia. Here, she was immediately provided with antibiotics and oxygen. UNICEF reports.

A few months prior this would not have been the case. Due to a deteriorating infrastructure, the Kayunga Regional Referral Hospital held very limited access to oxygen therefore constricting its ability to treat the increasing numbers of pneumonia cases in children. Now, with the Oxygen Pant-in-a-Box running, Constance is one of hundreds of children supplied with the proper medical care. The new plant covers an area of 2.8 million people, according to UNICEF.

Pneumonia is still the biggest infectious killer of children, with millions of children still contracting the infection. However, local and sustainable solutions will continue to be found to prevent more deaths from pneumonia. The Oxygen Plant-in-a-Box Project contributes to this goal, supplying oxygen to healthcare facilities and treatment to those who need it.

– Amelia Short

Amelia is based in Bradford, UK and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Improving Health Care Accessibility in Developing Countries

Improving Health Care Accessibility in Developing Countries Approximately 1.2 billion people live in acute, multidimensional poverty across 111 developing countries. Many suffer from preventable and curable diseases due to limited access to health care services. According to a Geneva report by the International Labour Organization (ILO), 56% of rural residents do not have access to essential health care services. Currently, 800 million people allocate at least 10% of their household budgets to health expenses for themselves, a sick child or another family member. For nearly 100 million people, these expenses are substantial enough to push them into extreme poverty, forcing them to survive on $1.90 or less per day. Globally, many countries collaborate with the World Health Organization (WHO) to provide essential health services to the most vulnerable and needy populations.

Implementation of Telemedicine in Cambodia

Implementing telemedicine in Cambodia has significantly improved health care accessibility, largely through initiatives like Operation Village Health, part of the broader Village Leap program. This program, established by Japan Relief for Cambodia and American Assistance for Cambodia, aims to rehabilitate the country after the Khmer Rouge reign and the Vietnam War by bringing technology to rural areas. Operation Village Health uses this infrastructure to support local health workers, build capacity and provide medical care to those without expertise. An email-based telemedicine program established in 2001 allows Harvard-affiliated physicians to offer clinical recommendations to Cambodian health workers, enhancing the quality of care in remote areas.

Mobile Clinics in Madagascar

Since June 2022, mobile clinics have been crucial in improving health care accessibility in Madagascar. Funded by the United Nations Central Emergency Response Fund, 20 mobile clinics have been reaching remote and hard-to-access areas, providing essential health services to around 1 million people. These clinics have been especially vital in restoring health care services, such as vaccinations, following the destruction caused by cyclones Batsirai and Emnati, which destroyed more than 150 health facilities and left 800,000 people without access to health care. Staffed by trained health professionals who travel by various means, these mobile clinics have provided care and vaccinations and strengthened epidemiological surveillance and the detection of vaccine-preventable diseases in isolated communities.

Training Health Care Workers in Liberia

Training health care workers in Liberia through the Last Mile Health’s From Response to Recovery program has significantly improved health care accessibility. This initiative focused on building resilient health systems by investing in community and frontline health workers. Over three years, the program strengthened the National Community Health Assistant Program, rolled out a digital training platform and developed online educational resources for health system leaders. Additionally, it advocated for integrated community health worker systems, which improved the capacity to deliver essential health services, especially in remote areas. This approach enabled better health care access and quality for the communities in Liberia.

Investing in Health Care Infrastructure in Morocco

With the population steadily increasing in Morocco and a large segment entering an age group that typically requires more medical attention, demand for health care facilities, medical services and pharmaceuticals has surged. The Moroccan government has shown a strong dedication to upgrading health care infrastructure and services through initiatives like the National Health Plan (Plan Santé 2025). This plan offers long-term stability and support for the health care sector, creating a secure environment for investments. Investors can explore opportunities in public-private partnerships (PPPs) and other investment options in health care. This collaborative approach has led to the development of a robust health care system, ensuring better access to essential medical services for the Moroccan people.

