SDG Goal 3 in Vietnam During the U.N. Summit for 2015, world leaders decided on 17 goals that they would like to track around the world. These goals would help motivate changes for a better future and identify where these changes were most needed. Titled, the Sustainable Development Goals (SDGs) — these goals range from conserving and creating a sustainable industry in the ocean (SDG goal 14) to ending poverty in all forms (SDG goal 1). Moreover, the U.N. rates the status of a country and its ability to achieve a certain SDG by 2030. This article will provide a brief update on SDG goal 3 in Vietnam.

Vietnam, a country located in Southeast Asia, has achieved several of the goals. For instance, Vietnam has achieved the goals for quality education (SDG 4), responsible consumption and production (SDG 12) and climate action (SDG 13). One of the goals, however, the “Good Health and Well-Being” (SDG 3) has been rated as the furthest from achievement with the “major challenges remain” status.

SDG 3: A Deep Dive

The description of SDG 3 is simple but will require a great effort to achieve; “Ensure healthy lives and promote well-being for all at all ages.” Some of the sub-scores — specific statistics that have led Vietnam to the depleted state of wellness and well-being goal include the high incidences of tuberculosis, traffic deaths and the percentage of surviving infants who received two Word Health Organization recommended vaccines.

Some of the greatest identified challenges include the control of communicable diseases, such as the aforementioned tuberculosis score, creating healthcare equality and accessibility. These issues share a strong connection because some new policies that have improved the control of communicable diseases in one sector are not established in others.

Improvements to SDG 3

Though the scores may be an indicator of a national problem in Vietnam, they have led to great improvements. In response to the inaccessibility score, the health service delivery has improved greatly. For example, there has been an increase in investment for healthcare facilities that are accessible to all Vietnamese. Also, the ability of Vietnamese to pay for healthcare is increasing as the coverage from insurance rises. In 2017, 86.4 % of Vietnamese had health insurance. Moreover, the National Tuberculosis Control Programme helps identify those who need treatment. This has continued to reduce the incidence over the years.

Traffic accidents are another low score for SDG goal 3 in Vietnam — something unique to the country. Accidents, injuries and deaths are all counted into the well-being score for SDG 3 in Vietnam. While the number of incidences has decreased, an estimated 14,000 people continue to lose their lives due to traffic accidents each year. The National Traffic Safety Committee and WHO have started a road safety project that works on reducing the number of deaths and accidents. The initiative holds a large focus on motorcycle safety and the prevention of drinking while driving.

What is Currently Being Done?

The inequality and inaccessibility for healthcare and sources of well-being, such as nutritious and reliable sources of food are especially culpable concerning child mortality statistics. The national statistics show a hopeful decreasing trend but have revealed stunning discrepancies between ethnic and regional groups. Highlighting this — child mortality in some mountainous regions in the Northwest and Central Highlands are four times as high as the national average. To create a way in which all children can be treated equitably, the Sustainable Health Development Center (VietHealth) has developed many programs to help mobilize primary care, screenings and disability care.

Vietnam is currently facing several different challenges in reaching the SDGs for 2030. However, with the help of (among others) the National Tuberculosis Control Programme, the road safety programs and VietHealth, much progress can be made in the next decade. Vietnam and the U.N.’s SDGs have proved to be a valuable resource for highlighting severe issues and motivating organizations and governments to improve conditions for citizens around the world.

Jennifer Long
Photo: Flickr

healthcare in kiribati
The Republic of Kiribati, better known as just Kiribati, is an Oceanic country formed by 33 unique islands, of which 20 are inhabited. The majority of Kiribati’s population is located on the Eastern Gilbert islands, while many islands located in the center function without a permanent population. Healthcare in Kiribati has been a committed work-in-progress, especially after the notification in the late 20th century that its population was at one of the lowest standards of living in Oceania. The disjointedness of the islands and a lack of cohesive national health policy has significantly impacted Kiribati’s ability to effectively provide national healthcare services to all that need it.

In fact, as recently as 2012, there was not an official agency for national health policy, regulation of health standards, assessment of health technology, or management of health technology. However, despite this glaring lack of infrastructure, Kiribati has instituted projects at the national level to improve its primary level of healthcare. The government, along with partnerships from international health organizations, is working to invest in Kiribati’s health infrastructure.

