4 Key Facts about Healthcare in Papua New GuineaPapua New Guinea comprises the eastern portion of New Guinea and a plethora of offshore islands. With the highest infant mortality rate in the region, it is evident that the country suffers from poor health outcomes. Here are four key facts to consider to better understand the state of healthcare in Papua New Guinea.

4 Key Facts About Healthcare in Papua New Guinea

  1. Unique Geographical Challenges: Papua New Guinea features mountain ranges on the mainland as well as 600 small islands. This unique geography introduces challenges in delivering adequate healthcare services to the population, as isolated rural and remote communities are often cut off from essential healthcare services. While all countries have particular groups that are geographically isolated, the situation in Papua New Guinea is exacerbated as 80% of the population lives outside of city centers compared to the global average of 54% urbanization.
  2. Hygienic Inefficiencies: Hygenic inefficiencies occur in two ways: education and access. Awareness of proper hygiene and health operating procedures remains low in Papua New Guinea. For example, only 10% of schools in the country promote handwashing. But even if education rates were high, proper infrastructure does not exist in Papua New Guinea. Only 40% of the population has access to clean drinking water, and roughly 28% of schools have access to sanitation.
  3. Scarcity of Doctors and Nurses: For a population of more than nine million, Papua New Guinea has approximately 500 doctors and 400 nurses. The country has 0.1 physicians per 1,000 people, compared to the world average of 1.566 physicians per 1,000 people. The quality of the small healthcare force is further hindered by poor working conditionals, low wages and inadequate infrastructure. These limiting factors, combined with an inefficient training capacity, reduce the scarce healthcare workers’ performance in Papua New Guinea.
  4. Missing Resources: The lack of access to the resources necessary for health care workers to do their jobs serves only to worsen the prospects of an already struggling workforce. Recently, Papua New Guinea could not provide nurses with basic medical supplies resulting in nurses threatening a strike. Concerns regarding COVID-19 served to highlight that the country only possesses 14 ventilators. For reference, the U.S. had 160,000 ventilators before the pandemic. Even if these resources became available, many nurses and healthcare practitioners would use them inefficiently as there is a lack of adequate training regarding equipment and disease control.

The Future of Healthcare in Papua New Guinea

While the current state of healthcare in Papua New Guinea is lacking compared to global standards, there are many plans in place to increase the scope and effectiveness of healthcare efforts. The Provincial Health Authority (PHA), endorsed by Minister for Health Sir Dr. Puka Temu, is a widespread reform movement attempting to revitalize healthcare in Papua New Guinea. According to Dr. Temu, the program “will bring [Papua New Guinea’] district and provincial health systems under one umbrella, and allow [public health officials] to improve planning and funding of primary health care.”

The healthcare situation in Papua New Guinea presents both unique and general challenges. While many countries suffer from under-resourced and staffed facilities, Papua New Guinea has its unique geography to overcome. To address these concerns, the nation is preparing for the future with its Development Strategic Plan 2010-30, which aims to work alongside the National Health Plan to make Papua New Guinea “among the top 50 countries in the U.N. Development Programme’s (UNDP) Human Development Index (HDI) by 2050.” International partnerships and a domestic governmental focus on health outcomes provide hope for the future of healthcare in Papua New Guinea.

– Kendall Carll
Photo: Flickr

Healthcare in Armenia
Armenia is a mountainous nation of nearly 3 million people. It neighbors Iran, Georgia and Turkey. Over the past three decades, healthcare in Armenia has undergone a slow reform. The country is transitioning from an inefficient model of centralized healthcare to a modern system focusing on family medicine. Many Armenians feel dissatisfied regarding their healthcare system. However, organizations like the Health for Armenia Initiative and the World Bank are working with the Armenian government to improve options for Armenians.

Armenia’s Healthcare History

Healthcare in Armenia during the Soviet era was a centralized medical system. Experts state that the Soviet system was technologically underdeveloped and inefficient. The healthcare model focused on centralized care in hospitals and medical professionals were highly specialized.