Health Information Technologies in Nigeria

Utilizing health information technology, particularly through the adoption of electronic medical records (EMRs), is significantly improving data management and resource distribution in Nigeria, thereby improving health care accessibility in developing countries. By implementing EMRs, Nigeria’s health care system has seen improvements in patient care and overall health care efficiency. EMRs facilitate better data management, enabling health care providers to track patient histories, streamline workflows and reduce errors. Despite challenges such as inadequate infrastructure, lack of training and limited funding, the Nigerian experience emphasizes the importance of government support and investment in technology and training. This approach not only addresses the unique needs and constraints of developing countries but also sets a precedent for other nations looking to improve their health care systems through advanced health information technology.

Looking Ahead

Improving health care accessibility in developing countries requires a multifaceted approach that addresses various barriers to quality care. The innovative strategies discussed, telemedicine in Cambodia, mobile clinics in Madagascar, community health worker training in Liberia, infrastructure investment in Morocco and health information technology in Nigeria, demonstrate the potential for significant improvements in health care delivery. By focusing on these targeted interventions, developing regions can potentially make significant advancements toward fair and effective health care systems. These ongoing efforts not only improve the quality of care but also foster healthier communities, facilitating sustained development and well-being.

– Maria Urioste

Maria is based in Maspeth, NY, USA and focuses on Good News for The Borgen Project.

Photo: Flickr

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China’s malaria elimination

China’s malaria eliminationOn June 30, 2021, the World Health Organisation (WHO) certified China as malaria-free. Achieving this amazing status highlights the country’s success and the importance of strategic planning and adaptability in facing challenges. These include drug resistance, changing weather patterns and the COVID-19 pandemic. Due to this success, China could serve as an example for Africa, where malaria remains a significant challenge that claims more than 600,000 lives annually.

The 1-3-7 Strategy: The Key to Success

One of the cornerstone strategies in China’s malaria elimination was the 1-3-7 surveillance method. The efficient system requires reporting any confirmed malaria case within one day, then investigating within three days and responding within seven days. This rapid detection and response model was integral to China’s ability to control and eliminate malaria.

Real-time data-sharing technology is further enhanced using this method, according to The Lancet. The country also provided monetary incentives to health care workers to encourage timely reporting in some regions. The Gates Foundation recognized the 1-3-7 approach as a model for other countries with malaria breakouts.

Additional Steps to China’s Success

On top of the 1-3-7 strategy implemented to tackle China’s malaria elimination, the country also developed innovative genetic-based approaches by studying parasite populations. Scientists noticed that there is an ideal stage to intervene when it comes to intracellular parasites, this is when they decide to either continue multiples or be transmitted through a mosquito. This is because only a few parasites turn into gametocytes which is required for the transmission. China used strategies like insecticide spraying and mosquito breeding ground elimination.

Furthermore, China also turned its attention to the surveillance of drug resistance. A similar approach could help reduce malaria transmission rates in Africa. WHO recommends frequent efficacy studies to monitor the effectiveness of antimalarial drugs, according to the International Journal of Maternal and Child Health and AIDS (IJMA). China also partnered with international research institutes such as Harvard University where it used advanced genomic tools to study and predict malaria parasite movements.

China’s Leadership

China’s success in eliminating malaria shows the need for strong government leadership and cross-sectoral collaboration. Starting in the 1940s, when China was reporting 30 million cases of Malaria annually, the country gradually reduced its malaria through a series of national plans and partnerships with other nations. In 2010, it launched the National Action Plan for Malaria Elimination. This, combined WHO guidelines with China’s local strategies to achieve elimination.

During this time, China’s government committed over ￥1.38 billion towards malaria elimination efforts, according to BMJ Global Health. This robust financial backing, combined with scientific research, allowed China to upscale its interventions. The discovery of artemisinin is one of the most notable contributions from Chinese research, according to The Gates Foundation. These advances played a key role in China’s success and remain crucial tools in global malaria control efforts.

