Efforts to Eradicate PovertyOn July 29, 2020, Ghana released its Multidimensional Poverty Index (MPI) report, which outlines the various conditions that contribute to poverty in the country. Instead of using a monetary metric, the report looks at education, health and living standards to interpret the rate of poverty and determine the efforts to eradicate poverty in Ghana.

Using data collected between 2011 and 2018, the report found the rate and severity of multidimensional poverty have reduced across Ghana, with significant improvements in electricity, cooking fuel and school attainment.

Overall, Ghana reduced its incidence of multidimensional poverty by nine percentage points from 55% in 2011 to 46% in 2017. This indicates that poverty itself has been reduced and the experience of the impoverished has improved.

Each dimension examined in the report is measured through specific indicators relevant to poverty in Ghana. The government then prioritizes the country’s needs by examining the various deprivations that the poor experience most.

The report concludes that the indicators that contribute most to multidimensional poverty are lack of health insurance coverage, undernutrition, school lag and households with members that lacked any education.

The report also reveals stark differences between poverty in rural and urban populations, with 64.6% of the rural population and 27% of the urban population being multidimensionally poor.

Based on the results of the report, it is paramount that resources must be allocated to the health and education sectors to improve the quality of life for the most at-risk members of Ghana, particularly in rural areas.

Efforts to Eradicate Poverty: Healthcare

The USAID is addressing the need for comprehensive healthcare reform through a multi-pronged approach to improve care for children and women in rural Ghana.

Since 2003, the Ghanaian government has developed and expanded the National Health Insurance Scheme (NHIS), which provides residents with public health insurance. The program has provided many improvements to the healthcare system, but systemic barriers continue to limit the quality and accessibility of care.

In particular, a 2016 study published in the Ghana Medical Journal found that rural hospitals’ lack of personnel, equipment and protocol put women and children at the highest risk. This is attributed to poor nutrition, inability to seek neonatal care and lack of health insurance.

To address barriers to healthcare, the USAID first compiled a network of preferred primary care providers to allow healthcare workers to communicate, educate and synchronize their standards of quality care.

“The networks help connect rural primary health facilities with district hospitals, enabling mentoring between community health workers and more experienced providers at hospitals,” the USAID stated.

The second prong was providing training to government staff and frontline healthcare workers to better understand health data and its uses for maternal and child health decision-making. By using the network of providers and standardizing data, doctors are better equipped to determine whether patients need a referral to a specialized caregiver.

The USAID reports that these improvements have resulted in a 33% reduction in institutional maternal mortality, a 41% increase in the utilization of family planning services and a 28% reduction in stillbirths.

As the healthcare sector has grown stronger and poverty has decreased, the USAID and other outside support have scaled back aid to allow the network of health providers to operate autonomously.

This is a positive indication that the country is moving in the right direction to end poverty and improve the quality of life in the coming years, but it is also a critical moment in its development. The Duke Global Health Institute warns that the country must secure a robust medical infrastructure for the transition to independence to be a success.

According to the Duke Global Health Institute, if global aid is removed too early, the poor will suffer the most. Therefore, they state that it is essential that the government has a firm grasp on funding and organizing principals before they move away from outside aid.

Efforts to Eradicate Poverty: Education

The level of deprivation of education is also heavily dependent on rural or urban residence. The educational dimension is measured by school attendance, school attainment and school lag. In rural areas, 21.1%, 33.9% and 34.4% of the population is deprived of each respective indicator. In contrast, the deprivation is only 7.2%, 10% and 12.8%.

To combat education deprivation, the current government has vowed to make secondary education free in an attempt to retain students who cannot afford to continue their education past primary schooling.

Before secondary school was made free in 2017, 67% of children who attended elementary went on to secondary school. In 2018, the ministry of education reported that attendance had increased to 83%.

To promote education in rural areas, this past March the ministry of education presented over 500 vehicles, including 100 buses, to secondary schools throughout the country.

Efforts to Eradicate Poverty: Living Standards

Deprivation of proper sanitation ranked highest out of all indicators for living standards, health and education. The report stated that sanitation deprivation affected 62.8% of the rural population and 25.8% of the urban population.

Although more than 75% of the country lacks access to basic sanitation, little improvement has been made. Between 2000 and 2015, access only increased from 11% to 15%.

To encourage private investments in the sanitation sector, the ministry of sanitation and water resources hosted a contest between public and private entities to design liquid waste management strategies for different localities throughout the country.

In 2019, nine public and six private partners were announced as winners of a total prize of £1,285,000 and US$ 225,000 respectively – for excellence in the implementation of urban liquid waste management strategies.

Winning strategies included an aquaponic system that sustained vegetable growth with treated water and the rehabilitation of a treatment center to raise fish.

Overall, the competition provided education about sanitation to rural communities, increased access to private toilets and spurred economic interest in developing the sanitation system in Ghana.

