Mental Health in NigeriaNigeria, Africa’s most populated country, is having a mental health crisis. Many developing nations fall prey to mental health traps, and this West African country is no different. Developing nations spend too little, if any, resources on mental healthcare, and their nation’s population suffers because of it. Healthcare in Nigeria, especially for those with mental health issues, is poorly managed, underfunded and outdated. Here are five facts about mental health in Nigeria.

Five Facts about Mental Health in Nigeria

  1. With a population of 181 million, it is estimated that as much as 30 percent of the population suffers from a mental illness. This means that more than 54 million people are dealing with mental illness with little to no help. In comparison, the Center for Disease Control estimates that 54 million is the same number of people who are diagnosed with arthritis in the United States.
  2. In Nigeria, fewer than 10 percent of those battling mental illness have access to mental healthcare. Access is mainly limited to cities, leaving the rural areas without resources for psychiatric care. Since half of the population of Nigeria live in rural areas, those people do not have access to mental healthcare. Those people are turning to self-medication, self-diagnosis and misunderstanding or denial of their symptoms. Many of those without help are children and adolescents.
  3. There has not been an update to the laws regarding mental health in Nigeria since 1958. These laws are outdated and contradict decades of mental health research. This is how it is possible for the Nigerian government to spend only 4 percent of its annual budget on healthcare.
  4. Depression is the most common illness that affects mental health. In a global survey, Nigeria ranked 15 in the number of suicides per year. In another survey, Nigeria was ranked the most depressed country in Africa. Despite the government’s inability to manage mental health in Nigeria, there is hope.
  5. MANI, or the Mentally Aware Nigeria Initiative, is the largest and most successful NGO fighting mental illness in Nigeria. This group focuses on ending the negative stigma surrounding mental health in order to increase the demand and the resources for psychiatric care. MANI has been successful since its inception in 2016 by using the internet and social media to spread awareness as well as providing a suicide and distress hotline.

MANI has grown its following from 500 to more than 20,000 Nigerians, spreading the word across the country about the free mental health services that it offers. MANI is providing an important resource for mental health in Nigeria, but until NGOs like MANI gain more traction, those struggling with a mental illness will continue to find a lack of support and continued opposition to changing laws surround mental healthcare.

Kathryn Moffet
Photo: Flickr

health care system in Senegal
The health care system in Senegal is focusing its reforms on expanding the range of health services offered. For example, increasing access to traditionally underserved populations and introducing social protection measures.

Health Care Sections and Structure

Both private and public health sectors exist in Senegal. Employees receive coverage from the IPM (Institut de Prévoyance Maladie) Health Fund, a public health care system in Senegal. In fact, employers have the responsibility of providing health care to employees.

However, employees must contribute to the workplace for at least two months before receiving coverage. Some services of these health care systems in Senegal include partial coverage of pharmaceutical and hospital costs, primary care, vaccinations and emergency treatment.

The public health care system in Senegal includes a Social Security department, but the responsibility of health care and employment are not inclusive. Therefore, if an individual is not employed but wants to receive public healthcare services, they have the option to use Welfare services, which covers primary care. On the other hand, private health services are also available for those unemployed, not receiving health care services.

Addressing Access to Health Care Services

While the health care system in Senegal is improving, there is still a lack of effort to address health disparities within the population. As a result, only 32 percent of rural households have access to regular health care.

Many organizations are working to provide aid ensuring wider access to health care in Senegal. For example, Health Systems Strengthening, a program stemming from USAID, is working to establish a performance-based financing project in six regions in Senegal. Additionally, it is working to provide services to three-quarters of the population.

The Role of International Aid

The Centers for Disease Control and Prevention (CDC) is also providing health care services in Senegal. Their initial focus is on providing medical services for HIV/AIDS through the HIV sentinel surveillance program. Widening their goals for the health  care system in Senegal is due to the U.S. President’s Malaria Initiative of 2006 and the U.S. President’s Emergency Plan for AIDS Relief of 2010.