Future Prospects: China’s Lessons for Africa

This amazing achievement could help African nations achieve malaria-free status. By creating multi-sector collaborations and adapting the 1-3-7 strategy they can unite in the fight against malaria. Furthermore, adapting China’s genetics-based approach could strengthen these efforts.

Additionally, community engagement could be key to success. Educating communities about malaria prevention and involving local leaders in control measures could help ensure these efforts. With the right combination of financial investment and government action, African nations can make significant progress towards reducing malaria. China’s malaria-free certification is not just a victory for China but also a beacon of hope for the global fight against malaria.

– Ellisha Hicken

Ellisha is based in London, UK and focuses on Good News for The Borgen Project.

Photo: Unsplash

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DRC Begins Mpox Vaccination Program

Mpox Vaccination ProgramIn October 2024, the Democratic Republic of the Congo (DRC) began its official vaccination scheme against Mpox, following a nationwide outbreak. First detected in the country more than 50 years ago, Mpox is a viral infection that can cause fatal illness. The emergence of a new strain in 2023 led the World Health Organization (WHO) to declare the recent outbreak a “global health emergency” in August 2024. Two months later, following 30,000 recorded cases and more than 900 deaths as of October 2024, the DRC’s Ministry of Public Health is beginning the rollout of hundreds of thousands of vaccines as the start of its official Mpox vaccination program.

Provisions from the EU

To curb the spread of the virus, the DRC relies on the European Union (EU), donation of 265,000 MBA-BN vaccines, with the help of the U.S. Government, Gavi and Africa CDC. These vaccines require two shots administered one month apart and are available only to adults, according to UNICEF.

With a population of more than 100 million, this means there is a limited amount of doses, so officials have had to target the campaign to those most vulnerable to Mpox. So far, the campaign has focused on the country’s North Kivu and Equateur provinces, the two regions that have recorded the highest number of cases. Within these areas, the Ministry of Health will provide the doses to the most at-risk groups, such as those with existing health problems. UNICEF has coordinated the transport and delivery of the vaccines, as well as the storage and shipment across the DRC.

Further Expected Doses

Although officials in the DRC are currently working with a limited supply of vaccines, the nation has also signed an agreement with the government of Japan, which promises the supply of LC-16 vaccines. LC-16 only requires one shot for immunisation and is currently the only one that has approval for children. One of the most disproportionately impacted, children under 15 are some of the most vulnerable to the virus, accounting for 60% of all recorded cases and 80% of deaths in the DRC, according to UNICEF.

Logistical Difficulties

Alongside limited availability, officials have also faced difficulties when planning the implementation of the Mpox vaccination program itself. Vaccines must be kept as low as -20 degrees Celsius, and, once defrosted, need to be used within 40 days to be effective. Officials are therefore working with a limited time frame in which they can transport and administer doses from the central storage facility in Kinshasa. This poses particular difficulty for the nation’s more rural areas which take longer to reach, an issue that has only been exacerbated by the ongoing conflict in the DRC between the government and rebel groups. This has made access to rebel-controlled regions much more limited and therefore made the transportation of medical resources such as vaccines to these areas much more difficult.

Government efforts, educational campaigns and attempts to raise awareness about the virus, and vaccines are just some of the ways the DRC is currently working to combat the spread of Mpox. Its collaboration with international organizations has proved key to the start of the Mpox vaccination program, and further provisions from nations such as Japan will hopefully allow for the continued suppression of the virus.

– Izzy Tompkins

Izzy is based in Leeds, UK and focuses on Global Health and Politics for The Borgen Project.

Photo: Flickr

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Causes of Mental Health in Estonia

Mental Health in EstoniaThe people of Estonia have been grappling with mental illness for years. With a population of 1.3 million, approximately 20% are affected by anxiety and depressive disorders. Several factors contribute to the high rate of mental illness in the country, including gender, economic status and the impact of COVID-19. However, a significant factor is the existing policies regarding mental health.

Gender Differences

Worldwide, women are at a higher risk for certain mental illnesses than men. Women are more likely to have mental distress like anxiety, depression, eating disorders and more. At the same time, men are more likely to have Attention-deficit/hyperactivity disorder (ADHD) and autism.