Sophie Kidd
Photo: Flickr

IMF in JordanJordan, bordered by Saudi Arabia, Iraq, Syria and Israel, is an Arab country in the Middle East. The country is on the East Bank of the Jordan River yet relatively landlocked. It has accordingly received a massive influx of Palestinian and Syrian refugees. Recently, the International Monetary Fund (IMF) in Jordan provided two different forms of economic relief to people in light of the ratio of debt to its gross domestic product (GDP) and the current pandemic. Read more about the IMF in Jordan below.

The Effects of the Pandemic on Jordan

Jordan’s economy will experience contraction in 2020 due to the effects of COVID-19. The pandemic-induced lockdown significantly impacted 250,000 daily-wage workers and businesses facing a liquidity crisis. It also delayed foreign investment, trade and tourism. The latter industry generates $5 billion annually for Jordan.

Only 11.3% of respondents in a UNDP survey claimed that their income was unaffected by the pandemic, which has significantly impacted young adults. In the survey, 38.3% of respondents experienced challenges getting clean drinking water, and 69.3% struggled with accessing basic healthcare.

Countries in the Middle East and Central Asia, including Jordan, will experience a 4.7% drop in its constant-price GDP, adjusted for the effects of inflation, in 2020. Additionally, the average size of economic relief programs in the Middle East was smaller than in other regions in the world. The Middle East and North Africa (MENA) oil-importing countries’ ratio of debt to income will reach 95% in 2020. Thankfully, the IMF provided $17 billion in aid to the area since the beginning of 2020. It also helped catalyze $5 billion from creditors.

The IMF in Jordan

Jordan’s four-year Extended Fund Facility (EFF) is a partnership between the Jordanian government and IMF staff, which focuses its $1.3 billion on growth, jobs and social safety nets. The loan program, approved on March 25, 2020, will create more jobs for women and young people. EFF funds finance the general budget, including health, education and social support, while also providing support to Jordan’s Syrian refugees.

Although the IMF in Jordan created the EFF funds before the pandemic, it changed the program to support spending on emergency outlays and medical equipment. The IMF in Jordan also helped secure congressional grants to ease annual debt, as public debt increased in the past decade to an amount equivalent to 97% of its GDP.

In addition, the IMF in Jordan approved $400 million in emergency assistance under the Rapid Financing Instrument (RFI) to fight the COVID-19 pandemic in May 2020. Due to the fall of domestic consumption during the outbreak, these funds answer companies’ and consumers’ borrowing needs. The government will spend the RFI funds through the national treasury account, where specific budget lines track and report crisis-related expenditures.

The emergency economic assistance allows for higher healthcare budgets, containment and support to vulnerable households and businesses. Moreover, it will ease external financing constraints and avoid loss in official reserves. The $1.5 billion balance of payment gaps, however, will emerge with increased public debt and a widened fiscal deficit.

Moving Forward

Despite the challenges presented by the pandemic, Jordan’s tech start-ups, global supply chains and exporting masks have helped its economy. Tech literacy, in particular, has been especially vital for Jordanian youth to find remote jobs. Moreover, the EFF program can ensure support for the people in Jordan by easing access to basic needs. The program will also help reduce the impacts of poverty by increasing social protection coverage on poor families.

Monetary and fiscal authorities in Jordan have reduced interest rates and delayed bank loan installments and tax payments due to the outbreak, injecting over $700 million in liquidity. Additionally, the country implemented a cash-flow relief program for companies. It also activated the National Aid Fund cash transfer program for daily wage workers.

Jordan has prioritized human safety for its citizens and refugees in the fight against COVID-19. So far, it has only had low to moderate numbers of per capita COVID-19 cases. Thanks to the help of the IMF in Jordan, the country seems to be on track to recover from pandemic.

Isabella Thorpe
Photo: Flickr

healthcare apps
In September 2000, the United Nations released a list of eight Millennium Development Goals that aimed to enhance gender equality, literacy, education and health in developing nations. Goals four through six specifically target the need to improve child mortality rates, maternal health and disease prevention in underdeveloped regions. Achieving these goals requires information distribution among populations, thus equipping individuals with the resources necessary to practice safe self-care. Two healthcare apps called MedAfrica and the Mobile Alliance for Maternal Action (MAMA) are providing these resources to the most remote parts of Africa. The apps give life-saving health advice via voice calls, SMS and the web, and are working to eradicate healthcare inadequacies in Africa.

Poverty and Health Linked

The experiences of many developing countries showcase correlations between low poverty rates and the success of healthcare systems. Low-income regions face high child mortality, low economic and educational development and increased disease transmission. Overcrowded living conditions common in low-income areas aid in the rapid spread of disease. In many African nations, the lack of available medical practitioners increases infection rates, places a financial strain on families and reduces the availability of educational health resources. Kenya, for example, has more than 40 million residents but only 7,000 medical professionals, which presents a clear disparity in access to care compared to higher-income countries.

