10 Facts about Life Expectancy in Myanmar
Formerly known as Burma, Myanmar is a country in Southeast Asia nestled between India, Bangladesh, China, Laos and Thailand. While it is currently transitioning from a military government to a democracy, the following are 10 facts about life expectancy in Myanmar.

10 Facts About Life Expectancy in Myanmar

  1. Myanmar’s Life Expectancy: For the first of the 10 facts about life expectancy in Myanmar, the average life expectancy in Myanmar is 66.96 years. For males, the average is 65 years and for females, it is 69 years. Steadily rising since 1950, the average life expectancy was once 33.63 years. By 1990, life expectancy slowed as it only reached 56.65 years and did not exceed 60 years until 2001. Based on data collected by the United Nations, Myanmar is not projected to have an average life expectancy exceeding 70 years until almost 2040.
  2. Other Countries’ Life Expectancies: Myanmar’s life expectancy is lower than most of its neighbors. Compared to surrounding countries, such as China, Thailand, India and Bangladesh the average life expectancy ranges between 69 and 77 years. However, Myanmar has a relatively similar life expectancy to the Lao People’s Democratic Republic, which is at 67.27 years. This could be due to Myanmar’s changing government and tumultuous internal conflict. Unlike its neighbors, Myanmar has engaged in a civil war since it broke from British rule in 1948. In fact, it is the world’s longest ongoing civil war.
  3. Myanmar’s Internal Conflict: These disparities in life expectancies between Myanmar and other Asian countries could be due to its internal conflict. In Myanmar, there is a constant struggle for power in the government with the military primarily seizing control and ending rebellions since the country gained independence in 1948. Among this political struggle is an ethnic one; the Buddhist population (which makes up 90 percent of Myanmar’s total population) targets minority religious groups, specifically the Rohingya, a Muslim minority group. While there have always been tensions between ethnic groups in Myanmar, violence did not escalate until 2016. Thousands of Rohingya are fleeing Myanmar to Bangladesh because of persecution, extreme violence and borderline ethnic cleansing by Myanmar’s security forces. People do not know much about the death toll in Myanmar but BBC reports that the violence resulted in the killings of at least 6,700 Rohingya a month after violence broke out in August 2017. People burned at least 288 Rohingya villages since then and nearly 690,000 Rohingya have fled to Bangladesh. Myanmar’s rapid population decline and lowered life expectancy may be due to either genocide or the fleeing of many of its civilians.
  4. Rising Life Expectancy: Despite the ongoing civil war in Myanmar, life expectancy is rising. One of the greatest links to health and life expectancy is the standard of living. According to a study by the World Bank, “the proportion of the population living under the national poverty line halved from 48.2 percent in 2005 to 24.8 percent in 2017.” More people are now able to afford health care and medical treatments, allowing for the rise in life expectancies. Additionally, as poverty declines, the Myanmar government is devoting more resources to improving health care. Myanmar has specifically targeted malaria. In a study by the World Health Organization, in Myanmar, “malaria morbidity and mortality has declined by 77 percent and 95 percent respectively by 2016 compared to 2012. The country is moving forward as per the National Strategic Plan aiming for malaria elimination by 2030.” By abiding by the National Strategic Plan, Myanmar was able to successfully reduce malaria in the country and boost life expectancy.
  5.  Reducing Poverty: Myanmar and various international powers are making efforts to reduce poverty in the country. In April 2017, the World Bank approved a $200 million credit for a First Macroeconomic Stability and Fiscal Resilience Development Policy Operation. The purpose of this is to help Myanmar achieve economic stability and reduce poverty. It would also allow greater access to public services, such as electricity and health care resources. In addition, China agreed to assist in reducing poverty in rural areas of Myanmar in February 2018. Rural Myanmar has higher poverty rates than in urban centers (38.8 percent compared to 14.5 percent in towns and cities). The project from China includes infrastructure development and vocational training, which will implement better roads and agricultural techniques. With these efforts, poverty is in decline and quality of life rises, allowing for people to live better and longer lives.
  6. Access to Electricity: People across Myanmar are gaining access to electricity. According to the World Bank, 69.815 percent of the population had access to electricity in 2017, as opposed to 55.6 percent in 2016. In 2015, both the government of Myanmar and the World Bank developed a National Electrification Plan that will achieve universal electricity by 2030. To do this, the World Bank has given Myanmar a $400 million credit to launch this plan throughout the country. Myanmar has already exceeded the goals set in 2015. One goal was to have 1.7 million households connected to electricity by 2020. Currently, 4.5 million households have electricity. Because of this and the decline of poverty, more households can obtain home appliances as well as other consumer goods like cell phones and computers. While these are not direct causes of rising life expectancy, they do indicate that people in Myanmar are gaining a better quality of life, which can attribute to living longer lives.
  7.  Health Care: Myanmar consistently ranks among the worst health care in the world. Myanmar citizens pay for most health care resources out of pocket. Only 600,000 of 53.7 million people in Myanmar have health insurance, the Social Security Scheme. There are shortages across the country in human resources for health. There are only 61 doctors per every 100,000 people in Myanmar. There are not many medical schools available and therefore a lack of other health professionals like pharmacists, technicians and bioengineers. Many of the current doctors in Myanmar feel overworked and burnt out of the profession. The lack of many resources can contribute to lower life expectancies.
  8. Leading Causes of Death: Without access to health care, diseases become the leading cause of death in Myanmar. Non-communicable diseases cause 68 percent of deaths in Myanmar. COPD, stroke, ischemic heart disease, diabetes and Alzheimer’s disease are some of the leading causes of death in Myanmar. However, preventable diseases are in decline. Tuberculosis, HIV and lower respiratory infections have decreased as leading causes of death. Even though access to health care is limited, the quality has improved overall, allowing for people to fight off these infections and live longer.
  9. Improving Health Care: The Myanmar government is slowly improving health care. Unfortunately, government spending on health care is one of the lowest in the world at 5 percent of the country’s gross domestic product (GDP). However, studies by the World Bank shows that this percentage has increased over time. In 2011, the Myanmar government only spent 1.687 percent of its GDP on health care, the year Myanmar began its transition to democracy. Since 2013, Myanmar began to implement more policies devoted to national health care. The government went from spending 2.11 percent on health care in 2013 to 5.03 percent in 2014, making health care more affordable and available for mothers and children. Myanmar also reduced the number of medical students to ensure a better quality of education. The severe lack of government investment in health care makes health resources difficult to access by the population, which one can attribute to the lower life expectancies, but it is clear that Myanmar is taking steps in the right direction.
  10. International Support for Health Care: There is a lot of international support for health care in Myanmar. Cooperative for Assistance and Relief Everywhere (CARE) has worked with Myanmar since 1995 and has helped improve community health services. It also provides women valuable information on sexual and reproductive health. The Japanese International Cooperation Agency has also worked on special projects in Myanmar since 2000, most notably creating a standard for sign language and providing teachers. Additionally, the World Health Organization has also worked with the Myanmar government to set goals for their health care. The WHO assisted in drawing up Myanmar’s Health Vision 2030. Further, the World Bank provided a $200 million loan to Myanmar for an Essential Package of Health Services. Much of the international support is at local levels; it is up to the Myanmar government to provide support across the entire country.