A 2021 post-COVID-19 survey in Estonia revealed that 31% of women in the study had developed depression, 25% had anxiety and 44% experienced sleep disorders. While women showed higher rates of certain mental disorders, men had a significantly higher rate of alcohol addiction at 34%, compared to 17% among women.

The Effects of Socioeconomic Status

The economic status of certain demographic groups in Estonia also correlates with higher levels of mental distress. According to the National Library of Medicine, “lower personal income was associated with higher rates of all mental health complaints (stress, depressiveness, overtiredness and suicidal thoughts) among employed adults in Estonia.” Economic status is not the only socioeconomic factor contributing to the rise in mental distress in Estonia.

Education has also been identified as a high-risk factor for mental health disorders. “The mental health of Estonian students has never been as critical as today.” Compared to other European countries, Estonia’s student population has twice as many reported mental health 0issues. In 2021, 5% of students across Europe were admitted to university with mental health problems, while Estonia’s rate was 9%.

COVID-19

COVID-19 significantly contributed to a global increase in mental distress and Estonia is no exception. The country continues to feel the effects of the mental strain left by the pandemic. According to the Health Systems and Policy Monitor, a 2022 study revealed that one in four adults in Estonia is at risk of developing depression in the aftermath of COVID-19.

Furthermore, a survey conducted by the National Library of Medicine found that elite athletes in Estonia experienced high levels of mental distress when COVID-19 hit. Female athletes showed higher distress levels than their male counterparts. With competitions canceled, training facilities closed and face-to-face coaching suspended, stress levels among athletes soared.

Policies

Estonia’s mental health services have improved in recent years due to continuous policy changes. Initially, the country had only drafts of policy documents for mental health services. However, as mental distress increased among its citizens, Estonia updated and strengthened its policies to address the growing need.

The Health Systems and Policy Monitor (HSPM) Network has provided an update on future policy changes aimed at improving mental health in Estonia. Due to the impact of COVID-19 and the rise in mental illness among low-income groups, policymakers have made mental health initiatives a top priority. A new “Mental Health Action Plan” is set to take effect from 2023 to 2026.

The Mental Health Action Plan details anticipated changes in the field of mental health. The plan emphasizes the Ministry of Social Affairs’ (MoSA) role in implementing these changes. It recognizes that addressing issues in mental health will require additional actions beyond what is currently outlined and achievable within the plan’s timeframe.

Conclusion

Mental distress can affect individuals regardless of gender or socioeconomic status, highlighting a widespread issue. However, positive strides have been shown, as evidenced by the significant improvements in Estonia’s mental health services in the past 10-15 years.

– Ashley Diaz

Ashley is based in Homestead, FL, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Monkeypox Outbreak in Africa

monkeypox outbreakCOVID-19 was a difficult time for everyone. Not only did we see extreme drawbacks in the economy, but drawbacks socially and personally as well. The world has worked hard to move on from a time of social isolation, and face masks, but a new problem has begun to arise that threatens the world’s plans for global stability. Monkeypox, now known as Mpox is a rare disease that leads to a rash and flu-like symptoms. There are two strains that affect a multitude of people at different rates and are contracted in various ways. Infected are commonly found in central African countries like the Democratic Republic of Congo (DRC), Uganda, and Rwanda. These countries are now facing high rates of spreading, stirring tensions and concerns of another global crisis and potential monkeypox outbreak.

Countries at Risk

Mpox is causing major outbreak fears in the DRC, Uganda and Kenya as people are starting to experience an increase in cases. Mpox in the DRC has reached over 15,000 reported cases, as of August 2024, making it the largest concentration of infected on the continent, and surrounding countries are at risk. Kenya, Uganda, and Rwanda have now reported their first cases of monkeypox, and have begun taking necessary precautions to isolate the problem before more are infected.