Work in Senegal

In 2015, the Global Health Security Agenda, in partnership with the CDC was able to establish an office in Senegal. Through this, there has been additional development of networks and partnerships. For example, the CDC is now working with the World Health Organization and the Ministry of Health and Social Action.

Furthermore, IntraHealth is an organization working in Senegal for over a decade. Their goal is to help increase services for family planning and education about Malaria. So far, training has been provided for more than 1,000 workers. These workers specialize in family planning services. On a broader scale, 15,000 home visits throughout Senegal have. been conducted; Ultimately, to raise awareness about Malaria.

Overall, groups, such as USAID and the CDC are working with the government to address the health care system in Senegal. In partnership, there are increasing quantities of awareness and involvement.

– Claire Bryan
Photo: Flickr

HIV/AIDS in Zambia
Zambia is a tropical country in southern Africa with a population of approximately 16,445,079 people. It has a rich history of copper production and is one of the world’s fastest-growing economies. However, HIV/AIDS has become prevalent throughout Zambia and is a large contributing factor to the country’s low life expectancy, which currently ranks second to last in a global comparison.

HIV, or the human immunodeficiency virus, attacks a person’s immune system by destroying white blood cells that fight disease and infection. Though there is no cure for HIV, people can control it successfully. Without proper medical care, the infection can lead to AIDS, which is the most severe phase of HIV infection.

The Current State of the HIV/AIDS Epidemic in Zambia

Heterosexual intercourse is what mainly drives Zambia’s HIV/AIDS epidemic. HIV/AIDS particularly affects adolescent women compared to other age groups in Zambia. In fact, according to data collected by UNAIDS, one million women between the ages of 10 and 19 were living with HIV in 2017, while only 770,000 of their male counterparts had the same prognosis.

This discrepancy is due in part to the many societal issues that permeate throughout the lives of Zambian women. Younger Zambian women are more likely to have an older partner already infected with HIV. Additionally, many Zambian women are not in charge of their own reproductive health or education.

In fact, only 56 percent of Zambian women are literate. Meanwhile, the country only has a contraceptive prevalence rate of 49 percent. Both issues decrease a Zambian woman’s ability for education on the matter, as well as the ability to prevent pregnancy and the eventual exposure of HIV to a fetus in the womb.

Other marginalized Zambian groups disproportionately affected by HIV/AIDS are children, sex workers and prisoners. According to UNAIDS, an estimated 8,900 children were newly infected with HIV in 2016 due to perinatal transmission. Perinatal transmission refers to when a mother passes HIV to her child during pregnancy, labor or breastfeeding. Meanwhile, sex workers and prisoners had HIV prevalence rates of 56.4 percent and 27.4 percent respectively.

The Future of HIV/AIDS in Zambia

Zambia is currently taking steps towards decreasing the prevalence of HIV/AIDS in the country. The first step has to do with prevention and education. According to the 2014 Zambia Country Report, the country’s provision of free condoms nearly doubled from 7.8 million to 19.6 million.

Additionally, according to the National AIDS Strategic Framework (NASF), comprehensive sex education will become a larger focus for adolescent Zambians within forthcoming years. Furthermore, several HIV prevention programs are active in Zambia and focus on empowering the country’s most susceptible population — young and adolescent women. Zambia is one of 10 countries that takes part in the DREAMS initiative, which strives to reduce new infections among women by addressing structural inequalities and gender norms.

Though Zambia has recently scaled up its efforts to fight HIV/AIDS, it needs to do more to effect real change. Zambia’s domestic spending on HIV/AIDS only takes four percent of the overall budget, despite having risen drastically within the past few years. Even if Zambia were to spend this portion of the budget on providing ART, testing facilities and eMTCT services, a real societal change would not occur unless communication in Zambia health care systems increases. Zambia must see to the general population being educated about adhering to treatment, getting tested regularly and exercising effective prevention techniques.