As evidenced by the 10 facts about life expectancy in Myanmar, several circumstances could be contributing to the lower life expectancy of the country. However, despite the long and winding path ahead, it is clear that life expectancy is rising as living conditions continue to slowly improve. 

– Emily Young
Photo: Pixabay

Advances in Cambodian Health Care
Cambodia is a country located in Southeastern Asia, bordering Thailand, Vietnam, Laos and the Gulf of Thailand. The Khmer Rouge regime and its actions brought the nation’s mostly positive trajectory to a definitive halt in the 1970s. However, the nation has been rebounding. The recent advances in Cambodian health care illuminate the country’s gains and foreshadow the possibilities for this economically developinging country.

Cambodia’s regression in the 1970s was significant in its health care field. This is because the Khmer Rouge explicitly targeted the educated and elite in Cambodia during the reign of the regime. In fact, one could easily qualify the regime’s activities as genocide. By the end of the regime’s four-year rule, it is estimated that only 12 doctors remained in Cambodia.

Regardless of the strife and hardships Cambodians faced, those in Cambodia have not lost faith. The Cambodian health care system has made advances from a multitude of angles. Through its work with NGOs and making advancements within its own government by way of reform, Cambodia is developing a just and proper health care system.

Transform Healthcare Cambodia

There are a variety of NGOs offering assistance with the health care crisis in Cambodia. Transform Healthcare Cambodia’s work highlights these efforts. The goal for Transform Healthcare Cambodia is to protect the region from diseases the Southeastern Asian population do not receive treatment for.

With Khmer Rouge eliminating almost all of the country’s doctors, the number of doctors has remained limited. However, by training physicians to diagnose, treat and manage diseases prominent in the region, the organization is taking action against diabetes and many infectious diseases plaguing the region.

The charity accomplishes this by sending its partners to Battambang Provincial Hospital where they train the Cambodian staff in instances of health care. In turn, the existing staff trains future medical professionals.

Governmental Reforms

A health care system is only as strong as the government that supports it. That is why the Second Health Sector Support Program Project (HSSP2) has taken on the task of governmental reform in Cambodia. By improving the coverage and quality of health care, it gives the government a quality guideline to uphold.