Pregnant mothers often suffer the most from poverty. In low-income countries, more than 500,000 women die every year either during or after pregnancy. According to Dr. Charles P. Larson, improper prenatal care not only affects mothers, but it also threatens children’s growth and overall health. Children may face impaired cognition, causing intense behavioral problems and hindering school performance. The primary reason for these problems is a severe lack of access to healthcare information, which highlights a dire need to deliver accessible healthcare to underserved populations. Healthcare apps are helping many regions of Africa do just that.

MedAfrica

Shimba Technology launched MedAfrica in 2011 with the hope of providing health information and connectivity resources to people in Kenya and Uganda. The company’s primary goal was to increase interaction between practitioners and their patients through different communication systems available on the app. However, like other healthcare apps, MedAfrica does far more than create conversation. While in-person consultations often monopolize a doctor’s time, MedAfrica relieves pressure on overworked practitioners. The app’s audio calls, SMS and online instructions give individuals the tools they need to deal with general problems while allowing immediate medical issues to have a doctor’s time and attention.

MedAfrica users simply input their symptoms to receive diagnoses, basic information about medicine and a suggested treatment routine. If a patient needs to visit a doctor, the app provides a detailed registry, so the patient can choose who will monitor their care. The registry also defends against fraudulent providers, as every physician listed must undergo vetting and receive approval.

The app stands out from other healthcare apps for its success. MedAfrica won €15,000 in the 2012 Ericsson Application Awards, an annual competition that recognizes international app excellence. The app was also named one of the Top 10 Favorite Startups at Silicon Valley’s DEMO Conference due to its “hit factor” and “Technology for Good” assessment. In the future, Shimba Technology plans to expand MedAfrica’s reach in Africa before venturing into Eastern Europe and Southeast Asia.

MAMA

Limited access to medical counsel is particularly alarming for impoverished pregnant women who are at a greater risk for preterm birth, restricted intrauterine growth and maternal death. Former Secretary of State Hillary Clinton launched the Mobile Alliance for Maternal Action (MAMA) in 2011 to address this issue. MAMA now provides innovative solutions for health information deprivation in Bangladesh, India, Nigeria and South Africa. Since its inception, the app has collected $4.5 million in public and private investments.

Because communication channels differ in each country, MAMA alters its program based on phone and internet access, literacy rates and channel cost. For example, when literacy is low, MAMA uses audio messages instead of SMS. If internet access is widely available, the app relies on web connection. Local dialects in the app also help customize user experiences and increase usage rates. In these ways and more, MAMA is constantly changing to accommodate its users’ locations and situations.

Additional functions of the app include peer support, knowledge sharing, and the option to turn on notifications. Some of the most significant MAMA app features are birth plan distributions, childcare and breastfeeding tips and the option for mothers to record their due dates in order to learn more about their pregnancy stages.

In just eight years, MAMA has gained almost 3.5 million subscribers in four countries alone, making it a success among a plethora of healthcare apps. MAMA recently invested $10 million into building its programs in Bangladesh, India and South Africa, three countries where the app has been largely successful.

One Step Closer

As MedAfrica and MAMA continue their work, the countries in which they operate will become one step closer to achieving at least three of the United Nations’ Millennium Development Goals. Increased access to proper healthcare and self-care information reduces poverty by increasing self-sufficiency and allowing families to focus on education, entrepreneurship and other means of national development. Healthcare apps are one proven way to accomplish this goal.

– Natalie Clark
Photo: Flickr

Last Mile HealthLiberia borders Sierra Leone, Guinea, Cote d’Ivoire and the Atlantic Ocean. The West-African nation was established as a settlement by freed American slaves in 1820. Despite gaining independence in 1847, the country suffered from years of instability brought on by the military coup of 1980. Civil war broke out in Liberia in 1986 and endured until late 2003. With 14 years of civil war devastating both the population and the economy, Liberia, now home to nearly five million immigrant and indigenous peoples, has shifted its focus towards recovery. Many efforts acknowledge the inadequacies of healthcare in Liberia, one of them being Last Mile Health.

Founded by Liberian civil war survivors and American healthcare workers in 2007, Last Mile Health is a nonprofit organization dedicated to rebuilding healthcare in Liberia by creating a stronger, more resilient public health infrastructure within both urban and remote regions of the country. To date, Last Mile Health is responsible for a plethora of noteworthy improvements in healthcare and health outcomes in Liberia.

Healthcare in the Past

Between 1986 and 2003, 80% of healthcare clinics across Liberia closed their doors as a result of looting, destruction and the exodus of healthcare workers. Only 168 physicians remained in Liberia, predominantly in the capital city of Monrovia. Medical training systems stood on the verge of collapse. Today, nearly 1.2 million people throughout Liberia live more than an hour’s walk from the nearest healthcare facility.