The following five facts about healthcare in Kiribati are integral to understanding the country’s changing health structures and transition out of poverty.

5 Facts About Healthcare in Kiribati

  1. Around 22% of the Kiribati population is living under the “basic needs” threshold, according to the Department of Foreign Affairs and Trade. However, the traditional definition of poverty is not used in Kiribati, as much of the population believes that as long as one can maintain subsistence living, they are not poor. Instead, poverty is related to meet their basic expenses on a daily or weekly basis. This culture has made it so that many residents in Kiribati live in housing without access to clean water, sanitation or other basic hygiene utilities.
  2. Kiribati is at an elevated risk for infant mortality, consistently ranking as the highest country in Oceania by the estimated absolute number of incident cases, with approximately five times the number of cases as Australia. In 2012, the rate of infant mortality stood at 60 deaths per 1,000 individuals. While this statistic was significantly reduced from years past, there is no reason for such a high percentage of the population to suffer from infant mortality. The most common causes of infant mortality in Kiribati are perinatal diseases, diarrhoeal diseases and pneumonia. As a result of inadequate water supply and poor sanitation, water and food-borne illnesses can also contribute to the incidence of infant mortality.
  3. Kiribati also suffers from its lack of developed healthcare infrastructure. Hospital facilities, doctors to assist the population, and trained nurses are all hard to come by in Kiribati. Though they meet standards for routine care, the scarce availability of such facilities makes them hard to access for the general population. With only three district-level hospitals and one referral level hospital, patients often must be sent overseas if serious conditions arise. This remote level of treatment can often make timely access to medicines an issue as well.
  4. In Kiribati, there is a low number of doctors and nurses relative to the population overall. This low number contributes to the relatively high infant and maternal mortality rates of Kiribati. Recently, the government has worked with smaller groups around Kiribati to train more healthcare professionals. By holding orientation courses for all health staff and developing long-term courses for primary care staff, communities on many of Kiribati’s islands could tackle the lack of healthcare personnel issues. As a result of these programs and increased training, the number of individuals that are able to assist with healthcare is rising, and the rates of morbidity from common diseases have been reduced.
  5. Water supply is an issue in Kiribati that most don’t directly associate with healthcare and disease, but can have a significant impact on the health of the population. Outdoor defecation is said to be prevalent in Kiribati, which can lead to contamination of the water supply. Groundwater contamination is often related to a higher incidence of diarrheal diseases. However, outdoor defecation is not entirely the result of a lack of other options, but education is necessary to help the population of Kiribati understand the risks associated with it.

In the fight against poverty and for a healthcare system that can serve its entire population, Kiribati has much work to do. Progress has been made in developing training for healthcare professionals and educational programs for communities, but many services such as sanitation and clean water supply still aren’t up to standards. Still, with a government committed to increasing the healthcare provisions for its people, Kiribati is sure to develop into a country that can provide for its growing population.

Pratik Samir Koppikar
Photo: Pixabay

Healthcare in UzbekistanUzbekistan is a former Soviet country and many consider it to be the population center of Asia with a young population. Since its independence in 1991, the country has diversified its agriculture, while keeping a significant agricultural base to its economy. The quality of healthcare in Uzbekistan endured a drop after its independence from the USSR but now is on the upward trend, even though it remains low in global rankings. Here are seven facts about healthcare in Uzbekistan.