By supplying and supporting these health programs, it gives the health care system legs to stand on. Since its involvement, the project has accomplished much in the region, including the following:

  1. Newly trained professionals have successfully delivered 85 percent of babies in Cambodia.
  2. Vaccines administered to children increased by 10 percent from 2010 to 2015.
  3. All of Cambodia’s impoverished receive health care, at approximately 3 million people.
  4.  HHSP2 has added 121 health centers, five health posts, 79 delivery rooms, 15 maternity wards and one pharmacy.
  5. The project has improved water quality, electricity, sanitation and 280 preexisting health centers.
  6. The project established 12 non-communicable disease clinics.

Through strife, struggle and hardship to the extent of genocide, the Cambodian people have persevered. Although Cambodia still requires much work in regards to regulating and sustaining its health care system, the advances the country has made are a clear indicator of growth and a sign of a brighter future.

– Austin Brown
Photo: Flickr

Breastfeeding in Zimbabwe
Zimbabwe is an African country located in the southern region of the continent. It has beautiful landscapes and wildlife that attract many people every year, but the country is still intensely poverty-stricken. In fact, it is one of the poorest nations in the world with a whopping 70 percent of the entire nation living under the poverty line.Many of the downsides that come with poverty are present in the country, but one downside that people often do not consider is how poverty affects breastfeeding in Zimbabwe. While people often see breastfeeding as a natural process that even the poorest populations do, breastfeeding is limited in Zimbabwe. About 66.8 percent of Zimbabwean women exclusively breastfed their newborns between the first six months of life with only 32 percent starting breastfeeding within the first day of life. In a country of malnourished people and food scarcity, this article will explore why women do not frequently breastfeed in Zimbabwe.

The Reason Women Do Not Breastfeed in Zimbabwe

One can attribute the lack of exclusive breastfeeding in Zimbabwe to a set of issues that include low education, low income and traditional practices as well as the country having a patriarchal society. Women said what they were only comfortable exclusively breastfeeding for the first three months of their child’s life and this directly relates to the fact that there is intense pressure from in-laws to include different foods in their babies’ diets which stems from long uninformed traditions. With little to no support from the male partner, mothers can find it difficult to resist this pressure.

In combination with these factors, there is also the simple fact that many Zimbabwean women suffer extreme malnourishment. Some reports also stated that many mothers who did not engage in exclusive breastfeeding for at least the first three months of life were simply unable to produce enough milk to fully nourish their babies.

The Effect On Zimbabwean Babies

Zimbabwe has an infant mortality rate of 50 deaths per 1,000 births. For perspective, the infant mortality rate in the United States is five deaths per 1,000 births. Reports determined that 10 percent of all mortality in children aged 5 years was because of non-exclusive breastfeeding at the beginning of life, which is quite significant.

In conjunction with this high infant mortality rate, there is also chronic malnutrition and stunting. Approximately 27 percent of children under the age of 5 in Zimbabwe suffer from chronic malnutrition. Stunting also occurs in Zimbabwean children but varies by region from 19 percent to 31 percent.

There is a correlation between education and breastfeeding in Zimbabwe as well. People have observed a connection between education and breastfeeding not only in the patterns of the mother but also in how it affects her children.

Solutions

Some are making efforts to bring more awareness and education to the people of Zimbabwe. One of these efforts is the initiation of World Breastfeeding Week which representatives from WHO, UNICEF and the Ministry of Health and Child Care launched due to concerns about the low exclusive breastfeeding rates. Only 48 percent of babies below the age of 6 months received exclusive breastfeeding at the time of this event which is significantly lower than the 66.8 percent in 2019.

The improved statistics show that efforts to combat the misinformation and societal pressures among Zimbabwean women to improve rates of exclusive breastfeeding are working. While poverty negatively affects breastfeeding in Zimbabwe, others are slowly combating it.

– Samira Darwich
Photo: Pixabay

Eliminating HIV In Kenya

The HIV/AIDS epidemic in Africa affects adolescent girls more than any other group within the population. As a public health response, a new approach for the elimination of HIV in Kenya emerged which addresses the gender and economic inequality that aid in spreading the disease. This new approach is related to female empowerment eliminating HIV in Kenya with new effective methods.

Health Care System in Kenya

Kenya is home to the world’s third-largest HIV epidemic. Kenya’s diverse population of 39 million encompasses an estimate of 42 ethnic tribes, with most people living in urban areas. Research shows that about 1.5 million, or 7.1 percent of Kenya’s population live with HIV. The first reported cases of the disease in Kenya were reported by the World Health Organization between 1983 to 1985. During that time, many global health organizations increased their efforts to spread awareness about prevention methods for the disease and gave antiretroviral therapy (ART) to those who were already infected with the disease. In the 1990s, the rise of the HIV infected population in Kenya had risen to 100,000 which led to the development of the National AIDS Control Council. The elimination of HIV in Kenya then became a priority for every global health organization.