There is much room for improvement when it comes to fighting HIV/AIDS in Zambia. However, by increasing access to education and focusing upon marginalized groups — such as young women — the prevalence of this infection in Zambia will drastically decrease.

– Shreya Gaddipati
Photo: Flickr

Top Ten Facts About Living in Croatia
Nestled between Bosnia, Herzegovina and Slovenia, Croatia is a small country in Eastern Europe with an extensive history. Once a part of Yugoslavia, Croatia officially declared its independence in 1991 and became a fully developed country in 1998. Despite the country’s tumultuous beginnings as an independent nation, it has established itself fairly well as a developed nation. Keep reading to learn about the top 10 facts about living conditions in Croatia.

Top 10 Facts About Living Conditions in Croatia

  1. Ninety-nine percent of children attend primary school, which is split into two stages: grades one to four and grades five to eight. After primary school, children receive the option of stopping school or obtaining a secondary education. There are three options for secondary education in Croatia including grammar schools, vocational schools and art schools. After completing any of these options and receiving a Certificate of Education, students may enroll in a university.
  2. Croatia requires people to have a public health insurance plan as of 2002 which is funded via tax collections. While the quality of medical care in Croatia is good, the country is facing a financial problem due to low fertility rates in relation to the older population. To help combat this burden, doctor’s appointments, hospital visits and prescription medications require co-payments.
  3. Taking the bus is the most efficient way to travel in Croatia. The railways are not up-to-date and run slowly, whereas the bus systems are well-developed and fairly priced. Other travel options throughout Croatia include flights, coastal ferries and of course, driving.
  4. A portion of Croatia’s population (24.4 percent) is obese, ranking the country 59th in the world for obesity rates. The large reliance on transportation to get around the country may be a cause.
  5. Up until the 1990s, Croatia’s population was steadily increasing. In the 1990s, however, the population underwent a significant demise in population growth due to displacement from war, emigration to countries like the United States, Australia and Canada and increased deaths. As of 2018, 40 percent of the Croatian population is between the ages of 25 and 54, which places stress on both the majority population of older citizens and the minority population of younger citizens.
  6. Formerly a communist state up until 1990, Croatia’s economy has shifted to market-oriented capitalism. This shift was not easy due to the lasting effects of war in the country, leading to high unemployment rates lasting into the 21st century. Additionally, Croatia’s war-torn past has allowed the country to sustain an informal economy and has led to the emergence of a black market.
  7. Unemployment is prevalent among young Croatian citizens in particular, with 27.4 percent of people between the ages of 15 and 24, and 12.4 percent of the total population living without work. However, the government’s economic reform plan — scheduled for implementation beginning in 2019 — may lead to more job opportunities.
  8. Croatia largely depends on its imports in terms of resources and power. It uses up more oil and gas than it can produce, and while it has enough rivers to potentially use hydroelectric power, Croatia receives the vast majority of its electricity as imports. Croatia has begun efforts to implement the use of liquefied natural gas by early 2020, planning to redistribute this LNG throughout southeast Europe.
  9. Croatia had no organized armed forces when the country declared its independence in 1991 but subsequently formed an army, a navy and an air force. The country is not very militaristic and relies mostly on the North Atlantic Treaty Organization (NATO) for national security after joining the Treaty in 2009.
  10. Croatia is not a significant haven for refugees, though refugees do use it as a transit country. Between 2015 and 2019, roughly 672,418 refugees and migrants passed through Croatia. However, as of June 2018, the country only had about 340 asylum seekers actually residing in Croatia.

These top 10 facts about living conditions in Croatia make it clear that despite progress, the country still has work to improve the quality of life for its inhabitants.

– Emi Cormier
Photo: Flickr

Women’s Health care in CambodiaThe Southeast Asian nation of Cambodia is currently experiencing its worst in maternal mortality rates. In Cambodia, maternal-related complications are the leading cause of death in women ages 15 to 46. The Minister of Health has created several partnerships with organizations such as USAID to help strengthen its healthcare system. Here are five facts about women’s health care in Cambodia.