Lack of access to quality healthcare in Liberia has resulted in poor health outcomes for Liberians. Alongside suffering from one of the world’s worst maternal and under-5 mortality rates, malaria, diarrhea, HIV/AIDS and other preventable and treatable illnesses are amongst the leading causes of death and disease in Liberia. A mere 39% of children under two in Liberia have received their recommended vaccinations.

Bringing Care to Patients

Last Mile Health builds community-based primary health systems within Liberia to bring healthcare to the poorest and hardest-to-reach regions. In 2012, Last Mile Health piloted a community health worker program in the Konobo District of Liberia that resulted in an unprecedented 100% coverage of the district by healthcare personnel. This pilot program has since been replicated, extending primary healthcare in Liberia to 1.2 million people.

Training Healthcare Workers

In 2017, Last Mile Health launched the Community Health Academy to strengthen the clinical skills of community health workers in Liberia. The Community Health Academy provides training to health care leaders to help them build resilient and effective public health infrastructure. As of 2019, more than 16,000 healthcare personnel from around the world have enrolled in the academy’s courses.

Improving Health Outcomes

In 2010, Last Mile Health launched Liberia’s first rural, public HIV/AIDS treatment program. The program exists in over 19 of Liberia’s public clinics.

By increasing access to and quality of healthcare in Liberia, Last Mile Health has increased the number of children receiving malaria, pneumonia and diarrhea treatment by over 40%, resulting in a significant reduction in under-5 mortality rates and improvement in child health outcomes. Maternal health outcomes have improved as more women can access skilled birth attendants and facilities for delivery and maternal care.

Increasing Average Life Expectancy

The average life expectancy for Liberians continues to increase each year as healthcare in Liberia rebuilds and recovers. By linking community healthcare workers with nurses, doctors and midwives at community clinics and equipping workers with the knowledge and skills that they need, Last Mile Health continues to fulfill its mission of bringing life-saving care to people in even the most remote areas of the country.

Last Mile Health promises a future in which no patient is out of reach from quality healthcare in Liberia. In the years to come, the nonprofit organization intends to expand its reach within Liberia and across Africa.

– Alana Castle
Photo: Flickr

South African PovertyThe battle against poverty has always been a difficult one, but the novel coronavirus pandemic has presented many new challenges. Actions currently being taken to combat South African poverty and COVID-19 have proven that, with new options and renewed commitments, there is still much that can be done to alleviate poverty. Impoverished people around the world need aid now more than ever.

An Ongoing Struggle

Historically, South Africa has struggled to aid its most economically vulnerable citizens. According to the most recent government analysis, almost half of the adult population is living under the poverty line—an alarming figure. It seems apparent that this South African poverty crisis would be seen on nearly every level of society. Sadly, this widespread poverty has had a notable impact on which necessary resources are available to people. While electricity infrastructure is fairly widespread, between 28% and 30% of poor households lack access to water and sanitation services. As is relatively common in cases of inequality, the most vulnerable frequently lack access to basic necessities, making their struggles far more urgent.

COVID-19 Developments

The 2020 COVID-19 pandemic is poised to exacerbate South African poverty. The World Bank has predicted that while the pandemic will increase poverty worldwide, the hardest-hit region will be Sub-Saharan Africa. Although South Africa has been relatively spared from the worst of COVID-19 on a health level, the poverty-inducing effects of the pandemic are daunting—it is projected that some 23 million South Africans will be pushed into poverty in 2020. Beyond the immediate tragedy, this decline will present new challenges. In order to protect them, governments will need to find new ways to offer meaningful support throughout the crisis.

Innovation Brings Hope

Fortunately, the government of South Africa has begun to take steps to properly aid its impoverished citizens during this time. They have rolled out a new, easily accessible digital tool called HealthCheck in order to provide self-assessment resources. Members of the public can download the program, which will ask them a few simple questions and then provide a COVID-19 risk prediction along with a pertinent guideline and suggested actions.

While HealthCheck is designed to be available to the entirety of the South African populace, it aids low-income South Africans in particular. Although only a third of the population uses smartphones, feature phones enjoy more widespread use, so a lack of hardware is not necessarily an issue. For many impoverished people in South Africa—and across the world—receiving the proper healthcare needed to determine a risk of infection may be difficult or outright impossible.

Partnerships Increase Access

To further alleviate this issue, the South African government has coordinated with network operators MTN, Vodacom and Telekom, to have facilitate free access to the USSD line. This way, South Africans who could not typically afford cellular or wi-fi services can make use of the HealthCheck tool. As a matter of fact, they have—authorities have reported that so far, over one million members of the public have used HealthCheck.

The digital tool has been utilized in conjunction with NGOs like Doctors Without Borders.  The NGO has worked to fill the gap in fighting South African poverty by creating impromptu field hospitals in otherwise-ignored townships. In Khayelitsha, it has opened up 70 additional beds in a basketball arena in order to serve as many people as possible in the area. This was part of a broader government plan to have over 1,400 extra beds ready as needed. Providing aid such as this is an important part of the battle against poverty.