7 Facts About Healthcare in Uzbekistan

  1. Under Soviet control, all healthcare in Uzbekistan was free. However, the government focused on access and less on outcome, leading to weaknesses when dealing with sickness and disease, especially in rural communities. Meanwhile, about 27% of hospitals in rural areas had no sewage and 17% had no access to running water, while doctors received 70% of the salary of a farmer, a common Uzbek job. Now, reforms focused on rural areas have improved conditions in all hospitals, and doctors now make 26 times the amount of a rural farmer.
  2. In Uzbekistan, most people rely on public healthcare providers, organized in three layers: national, regional and city. Private healthcare is minimal due to unsafe practices in treatment and surgery. As a result, the government is the principal employer of health workers, as well as the primary purchaser and provider of health-related goods and services.
  3. Spending on healthcare in Uzbekistan has increased from the country’s independence in 1991, as the country aimed to westernize and reform. Uzbekistan’s current health expenditure is 6.4%. The government health spending increased from $36 to $85 per person; out of pocket spending almost doubled from $37 to $69 per person, and developmental assistance doubled from $3 to $7 per person in the 30 years from its independence. The increased funding led to higher availability in healthcare, especially in rural areas, and better quality of care.
  4. In the past 30 years, Uzbekistan has implemented healthcare reforms in rural areas. Some improvements include increasing sanitation levels in hospitals and healthcare availability, allowing for all patients to get better care. Overall, the under-5 mortality rate has decreased by 50%, and healthcare access and quality (HAQ) grew from 50.3 to 62.9 from 1990 to now.
  5. The physician’s density is low, at 2.37/1000 people, mostly due to the emigration of skilled professionals, even though the median pay for physicians has sharply increased to about $13,000 a year. On the other hand, the hospital bed density is higher than in some highly developed countries, such as the United States, at four for every 1,000 people.
  6. Uzbekistan ranks low in maternal and infant mortality. At 29 deaths out of 100,000, it ranks 114 in maternal mortality. At 16.3 deaths out of 1,000, it ranks 93 in infant mortality. Although its healthcare system has gotten better with reforms in sanitation and access to healthcare, Uzbekistan still needs to create more improvements, as the mortality rate is still high.
  7. Uzbekistan is also low-ranking in adult health. The country holds the rank of 125 in life expectancy, with an average lifespan of 74.8 years. As for the quality of health, Uzbekistan ranks 115 in HIV/AIDS, with a prevalence of 0.2% and ranks 123 in obesity, with a prevalence of 16.6%.

Project Hope

Uzbekistan has not accomplished everything on its own. Many charities have worked with Uzbekistan, such as Project Hope. In 1999, Project Hope established its first office in Uzbekistan, with a focus on reducing child and maternal mortality rates, through the Child Survival Program and Healthy Family Program. It created initiatives, as well as opportunities for sexual education for the new mothers. Since then, under the Global Fund to Fight AIDS, Project Hope has focused on creating opportunities for AIDS-focused healthcare and education.

Uzbekistan has made progress in healthcare from the time of its independence, but it still has a long way to go. As Uzbekistan’s government continues to implement reforms heavily focusing on rural areas, it will most likely continue on its upward trajectory and create a health system that is beneficial to all of its citizens. As healthcare grows, poverty will decrease. Currently, Uzbekistan’s most poor are in rural areas, the areas with the least access to healthcare, as well as the lowest levels of sanitation. If Uzbekistan continues making reforms, rural areas will receive more healthcare, decreasing the disadvantage of living there, and therefore increasing the quality of life for Uzbekistan’s poor.

Seona Maskara
Photo: Flickr

Documentaries About Healthcare
During quarantine, many people resort to watching Netflix shows and movies. Though the pandemic has freed up more time for binging meaningless films, one can also use this time to learn about how impoverished countries are handling the COVID-19 pandemic. While documentaries have a reputation for being boring, many documentaries about healthcare are the opposite. Here are five documentaries about healthcare around the world.

1. “The Final Inch” (2009)

Rating: PG-13

Where to Watch: HBO

In the late 2000s, polio spread through India, Pakistan and Afghanistan. “The Final Inch” focuses on efforts to eradicate polio in these countries (it has since seen elimination in India, but there are ongoing efforts to reduce the numbers in Pakistan and Afghanistan). Produced by the philanthropic division of Google, this documentary aims to increase awareness of the outbreak of polio in these countries and the efforts of healthcare workers to eradicate the disease. This documentary follows numerous workers and volunteers in their efforts to administer the polio vaccine in these vulnerable places. While dangers arose in Afghanistan while filming, this documentary about healthcare provides a raw outlook on the polio epidemic and its effects on these countries.