The health care system in Kenya is a referral system of hospitals, health clinics, and dispensaries that extends from Nairobi to rural areas. There are only about 7,000 physicians in total that work within the public and private sector of Kenya’s health care system. As the population increases and the HIV epidemic intensifies, it creates more strenuous conditions for most of the population in Kenya to get the healthcare they desperately need. It is estimated that more than 53 percent of people living with HIV in Kenya are uninformed of their HIV status.

In addition, HIV disproportionately affects women and young people. After an initiative implemented by UNAIDS in 2013 to eliminate mother-to-child transmission of HIV through increased access to sex education and contraceptives, significantly fewer children are born with HIV. Today, 61 percent of children with HIV are receiving treatment. However, the young women (ages 15-24) in Kenya are still twice as likely to be infected with HIV as men their age. Overall HIV rates are continuing to decrease for other groups within the population, but studies show that 74 percent of new HIV cases in Kenya continue to be adolescent girls.

Female Empowerment Eliminating HIV in Kenya

Women’s empowerment is an overarching theme for the reasons that HIV is heavily impacting the young women in Kenya. A woman’s security in the idea that she is able to dictate personal choices for herself has the ability to hinder or help her well-being.
Female empowerment eliminating HIV in Kenya uses these four common conditions to eliminate HIV:

  1. Health Information – Many girls in Kenya lack adequate information and services about sexual and reproductive health. Some health services even require an age of consent, which only perpetuates the stigma towards sexual rights. Also, the few health services available are out of reach for poor girls in urban areas.
  2. Education – A lack of secondary education for young women and girls in Kenya often means that they are unaware of modern contraceptives. A girl that does not receive a secondary education is twice as likely to get HIV. To ensure that adolescent girls have access to sexuality education, the 2013 Ministerial Commitment on Comprehensive Sexuality Education and Sexual and Reproductive Health and Rights in Eastern and Southern Africa guaranteed that African leaders will commit to these specific needs for young people.
  3. Intimate partner violence –  Countless young women and girls have reported domestic and sexual violence that led to them contracting HIV. Something as simple as trying to negotiate contraceptive use with their partners often prompts a violent response. There has been an increased effort to erase the social acceptability of violence in many Kenyan communities. An organization called, The Raising Voices of SASA! consists of over 25 organizations in sub-Saharan Africa that work to prevent violence against women and HIV.
  4. Societal norms – Some communities in Kenya still practice the tradition of arranged marriages, and often at very young ages for girls. The marriages usually result in early pregnancy and without proper sex education, women and babies are being infected with HIV at a higher rate. In 2014, the African Union Commission accelerated the end to child marriages by setting up a 2-year campaign in 10 African Countries to advocate for Law against child marriages. Research suggests that eliminating child marriages would decrease HIV cases, along with domestic violence, premature pregnancies by over 50 percent.

Young women in Kenya face various obstacles in order to live a healthy life, and poverty acts as a comprehensive factor. Studies show that a lack of limited job opportunities leads to an increase in high-risk behavior. Transactional sex becomes increasingly common for women under these conditions, while they also become more at risk for sexual violence. An estimated 29.3 percent of female sex workers in Kenya live with HIV.

Solution

The most practical solution to tackling the elimination of HIV in Kenya combines HIV prevention with economic empowerment for young girls. The Global Fund to fight AIDS, Tuberculosis and Malaria is an organization that has worked hard at implementing strategies, and interventions across Africa that highlight women’s access to job opportunities and education. In 10 different countries in Africa (including Kenya), young women can attend interventions in which they learn about small business loans, vocational training and entrepreneurship training. One way that more women in Kenya are able to gain control over their financial resources is by receiving village saving loans. To participate in village saving loans it requires a group of 20-30 to make deposits into a group fund each week. Women within these groups can access small loans, which enables them to increase their financial skills while gaining economic independence. The Global Fund to fight AIDS has cultivated a space for numerous empowerment groups for young women out of school called the RISE Young Women Club. The young women in these clubs often live in poverty and receive HIV testing as well as sexual health education.

Overall, the global health programs that aid in the elimination of HIV in Kenya are continuously improving their strategies by including young women in poverty. The HIV/AIDS epidemic in Kenya steadily sees progress thanks to the collective efforts of programs that empower young women.

– Nia Coleman
Photo: Flickr

Water Competition and Efficiency in Kazakhstan
Former Soviet-controlled Kazakhstan has come a long way since the end of the Cold War. Despite becoming a more stable nation in the Middle East compared to its neighbors, it still struggles with water distribution and quality to this day. This article shall discuss these chief problems through water competition and efficiency in Kazakhstan.