Just a Start

The COVID-19 pandemic has disrupted the growth of the continental African economy, and threatens its growing middle class. Across the entire continent, nearly eight million people are predicted to fall into poverty, in many cases due to the lack of a social safety net. By providing essential resources, NGOs like Doctors Without Borders are working to limit the economic burden that falls on the South African populace.

While it’s just a start in terms of supporting the impoverished population, these initiatives have clearly provided accessible ways for low-income citizens to keep themselves and their loved ones safe and healthy. There are still many hurdles to overcome in the fight against South African poverty, but these recent initiatives have shown that we can still work to effectively aid the poor.

Aidan O’Halloran
Photo: Flickr

Maternal healthcare in Algeria
Algeria, a large country in North Africa, bordering the Mediterranean Sea. The country is known for its rich history and culture, as well as its scorching temperatures. Like many nations in Africa, Algeria struggles to combat maternal mortality – a long-standing, persistent issue for many women in the country. However, in the last several years, Algeria has taken numerous steps to expand maternal healthcare and reduce pregnancy and labor complications. Here are four facts about maternal healthcare in Algeria.

4 Facts About Maternal Healthcare in Algeria

  1. According to recent updates on the maternal mortality ratio in Algeria — it has gradually dropped from 179 deaths per 100,000 live births in 1998 to 112 deaths per 100,000 live births in 2017. Much of the success in lowering the number of deaths is attributed to a multitude of factors such as increased medical training, investments in healthcare and specific government initiatives aimed at reducing maternal deaths. During the years 2009–2017, Algeria trained about 900 professionals from university hospitals such as, Benni Messous, Kouba, Oran and Bab El Oued on multidisciplinary management of pregnancy.
  2. Within the last couple of years, Algeria has managed to make major investments in healthcare. Algeria managed to increase expenditures in healthcare as a share of GDP from 3.6 % in 2003 to 6.4 % in 2017 — growing at an average annual rate of 4.57%. This is an impressive number when compared with Algeria’s neighboring countries. Moreover, these investments have also helped to establish successful disease detection programs and allowed for improved medical facilities.
  3. In 2015, the Ministry of Health in Algeria began to work in collaboration with UNICEF in an attempt to implement a neonatal and maternal mortality reduction plan. This plan was implemented with the intention of reducing as many preventable, maternal deaths as possible, with a target of 50 deaths per 100,000 live births by 2019. Additionally, in 2016 the Ministry of Health put forward an emergency maternal mortality rate (MMR) reduction plan. “The goals set by the plan relate to strengthening family planning, improving the quality of healthcare during pregnancy, birth and postpartum.”
  4. In order to continue the reduction of the maternal mortality rate, the Health Ministry of Algeria held a survey to consolidate the maternal death rate with the technical and financial collaboration of the three U.N. agencies: (UNFPA, UNICEF and the WHO). The objectives of this survey were to reach a consensus on connections between frequent causes of maternal death, update the maternal death rate and cultivate reliable data “for the readjustment of national programs on maternal health and the reduction of preventable maternal deaths for the implementation of Algeria’s ICPD commitments.”

A Leader in Maternal Healthcare

Much work remains in order for Algeria to be able to effectively put an end to preventable, maternal deaths. However, the measures put into practice within the last several years have already proven to be a success. Thanks to these policies, Algeria has become known as a leader in maternal healthcare in North Africa and the country continues to build a strong momentum and infrastructure to fight this problem.

Shreeya Sharma
Photo: Flickr

Healthcare in Nimiba
Namibia aims to improve the accessibility and quality of its healthcare system. Namibia is an upper-middle-income country located in southern Africa. Unfortunately, as it became an upper-middle-income country, Namibia’s healthcare fell behind. The country must overcome obstacles to continue improving its healthcare system. These obstacles include a shortage of doctors, inadequate funding and income inequality. The country also faces HIV/AIDS and tuberculosis crises. Despite its economic progress, Namibia has the sixth highest HIV prevalence rate in the world. This article covers this nation’s efforts to ensure its citizens have access to quality healthcare.

Healthcare Structure

Namibia gained independence in 1990. In its early years, the government declared healthcare a human right and made systemic changes to its healthcare system. The Ministry of Health and Social Services (MoHSS) formed. The MoHSS is responsible for implementing policy and delivering primary healthcare to Namibians.

Namibia has one of the lowest population densities in the world with about three people per square kilometer. According to The World Bank, 48.9% of Namibians live in rural communities. Therefore, providing access to healthcare is a significant challenge.

Namibia’s healthcare system consists of four distinct components: intermediate and referral hospitals, clinics, health centers and district hospitals. Each component has a unique role and specialized medical staff. For example, nurses staff clinics who provide basic care. People receive referrals to a health center or a district hospital for more serious cases. The most serious cases obtain treatment at intermediate and referral hospitals. Namibia houses “1150 outreach points, 309 health centers [and] 34 district hospitals.”