Armenia declared independence in 1991, and healthcare in Armenia underwent radical changes. Local governments took over primary health care sectors while regional governments gained ownership over hospitals. Armenia’s State Health Agency is now in charge of the healthcare system. The government allocates resources to these publicly owned facilities. Since its independence, Armenia has implemented many healthcare reforms. A major piece of legislation called the “On Medical Aid and Medical Services for The Population” created a system that allows patients to help pay for healthcare services. This development plays a role in why Armenians find themselves funding most healthcare expenditures with out-of-pocket expenses.

Armenians in certain years paid up to 89% of healthcare charges in out-of-pocket expenses. This is incredibly taxing, given that Armenians earn an average per capita household income of around $1,500 USD. Their inefficient and expensive healthcare system places a heavy financial burden on impoverished peoples. Patients are slowly transitioning to primary healthcare providers with financial regulations replacing older regulations. However, a lot of work is still ongoing to improve the healthcare situation in Armenia.

How Armenians Feel About Their Healthcare

A 2018 report outlined a recent picture of healthcare in Armenia. Around 400,000 people in Armenia are poor or near-poor. Meanwhile, at least 233,000 of these people are part of a vulnerable group including the disabled, children and the elderly. In 2014, 31.8% of the poorest of Armenians reported that they were sick for more than three days, but they did not seek treatment because of financial reasons. Only 4.2% of the richest Armenians made the same decision.

A public opinion report that BMC published in 2020 outlined the current feelings the Armenian people have towards their healthcare system. The researchers polled over 500 Armenian citizens about the country’s healthcare system. Nearly half of respondents did not believe that citizens had equal access to healthcare in Armenia. Almost 70% of respondents felt that the government should have a larger responsibility towards an individual’s health which included funding healthcare services.

The Healthcare for Armenia Initiative’s Mission

Armenian natives and internationals formed the Healthcare for Armenia Initiative (HAI) in 2016. The initiative’s team focuses on bottom-up reforms to increase rural Armenians access to the constitutional right to healthcare. HAI’s projects focus on developing and maintaining healthcare professionals that can provide services in high-need areas.

HAI defines its work around six pillars, and among these pillars are education, research and leadership. It focuses on these three by holding workshops. It held a two-day workshop in partnership with the National Institute of Health of Armenia where it “[discussed] how to improve health education and healthcare in Armenia.” Organizations like HAI have helped to inform recent changes in government policy that will hopefully address the healthcare needs of the Armenian people.

Recent Changes for Healthcare in Armenia

The Armenian government in partnership with the World Bank published a guideline for the Health System Modernization Project. The main goal of the partnership is to improve access, quality, efficiency and governance for Armenian healthcare. The project focuses on adopting an efficient family medicine model. The transition to a family medicine model requires training new doctors that are not overspecialized.

A major priority of the project was to train the number of healthcare professionals necessary to run a family medicine-style healthcare system. At a final cost of nearly $6 million USD, this project component costs less than the projected $7 million. This key part of the project trained 980 family medicine doctors and nurses. The World Bank reports that these numbers should support 60% of the country’s needs.

Armenia and the World Bank cooperated on three other major components as part of this modernization project. They optimized and renovated the hospital network. The project reorganized the Armenian Ministry of Health so the agency could better function as a regulator of healthcare. These reforms gave the Ministry of Health many monitoring tools to efficiently implement and regulate the healthcare reforms the country is undergoing. Armenia’s government also established the Health Project Implementing Unit (HPIU). HPIU is a part of the Armenian Health Ministry that monitors, reports on and provides strategic planning for the overall healthcare modernization project. All of these developments cost around $30 million USD to achieve.

Where Healthcare in Armenia Stands

Healthcare in Armenia is an inequitable system in the process of reforms and transition. Armenia with the help of national and international institutions is moving to a family medicine system that meets the financial and medical needs of its people.