Competition with China

As far as competition goes, Kazakhstan has a major problem in the form of China. Kazakhstan relies heavily on the Ili River for a good portion of its water supply and both countries connect to this valuable river. At the end of the day, China receives a larger share of the river than Kazakhstan. This is partly because the Ili River begins in China, and that China has 15.7 billion cubic meters of water flow into its borders every year. On the flip side, Kazakhstan only gets around half of that with 8.4 billion cubic meters. China states that it should have a larger share due to it being larger than Kazakhstan and the fact that Kazakhstan exploited the water profusely in the 1960s. In fact, Kazakhstan still does today at a rate of 42.7 percent which is over the 40 percent limit range.

Efficiency in Water Distribution

Kazakhstan has noted that it needs to exploit these waters due to its inability to give its population enough water or water that meets sanitary standards. This is partly due to the lack of efficient water distribution to people in certain parts of Kazakhstan. Meanwhile, Central Kazakhstan only receives 3 percent of the country’s water.

Another problem is that the government has been treating its water as an unlimited resource while it is becoming clear that it is very scarce. This lead to poor management of this water while leading the citizens into believing that the problem is not as dire as it seems.

Sanitation in Kazakhstan

Another issue that Kazakhstan has is that most of its drinking water is unsafe to ingest. Due to the aforementioned poor distribution and supply of the water within the country, the amount of clean water sits at only 30 percent. A key cause of poor distribution is that the water often stops in pipes, which allows it to collect bacteria and disease. These interruptions in water flow can occur 14 days a month and last as long as 12 hours. The fact that the pipes that flow this drinking water are also in the same trenches as sewer pipes, causing cross-contamination and a possible epidemic does not help matters. This only further highlights why water competition and efficiency in Kazakhstan is so important.

Course of Action

Kazakhstan is looking to revamp its water system by not just fixing its own, but also by importing water from outside sources, namely other neighboring countries. The government is also receiving support from the E.U.; it is helping to create policies that can help Kazakhstan better preserve its water for drinking and agricultural needs. The E.U. is also going so far as to provide new technology to better equip the country in preserving this water. This is not surprising since the E.U. also provided $1.5 billion to help with water management from 2010 to 2013. With all of this support, the government of Kazakhstan is hoping to increase its people’s access to clean, sustainable drinking water by 2030.

In this article about water competition and efficiency in Kazakhstan, it is clear that the country is in a rough patch to competition outside of its borders, as well as its poor management of the water it possesses. With the proper restructuring of its water system and outside help, the country should be able to improve this issue. With the E.U.’s continued help and allocated funds and resources to fix the contamination and distribution problems, Kazakhstan should be able to see a great increase in clean water.

Collin Williams
Photo: Flickr

Mental Health and Poverty
Although mental health and poverty are two things that one might not always group together, there is a serious link between people living below the poverty line and mental health disorders. According to a Substance Abuse and Mental Health Services Administration SAMHSA report, around 9.8 million people living in the United States had mental health disorders in 2015, and 25 percent of those people were living below the poverty line.

Both poverty and mental health can bring about the other. For instance, a Gallup poll found that about 15.8 percent of people not living in poverty reported having diagnosed depression, while 31 percent of people living in poverty reported depression. In addition, a McSilver Institute for Poverty Policy and Research study based on data from the National Center for Education Statistics found that a household is likely to experience a 50 to 80 percent increase in food insecurity if the mother has diagnosed depression. While it is not clear whether the depression leads to living in poverty or living in poverty results in depression, the link between the two issues is clearly prevalent. Therefore, it is crucial that others address and treat the mental health of people living in poverty.

Ways to Treat Mental Health

One large issue with impoverished people having mental health disorders is that they often do not have the insurance and money to seek therapy and get medical help. This can be especially harmful to children living in poverty. The Official Journal of the American Academy of Pediatrics has three main recommendations for low-income families to seek help for mental health disorders, including education and training, establishing relationships with providers and creating multidisciplinary teams.

The best way to help and treat mental health in low-income families and communities is education. By integrating mental health education in schools and free programs that schools offer to families and communities, more people can learn about how to cope with mental health disorders and keep themselves and their families healthy and happy. In addition, integrating mental health services into school health services allows children to seek help for any mental health disorders right at school.

Further, establishing relationships with school health providers and counselors allows children to feel comfortable enough to seek the help that they need, in a safe space that they are used to. Communication between children/families and health care providers also allows the providers to be available more quickly and could result in more effective treatment.

Effects of Improving Mental Health

Poverty can strain a person’s mental health due to stress and instability. Therefore, public mental health has a huge impact on communities and the mental health of the people. People do not widely recognize public health, which is why is it crucial that communities are actively working to prevent mental health problems and to educate the community on how to cope with mental health strains.

Mental health problems and poverty have a serious link and it is vital that people are aware of the strains of poverty and understand their community and who is at risk. Only by monitoring and evaluating impacts of mental health, creating educational programs and addressing both physical and mental health, both mental health and poverty can improve together.