Namibia’s bed-to-population ratio is equivalent to that of higher-income countries including New Zeland and Norway. However, because of Namibia’s low population density, about 21% of Namibians live more than 10 km away from a health provider. The MoHSS partners with private organizations like USAID SHOPS to provide mobile health clinics. Mobile health clinics help reach rural communities in Namibia. They provide a range of services including immunizations, health education and HIV tests. Both the private and public sectors fund the mobile health network.

Funding Healthcare

In 2014, Namibia spent $200 million to prevent and treat HIV cases. Unfortunately, despite the work of the MoHSS, the leading cause of death is from non-communal diseases like HIV/AIDS and tuberculosis. In 2019, approximately 210,000 adults and children were living with HIV in Namibia; about 11.5% of these adults and children are between 14 and 49. Thankfully, Namibia is not alone in fighting against the virus; organizations including the U.S. Center for Disease Control and Prevention help with technical assistance and workforce recruiting.

The Namibian government aims to spend 15% of its GDP on healthcare. However, Namibia only spent about 8.6% of GDP on healthcare in 2017. Funding from donors has been declining since Namibia’s reclassification in 2009. The decrease is because of Namibia’s reclassification as an upper-middle-income country. In 2008, donors made up 22% of the country’s healthcare funding. In 2017, donors funded 7% of Namibia’s healthcare expenditure.

A variety of other sources fund Namibia’s healthcare system: 19% from the private sector, 11% from households and 63% from the government. Namibia needs additional funding to improve its healthcare system, especially as its GDP growth slows. Additionally, healthcare costs will increase as the country’s population ages.

Healthcare Workforce

Another of Namibia’s largest healthcare problems is the lack of public doctors. There are more private doctors than public doctors in many regions of the country. In Hardap, 80% of the doctors work in the private sector. A shortage of public doctors increases the cost of healthcare. According to The World Bank, there are approximately 1,222 doctors; 784 doctors work in the public sector and 438 work in the private sector. Half of Namibia’s physicians work in Khomas, the region containing Namibia’s capital. In 2018, there were approximately 0.33 doctors for every 1,000 people.

Namibia is working to address the shortage of public doctors; the Namibian government is supporting medical students’ education, hoping doctors and nurses will enter the public sector. In 2019, Namibia sponsored about half of its medical students.

Many issues persist within the Namibian healthcare system. Fortunately, groups like the Namibian government and the U.S. Center for Disease Control and Prevention have dedicated themselves to improving healthcare in Namibia. Hopefully, by making investments like supporting medical students’ education, Namibia will improve its healthcare system.

Joshua Meribole
Photo: Unsplash

Located in Southeast Asia, Laos is the country around seven million people call home. Despite the multitude of people that reside in Laos, the country’s healthcare system does not sufficiently support all those who live there. As a nation that was once colonized by France, Laos was left in a state of dependency towards wealthier countries, as colonization and poverty oftentimes go hand in hand.

Since Laos is one of the poorest countries in Asia, healthcare is a struggle that many have to endure on top of other poor living conditions. Insufficient government funding affects how low spending on healthcare is in Laos. Since public spending towards healthcare is low, people have to rely on out-of-pocket options and external financing rather than having comprehensive healthcare covered by the government. Health insurance in Laos currently only covers 20% of citizens, with less than 15% of the nation’s poor having access to health insurance. With basic necessities like food and shelter existing as one’s biggest priority, healthcare becomes an afterthought for those who cannot afford it.

Recent Advancements in Healthcare

In 2016, domestic allocation for healthcare was 5.9% which is lower than the goal of 9% of general government spending. Despite the lack of funding for Laos’ healthcare system, there have been advancements made in more recent years. According to the World Health Organization, “over the past 10 years, the health of the Laotian population improved significantly,” which has allowed the life expectancy at birth to reach 66 years in 2015.

One effective way to measure the health of a country like Laos is by looking at the mortality and life-expectancy rates. The mortality and life-expectancy rates have decreased and risen respectively due to the reported vaccination coverage. In the 2000s, 82.5 infant deaths per 1000 live births and 5.46 maternal deaths per 1000 live births were reported. Since then, the MMR, or maternal mortality ratio, has seen a reduction by more than 75%, meaning both mother and child death rates have improved. Laos was given praise for their tremendous reduction of maternal mortality rates, as Laos was the “third fastest country…between 2000 and 2013” to achieve the feat.

Laotian Health Policies

Adding policies to Laos’ healthcare system has been beneficial in the past years. A major policy implemented in 2005 called the Law on Health Care allowed for Laos to significantly improve the country’s healthcare system. This policy guarantees that all citizens of Laos be given equitable and quality health care so that everyone can “effectively contribute to the protection and development of the nation.” Financially struggling health patients are awarded free medical care if they have been certified “with the regulations of the relevant organization.” This is a step forward for Laotian healthcare, as those who are struggling the most are able to have healthcare guaranteed and one less financial obstacle to worry about.