2. “Sicko” (2007)

Rating: PG-13

Where to Watch: Amazon Prime Video

Directed by Michael Moore, “Sicko” is a political documentary that investigates healthcare in the United States. Centered around the American pharmaceutical industry, this film compares the non-universal U.S. healthcare system to systems in Canada, France and Cuba. “Sicko” follows Moore’s journey to understand the difference in how the United States and other countries around the world handle the same problems. Moore considers issues of health insurance and money, revealing horror stories behind healthcare policies. Moore effectively combines tragedy and comedy in this raw film and exposes the truth behind American healthcare. 

3. “Living in Emergency: Stories of Doctors Without Borders” (2008)

Rating: Unrated

Where to Watch: Amazon Prime Video

Doctors Without Borders is a nonprofit organization that provides medical care in impoverished countries around the world. Set in the Congo and post-conflict Liberia, Oscar-nominated documentary “Living in Emergency” follows four doctors and their efforts to provide emergency medical care to the public. Through the chaos, this documentary about healthcare follows these volunteers as they confront many challenges and make tough decisions. The doctors often face limited resources, personnel and poor living conditions. “Living in Emergency” provides a new, more realistic perspective for those privileged enough to access proper healthcare.

4. “Period. End of Sentence” (2018)

Rating: TV-PG

Where to Watch: Netflix

While menstruation is a shared experience across the world, it is a taboo topic in India. In rural communities in this country, sanitary products are out of reach, as proper healthcare is often available only in urban areas. “Period. End of Sentence” follows a group of women in the Harpur district outside of Delhi, India as they create sanitary products. Throughout the film, these women not only learn how to produce pads, but they also rid their community of stigma against menstruation. Nominated for an Oscar, this documentary about healthcare in India has severely changed the view on periods in healthcare systems and rural communities as well. Beyond changing the way people view menstruation, “Period. End of Sentence” has also yielded significant praise as a documentary.

5. “Cervical Cancer in Uganda: Three Perspectives” (2014)

Rating: Unrated

Where to Watch: YouTube

In sub-Saharan Africa, the most prominent form of cancer is cervical cancer. Research from the National Center for Biotechnology Information concludes that cervical cancer causes the most cancer-related deaths in Uganda. While cervical cancer is common in this country, however, it does not get mainstream attention. This documentary follows Sascha Garrey as she travels through the country to understand the prevention and treatment options for women in Uganda. Produced by the Pulitzer Center, this documentary on healthcare educates viewers on cervical cancer and its prevalence in impoverished countries.

While these five documentaries may not all be the most recent, watching them during the pandemic can provide valuable insight into healthcare in impoverished countries. Instead of watching mindless films to pass the time, consider watching an informative and interesting documentary about healthcare conditions around the world.

Aditi Prasad
Photo: Flickr

Women and Pandemics
Most healthcare workers on the front lines are female, but there is another pandemic that plagues women during times of health crises: gender inequality. Epidemics and pandemics further gender inequality as women struggle socioeconomically and in healthcare. Gender equality can combat world poverty, but diseases can slow societal advancement for women.

Society and the Economy

Globally, 740 million women work low-paid and informal jobs, which they are quick to lose during pandemics and epidemics. The livelihoods of women are at risk with an increase in job insecurity and job loss during times of crisis. During the Ebola outbreak in Liberia, closed borders caused women to face much higher unemployment rates than men since 85% of cross-border traders are women.

In the developing world, 70% of women work informal jobs, but women’s unpaid labor boosts global economies and should not be ignored. According to the United Nations Foundation, “women on average do three times more unpaid care work than men.” Women who work to care for their families bring in $1.5 trillion to the world GDP. Jobs without pay create even more inequality as women stay at home, complete domestic tasks and care for the sick. The burden of caring for the ill in the family puts women at a greater risk of falling ill. More West African women were affected by Ebola because they worked in hospitals or aided the sick at home.

A shelter-in-place due to pandemics can result in girls dropping out of school and puts women at a higher risk for violence. As seen from the Ebola outbreak, closures of schools put young girls at high risk for pregnancy and child marriage. During country-wide lockdowns in 2020, women have to remain with their abusers. Domestic violence against women tripled in China and increased by 30% in France. Even more shocking, some use the exposure of COVID-19 as a means of suppression against women.