Top 5 Facts About Women’s Health Care in Cambodia

  1. Health Care Professionals and Midwives
    USAID has provided a helping hand when it comes to educating healthcare professionals and midwives. Since USAID’s partnership with the Ministry of Health, USAID has helped raise the percentage of deliveries assisted by skilled professionals from 32 percent to 71 percent. The Ministry of Health was also able to implement the Health Sector Strategic Plan to improve reproductive and women’s maternal health in Cambodia.
  2. Health Care Facilities
    Between 2009 and 2015, the number of Comprehensive Emergency Obstetric and Newborn Care (CEmONC) facilities increased from 25 to 37. With more access and an increase in healthcare facilities, 80 percent of Cambodian women are giving birth in health care facilities.
  3. Postpartum Care
    The Royal Government of Cambodia renewed the Emergency Obstetric & Newborn Care (EmONC) Improvement Plan and extended the Fast Track Initiative Roadmap for Reducing Maternal and Newborn Mortality to 2020. This aims to improve women’s health care in Cambodia to improve the lives of women living with postpartum depression. It is also used to improve newborn care and deliveries.
  4. Obstetric Care
    Obstetric care has improved rapidly. According to a 2014 Cambodia Demographic and Health Survey, 90 percent of mothers receive obstetric care two days after giving birth, and three-quarters of women receive care three hours after. Intensive obstetric care has helped drop Cambodia’s maternal mortality rate significantly. In 2014, Cambodia’s maternal mortality rates decreased from 472 deaths per 100,000 live births in 2005 to 170 deaths per 100,000 live births.
  5. U.N. Women
    U.N. Women is working closely to help address the AIDS epidemic in Cambodia. The organization’s efforts to reduce the epidemic focus on protection and prevention. In 2003, 3 percent of Cambodian women reported being tested for AIDS. It has also been observed women in urban areas are more likely to get tested than those in rural areas. Ultimately, Cambodia has set a goal to eradicate AIDS from the country by 2020 through prevention and protection.

Cambodia has seen much economic growth over the years, but the money provided for health care is minimal. Consequently, it is difficult for the government to provide all services. However, there have been great strides in improving women’s healthcare in Cambodia. By fighting to better the lives of women, the Cambodian government has set a goal to establish universal health care by 2030.

Andrew Valdovinos
Photo: Flickr

Innovations in sub-Saharan Africa are emerging, aiming to improve sanitary conditions and facilitate access to medical care, directly combatting some of the region’s most prominent health crises. Due to health and sanitation concerns being a primary factor in high rates of illness and morbidity, advances in technology are progressively bettering the quality of life of many citizens in these regions.