The DRC and other countries are working hard to contain the threat; a mixture of existing economic setbacks and Mpox would be detrimental to the progress and stability Africa has worked hard to achieve. Mpox in the DRC is close to a total outbreak in the eastern provinces of South and North Kivu where millions of displaced people are living in overcrowded conditions, inevitably causing an immediate rise in cases.

Kwazulu Natal reported nine cases of Mpox and two confirmed deaths already in July 2024. Men between the ages of 17 through 43 were among the first groups to contract the disease in July 2024. Exposure can occur through contact with contaminated materials, infected animals or infected people, most notably through sexual contact. South Africa fears of growing community transmission in areas with high concentrations of vulnerable groups.

Monkeypox Outbreak: Solutions

Government organizations like UNICEF, WHO and the African CDC are working in partnerships to provide vaccines, services and information, and health kits to healthcare facilities across Africa. A collaboration with Gavi, the vaccine alliance has led to the approval of several projects aimed at containing and stopping Mpox in the DRC and other African countries.

Beginning in 2026, Gavi will start stockpiling vaccines, but progress will rely on funding, prequalification of a recommended vaccine and the availability of WHO Emergency Use Listing. Gavi will support outbreak response in DRC and surrounding countries in the meantime. The organization will invest in the learning agenda which aims to help inform and improve future vaccination efforts.

In 2022 the CDC Foundation activated the Emergency Response Fund, previously used to bolster support to communities and organizations when Ebola, Zika, and most recently COVID-19 threatened the world. Appealing with government and private entities the CDC aims to raise as much support as possible, the first of many donations coming from the Robert Wood Johnson Foundation.

Going through the COVID-19 pandemic, the world gained an experience. Support in awareness and advocacy of the problem that the monkeypox outbreak poses is necessary for low-income countries to receive help. The world has the chance to stop another pandemic from taking shape.

– Immanuel Wiggins

Immanuel is based in Jackson, MS, US and focuses on Global Health for The Borgen Project.

Photo: Flickr

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GPEI Eliminating Polio: Ongoing Efforts and Future Challenges

GPEI Eliminating Polio: Ongoing Efforts and Future ChallengesSince launching the Global Polio Eradication Initiative (GPEI) in 1988, the World Health Organization (WHO), United Nations International Children’s Emergency Fund (UNICEF) and several other international organizations have worked tirelessly to eliminate poliovirus. As of Oct. 2023, cases due to wild poliovirus have decreased by more than 99% since 1988, from an estimated 350,000 cases in more than 125 endemic countries, to just two endemic countries.

Polio Aftermath

There is no consensus on the number of polio survivors experiencing the effects of paralytic polio; however, estimates from 2014 suggest about 20 million people are affected. Most of these cases occur in countries where polio remains endemic or has only recently been eradicated, such as Pakistan, Afghanistan and Nigeria.

Research indicates that most individuals living with paralytic polio reside in rural, low-income and isolated communities. A 2019 study found that nearly 80% of polio survivors develop post-polio symptoms, which can lead to chronic medical issues if not addressed. Apart from local community support groups, these survivors have limited resources to aid their rehabilitation and recovery. Consequently, due to this lack of resources, polio survivors often must manage their chronic post-polio or paralytic polio symptoms on their own. This combination of isolation and limited access to medical care creates a poverty spiral that is incredibly difficult to break.

GPEI and Polio Eradication

UNICEF received funding to support vaccinations for 370 million children worldwide. Recently, the Global Polio Eradication Initiative (GPEI) enhanced its relationship with Pakistan, boosting funding and resources to eliminate polio in the nation’s endemic regions.

In 2024, Luxembourg and Japan pledged significant funds toward the global eradication of polio. In May, authorities officially ended two wild poliovirus outbreaks in Malawi and Mozambique. Amid these successes, there is a growing need to focus more on polio survivors and the needs of individuals beyond vaccination. The effort to eliminate polio is incomplete until all those affected by polio, especially survivors who will never fully recover, receive the proper medical and social care necessary to ensure their quality of life and safety.