Paige Regan
Photo: Flickr

Health Care in Ghana

The West African nation of Ghana is a vibrant country filled with natural beauty and rich culture. However, like many of its neighbors in sub-Saharan Africa, Ghana suffers from a high poverty rate and lack of access to adequate health care. In fact, according to the Ghana Statistical Service, 23 percent of the total population lives in poverty and approximately 2.4 million Ghanaians are living in “extreme poverty.” That being said, many organizations and groups — both national and global — are working to improve health care in Ghana.

Malaria in Ghana

A disease transmitted through the bites of infected mosquitoes, malaria is a common concern throughout much of West Africa, including Ghana where it is the number one cause of death. In fact, according to the WHO’s most recent World Malaria Report, nearly 4.4 million confirmed malaria cases were reported in Ghana in 2018 — accounting for approximately 15 percent of the country’s total population.

All that in mind, many NGOs, as well as international government leaders, have taken up the mantle to eliminate malaria in Ghana. This includes leadership from the United States under the President’s Malaria Initiative or PMI which lays out comprehensive plans for Ghana to achieve its goal of successfully combating malaria.

With a proposed FY 2019 budget of $26 million, the PMI will ramp up its malaria control interventions including the distribution of vital commodities to the most at-risk citizens. For instance, the PMI aims to ensure that intermittent preventative treatment of pregnant women (IPTp) is more readily accessible for Ghanaian women. Progress has been made, too, as net use of IPTp by pregnant Ghanaian women has risen from 43 percent to 50 percent since 2016. This is just one example of the many ways in which PMI is positively contributing to the reduction and elimination of malaria in Ghana.

National Health Care System

National leaders are also doing their part to positively impact health care in Ghana. In 2003, the government made a huge step toward universal health coverage for its citizens by launching the National Health Insurance Scheme (NHIS). As of 2017, the percentage of the population enrolled in the scheme declined to 35 percent from 41 percent two years prior. However, 73 percent of those enrolled renewed their membership and “persons below the age of 18 years and the informal sector workers had significantly higher numbers of enrolment than any other member group,” according to the Global Health Research and Policy.

It is difficult to truly understand Ghana’s health issues without considering firsthand perspectives. In an interview with The Borgen Project, Dr. Enoch Darko, an emergency medicine physician who graduated from the University of Ghana Medical School, commented on some of the health issues that have plagued Ghana in recent decades. “A lot of problems that most third world countries, including Ghana, deal with are parasitic diseases such as malaria and gastroenteritis. Though health issues like diabetes and hypertension still remain in countries around the world, and even the United States, the difference is that some diseases that have been eradicated in Western countries still remain in countries like Ghana,” Darko said. “Many people in Ghana simply do not see a doctor for routine checkups like in the United States. Rather, most people will only go to see a doctor when they are feeling sick. As a result, lesser symptoms may go unchecked, thus contributing to the prevalence and spread of disease and infection. Combined with the fact that many Ghanaians in rural communities may not have sufficient money to afford treatment or medicine, this becomes a cycle for poor or sick Ghanaians.”

That said, it is hoped that with continued support from international players as well as government intervention, the country can continue to make strides in addressing health care for its citizens.

Ethan Marchetti
Photo: Flickr

 

Facts About Life Expectancy in Malawi

The landlocked country of Malawi has a life expectancy rate of 60.2 years for males and 64.3 years for females. While this is much lower than the global average of 69.8 years for males and 74.2 years for females, it represents an improvement from previous years. These eight facts about life expectancy in Malawi will help shed light on the reasons for the low rate as well as what the country has done, and can still do, to improve it:

