The Safe Delivery AppAcross the globe, thousands of women die every year as a result of complications during birth. A variety of organizations have been developing to combat these preventable deaths. The Safe Delivery app, a maternal healthcare app, provides one of these solutions. Below are four facts outlining the app’s purpose as well as its successes since its release in 2012.

4 Facts about the Safe Delivery App

  1. Maternal mortality is an issue around the world. Every year, more than 300,000 women die from causes related to pregnancy. Women typically die in pregnancy and childbirth for five main reasons: “severe bleeding, infections, unsafe abortion, hypertensive disorders, and medical complications like cardiac disease, diabetes, or HIV/AIDS.” There is also a greater chance of death for pregnant women who lack proper assistance. Unfortunately, in sub-Saharan Africa, less than 50% of women during birth have a trained midwife, nurse or doctor to help them through the process. Many instances of maternal mortality are 100% preventable when access to quality maternal care is provided.
  2. The Safe Delivery App educates. The University of Copenhagen, the University of Southern Denmark and the Maternity Foundation launched the app to provide skills and to assess knowledge of those assisting with births in remote areas of developing nations. The app consists of 12 modules that address numerous childbirth emergencies and the appropriate preventative procedures for each. It uses “animated instruction videos, action cards, drug lists, practical procedures, and an individualized e-learning component, MyLearning,” to guide healthcare workers. The Safe Delivery app also works offline so healthcare workers can access the modules in any place, at any time.
  3. The app’s creators collaborate. Some key partners include The Bill and Melinda Gates Foundation, Jhpiego, the Danish Emergency Relief Fund and MSD for Mothers. The app’s creators have teamed up to prep for launching the app in even more countries. For instance, Merck for Mothers is working with the Maternity Foundation to incorporate user feedback into the app’s design. They are also collecting user data through case studies and stories to help improve the app’s adoption in other countries. Additionally, the creators of the Safe Delivery App partnered with the United Nations Population Fund (UNFPA) to study the effectiveness of the app; for the study, the app trained 58 birth attendants across four different regions. After collecting feedback, the UNFPA found there was an “association between high user engagement and improvements in the health workers knowledge and competencies when handling childbirth emergencies.”
  4. The Safe Delivery app is succeeding and improving. The Safe Delivery app boasts over 17,000 downloads in 44 low- and middle-income countries. In 2019, the top five countries were Ethiopia, Sierra Leone, Ghana, Somalia and Togo. Also in 2019, a total of 10,418 users actively used the quiz functions. According to research conducted by Merck for Mothers, “Workers’ skills in handling complications increased by more than 100%” after using the app for 12 months. In 2017, a Hindi version of the app launched for users in India; this drastically increased healthcare workers’ skill sets in the region. The Maternity Foundation has also released multiple case studies that show the positive impact of the Safe Delivery app. For example, the Maternity Foundation tracked the app usage of 62 health workers across eight facilities in Congo. According to the Maternity Foundation, “The study showed a significant increase in the healthcare workers’ knowledge and confidence when handling post-partum hemorrhage and neonatal resuscitation.”

Since the launch of this maternal healthcare app, researchers have seen great improvements in healthcare knowledge. While maternal mortality is still an issue around the world, innovations like the Safe Delivery app can eradicate the dangers of childbirth.

Sara Holm
Photo: Flickr

Healthcare in MonacoWith nearly 40,000 people, Monaco is one of five European micro-states and is located on the northern coast of the Mediterranean Sea. According to the Organisation for Economic Co-operation and Development (OECD), Monaco has one of the best global healthcare schemes. The World Health Organization established that an individual born in 2003 can expect to have, on average, the longest lifespan in Europe. The country also has the third-highest proportion of doctors for its population in Europe.

Healthcare Education in Monaco

Leaders in Monaco believe that prevention and screening are essential to maintaining health and it is customary for young people to access comprehensive health education. This education aims to promote high-quality lifestyles and prevent early-risk behavior, such as tobacco use, drug addictions and sexually transmitted diseases.

Caisses Sociales de Monaco (CSM)

The Caisses Sociales de Monaco (CSM) is the official agency responsible for supervising Monaco’s public health service. Public healthcare automatically covers all citizens and long-term residents who contribute to the agency. French and Italian citizens may also access public health facilities in Monaco upon evidence of regular contributions to their home country’s state healthcare scheme. Foreign visitors can receive health treatment at all public hospitals and clinics. However, without state insurance contributions, travelers and expatriates will be forced to pay for all healthcare expenses accrued from treatment.