Current Support Systems

While many polio support and survival groups exist, most primarily function as support networks and often lack the resources to provide extensive post-polio disability care, although some can finance care in certain instances. When these groups do offer medical assistance, it typically comes from volunteer medical professionals who face challenges due to insufficient funding and equipment, much like the Turkish Polio Society.

Most major relief organizations focusing on global polio eradication develop infrastructure to distribute vaccines to as many people as possible. Historically, polio disability care centers have primarily been established for high-income populations in wealthy nations like France and the United States (U.S.) However, there is minimal effort to establish similar care centers in regions with higher rates of polio-related disabilities, where medical and social support could have the greatest impact.

Looking Ahead

Efforts to eradicate polio have made significant strides, with UNICEF securing funding to vaccinate 370 million children in 2024 and additional pledges from Luxembourg and Japan. However, addressing the long-term needs of polio survivors, especially in regions with limited medical access, remains crucial. Comprehensive support systems could ensure the well-being and quality of life for those affected by the aftermath of polio.

– Jamie Sackett

Jamie is based in Hutto, TX, USA and focuses on Global Health and Politics for The Borgen Project.

Photo: Flickr

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Affordable Eye Care: The Aravind Eye Care System

The Aravind Eye Care SystemIn a world where quality health care often comes with a hefty price tag, the Aravind Eye Care System shines as a remarkable exception. Founded in 1976 by the visionary Dr. Govindappa Venkataswamy, this institution has transformed from a modest 11-bed facility into a vast network dedicated to affordable, high-quality eye care.

About Venkataswamy

Venkataswamy, fondly known as “Dr. V,” was born on October 1, 1918, in Vadamalapuram, Tamil Nadu In, India. After earning his medical degree from Stanley Medical College in 1944, he served in the Indian Army Medical Corps. However, Venkataswamy retired early due to severe rheumatoid arthritis. Undeterred, he specialized in Ophthalmology and went on to perform more than 100,000 successful eye surgeries. Additionally, Venkataswamy introduced innovative programs to combat blindness in India, including outreach camps and an ophthalmic assistants training program. In 1973, he was awarded the Padmashree by the Government of India for his contributions.

Aravind Eye Hospital

Aravind Eye Hospital was established by Venkataswamy without any initial capital, business plan or safety net, relying primarily on faith in its mission to eliminate needless blindness. Since its inception, Aravind has expanded to include seven tertiary centers, seven secondary centers, six community eye clinics, 80 vision centers and eye banks. The Postgraduate Institute of Ophthalmology and the Lions Aravind Institute of Community Ophthalmology provide essential training. At the same time, Aurolab manufactures affordable, high-quality ophthalmic consumables exported to more than 160 countries.

In the 2022-23 year, Aravind performed more than 704,000 surgeries and had more than 5.7 million outpatient visits. Remarkably, more than 50% of these surgeries were provided either free or at highly subsidized rates to people experiencing poverty. This is made possible via the earnings from paying patients. Aravind’s efficient service delivery and innovative practices, such as an “assembly line” system in operating rooms, enable doctors to perform a high volume of surgeries while maintaining exceptional quality.

Furthermore, Aravind’s outreach program, supported by organizations like Lions Clubs International and Rotary International, extends its services to villages lacking eye care facilities. The model, originally focused on cataract screenings, now provides comprehensive eye exams and necessary treatments, bringing those requiring surgery to the base hospital for free procedures.

Sustainability and Innovation

Aravind has optimized patient care practices to reduce its carbon footprint. Spectacle delivery times and transport emissions have been significantly reduced through an innovative online selection and central lab fitting process. The hospital’s energy-efficient buildings, solar plant and sustainable dining services further align its social, environmental and financial goals.

Enhancing Productivity

Recognizing the scarcity and cost of ophthalmologists, Aravind reassigned routine tasks to mid-level ophthalmic personnel, boosting the productivity of ophthalmologists by more than four times. Medical schools and business schools worldwide have replicated this innovative approach. Moreover, Aravind now provides consultancy services and training to eye hospitals and personnel globally.