Jacob Richard Bergeron
Photo: Flickr

Surjer Hashi NetworkBangladesh is a country in South Asia with a population of 163 million people. As a developing country, Bangladesh struggles to provide adequate healthcare for such a large number of people. The problem particularly brings challenges for people from rural and marginalized communities, who often cannot access quality health services. To combat this issue, the Surjer Hashi Network has been established. Funded by the U.S. Agency for International Development (USAID), it is a network of hundreds of health facilities throughout the country. The facilities bring free or reduced-cost healthcare to low-income populations in Bangladesh while simultaneously bringing the country closer to achieving universal healthcare.

Healthcare in Bangladesh

Despite Bangladesh’s current struggles to provide a reasonable level of healthcare for its citizens, the country has made significant progress over the past few decades. Certain indicators have seen improvements such as maternal and infant mortality. Furthermore, the rate of vaccinations for children has increased dramatically, with the percentage of tuberculosis vaccinations for children under 1 increasing from 2% in 1985 to 99% in 2009. While the developments are a good sign, Bangladesh still faces many challenges in maintaining its healthcare system. For instance, the country suffers from a severe shortage of healthcare workers. As of 2009, only about one-third of the country’s facilities have at least 75% of qualified staff working in healthcare and 36% of health worker positions are vacant.

The ineptitude of Bangladesh’s governmental structure and the inability of its institutions to carry out its policies cause problems. The healthcare system is concentrated in urban areas even though 70% of the population lives in rural areas. Meanwhile, careless management obstructs the allocation of resources. Healthcare workers suffer from high turnover and absenteeism while maintenance of facilities is poor. Meanwhile, rural Bangladeshis often forego formal healthcare due to a lack of access in the communities. As a result, only a quarter of the population uses public healthcare.

The Surjer Hashi Network

USAID backs the Surjer Hashi Network of health clinics aiming at serving low-income and other underserved communities in Bangladesh. With 399 facilities nationwide, the network serves at least 16% of the population. In just a five-year period, USAID helped the Surjer Hashi Network prevent 2,000 maternal deaths and 10,000 child deaths. The facilities provide communities with proper healthcare in remote and underserved areas. Rural women, in particular, have benefited as the Surjer Hashi Network of clinics provides for reproductive health and child care.

Universal Healthcare in Bangladesh

In 2018, USAID started the Advancing Universal Health Coverage (AUHC) program, which has allowed the Surjer Hashi Network to remain operable in the long term. The program has consolidated the hundreds of clinics in the network into a centrally managed organization and it has introduced new business models aimed at keeping costs down and expanding health services. The efforts will ensure that clinics in the Surjer Hashi Network will be financially independent while providing high-quality and affordable healthcare for the disadvantaged.

As its name suggests, the AUHC’s goal is to achieve universal healthcare in Bangladesh. Through the Surjer Hashi Network, USAID is ensuring that Bangladesh can provide healthcare coverage for as many people as possible with healthcare facilities that are accessible in rural areas as well.

Nikhil Khanal
Photo: Flickr

Ongoing Harm, Female Genital Mutilation in LiberiaLiberia is one of three West African countries that has not yet made female genital mutation (FGM) illegal. FGM refers to the partial or complete removal of external female genitalia or other harm to the female genital organs for non-medical reasons. Considered a violation of the human rights of girls and women by U.N. Women Liberia, FGM has no health benefits and is extremely harmful.

Legal Activism

In 2018, President Ellen Johnson Sirleaf of Liberia signed the Domestic Violence bill, an executive order that banned FGM performed on girls younger than 18 years old, but the criminalization of FGM was limited to one year and expired in February 2019. The executive order did little to address the part community leaders play in perpetrating this crime. It also failed to change the immense social pressure placed on girls to undergo these treatments. For these reasons, female genital mutilation in Libera continues to be an issue.