7 Health Care Innovations in sub-Saharan Africa

  1. The Mamaope Jacket
    In Uganda, a leading cause of infant mortality is pneumonia. In its early stages, pneumonia can be difficult to distinguish from malaria. As a result, misdiagnosis is the leading cause of infant and toddler deaths attributed to pneumonia. One of the innovations of sub-Saharan Africa became the solution to reducing the impacted community. The Mamaope Jacket was created by a Ugandan engineer, Brian Turyabagye. This Mamope Jacket records audio of a child’s breathing via a modified stethoscope inserted into a vest. Analyzing this data aids in detecting key signs of pneumonia. It is estimated that the Mamaope Jacket’s diagnostic rate is three to four times faster than a traditional doctor, and also greatly reduces the risk of human error.
  2. SafariSeat
    Access to wheelchairs and other assisted mobility devices is severely limited in rural regions of developing nations. However, the SafariSeat is changing this; the SafariSeat is an inexpensive, durable wheelchair. This offers both a solution to individuals living with limited mobility in rural areas and is environmentally sustainable. SafariSeat is both produced and maintained using bicycle parts to create a wheelchair suitable for use in all terrain types.
  3. NIFTY Cup
    The NIFTY cup is lowering the rate of infant deaths from malnourishment by providing a cost-effective, convenient way to feed newborns unable to breastfeed. Some causes of not being able to breastfeed include birth defects such as a cleft palate or premature birth. Amongst the other innovations of Sub-Saharan Africa, the NIFTY cup funnels breast milk from the main cup into a small reservoir that a baby can sip from easily without choking or spilling. The creator, a mother herself, Trish Coffey, created the NIFTY cup after giving birth to her daughter prematurely. Manufacturing a NIFTY cup costs just $1, a viable alternative to breastfeeding for impoverished rural communities such as Tanzania and Malawi. In addition, it is reusable.
  4. Flo
    In developing African nations such as Kenya, on average, girls miss a week of school per month due to menstruating. This is because of the stigma associated with periods and limited sanitation resources. That being said, Flo is a reusable menstrual hygiene kit equipped. Within this kit, are reusable pads, a discreet carrying pouch, and a container used while washing clothes to avoid soiling other garments. This offers a cost-effective, environmentally friendly method for women lacking disposable alternatives. Flo opens the door for greater educational and occupational opportunities. It also lowers the rate of reproductive diseases resulting from poor menstrual hygiene.
  5. LifeStraw
    With more than 10 percent of the global population lacking access to sources of clean drinking water, diseases resulting from consuming contaminated water are a major contributor to high child mortality rates. Approximately, illnesses from drinking contaminated water kill a child every 90 seconds. The high temperatures and unpredictable climate shifts in the sub-Saharan region make potable water extremely valuable, but can also cause availability to fluctuate. Innovations in sub-Saharan African, such as LifeStraw is a simple, portable device that uses a mesh fiber to filter out bacteria and parasites commonly found in contaminated water. The LifeStraw corporation works with major humanitarian organizations such as World Health Organization and the United Nations to provide both individual LifeStraw filtration devices and larger filtration systems to developing communities in need.
  6. Speaking Books
    There is a lack of information about mental illness available to impoverished communities in Sub-Saharan Africa. As a result, there is a higher rate of suicide among younger populations. Just a decade ago, more than 15 percent of South Africans afflicted with mental illness had little to no access to any kind of treatment. Zane Wilson, the founder of the South African Depression and Anxiety Group, created a range of free audio pamphlets on mental health. Innovations in sub-Saharan Africa like Speaking Books have a goal to combat the lack of access to treatment, which in many rural areas, also reflects high rates of illiteracy. The Speaking Books series now offers 48 different booklets explaining and destigmatizing mental health disorders. Furthermore, these pamphlets are available in 24 languages and distribution spans among 20 African countries.
  7. Tutu Tester Van
    Although HIV is a global epidemic, South Africa has especially high rates of infection. As a result, the country’s rate of tuberculosis has dramatically spiked over the last two decades. However, because of the stigma surrounding HIV, very few communities have access to effective counseling, testing and treatment methods. The Tutu Tester van, introduced by the Desmond Tutu HIV Foundation, is a fully-staffed clinic on wheels. They visit rural and impoverished communities to provide health screenings using modern equipment – including tests for HIV and TB. As a result, this reduces the stigma attached to these diseases, as patients retain anonymity once they enter the van. Globally, increasing availability to testing is a primary goal of the United Nation’s plan to eliminate the epidemic of HIV by 2030.

Access to these health care innovations in sub-Saharan Africa is having numerous impactful effects: reducing mortality rates, advancing mental health awareness, contributing to greater longevity and improving quality of life for people in impoverished communities across the region. With improved healthcare and sanitation access,  communities have greater chances of reducing poverty and increasing economic and cultural growth.

– Emmitt Kussrow

Photo: Flickr

top 10 facts about living conditions in trinidad and tobago

North of the coast of Venezuela, Trinidad and Tobago is a wondrous country with elements that make the island unique. Living conditions in Trinidad and Tobago are bewildering due to its economic growth and the risks of HIV. There are many factors that affect living conditions on this island that make it whole. These are the top 10 facts about living conditions in Trinidad and Tobago.