Healthcare

Although 70% of health workers are women, men make most of the decisions in the healthcare sector. Only 27% of women are executives in world healthcare. This gender segregation in healthcare leaves women in lower roles and creates a bias towards men. Personal protective equipment uses male sizes and thus does not protect female workers as effectively. In Spain, 5,265 out of 7,329 health workers infected by COVID-19 were women. Data collection may ignore gender in some studies, which makes it harder to understand the current trends and how they affect women.

While most healthcare resources are focused on fighting pandemics, women’s health may be overlooked. More women in Sierra Leone died from obstetric complications than from Ebola. COVID-19 will likely cause 18 million women to not be able to acquire contraceptives in Central and South America. Providing fewer health services during pandemics has detrimental effects on women’s health.

Operation 50/50

Pandemics affect both men and women, but 80% of the WHO Emergency Committee on COVID-19 are men. In order to provide women with more representation during the COVID-19 pandemic, the United Nations has created the campaign Operation 50/50. The campaign aims to accomplish five goals: recruiting more women for leadership roles, valuing women’s unpaid care work, providing better conditions for health care workers, utilizing gender attentive data and funding NGOs for women. Around the world, women have a high risk of exposure to disease, whether that be in the healthcare field or staying at home with the sick. Elimination of gender inequality in healthcare will increase safety for women during global pandemics.

Hannah Nelson
Photo: Pixabay

Health Policy Evolution in LaosMany countries throughout Southeast Asia face increased health risks due to the propagation of COVID-19. Healthcare policy and infrastructure in Laos has been developing over the past few decades. Laos is one of the most ethnically diverse countries in the world with more than 49 ethnic groups. It includes variegated customs, beliefs and health-related behaviors. The government’s response to health issues in the past 20 years has greatly improved child mortality, maternal mortality and nutrition throughout the country. These five facts about health policy evolution in Laos are integral to understanding the country’s past infrastructure development and how it is currently responding to the COVID-19 pandemic.

5 Facts About Health Policy Evolution in Laos

  1. The National Commission for Mothers and Children (NCMC) was established as a government agency in Laos during 1999. NCMC works with local groups in Laos to proactively combat violence against women and children. The agency’s work also includes researching the current state of the healthcare system and proposing policies towards gender equality.
  2. The National Growth and Poverty Eradication Strategy (NGPES) is the foundation for national poverty reduction and healthcare sector growth. Implemented in 2004, this policy provides background for enabling growth in sectors like education, infrastructure and agriculture. As Laos continues on its course to exit the Least Developed Country status, the government focuses on solving both larger scale and local issues to eradicate poverty. Between 1997 and 2015, due in part to the NGPES, Laos’ poverty rate declined from 40% to 23%.
  3. The Laos Law on Health Care established a framework for organizing, managing and developing healthcare in Laos. The law, passed in 2005, aims to provide equitable healthcare services to all communities. The legislation also focused on developing modern healthcare services over the long-term to protect and develop the nation. Outlining both public and private healthcare services, the 2005 Law on Health Care is crucial in the country’s development. The public option only covers around 20% of the current population. However, the Ministry of Health in Laos hopes to have universal coverage by 2025.
  4. The National Nutrition Policy (2008) has the general objective of reducing malnutrition levels throughout the country. It emphasizes nutrition as a key factor of concern in the National Growth and Poverty Eradication Strategy. Though the policy targets all citizens of Laos, the policy specifically focuses on malnourished citizens and the Non-Lao Tai ethnic group. Through principles of decentralization, sustainability and nutrition surveillance, the policy has helped reduce stunting from 40% of the population in 2006 to 28% in 2020.
  5. Though the country’s healthcare system is rapidly developing, the coronavirus pandemic posed a great threat to the safety of the populace. Securing funding from the World Bank to respond to the pandemic, Laos sought to target emergency preparedness pursuits such as contact tracing and infection prevention. The country was able to declare itself free of the virus in early June 2020 after 59 days with no new cases and all remaining cases recovered. The Laos government built a strong infrastructure, consequently, even remote locations have access to it.

At all levels, governments around the world are developing policies to improve healthcare in their countries. The COVID-19 pandemic has highlighted glaring issues in healthcare infrastructure worldwide. Additionally, Laos is a prime example of a country taking concrete steps to respond to the issue.

Pratik Koppikar
Photo: Flickr