International Pressure

The United Nations has been active in its role of fighting to end FGM globally. Due to the lack of policy regarding female genital mutilation in Liberia, Marie Goreth Nizigama, of U.N. Women Liberia, said, “50% of women and girls aged between 15-49 years” have been mutilated. On the International Day of Zero Tolerance for Female Genital Mutilation, Chief Zanzan Karwo who is the leader of Liberia’s National Traditional Council expressed frustration, rebuking international groups that have sought to abolish female genital mutilation in Liberia. He believes that FGM prepares young women to become good wives. Despite pushback, the pressure to end female genital mutilation in Liberia continues. Williametta E. Saydee Tarr, the gender, children and social protection minister in Liberia, claims that plans are being pursued to make FGM permanently illegal.

Cultural Progress

One of the most important aspects in fighting female genital mutilation both in Liberia and globally is engaging cultural leaders and communities in ending the tradition. If cultural attitudes toward FGM fail to change, then progressing human rights for girls and women will significantly decline. As a result of seemingly insurmountable cultural and financial pressures, girls and women willingly subject themselves to mutilation; therefore, even criminalization of FGM cannot end the mutilation without traditions and perspectives changing as well.

Liberia’s fight to end FGM is not restricted to policymaking and criminalization. Yatta Fahnbulleh, owner of a large bush school in Tienii that performed FGM on more than 200 girls, decided to end her engagement in FGM despite its financial benefits. In 2019, Spotlight Initiative aided in the startup of the Alternate Economic Livelihood program. This program provides resources and education to former practitioners. This way they can generate a source of income after losing their livelihood. Providing access to education and financial alternatives is essential in garnering the support of communities who depend on the practice for survival.

Looking Ahead

It is vital that the United Nations continues to place pressure on Liberia despite leaders expressing attachment to the practice. female genital mutilation endangers women and often causes lifelong sustained harm so, the pressure is appropriate and necessary. Alongside the international attention to criminalize FGM, efforts to engage leaders in ending devastating practices are of the utmost importance. The willingness of people like Yatta Fahnbulleh to close her school gives hope that people are willing to end female genital mutilation with proper education, tools and resources to survive.

Hannah Brock
Photo: Flickr

Healthcare in Ghana
Healthcare in Ghana has many levels to it. There are three primary levels: national, regional and district. Within these, there are different types of providers: health posts, health centers/clinics, district hospitals, regional hospitals and tertiary hospitals. On average, Ghana spends 6% of its gross domestic product on healthcare, and the quality of healthcare varies by region. Here are four facts about healthcare in Ghana.

4 Facts About Healthcare in Ghana

  1. Ghana has a public insurance system. In 2003, Ghana made the switch from the “cash and carry” system to public insurance. The “cash and carry” health system required patients to pay for their treatments before receiving care. Because of this process, few people were able to afford treatment. In response, the government established the National Health Insurance Scheme (NHIS). This system provides wide coverage, covering 95% of the diseases that affect Ghana. The coverage includes treatment for malaria, respiratory diseases, diarrhea and more. Between 2006 and 2009, the proportion of the population registered to NHIS increased by 44%
  2. Child mortality rates have decreased. Data from 2019 showed that 50 out of 1000 babies die before the age of five. While this may appear unsettling at first, the twice as high a few decades earlier. In low-income communities, there is a higher risk of death because of limited access to healthcare. To help prevent this, the NHIS provides maternity care, including cesarean deliveries. In the 1990s, Dr. Ayaga Bawah began a study to provide healthcare in rural areas to see if it would decrease mortality rates. Between 1995 and 2005, the study showed that when qualified nurses were working in communities, there was an equal distribution of child mortality throughout the country, rather than mostly in rural communities.
  3. Access to health services has increased. In rural communities, health posts are the primary healthcare providers. A 2019 study found that 81.4% of the population had access to primary healthcare in Ghana, while 61.4% have access to secondary-level, and 14.3% to tertiary care. Despite these relatively high rates of accessibility, approximately 30% of the population has to travel far to access primary facilities or see a specialist. To increase access to services, Ghana’s president, Nana Akufo-Addo, stated in June 2020 that he intended to build 88 more district hospitals.
  4. More and more scientists are being trained. Throughout Africa, scientists are being trained to improve research and the dissemination of information. The World Economic Forum has pushed for research in programs such as Human Health and Heredity in Africa. This program is dedicated to helping local institutes manage the diseases and conditions that affect its area. Another group, H3-D, trains scientists in many African countries, including Ghana, to focus on conditions that are prevalent in Africa, such as malaria, tuberculosis and cardiovascular disease.