Public Healthcare Coverage

Public healthcare insurance operates through reimbursements, so an individual who plans on using coverage provided by the CSM will be required to make up-front payments and then claim costs back. After joining the public healthcare system, an individual receives a card that provides access to medical and dental care. The card contains administrative information necessary to refund medical care.

The public healthcare system provides coverage for inpatient and outpatient hospitalization, prescribed medications, treatment by specialists, pregnancy and childbirth and rehabilitation. Some prescription drugs are also reimbursed through the CSM and emergency care is available to everyone at Princess Grace Hospital, one of three public hospitals. The hospital will be reconstructed to strengthen the complementary nature of all the hospitals in Monoco.

Out-of-Pocket Healthcare Costs

Out-of-pocket healthcare costs in Monaco are high and if the CSM fails to provide sufficient coverage, an individual may supplement with private insurance. Private health insurance is a tool for individuals who want to cover medical services and fees not paid for by the public healthcare system. Doctors fund privately-paid equipment and staff through private contributions. According to an article from Hello Monaco, most Monaco citizens take out extra private insurance to cover ancillary services and unpaid rates.

A Commendable Healthcare System in Monaco

Every resident in Monaco is eligible for public health insurance but private health insurance remains an option for those interested in more coverage. Healthcare in Monaco earned outstanding reviews from the OECD and officials continue to seek improvements by reconstructing medical buildings and providing health education for young people.

– Rachel Durling
Photo: Flickr

India's AIDS EpidemicIndia is the most populous country on the planet and one of the most densely populated countries. With over 1.38 billion densely packed people, diseases spread quickly and HIV/AIDS is no exception. Although only 0.2% of adults have HIV/AIDS, this equates to roughly 2.4 million people, a total far higher than any other country in Asia. For this reason, many new programs have started. Although their tactics differ, each program works to fight India’s AIDS epidemic.

Causes of the Epidemic

The causes of India’s HIV Epidemic stem from multiple, diverse issues. Two primary causes include the practice of unprotected sex between sex workers and the injection of drugs using infected needles. These two practices are most common among vulnerable populations such as low-income communities. Thus, India’s AIDS epidemic is centered in select regions; although only a small percentage of the total population has HIV, this number is high in certain regions, and extra precautions are necessary for prevention in these areas.

Despite these overwhelming statistical figures, recent research has provided optimistic results. The number of HIV infections per year decreased by 57% between 2000 and 2011, and the annual deaths from AIDS decreased by 29% from 2007 to 2011. Bold government programs inspired by independent research instilled this change within the Indian population. The programs’ success stems from a variety of HIV treatments and from education, challenging the stigma and misconceptions about the disease.

Methods of Success

One of India’s renowned HIV treatment methods is the Antiretroviral Therapy program, known as ART. ART is the provision of supplements and antiviral drugs for citizens infected with HIV. In 2004, the Indian government sponsored the program, striving to place 100,000 infected Indians on the program by 2007. This program likely played a major role in the steep decline in HIV-related deaths from 2007-2011.

Noticing the success of the ART initiative, the Indian government took a further step in 2017 by initiating the World Health Organization’s Treat All policy; this policy focuses on making the ART program accessible to all disadvantaged Indians. The Treat All policy increased the number of new monthly joiners by several hundred.

Along with these programs, the Indian government has sponsored adolescent education programs centered on preventing the spread of HIV; they aim to end the negative stigma towards the disease and those infected. These programs also provide basic sex education. Studies on these programs have shown extraordinary results; samples of students understand essential facts about the disease such as how it spreads and the current lack of a cure. Although direct government intervention is vital, ending India’s AIDS epidemic starts with educating the youth.

Plans for the Future

With such a large number of people carrying the disease, managing HIV in India is no small task. Although the aforementioned methods have shown optimistic results, the involvement of local communities, governments, and NGOs is essential to maintaining the trend. When discussing diseases such as HIV, the intervention of international bodies cannot maintain the health of individual citizens; ending India’s AIDS epidemic is ultimately the responsibility of Indians, and these new programs enable them to do so.