Top 10 Facts About Living Conditions in Trinidad and Tobago

  1. Trinidad and Tobago is regarded as one of the wealthiest countries in the Caribbean due to its oil reserves and rich resources which help boost the economy in great ways. It is also regarded as one of the top three wealthiest countries in the Americas because of the amount of oil and gas throughout the island allowing for the economy to thrive and helping people live well throughout the island.
  2. Public healthcare is provided for free for citizens on the island, but there are private healthcare providers that can be paid for if it is affordable. There are numerous healthcare centers established around the island making it easily accessible for the citizens in Trinidad and Tobago.
  3. Although the economy has seen a significant boost since its independence in the 1960s, 26 percent of the population is living in poverty, surviving on less than $2.75 a day.
  4. Education is free to children between the ages of 5 and 16. There are private institutions that citizens can pay for but public education provides children with free transportation, books, and meals while in school giving children the opportunity to learn effectively.
  5. Trinidad and Tobago suffer from an increase in crime rates compared to 2016. There has been a 5.5 percent increase in crime rates, which are mostly violent crimes including murder and robbery.
  6. Trinidad and Tobago have a rich cultural life throughout the island celebrating historical African music, dance and literature.
  7. Housing has become a primary concern throughout the country due to the increasing population throughout the island. Many people struggle to find housing in urban areas due to the increasing shortage of land and high construction costs.
  8. Housing conditions vary throughout the urban and rural areas of Trinidad and Tobago. Families in rural areas usually inhabit wooden huts and have various family types where women are typically the head of the household.
  9. The unemployment rate has reached its lowest in 2015 with a rate of 3.5 percent. It has seen a significant decrease since the 90s where it was 17.2 percent.
  10. HIV has become a prevalent disease affecting a large amount of the population. Nearly 11,000 people are living with HIV but with access to free public health care, nearly 75 percent of the population is receiving treatment for the disease.

Trinidad and Tobago is experiencing great economic growth due to the vast amount of resources and has seen progress regarding education and health care but still see issues regarding diseases, housing and poverty. Although these may be factors that can affect the country negatively, Trinidad and Tobago have the potential to combat these elements to help the country thrive. These are the top 10 facts about living conditions in Trinidad and Tobago.

Elijah Jackson
Photo: Flickr

Maternal Health in the Gambia

Maternal health continues to be a concern in developing countries around the world. Although overall maternal mortality decreased by 44 percent from 1990 to 2015, many nations still have a long way to go if the goal of fewer than 70 deaths per 100,000 live births is to be reached by 2030. Of note, despite improvements, the maternal mortality in The Gambia remains one of the highest in the world, with 706 maternal deaths per 100,000 live births.

Maternal mortality is a reflection of the disparities between the rich and the poor, with 94 percent of all maternal deaths occurring in developing countries. The fact that 50 percent of The Gambia’s population lives below the poverty line contributes to the high rates of maternal mortality in the nation.

A majority of the complications that lead to maternal deaths are preventable or treatable. However, either because the mother is giving birth outside of a health care facility or due to a lack of supplies or expertise, the necessary care is not always provided.

The main causes of maternal deaths are severe bleeding, infections, high blood pressure and delivery complications. Other deaths are caused by malaria, AIDS and other diseases.

Contributing Factors

In The Gambia, the national maternal mortality ratio decreased by 46 percent between 1995 and 2015. This can, in part, be attributed to an increase in antenatal care coverage, as 86.2 percent of Gambian women now receive antenatal care from a skilled health professional.

For deliveries, however, only 57.2 percent take place in the presence of a skilled health professional. Most women deliver at home with a traditional birth attendant; the main barriers to giving birth in a health care facility being insufficient time to travel and lack of transportation.