These four facts about healthcare in Ghana illuminate the progress that has been made, as well as the work that still needs to be done. While healthcare has improved, the government must take more steps to increase accessibility for all throughout the country. With a continued focus on healthcare, Ghana will hopefully continue to provide more communities with health services.

Sarah Kirchner
Photo: Flickr

Congenital Anomalies
Worldwide, congenital anomalies cause approximately 295,000 deaths of children within their first 28 days of life. Every year, about 7.9 million children are born with life-threatening defects and 3.3 million children under the age of five5 die from congenital disabilities. According to the World Health Organization (WHO), congenital anomalies are structural or functional aberrations that occur during intrauterine life. The most common congenital disabilities include heart defects, cleft lip (palate), down syndrome and split spine (also known as spina bifida). Although 50% of all congenital disabilities do not have a single definite cause, common causes include genetic mutation, environmental factors and various other risk factors.

Geographic Disparities

Although congenital disabilities are widespread globally, they are particularly prevalent in developing countries. Developing countries account for 94% of worldwide congenital disabilities.

The level of income -both individual and national- in developing countries is a crucial factor that indirectly influences the high incidence of congenital disabilities. Low income affects the incidence of congenital disabilities in developing countries in the following ways:

  • Poor Access to Adequate Maternal Healthcare for Women During Pregnancy: About 99% of the global maternal mortality cases occur in low-income countries due to inadequate maternal care.
  • Poor Maternal Nutritional Condition: Deficiency of vitamin B can, for instance, escalate chances of birthing a baby with neural tube defects.
  • Excessive Prenatal Alcohol Consumption: Pregnant mothers’ consumption of alcohol increases their risks of giving birth to a child with Fetal Alcohol Syndrome (FAS). FAS is a total of the damage – both physical and mental – to an unborn child as a result of their mother’s alcohol consumption.
  • Presence of Other Infections: Some sexually transmitted diseases can transfer from a pregnant mother to her child. For example, syphilis during pregnancy accounts for an estimated 305 000 fetal and neonatal deaths annually. It also jeopardizes 215,000 infant lives due to congenital infections, prematurity or low-birth-weight.

How WHO is Taking Action

The World Health Organization has taken and implemented various measures to fight congenital anomalies. In the 2010 World Health Assembly, WHO took on a resolution encouraging its member states to fight against congenital anomalies by:

  • Raising awareness throughout governments and the public about congenital disabilities and the risk they impose on children’s lives
  • Developing congenital disabilities surveillance systems
  • Providing consistent support to children affected by congenital anomalies
  • Ensuring that children with disabilities have the same rights and equal treatment as children without disabilities
  • Assisting families whose children have congenital disabilities

In addition to the resolution, WHO designed a manual that showed illustrations and photographs of selected birth defects. The manual’s primary purpose was to foster further development of the surveillance system, especially in low-income countries.

The Global Strategy for Women’s and Children’s Health

In 2016, WHO went an extra mile and published the Global Strategy for Women’s, Children’s and Adolescents Health 2016-2030, an updated version of the Global Strategy for Women’s and Children’s Health devised five years prior. The Global Strategy’s grand theme was “Survive, Thrive, Transform.”

  • Survive: “Survive” encompassed various goals that the Global Strategy hoped to accomplish. These include ending preventable deaths, lowering maternal mortality rates and newborn deaths among others.
  • Thrive: The main target was promoting health and wellbeing by responding to the dietary needs of children, adolescents and pregnant & lactating women.
  • Transform: This objective’s primary goal was to create a safe and nurturing environment by terminating extreme poverty. Poverty one of the leading causes of congenital disabilities.