Joe Clark
Photo: Flickr

Smart Card IndiaIn South Asia, by the Bay of Bengal and the Arabian Sea lies the second most populous country in the world, India. The country remains in poverty despite decades of work by development programs. However, one program that has proven effective is the Smart Card India initiative. A Smartcard is a plastic card with a built-in microprocessor, used for many purposes such as financial transactions and personal identification.

The Indian government uses Smartcards to aid people living below the poverty line. In Tamil Nadu, a rural region, impoverished people use Smartcards to take advantage of medical facilities and to find improved healthcare. In Bhubaneswar, Kerala, and Amritsar farmers use Smartcards to take out bank loans. Meanwhile, in New Delhi, the cards were used for parking, school administration and metro travel through cities including Mumbai, Bangalore, and Kolkata.

Overcoming Barriers

Overall, India’s state-sponsored welfare programs are inefficient; only 15% of investments in social programs reach the people in need. This corruption overburdens state finances and lowers the prospective influence of government programs. Shifting benefits using payment systems that incorporate biometric authentication to substantiate recipients’ identities can help in spreading awareness on the matter. Inviolable electronic transfers in India can lower dealings costs and financial outflows.

Innovative wages technologies such as Smartcards can improve corrupt and lagging public welfare programs. These programs have not fully utilized the Smart Card India initiative. Nevertheless, there was an increase in payment speed and a decrease in corruption with the implementation of the initiative. Additionally, Smartcards are inexpensive, and beneficiaries tend to like them.

While there are many benefits to the Smartcard system, there are also some drawbacks. The transition to electronic payments burdens those who opt-out of the Smartcard program. Similarly, program users may misplace their cards or experience technical difficulties.

Smartcard Case Study

In southeast India, the Andhra Pradesh government use Smartcards to distribute welfare. The government planned to use Smartcards for a variety of initiatives; however, they have focused on two social welfare enterprises. The Social Security Pensions (SSP) provides monthly allowances to the disabled and elderly, and the Mahatma Gandhi National Rural Employment Scheme (NREGS) ensures rural households a hundred days of paid employment every year.

The time it took NREGS beneficiaries to collect payments plunged from 112 minutes to 21 minutes. The new Smartcard system also lowered the delay between receiving payment and working on an NREGS project from 34 days to seven days. Welfare recipients of NREGS in Smartcard system locations received weekly earnings that went from 146 rupees to 181 rupees. There was no crucial influence on the quantity the government spent on NREGS, which meant there was a depletion of leakages. The benefits from the SSP remained fixed, however, there was a 47% reduction in bribes for payment. Satisfaction with the new payment system was assured with 91% of SSP beneficiaries and 84% of NREGS beneficiaries finding it advantageous.

Additional Benefits

The Smartcard system is cost-efficient: management of the payment system costs the government $4 million. However, savings counterbalance this cost. Through the NREGS, there was a profit of beneficiary time savings of $4.5 million. Additionally, the Smartcard system diminished leakage from the SSP by $3.2 million per year, which is greater than the price of the project. The leakage minimizations symbolize redistributions from corrupt officials to recipients.

This program is designed to improve the lives of the needy by creating a quicker and honest payment process. The Smart Card India initiative has lowered transaction time, decreased leakages, and augmented beneficiary gratification. Hopefully, innovative technology will continue to improve future welfare programs with the Smartcard program leading the way.

– Shalman Ahmed
Photo: Flickr

Sickle Cell Anemia in Sub-Saharan AfricaThere are a total of 46 countries that compose sub-Saharan Africa. These countries account for 75% of the total cases of sickle cell anemia. Due to the high concentration of this disease in one area of the globe, high rates of early mortality have devastated sub-Saharan Africa. Researchers estimate that 50-90% of infants born with the disorder will die by the age of 5. In response, methodologies have been developed in hopes of eradicating sickle cell anemia in sub-Saharan Africa.

Early Screening

It is crucial to provide screening for newborns in order to diagnose children with sickle cell anemia as early as possible. Early detection of the disease is proven to increase survival rates. In under-resourced communities, many children have died without ever being diagnosed. Early detection allows for the initiation of treatments, therapies, physician follow-ups and medical attention. Previously, diagnoses of patients happened through isoelectric focusing and liquid chromatography, but they have shown to be inaccurate and expensive. Now, there are “point-of-care” diagnostic methods available that are affordable and provide accurate results.