Maternal health in The Gambia is further complicated by social and cultural factors that contribute to pregnancy complications and the low percentage of women who give birth at a health facility or with a health professional. A study done in rural Gambia found that there were four interrelated factors that impacted maternal health:

  • Pregnant women’s heavy workload
  • The gendered division of labor
  • Women’s inferior status in the household
  • Limited access to and utilization of health care

Women in rural Gambia generally work alongside their husbands on farms, a fact that does not change even with pregnancy. Gambian women described being physically and emotionally exhausted from physical labor in the field and the house, noting that they did not get sufficient rest at any point during their pregnancy.

This is connected to the way labor is divided between men and women, as women often work longer hours than their husbands, regardless of whether they are pregnant or not. Social practices prevent men from doing certain household chores while their wives are pregnant to allow them to get more rest, which contributes to poor maternal health in The Gambia.

The activities that women continue to perform can also have negative impacts. Women noted that they had to fetch and carry water from long distances, pick groundnuts and cook with firewood, all of which are health risks for pregnant women.

Additionally, women have less control than their husbands, largely because they are economically dependent on them. Despite doing equal work in the field and more work in the house, women receive no financial benefits. This keeps them from becoming economically independent and forces them to rely on their husbands, giving their husbands more power.

As a result, many women who wanted to stop working could not unless their husbands allowed it. They also could not make certain decisions, including where to give birth, without the oversight of their husbands, contributing to a lack of utilization of health care facilities. As women are often required to work up until they give birth, their workload prevents them from being able to travel to a health care facility in time for delivery.

Improving maternal health in The Gambia, therefore, is connected to women’s autonomy. In addition to improving access to health care facilities and ensuring adequate supplies are available, work needs to be done to ensure that families are educated about the dangers of working during pregnancy and that women have the ability to make decisions for themselves about where to give birth.

Improvement Efforts

Other efforts are also important to decreasing maternal mortality in The Gambia. Within the last decade, the Horizons Trust Gambia and The Gambian Ministry of Health partnered with an organization called Soapbox to launch the Maternal Cleanliness Champions Initiative aimed at reducing infections from childbirth.

One of the main projects of this initiative is the distribution of Clean Birth Kits, which include soap, a clean blade and a clean plastic sheet to help ensure that expectant mothers have sanitary materials regardless of whether they are giving birth at a hospital or at home.

The Maternal Cleanliness Champions Initiative also worked to create a manual for cleanliness standards at health care facilities in The Gambia, adapting the manual to work with the local context of each hospital. The program also supported the training of facility staff to ensure that they knew how to adequately clean to prevent infections and other health complications.

These important efforts need to be combined with others to form a holistic approach to improving maternal health in The Gambia. Only coordinated efforts that are adapted to cultural and social contexts will be successful in significantly reducing maternal mortality in the nation.

– Sara Olk
Photo: Flickr

 

Antenatal Care in NigeriaMany developing countries have reduced their maternal mortality rates by expanding maternal care through policy innovations. Between 1990 and 2015, maternal mortality has dropped by 44 percent. While this is a considerable amount, maternal mortality remains high in developing countries. For example, in Nigeria, only 61 percent of pregnant women visit a skilled antenatal care provider at least once during their pregnancy. The average rate for similar lower-to middle-income countries is 79 percent.

Maternal health concerns the health of women during pregnancy, childbirth and the postpartum period. During this time, major causes of maternal mortality include hemorrhaging, infection, high blood pressure and obstructed labor.

Every day, 830 women die from preventable causes related to pregnancy and birth. In fact, 99 percent of maternal deaths occur in developing countries. It is necessary for policy innovation in developing countries because sustained use of maternal and antenatal care and increased rates of institutionalized delivery reduce maternal mortality.

Antenatal Care in Nigeria

Of the women who did access and antenatal care, 41 percent did not deliver in a health care facility. Nigeria ranks in the top 16 nations in maternal mortality: 576 deaths per 100,000 births. Containing only 2.45 percent of the world’s population, Nigeria contributes to 19 percent of maternal deaths globally.