Results

Over the years, the World Health Organization’s relentless efforts in battling against congenital disabilities have made remarkable progress in alleviating the issue. For instance, the number of newborn deaths has plummeted from 5 million to 2.4 million between 1990 and 2019, thanks to the various innovations and programs put in place. Although the current state of affairs is far from ideal, past accomplishments lay the groundwork and identify clear steps for future progress.

Mbabazi Divine
Photo: Flickr

tobacco in myanmarMillions of people worldwide use tobacco every day. Though tobacco usage has decreased in some countries, it still remains a significant public health concern for various populations. This is especially true for lower-income countries all over the globe. Myanmar is no exception. With the highest rate of tobacco usage in Southeast Asia, tobacco in Myanmar runs rampant with limited regulation.

The Feedback Loop: Tobacco and Poverty

Worldwide, 1.8 billion people smoke, with 84% of smokers from underdeveloped countries. The world’s poor are prone to spending their limited income on tobacco. However, smoking comes at a high opportunity cost. Money spent on tobacco could instead go toward food, education and health care. In countries such as Bangladesh, the poorest households spend 10 times more on tobacco than they would on education. In Mexico, the poorest 20% of households spend at least 11% of their income on tobacco. Overall, the world’s poor sacrifice significantly more of their income to satiate tobacco addiction than do richer households.

In addition to being a financial drain, tobacco also presents numerous health risks. Users of tobacco are at risk for cancer, respiratory diseases and heart problems. These illnesses create higher medical and insurance costs, which could cause households to spiral deeper into poverty.

Tobacco in Myanmar

Currently, around 1.6 million people in Southeast Asia die from tobacco-related illnesses each year. Myanmar currently has the region’s highest prevalence of tobacco use. Approximately 80% of men use tobacco in Myanmar. In this country alone, over 65,600 people die from tobacco-related diseases annually. Regardless of this risk, more than 5 million adults in Myanmar continue to use tobacco every day.

The lack of regulation of tobacco in Myanmar puts millions of individuals at risk of exposure to secondhand smoke. Currently, 13.3 million smokers and individuals exposed to secondhand smoke are at risk of developing tobacco-related diseases such as CVD (cerebrovascular disease). CVDs are one of the most common ways tobacco claims lives. They are also the leading cause of death in the country, contributing to 32% of all deaths.

Premature deaths have also greatly affected Myanmar’s economic growth, severely limiting income opportunities for the nation’s poor and middle-class families. In 2016, economic losses due to tobacco-related mortality were estimated at MMK 1.32 trillion. Overall, the economic loss caused by tobacco-related health complications places a huge strain on Myanmar. Most importantly, without explicit programming efforts, very few users have successfully quit tobacco in Myanmar.

So, What’s Next?

A number of efforts are looking to minimize the harmful effects of tobacco in Myanmar. For example, Myanmar’s government created various changes to its Tobacco Control Laws upon joining the World Health Organization’s FCTC (Framework Convention on Tobacco Control) in 2005. Despite these changes to the law, however, there are insufficient funds for smoke-free enforcement in public spaces. Currently, smoking remains legal in pubs and bars, indoor offices and public transportation.

A comprehensive tobacco control program is therefore necessary to limit the prevalence of tobacco in Myanmar. Luckily, many organizations are willing to assist in this fight. The World Health Organization released plans for its Tobacco Control 2030 campaign, which includes Myanmar. It will be one of the 15 countries chosen to receive aid from the U.N. to support its battle against tobacco.

In 2019, the People’s Health Foundation also implemented a four-year plan to turn Yangon, the largest city in Myanmar, completely smoke-free. This organization plans to raise public awareness of the dangers of smoking and passive smoking on various media platforms. The People’s Health Foundation also partnered with the Ministry of Health and Sports to minimize smoking and overall tobacco usage in the country. Already, the organization has converted regions including Ayeyarwady, Bago and Mon into smoking-free zones. While much work still remains, Myanmar these efforts to minimize the use of tobacco among its citizens are showing some signs of success. This provides hope that the epidemic of tobacco in Myanmar may soon end.

Vanna Figueroa
Photo: Flickr

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