Vaccinations

A consequence of sickle cell disease (SCD) is an exponential increase in the transmission of bacterial infections. The main vaccination that has resulted in improvement for patients with sickle cell disease is penicillin prophylaxis. With the increased availability of penicillin and medical monitoring, mortality rates for patients with sickle cell anemia in sub-Saharan Africa will significantly decrease.

Treatment Therapies

Once diagnosed, there are numerous preventive and therapeutic measurements that can alleviate the symptoms of SCD. Data collected through years of research have proven that hydroxyurea is the most effective therapy for patients with SCD. In addition, proper hydration and nutritious supplements are key to curing non-critical patients. The most critical patients receive blood transfusions. Lastly, stem cell transplantations provide great improvements in SCD patients; however, its high cost often prevents utilization of this method.

Health Education

A simple method to increase the life expectancy of SCD patients is to provide accurate and useful information about the disease. Parents well-informed on this condition can properly identify symptoms their children display and can seek immediate medical attention. This leads to early detection so their child can receive necessary medications, therapies, vaccinations and treatments.

Global Advocacy

In recent years, more institutions have recognized the prevalence of sickle cell anemia in African and have shifted their focus to aiding those countries. The U.S. National Institutes of Health and the Gates Foundation created joint efforts in order to cultivate gene-based cures for both sickle cell disease and HIV.

The National Heart, Lung, and Blood Institute (NHLBI) and American Society of Hematology announced one of their priorities is to support the impoverished, disadvantaged countries across Africa in regard to sickle cell anemia. Also, the NHLBI Small Business Innovation research grant allowed for the utilization of the affordable, precise “point-of-care” diagnostic methods for SCD patients. Further advocacy for underprivileged, poor families is necessary to continue the fight in reducing sickle cell anemia in sub-Saharan Africa.

Despite its challenges, Africa has made major strides in improving sickle cell anemia in the last forty years. Continuing to utilize these methods would not only save vulnerable children, but their economy would flourish as well. A higher life expectancy has a direct correlation with an increase in projected lifetime incomes. This would result in more people contributing to their country’s economy and mobilizing their personal socioeconomic statuses. It is vital to take the above approaches to support patients with sickle cell anemia in sub-Saharan Africa.

Bolorzul Dorjsuren
Photo: Flickr

Innovations in the PhilippinesOver the past decade, there have been drastic innovations in the Philippines. The country has experienced dramatic economic growth and development. In 2019, the Global Innovation Index (GII) found that the country improved on all metrics used to calculate advancement.

Economic Growth

In 2019, the Philippines appeared for the first time in the “innovation achievers group.” The country outperformed many other countries in the area.  Some of the metrics used to calculate these scores included increased levels of creative exports, trademarks, high-tech imports and employed, highly educated women.

As a country, the Philippines has risen 19 spots in the ranking since 2018, to 54th out of 129 participating countries. This indicates a significant increase in the standard of living for many Filipinos. This is apparent in the significant decrease in the poverty rate over the past few years. From 2015 to 2018, the national poverty rate dropped a total of 6.7%, or by 5.9 million people.

Prosperity is largely due to the success of local business owners and entrepreneurs. They have used their influence and prosperity to help those in need in their communities and countries, especially in the health sector. Coincidingly, there was a significant increase in global trade. Both factors have propelled the Philippines into the global economy as an important emerging market to keep an eye on.

Global Benefits

In 2018, the Philippines and the United States trade relationship developed significantly. The total goods trade was $21.4 billion collectively, in the petroleum and coal, aerospace and computer software, motor vehicles and travel/hospitality sectors. This is beneficial to the U.S. because international trade employs over 39.8 million Americans. As the Philippines becomes more prosperous, more Filipinos are able to pour money and resources into helping marginalized communities across the country. As such, there has been an increase in innovations in the Philippines, notably in the health and medical sectors.

RxBox

A distinct industry on the frontlines of innovations in the Philippines is the health sector. Increased health for a population is directly related to better access to opportunity and a higher standard of living overall. One company doing this important work in the Philippines is RxBox.