Conclusion: A Model for Global Health

Aravind Eye Care System stands as a testament to the power of innovative, compassionate health care. By transforming how eye care is delivered, Aravind not only provides sight to millions but also serves as a model for sustainable health care worldwide. As Aravind continues to expand its reach, the foundation’s vision of eradicating needless blindness and fostering a healthier world becomes increasingly tangible.

– Sandeep Kaur

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

Photo: Flickr

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ARIDA: Tackling Childhood Pneumonia

ARIDAThe World Health Organization (WHO) identifies pneumonia as the leading cause of mortality among children under five, attributing more than 700,000 child deaths to the disease in 2019. Consistently, UNICEF estimates that pneumonia annually claims the lives of 800,000 children under five worldwide, marking it as the top cause of child morbidity from infectious diseases globally. Pneumonia can be contracted through various agents, including viruses, bacteria or fungi. It affects the lungs, specifically the alveoli—small sacs where air exchange occurs. Normally, these sacs expand with air when inhaling. In cases of pneumonia, the alveoli fill with fluid or pus, making breathing painful and limiting the ability to take deep breaths.

Typical Barriers to Treating Pneumonia

Pneumonia is often misdiagnosed as a disease like malaria or tuberculosis, complicating early detection efforts. The WHO reports that in remote areas with limited health facilities, health workers rely on manual counts of respiratory rates (RR) to diagnose pneumonia. However, manually counting a child’s breaths is challenging and subjective, with variations in what different health workers consider a single breath. This inconsistency makes it difficult to obtain an accurate RR, hindering effective diagnosis.

ARIDA

In 2014, UNICEF launched the Acute Respiratory Infection Diagnostic Aid (ARIDA) program to develop technology that would enable health workers to diagnose pneumonia more accurately. This initiative introduced two new devices: the Philips ChARM, which stands for Children’s Automatic Respiratory Monitor and the Masimo Rad G, both designed to improve the assessment of respiratory rates in children.

The Philips ChARM, priced at $44 per unit, automatically counts a child’s respiratory rate when strapped around the torso, designed for use while the child lies horizontally. The Masimo Rad G, costing $250 per unit, uses a clip-like monitor attached to the child’s finger to calculate respiratory rate and simultaneously measure blood oxygen levels. Using devices to calculate respiratory rates has enabled health workers to adhere more closely to WHO guidelines for diagnosing pneumonia quickly and accurately. More than one million children gained access to life-saving antibiotic treatments due to the ARIDA devices and an additional 300,000 received enhanced care services.

The Future of ARIDA

The trials of the ARIDA devices took place in Bolivia, Nepal and Ethiopia from 2017 to 2019, significantly advancing Ethiopia’s health goals for women and children. These ongoing efforts are part of a broader commitment to the Global Action Plan for Pneumonia and Diarrhoea, aiming to eliminate all treatable pneumonia and diarrhea-related deaths by 2025. The plan includes expanding the range of ARIDA products available for government purchase. However, the scaling of ARIDA products faces challenges such as unit costs, though countries may offset these costs through funding from UNICEF’s development partners. This initiative also supports the United Nations (U.N.) goal to end preventable deaths of newborns and children under five by 2030.

Looking Ahead

The ARIDA initiative has made significant strides in diagnosing and treating pneumonia, particularly in remote areas. Trials in Bolivia, Nepal and Ethiopia have already enabled more than a million children to access life-saving treatments. Despite cost challenges, the expansion of ARIDA products aligns with global health goals, aiming to reduce child mortality rates and improve health care outcomes by 2030.

– Naomi Finapiri

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

Photo: Flickr

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Technological Innovations in Maternal Health

Innovations in Maternal HealthThe United Nations Children’s Fund (UNICEF) reports that more than 25% of the estimated 300,000 maternal deaths each year stem from postpartum hemorrhage, which is severe blood loss following childbirth. Most of these deaths occur in developing countries where access to quality medical facilities is limited. The United Nations (U.N.) states that postpartum hemorrhage is the leading cause of maternal mortality, claiming the lives of 130,000 new mothers each year. Technological advancements and innovations have introduced two significant medical devices to combat this issue and improve maternal health: the Non-pneumatic Anti-Shock Garment (NASG) and the Uterine Balloon Tamponade (UBT).