Similarly, Laos has also implemented different healthcare programs for different income groups, to increase coverage for a broader cross-section of individuals. The State Authority for Social Security is healthcare used for civil servants, the Social Security Office is for those who are employees of state and private enterprises, the Community-based Health Insurance is for those who are informal-sector workers, and lastly, the Health Equity Funds is for the impoverished and provides maternal and child health services at no cost.

Another major policy that made advancement in Laos is the 2008 National Nutrition Policy. This healthcare policy aims to help with “the reduction of malnutrition among all ethnic groups and decreasing associated…mortality risks.” The most vulnerable groups such as women and children have a better fighting chance at surviving during childbirth. Lao children “are exclusively breastfed from 0-5 months,” which means that establishing the National Nutrition Policy was a crucial development, as babies get their nutrition from mothers and mothers need nutrition to nourish their young ones. By enabling and ensuring a baseline nutrition level be met in Laos, the country can take a step forward in healthcare and continue to promote healthy habits as a whole.

-Karina Wong

Photo: Pixabay


The country of Oman (officially know as Sultanate of Oman), located on the Arabian peninsula, can provide an example of a recovered and thriving healthcare system. Since 1970, Oman has been developing a highly esteemed healthcare system that is based on an efficient three-tiered system. The primary care model has produced a considerably healthier population compared to 50 years ago.

Oman’s Healthcare Progress

The progress of healthcare in Oman is represented in the statistics. Before His Majesty Sultan Qaboos first sat on the Omani throne in 1970, only 13 doctors were working for the 724,000 citizens of Oman. Since then, the number of doctors, as well as the number of hospitals, have grown tremendously. In 1958 there were only 2 hospitals while today there are 70 hospitals that are world-renowned for their medical treatment. There was also a significant growth in life expectancy from around 50 years in 1970 to over 76 years today.

At the beginning of his reign, His Majesty Sultan Qaboos made universal healthcare a goal, pushing for additional resources and policies to create accessible healthcare. The commitment of the government, including a law that ensures that the government will invest “in health care as a means of ensuring citizens’ well-being,” proved to be the momentum that the healthcare system needed to expand. With this commitment, a large amount of the government’s revenue from gas and oil, one of Oman’s largest exports, provided the healthcare sector the funding it needed to build hospitals, and improve medical staff and policy. By 2000, healthcare in Oman was ranked number eight in the world by the World Health Organization.

Moving Toward Universal Care

In addition to funding, healthcare needs policies to create a strong and lasting infrastructure. The platform on which Oman would grow its healthcare sector toward universal care was the focus on free primary care for all citizens. The aforementioned three-tiered healthcare system implemented in the Oman consists of primary care (hospitals at a local level), secondary care (care from a regional and district level), and tertiary care (any national care a citizen might receive.) By funding and creating ubiquitous accessibility for primary care, citizens can access healthcare in their community and be directed into a higher level or specialty if needed. Free primary healthcare for all has increased the quality and efficiency of healthcare in Oman.

Preventative Care

Healthcare in Oman has been effective in increasing life expectancy, decreasing child mortality and detecting diseases because there is a focus on preventative care. Preventive care is intertwined with the idea of accessible primary care because it encourages early detection of disease as well as easy and unburdened emergency care. Citizens can access the care they need without worrying about the cost of visiting a hospital in an emergency. In addition, the increasing amount of doctors who have an international perspective allows citizens to be better informed about their health issues and for doctors to take proactive measures in stopping development.

The progress made by Oman’s healthcare sector has caused significant positive change. From the efficient use of oil and gas revenue in the funding of hospitals to free primary healthcare for all, healthcare in Oman has arranged a secure and community-based framework that promises even greater future progress towards exemplary healthcare for all citizens. As the country continues to grow its investment in preventive care as well as the expansion of privatized healthcare, other healthcare systems can learn from Oman’s effective resource and policy implementation that has greatly improved healthcare for its citizens.

– Jennifer Long
Photo: Flickr

Apps that aid in healthcare in developing countries It can sometimes be difficult for people in developing countries to access healthcare, specifically those living in poverty. In order to address this problem, healthcare apps are being used to provide greater access. Here are 10 healthcare aid apps that are impacting access in developing countries.