8 Facts About Life Expectancy in Malawi

  1. HIV/AIDS: As of 2017, an estimated 1 million people in Malawi were living with HIV/AIDS which places the country at 10th in the world in terms of the number of people living with HIV/AIDS. In addition, there were also 13,000 deaths from the virus in the same year. Still, the government has made major strides to curb the epidemic in the last 10 years. Part of its strategy includes providing free condoms as well as educating young people. As of 2018, 78 percent of all people living with HIV in Malawi are on medication. There was also a decline in the number of new infections from 55,000 in 2010 to 38,000 in 2018.
  2. Maternal Health: In 2015, maternal mortality stood at 634 deaths for every 100,000 live births. This is considerably higher than the global average of 216 deaths per 100,000 live births. However, it represents a significant improvement as the government along with support from USAID has been able to reduce maternal mortality by 53 percent between 1990 and 2013. Today, more expectant mothers in both rural and urban areas are now receiving prenatal care as well as skilled birth assistance.
  3. Child Health: Great improvements have also been made in terms of child health, as most children under 5 in both rural and urban areas are vaccinated. This has helped reduce deaths from communicable childhood diseases such as measles, tetanus and pneumonia. The Ministry of Health has also implemented strategies like deworming and has also distributed vitamin A supplements to deal with other major causes of childhood death.
  4. Fertility Rate: In the 1980s Malawian women had about seven children per woman. Today, that number is at 5.5 children per woman. The high fertility rate affects life expectancy in Malawi as it puts pressure on the government to provide adequate social amenities in order to improve people’s lives.
  5. Population Growth: According to a 2018 census, Malawi’s population is 17.6 million people. By 2020 this is projected to hit 20.2 million, before doubling by 2050. This rapid population growth puts a lot of pressure on the country’s land, water and forest resources and threatens life expectancy as most Malawians derive their income from agriculture. The Third Malawi Growth and Development Strategy (MGDS III) sets out a number of policies including promoting family planning and sexual and reproductive health rights as a means to slow population growth, and better managing migration and urbanization.
  6. Infectious Diseases: Malawians are at very high risk of contracting infectious diseases. Food and waterborne diseases include diarrheal diseases and typhoid fever. In order to deal with diarrheal deaths, Malawians are in need of nutritious food as well as an unpolluted environment. Other diseases include malaria, dengue fever and rabies from animal contact. The country has been dealing with malaria by subsidizing mosquito nets. Additionally, Malawi is one of the three African countries taking part in a malaria vaccine pilot. The pilot aims to reach 360,000 children each year across Kenya, Ghana and Malawi.
  7. Water and Sanitation: One in three Malawians do not have access to clean water while 9.6 million people do not have a decent toilet. This affects the life expectancy in Malawi as it leads to an increase in diarrheal diseases. With the support of UNICEF and organizations such as Water Aid, the government of Malawi has made significant progress in reducing the number of people who lack access to safe water. Additionally, the rate of open defecation has declined from 29 percent in 1990 to four percent in 2015.
  8. Education: Malawi introduced free primary education in 1994 which put a strain on the education system. This is because the infrastructure, number of teachers and number of teaching and learning materials were inadequate when compared to the number of students who enrolled. It resulted in poor performance by the students, especially in terms of literacy.  The government of Malawi has been making an effort to improve the education sector by allocating more than 20 percent of the national budget to education.  It has also partnered with bodies such as USAID and UNICEF to improve literacy levels as well as student enrollment and completion rates. An educated and skilled population will help increase Malawi’s economic growth. Educational reforms will help reduce the unemployment rate which is currently more than 20 percent.

Malawi is considered one of the poorest countries in the world, and a lot still needs to be done to improve the lives of its people. It is however clear that the government is working with the support of nonprofit organizations around the world to make life better for its people.

Sophia Wanyonyi
Photo: Flickr


The UN’s 2016 High-Panel report on global access to medicine opens with an inspiring message: “Never in the past has our knowledge of science been so profound and the possibilities to treat all manner of diseases so great.” It is hard to debate that recent advancements in targeted cancer therapy and HIV drug development indicate a bright future for the Rx world. The potential for positive change may go unrealized, however, if access to medicine remains limited. To serve the 3.5 billion people without basic medical services, along with the 100 million who find themselves in extreme poverty because of high medical costs, governments and organizations have to confront the complex economic forces undermining global access to medicine. This article will discuss two such forces and consider how international actors have responded.

Too Big to Heal?

Economic orthodoxy holds that the equilibrium of a product’s supply and demand will determine its price, but medication prices do not adhere to this rule. This is because firms in the pharmaceutical industry possess the key to market distortion. Monopoly power or the ability for firms with outsized market shares to raise prices without experiencing a corresponding drop in sales. Pharmaceutical companies tend to obtain monopoly power for several reasons, such as:

  1. High entry costs, especially those associated with research and development. This excludes smaller, potentially disruptive firms from the market.
  2. The continuation of company consolidation. In the past 20 years, a group of 60 different pharmaceutical companies shrank to a mere 10.
  3. Large profits. Profits are huge, with the 10 highest-earning companies netting a 20 percent profit margin on average. This allows these companies to fortify their already-large market share. Most importantly, once a company patents a drug, it holds exclusive title to the production and distribution of that drug for 20-25 years.

During that period, no lower-priced, generic substitutes can enter the market. Equipped with this uncontested control, these companies can charge high prices for their products, as those who need them will have no other choice but to bear the cost. Yet some, especially individuals in poorer countries dealing with diseases like Hepatitis C and cancer, simply cannot afford these costs.

There are many individuals and corporations who are attempting to solve this problem, however. For example, GlaxoSmithKline (GSK), a pharmaceutical company based in London, England, is trying to put an end to exorbitant prices for prescription drugs in low-income countries. In March 2016, it announced that it would not seek patent protection for its drugs in 50 of the world’s poorest countries. By doing this, the company opened the path for smaller companies to bring lower-priced, generic versions of their drugs to the market. So far, the approach has been effective, earning GSK the top spot in the 2018 Access to Medicine Index. The positive publicity it receives from the ranking will hopefully motivate other companies to follow suit.