RxBox was developed by the country’s Department of Science and Technology. It is a biomedical telehealth system that provides health care and diagnoses to people in communities that are remote, difficult to access. The service is additionally available for people who do not have access or the ability to travel for health care.

It is a game-changer for disadvantaged people who would otherwise not be able to get fast, effective medical care. RxBox reduces costly hospital and medical visits, which facilitates better health for people. Communities are then better able to care for themselves and for their families, providing greater opportunities for everybody.

Biotek M

There is another player in the innovations in the Philippines: Biotek M. It is a revolutionary diagnostic kit for Dengue. A local team at the University of the Philippines-Diliman were the creators of this new technology.

Traditionally, the Polymerase Chain Reaction (PCR) test is used to confirm the disease but can cost up to $8,000 and takes 24 hours to get results. That is inaccessible to lower-income people who are oftentimes the demographic most commonly afflicted by the dengue infection. The kit helps reduce resource usage for both medical centers and patients by making the diagnosis process significantly more streamlined.

In 2017, 131,827 cases of Dengue were recorded with 732 deaths, mostly affecting young children aged 5 to 9-years-old. Being able to quickly diagnose and treat people who contract this illness makes a huge impact on people living in poverty.

When people spend less time, energy and money on being healthy, they are able to use their resources more efficiently. In this way, medical innovations in Philippines and a growing economy directly increased the standard of living for people living in poverty within the country.

Noelle Nelson
Photo: Flickr

Anti-Global Poverty Policies
Oftentimes, when one thinks of ending global hunger and poverty, raising and donating money comes to mind. However, analysis of anti-global poverty policies and programs has shown that ending global poverty is so much more than just giving money to individuals and communities. As much as money is important to the creation and implementation of effective programs, giving money directly to the poor is not always the best way to lift people out of poverty in the long term. Rather, it is important not only to invest in the programs that actually work well but also to invest in analysis of ongoing programs to recognize those who do have a positive impact. Moreover, pre-existing programs must constantly undergo updates and improvements as more education emerges about the populations they serve.

In reality, poverty is a much more complicated issue than just a lack of money and thus it requires a more elaborate solution than just pledging cash. Successful anti-poverty programs usually target social infrastructures such as access to health care, education and financial resources. Additionally, anti-poverty policies aim to help citizens not fall prey to exploitation and poor financial decisions. However, in the end, these programs are not successful unless they receive proper implementation and maintenance.

The Problem with Some Anti-Global Poverty Policies

The Borgen Project spoke with Dr. Gabriela Salvador, the Regional Director of Latin America and the Caribbean at AmeriCares; a health-focused poverty and disaster relief organization. Dr. Salvador argues that anti-global poverty policies fail because of a lack of understanding of the problems of individuals living in poverty, as well as a lack of proper implementation of such policies. Her emphasis on understanding the needs of the individual and their living situation stems from her firsthand experience with impoverished communities.

Salvador began her career as a pediatric eye surgeon in Mexico but soon realized that she was only scratching the tip of the iceberg with her work. She believed that it was too late for most of the serious cases and a lot of them could have experienced prevention to begin with. The lack of access to health care systems in impoverished communities blocked people from getting proper care in the first place, and thus, the cases she faced were much worse than they could have been.

Being one person alone, Salvador felt that she could make more of a difference by implementing programs to strengthen weak health care systems and provide relief to struggling communities. She returned to school to study global health and business to learn how to create effective and creative financial solutions to complicated health issues. With over five years of experience working in Latin America designing financially responsible health delivery programs, Salvador now creates and heads a wide variety of programs that include direct provision of services and emergency relief for natural and humanitarian crises.

Collaborating with Communities

Salvador believes that when stripped of religion and culture, the issues facing impoverished individuals are essentially the same globally. Salvador explains that although many programs have the best interest of their target community at heart, they often fail to recognize the barriers that prevent individuals from participating in them. For example, if a sexual health testing and medicine distribution clinic exists in an impoverished community, women may not utilize its resources because they have competing priorities such as child and elderly care, domestic abuse, lack of transportation and other domestic responsibilities. Additionally, Salvador explains that the programs that people launch and leave to work without experiencing proper integration into the local infrastructure of the community do not turn out to be very effective.