10 Apps That Aid Healthcare in Developing Countries

  1. Peek has its sights set on helping people with vision impairment issues and blindness, a problem exacerbated in developing countries by a lack of resources. Peek can identify people with vision problems. The app then works with healthcare providers to pinpoint an economically feasible way to supply the treatment they need, before allocating the appropriate resources. Currently, Peek is being used by the International Centre for Eye Health at the London School of Hygiene and Tropical Medicine, which is administering a population-based survey of blindness and visual impairments in Cambodia.
  2. SASAdoctor focuses on making healthcare consultations more accessible in Kenya. In the country, only 12% of people are insured. About 8 million are reliant on the National Hospital Insurance Fund, leaving 35 million Kenyans uninsured. Available to all Kenyans with an Android smartphone or tablet (65% of Kenyans have one), SASAdoctor decreases the cost of an in-person consultation for the uninsured and makes it free for those with insurance. Patients will have their medical history, list of medications and other such medical notes in their ‘file’ on the app, so that whoever tele-consults with them will have the information they need to create an informed medical opinion. SASAdoctor can decrease the cost of uninsured visits with a doctor to Kes 495 (the equivalent of $4.66) for a projected 80% of Kenyans who are predicted to have smartphones in the next few years.
  3. iWander allows people to keep track of Alzheimer’s patients. Set with tracking technology that can be discretely worn by the patient, it offers whoever uses the app several options on how to deal with situations involving the patient. Solutions can range from a group calling session to making an emergency medical call or summoning a caregiver. iWander gives families more control over the care of a loved one, which can have a positive impact in countries where healthcare may be less accessible. In the US, the average cost of care for a single person is $174,000 annually. About 7 out of 10 individuals with dementia remain at home to receive care, where 75% of the costs fall to the family to pay. In helping families be proactive instead of reactive to crises, iWander can help in cutting these costs, especially in poorer countries, where many families are struggling to keep up with the high costs of at-home care.
  4. Kenek O2 allows the user to monitor their oxygen and heart rate while they sleep. Kenek O2, built for the iPhone, also requires a pulse oximeter which connects to the phone and retrieves the data to be stored in the app. Together, the cost for these two items is around $100, compared to the price of a regular hospital oximeter and other similar products, which could easily cost more than $500. Having effectively been used in North America, South America, Asia and Africa, Kenek O2 is currently working on developing a special COVID-19 device to watch for early signs of hypoxia, or the deficiency of oxygen reaching tissues.
  5. First Derm is an app that requires a smartphone-connected device, called a dermatoscope. This allows detailed pictures to be taken of skin conditions and lesions to better allow for remote, teleconsultations. In places where doctors are few and far between, and public transport is less reliable, this can make getting a second medical opinion much easier. So far, First Derm has helped in more than 15,000 cases from Sweden, Chile, China, Australia and Ghana, ranging from ages of just 3 days old to 98 years. Of these cases, 70% could be treated without a doctor, most often by over-the-counter treatments available at local pharmacies.
  6. Ada takes user-input symptoms and provides appropriate measures to take as a result, like a personal health assistant. It’s intended to assist those who don’t have the means to seek an in-person consultation right away. The app has been released in several languages, which makes it more accessible. Currently, 10 million people around the world are using Ada for symptom evaluation.
  7. Babylon is intended to mitigate the obstacle of going to see a doctor in person by allowing users to input symptoms or solve common health problems via teleconsultation with a doctor. Babylon specializes in non-emergent medicine, allowing patients to skip a trip to the doctor’s office entirely if their condition allows it. This is beneficial in places where doctors are sparse, or the patient lacks the financial means or a method of transportation in getting to the hospital. Babylon caters to users across the U.S., U.K., Canada, Rwanda and several countries across Asia-Pacific and the Middle East. The app aims to expand to more countries in the upcoming years.
  8. MobiSante, through its ultrasound device, allows versatility in diagnostic imaging by bringing the ultrasound to the patient. This allows quality, diagnostic imaging to be done outside the confines of a hospital or clinic. As a result, it provides more holistic and informed treatment where people may need it most but have previously struggled in accessing a healthcare center with the necessary technology. While having a computer at home with a desk is much less common in developing countries, the world’s increasing reliance on the internet is shifting the status of internet technology from a luxury to a basic necessity. This means that technology such as smartphones are becoming somewhat of a necessity in impoverished countries, making an app like MobiSante effective in using smartphones to make diagnostic imaging more accessible.
  9. Go.Data is a tool released by the WHO. It is specifically for collecting data during global health emergencies. During the Ebola outbreak in Africa, Go.Data was praised for tracing points of contact. The app also tracked infection trends and helped in arranging post-contact follow up.
  10. Mobile Midwife is a digital charting app that stores information in a cloud so that healthcare workers have access to all pertinent patient information. It works even in cases of power outages, or home births where internet connection may be less reliable. This app can help in areas where mother and infant mortality is higher, ensuring that healthcare providers can efficiently access patient information to ensure the best care. It can also cut the extra time it takes to find records that could otherwise make procedures more dangerous for both mother and child.

Bridging healthcare accessibility with smartphone apps isn’t a perfect solution, as it comes with accessibility issues of its own. However, these healthcare aid apps can help people without insurance, or who are physically unable to visit a physician, access health consultations. As a result, more people are provided access to healthcare, empowering a healthier (and more health-conscious) population.

– Catherine Lin
Photo: Flickr