There is a stark difference in the number of women who seek antenatal care in urban and rural areas: 75 percent versus 38 percent, respectively. Studies also show that more skilled professionals attended births in urban areas, revealing that 67 percent of women had a trained professional helping them. In rural areas, only 23 percent of women had the help of trained professionals. In these rural areas, only 8 percent of newborns receive postnatal care, whereas 25 percent of children do so in urban environment.

Due to the lack of health coverage and used resources, many of Nigeria’s infants die from preventable causes. Approximately:

  • 31 percent die from prematurity,
  • 30.9 percent die from birth asphyxia and trauma and
  • 16.2 percent die from sepsis.

Ways to Increase Access to Antenatal Care in Nigeria

Improving maternal and antenatal care in Nigeria can encourage women to utilize services such as improved facility infrastructure and amenities. Policy innovation in Nigeria can result in better equipment, more available drugs and an increase in overall comfort for the spaces.

In a study of antenatal patients in Nigeria, women responded positively to increased interpersonal interactions with providers. The study also suggested that improved maternal care should include access to providers who have technical performance skills and experience. Improved maternal care also includes access to providers who display empathy for their patients. Furthermore, policy innovation in Nigeria could improve increased access to facilities for those in rural areas.

Accessed to maternal and antenatal care in Nigeria can be improved with policy innovations made throughout the country. By making health facilities more accessible to more women and giving them the supplies and support they need, Nigeria will be able to decrease its maternal mortality rate and save its families from preventable complications of during pregnancy and infancy.

Michela Rahaim
Photo: Flickr

antenatal care in IndiaIndia is home to one-fifth of all births but has no monitoring systems for basic maternal health and nutrition. A research brief published by the rice institute finds that India has far worse maternal nutrition rates than sub-Saharan Africa – a region much poorer with higher fertility rates. With improper antenatal care being linked with long term effects on the height, weight, cognition and productivity of a child, global attention has been brought to the antenatal care inequalities found in India.

Antenatal Care in India Today

Access to antenatal care in India depends strongly upon the geographic location and socioeconomic status of expectant mothers. Between 50 and 74 percent of expectant mothers in India receive prenatal care services – with a large gap in the distribution of these services.

According to a study done in 2011, 357,777 women in Delhi received at least three antenatal care check-ups, more than the entire state of Uttarakhand which had 153,202 women receive the same level of care.

Further studies showed that  “some states, such as Kerala and Goa, more than 93 percent of women used ANC [Antenatal Care] four times or more, while in Bihar and Nagaland, this figure was less than 17percent,” highlighting the substantial inequalities of access to antenatal care in India.

Current Government Initiatives

Currently, several government programs are in place to increase access to antenatal care services throughout India but have not shown largely promising results. India’s largest program for improving neonatal health, Janani Suraksha Yojana (JSY), uses cash incentives to encourage birthing in hospitals.

However, a study done in 2014 found that the cash transferred to new mothers is much less than advertised, due to how much of it goes towards paying for delivery services – which are meant to be free. In addition, this program only encourages women to give birth in hospitals, rather than address pressing maternal health problems in India – such as maternal nutrition and low birthweight.

Meanwhile, the Pradhan Mantri Matru Vandana Yojana (PMMVY) government program dispenses 5,000 rupees for expecting and lactating mothers. However, this is only available to first-time mothers.

The Integrated Child Development Services (ICDS) is intended to give food to expectant mothers and their children but is poorly implemented – with less than 30 percent of women having received food the ICDS program during their last pregnancy.

Looking Ahead

In order to improve access to antenatal care in India, studies suggest “policy and programme managers should shift from improving the ‘average figures’ to the ‘distribution’ of programme/health care indicators across the sub-groups of populations which need them most.”

The rice institute also notes that rather than rely on outdated surveys for indicators of maternal health, the government finally establish a national monitoring system allowing policymakers to view changes in maternal health over time.

With proper government oversight, the future of antenatal care in India looks promising, as suggested by a study published in The Lancet found that mortality rates for neonates declined by 3.3 percent annually between 2000 and 2015 due to government intervention.

– Shreya Gaddipati
Photo: Unsplash