She finds that the most effective programs are those that emerge when local officials and professionals collaborate with international aid to understand how to overcome the barriers of individuals in the area. When approaching a new problem, Salvador explains that she first asks the client who the patients are and what their priorities are so that she can best tailor a treatment solution to them. Her goals in targeting global health issues are to generate pragmatic solutions that create direct benefit and resiliency in communities.

The Challenges of Implementing Anti-Poverty Programs

The implementation challenge of anti-poverty programs is clearly one of the biggest reasons why fighting global poverty is such a difficult issue. Connecting with impoverished individuals and identifying their barriers is difficult because of the lack of access to information about specific populations and the abundant funding it takes to collect that information. There is also the issue of choosing who gets the benefit of certain programs; incredibly tough decisions that Salvador cites as perhaps the hardest part of her job. Yet, there is still a way to try and understand the plight of impoverished individuals through human experience.

Salvador emphasizes empathy and an understanding of her privileges as key components of her job. She believes that people need to “roll up their sleeves” and do the work themselves since many are prone to entitlement.

In a 2018 study of Challenges to Global Development Education, researchers Buchanan and Varadharajan underlined the importance of community engagement and individual agency as well. The study also advised strategies that implement drawing attention to understanding the misinformation and closed-mindedness around social and political conditions of impoverished communities. Similar to Salvador, the study suggests creating partnerships between organizations and local communities as well as providing resources to create resilience as an effective way to alleviate poverty issues.

Concluding Thoughts

In the end, people must make an effort to understand more about creating and implementing effective solutions to fight global poverty. However, it is clear that no matter how well designed anti-poverty programs are, they cannot be truly effective unless the communities they are targeting are engaged in their creation and implementation processes.

Data collection and the continued monitoring and analysis of current anti-global poverty policies and programs are impertinent to the future understanding and implementation of successful programs as well. As Dr. Salvador stresses, it is important to remember that impoverished communities contain individuals who have unique problems and issues that may be difficult to understand and relate to. Open-mindedness and a willingness to empathize with and learn about diverse populations is key to creating effective anti-poverty programs. At this time, Salvador continues to combat the COVID-19 stigma and prioritize resiliency and relief as she mitigates the effects of the global downturn of the economy and health care systems due to the pandemic.

– Giulia Silver
Photo: Flickr

Healthcare in Thailand
Thailand is a country of hundreds of islands in Southeast Asia with a population of nearly 70 million people. Thailand has a history of political instability and economic uncertainty along with rising poverty rates. However, the country has made great strides to improve its healthcare. Nearly 7 million of Thailand’s citizens live in poverty and a wealthy few control a large majority of the country’s wealth. With one of the most extreme wealth gaps in the world, universal healthcare in Thailand creates a meaningful movement toward equality for all its citizens.

Switching to Universal Health Coverage (UHC)

In 2002, Thailand made the transition from a combination of various healthcare policies to an all-encompassing, universal health coverage (UHC) system. Under the UHC system, every Thai citizen is entitled to health services — including preventative, curative and palliative care, at any age. Under this system, financial protection for high-cost services also improved.

Challenges in Financing the UHC System

Though universal health coverage in Thailand has allowed increased access for all ages and classes of citizens, the country still faces challenges with funding the program. The UHC system is a predominantly publicly funded program, meaning that it functions mainly through taxation. Because the nearly 7 million Thai citizens live no more than 20% above the poverty line, the UHC budget coming from taxes is relatively inflexible. Therefore, funding the growing demands for healthcare in Thailand often requires reaching into other public funds.

Access to preventative medicine has decreased the rates of many illnesses by keeping them from occurring in the first place. However, medical expenses in other categories are on the rise. As the average age of the population increases, healthcare in Thailand faces an influx in elderly patients needing more care. Unsafe road conditions and unenforced traffic laws in many regions also contribute to high rates of road accidents and result in excessive trauma cases. Also, air pollution in cities and extreme weather conditions in various regions across the many islands contribute to increased utilization of the UHC system. For the UHC system to be an equitable, effective and sustainable service for the country, other avenues of funding must be explored.

Challenges and Looking Ahead

Healthcare in Thailand has had many positive improvements since the national transition to universal coverage in 2001. Yet, like any system, it often faces continued challenges. The system is considered popular among lower-paid citizens that did not previously have access to care. Albeit, higher-income communities hold some distaste for the system due to increased access leading to more crowding in hospitals. Universal healthcare in Thailand has created a much more inclusive environment for the Thai people as it helps to bridge the immense wealth gap. A gap between the nearly 7 million living in poverty and the wealthy 1%.