The Non-Pneumatic Anti-Shock Garment

NASGs resemble trousers and are divided into five to six segments. Each segment features Velcro straps that apply targeted pressure from the ankles to the abdomen, allowing for simultaneous vaginal treatments. Developed using technology similar to NASA’s anti-gravity suits, NASGs prevent unconsciousness by promoting blood circulation toward the head. They also reduce blood loss and increase survival chances in cases of postpartum hemorrhage by compressing the lower extremities to drive blood toward vital organs. This effective management ensures prolonged survival until medical help is available.

NASGs provide up to 48 hours of crucial support in emergencies and can be reused up to 144 times. Costing approximately $0.50 per use, NASGs are cost-effective and vital for maternal health. The World Health Organization (WHO), UNICEF and the United Nations Population Fund (UNFPA) recognize these garments as essential tools for reproductive, maternal, newborn and child health. Research indicates that NASGs can potentially reduce maternal deaths from postpartum hemorrhage by half in specialized care settings, highlighting their critical role in improving reproductive health outcomes.

The Uterine Balloon Tamponade

The UBT is a medical device used to manage postpartum hemorrhage. It works by inserting a balloon into the uterus and inflating it with saline or sterile water using a syringe or gravity bag. This inflation applies pressure to the uterine walls, effectively controlling excessive bleeding. Although UBTs are effective, they are expensive, with costs ranging from $125 to $350 per use, limiting their use primarily to high-income countries as a surgical intervention for severe postpartum hemorrhage.

In areas without adequate medical facilities, health practitioners have improvised with makeshift versions of the UBT. UNICEF reports the use of condoms, inserted into the uterus and inflated with saline through a catheter, as an emergency alternative to UBTs. These ad-hoc solutions can mitigate blood loss but pose significant safety risks. A 2019 study in Ivory Coast confirmed the effectiveness of UBTs, successfully managing postpartum hemorrhage in nearly all treated cases, highlighting the need for both proper medical oversight when using such devices and further innovations in Maternal Health.

The Adoption of NASG and UBT Devices

Despite the clinical proof of its effectiveness, the NASG faces several challenges that limit its wider use. A general lack of awareness about the importance of NASG exists. Additionally, many health facilities report shortages due to the device’s high initial cost. Additionally, gaps in knowledge about the proper use and maintenance of NASGs further complicate efforts to implement them effectively.

Similar to the NASG, despite its effectiveness in controlling postpartum hemorrhage, UBT is expensive, challenging its widespread use in low- and middle-income countries. The WHO restricts UBT approval to environments where advanced treatments like blood transfusions and surgeries are available. Clinical trials reported in Obstetrics and Gynecology journals have highlighted potential risks of using UBT-like devices in remote settings, including instances where the intervention might have worsened blood loss. Trained medical personnel are advised to use such devices with caution, particularly in less-equipped environments.

Moving Forward

The U.N. agency is collaborating with governments and hosting online seminars. The aim is to promote the effectiveness of the NASG in reducing postpartum hemorrhage. Since 2019, UNICEF has included the NASG in its Supply Catalogue for global accessibility. Additionally, UNICEF is searching for cost-effective alternatives to the UBT. UNICEF has identified a manufacturer that offers the device at $5-15 per usage. More than 10 countries now recognize this affordable UBT as an essential medical product, with at least 16,000 units purchased. Concurrently, WHO is launching a study in Vietnam to test procedures, including a UBT-like device, to mitigate postpartum hemorrhage and improve maternal health. This research aims to address previous concerns about the UBT’s risks and develop more innovations to reduce maternal deaths and improve maternal health.

– Naomi Finapiri

Naomi is based in London, UK and focuses on Technology and Solutions, Global Health and Celebs for The Borgen Project.

Photo: Flickr