R&D Incentives

While the economics of monopoly power generates the problem of overpricing, the incentives of research and development make it such that many medicines needed in low-income countries go underproduced. As mentioned above, patents spell large rewards, but it costs $800 million on average for a company to obtain one and to bring a drug to the market. This pressures companies to develop the drugs that are most likely to produce a substantial financial return. Additionally, as the UN High-Panel notes in its report, this means that widespread, treatable diseases can oftentimes go unaddressed. For example, antimicrobial-resistant viruses and parasites threaten to kill as many as 10 million people annually by 2050, yet drug companies worldwide have developed virtually no new antibiotics in the past 25 years. In the absence of this innovation, however, public-private R&D partnerships have proven to be a successful substitute. The Global Fund is an example as it has saved 27 million people that malaria, HIV/AIDS and tuberculosis threatened by raising money from both public and private sources and collaborating with domestic task forces and commissions.

A Reconceptualization

Economic barriers to improve global access to medicine remain, but more and more people are starting to conceptualize the problem as an ethical one rather than an economic one. However, ensuring access to health care and maintaining market efficiency are not mutually exclusive. For example, cost-efficient drug production techniques are necessary to disseminate medicines at reduced prices. But other times “policy incoherencies,” as the UN High-Panel report calls them, force decision-makers to choose between the promotion of economic innovation and the provision of public health. Thanks to leading companies like GlaxoSmithKline and compassionate organizations like the Global Fund, the international community is starting to opt for the latter.

James Delegal
Photo: Flickr

Wasted Medical Supplies
The United States generates over two million tons of wasted medical supplies each year. Facilities do not use many of these supplies such as unexpired medical supplies and equipment. People even throw away completely usable, albeit expired medical supplies. This surplus exists because of hospital cleaning policies, infection prevention guidelines and changes in vendors. Additionally, because equipment must always be ready, replacements are always in order. As such, in the U.K., medical facilities replace equipment before the old versions are out of commission. Waste ranges from medicine to operating gowns, all the way to hospital beds and wheelchairs. Beyond consumables like medicine and one-time supplies like syringes, the need to replace before equipment is sub-optimal leaves a margin for waste on big-ticket items like MRIs.

Many hospitals have dumped their garbage from the reception and operating rooms along with usable medical surplus into incinerators. Although this burning is a source of many pollutants, it is still common practice in many developing countries.

This issue of medical supply waste intertwines deeply with a lack of access to medical equipment in the developing world. While developed countries live in a world of sterile excess, developing countries and remote villages with little access to suitable equipment to meet their needs suffer.

How Does this Waste Relate to Poverty?

People view access to the level of health care service in the developed world as the standard rather than a privilege. In places of poverty like Kivu, Democratic Republic of Congo, facilities are in desperate need of supplies and equipment to treat patients in their region.

Inadequate provisions leave patients on the floor or in out-of-date hospital beds paired with another patient. In the DRC, rape is a common weapon of war. The U.N. Human Rights Security Council passed a resolution that described the problem as “a tactic of war to humiliate, dominate, instill fear in, disperse and/or forcibly relocate civilian members of a community or ethnic group.” Many of the patients at the doorstep of Burhinyi Central Hospital are suffering from rape-related ailments. Some examples are HIV/AIDS, fistulas, bladder and intestinal damage and infections. Without the necessary equipment to handle such cases, impoverished areas, which are already more prone to injury and disease, deteriorate.

How Can it be Fixed?

Again, the issue of wasted medical supplies id deeply connected to poverty. In fact, they are complementary. The solution lies in moving the surplus from areas of excess to people in need. This reduces the waste in developed countries by giving supplies to hospitals that need them. Therefore, one can convert wasted medical supplies to usable surplus.

There are many NGOs like Medshare and Supplies Over Seas (SOS) that follow this process. These nonprofits operate based on collecting, sorting and sending the usable medical surplus to hospitals in need.

SOS has a container shipment program that sends cargo containers filled with medical supplies. These containers would have otherwise ended up in the landfill. A typical container contains six to eight tons. Its medical contents value conservatively at $150,000-$350,000. Since 2014, SOS has shipped containers to 20 countries in need.

A volunteer at Medshare outlined her experience working with surplus medical supplies, saying that, “It was shocking how much waste there actually was. Warehouses full of totally usable stuff all ready to be thrown away.” She added, “[she] sorted through things like syringes and gauze packets which were all put into huge containers for hospitals that need it. It feels like a difference is being made.”

Stop Wasting and Start Donating

Wasted medical supplies and impoverished areas without access to proper medical equipment are issues that people can resolve simultaneously by salvaging usable supplies and equipment that were ready to go to landfill and sending them to communities in need. Regarding medical waste and poverty, the best solutions occur when those who have more give to those who have less.

– Andrew Yang
Photo: Flickr