Positive Impact of the UHC System

This alteration of the previous healthcare system has led to an increase in the utilization of health services and decreased the prevalence of unmet needs in the country. Overall, healthcare in Thailand is improving. Not only did rates of care increase with the introduction of the UHC system, but other metrics of improving healthcare also rose.

Life expectancy from birth rose from 71.8 years before the introduction of the UHC system, to 77.2 years in 2020. Infant mortality rates similarly fell from more than 100 per 1,000 births in 1970 to 7 per 1,000 births in 2020. As citizens have been able to access preventative care and more expensive intervention at lower personal cost, out-of-pocket spending on healthcare needs have decreased. Meanwhile, household savings increased. Though the switch to universal healthcare certainly faces challenges, it has created quantifiable positive change for millions living in Thailand.

Jazmin Johnson 
Photo: Unsplash

Health Care in India
India, the second-most populous country in the world, faces a surprising paradox in its health care system. Though it has become a hub for high-quality medical treatment at supposedly affordable costs, health-related expenses cause as many as 63 million people in India to fall into poverty annually. As a result, it is essential that the country makes improvements to health care in India in order to improve its accessibility to those in poverty.

Fixing a Faulty Health Care System

As of 2015, prime minister Narendra Modi proposed the National Health Policy (NHP) to provide universal health care in India, regardless of socioeconomic status. This new policy also guarantees free public health care for those living below the poverty line.

This policy suggests an ambitious reform. Private practitioners continue to dominate India’s health care market. In fact, the private sector provides approximately 70% of health care.

Many more barriers come with delivering a new and improved health care program. With a severe shortage of medical professionals, financing issues and the public’s general lack of trust in the country’s ability to implement effective health care resources, India faces a problem in reforming its health care system.

This has presented a problem for citizens and the government alike. The government wastes expenditures on underutilized resources. Meanwhile, the private sector could include illegally trained doctors and possible medical malpractice, which may entail dangerous treatment and unnecessary expenditures for citizens. The prevalence of private health care partnered with poor insurance regulations results in up to 70% of medical costs from out-of-pocket expenditures, which exacerbates the economic stresses that the nation’s poor feels.

Lack of Public Trust

The driving force behind the underutilization of health care in India is public mistrust. People typically seek help from village doctors first, who are typically closer in proximity to their homes. Many citizens are also wary of poor service in public systems: many patients experience disrespect or the public systems overcharge them for various medical expenses and treatments.

Many citizens hesitate to turn to public hospitals until it is their last resort. There are cases of individuals earning less than INR 10 per day who would seek private care facilities rather than obtain government-granted medical care.

Cases like these are some in a pool of many. There are cases of mothers waiting hours before receiving help in labor, or individuals struggling to pay for necessary medications.

The expensive price tag of private practitioners makes quality care essentially inaccessible to those living in poverty. The prevalence of many low-income individuals desperate to pay high price tags for private care as opposed to visiting free, government-funded institutions presents a clear exclamation: health care in India experience reform to prioritize the trusts and needs of its residents.

Addressing the Problem

As low-income individuals face difficulty in obtaining quality health care, a number of organizations that readily seek to help continuously emerge.

HelpAge India has been around for multiple decades and has earned multiple accolades (NGO Leadership & Excellence Award, Times Social Impact Award, etc.) for its continued support of elderly populations in India. This NGO provides free medical care (cataract surgeries, cancer care, etc.) that would otherwise be unaffordable to many individuals in India.

The Smile Foundation has also focused on providing equitable medical care, especially to underprivileged families. The Smile Foundation provides easier access to health care in slums and lower-income communities and also promotes health care awareness within these communities.

The Rural Health Care Foundation also provides health care to low-income communities all across India. It provides primary care diagnoses, medications and cataract/cleft lip surgeries for those who are unable to pay for these procedures.

These organizations are a few of many seeking to improve systems of health care in India. The implementation of a new and improved health care system is ongoing. However, a combination of both newfound public optimism and institutional change is necessary to ensure health care access to everyone.

– Vanna Figueroa
Photo: Flickr

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