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

Typhoid in Zimbabwe
Typhoid fever, a serious disease affecting between 11 and 21 million people worldwide, is commonly found in the developing regions of Asia, Africa and Latin America. Symptoms include high fevers, weakness, stomach pains, headaches, loss of appetite and diarrhea. Severe cases even lead to serious health complications and even death. Typhoid occurs most often in areas with poor sanitation and contaminated food and water. There are 128,000 to 161,000 typhoid-related deaths every year.

Typhoid in Zimbabwe

On 24 February 2018, the Harare City Health Department (HCHD) suspected 3,187 cases and confirmed 191 cases of typhoid in Zimbabwe. This was the latest major typhoid outbreak in Zimbabwe. Most typhoid outbreaks in the capital, Harare, are caused by municipal water shortages and the use of contaminated boreholes and shallow wells. HCHD works to improve water, sanitation and hygiene (WASH) throughout the city in order to lower typhoid cases and outbreaks in Zimbabwe. They repair boreholes, fix burst sewers, conduct water testing and sampling and educate local residents about water quality and typhoid.

Resistance to antibiotics creates another problem. Around one in five typhoid patients are already resistant to the common typhoid antibiotics and in some areas, resistance raises to a staggering 73 percent. For example, ciprofloxacin is an antibiotic widely used in the treatment of typhoid. However, 20 percent of typhoid patients in Harare show resistance to ciprofloxacin. Alternative antibiotics are more expensive and less available to patients, and although the sale of these medications without a prescription is illegal, over-the-counter purchases are a common practice.

The Typhoid Conjugate Vaccine

A solution to the problem of ineffective medicine is the typhoid conjugate vaccine (TCV). The current typhoid vaccines can only provide short-term protection to patients and more importantly, cannot be given to children. The typhoid conjugate vaccine can reduce the need for antibiotics and unlike other vaccines, it provides longer-lasting protection, requires only one dose and works for children older than six months. The creation of the typhoid conjugate vaccine is a large step in global health.

Kathy Neuzil, leader for the Typhoid Vaccine Acceleration Consortium at the University of Maryland, said: “I have been in my career for around 25 years but these sorts of opportunities, where everything comes together, don’t happen very often. Here we had a vaccine that had been tested but wasn’t being used. Now it is licensed by the World Health Organization and Gavi is supporting countries to introduce it.” The TCV is making history, especially helping with typhoid in Zimbabwe.

The Typhoid Conjugate Vaccine in Zimbabwe

A major vaccine campaign began in Harare on 22 February 2019. Approved by the World Health Organization (WHO), carried out by Zimbabwe’s Ministry of Health and funded by Gavi, The Vaccine Alliance, this campaign is the first in Africa to use the typhoid conjugate vaccine. It targets children aged from six months to 15 years old, and in high-risk areas, it will provide adults up to 45-years-old with the typhoid conjugate vaccine. By the end of the campaign on 3 March 2019, the typhoid conjugate vaccine will be available to 325,000 people throughout the capital city.

Dr. Seth Berkley, CEO of Gavi, is optimistic about the typhoid conjugate vaccine, saying: “These new conjugate vaccines will be a game-changer, not only in the battle against typhoid but also in the global effort to tackle drug resistance. The fact that they are now ready to be used to contain this devastating outbreak in Zimbabwe is fantastic news.”

Although vaccination campaign will significantly decrease typhoid outbreaks in Zimbabwe, vaccines are only a short-term solution. Completely eradicating typhoid in Zimbabwe will also require sustainable solutions for clean water and improved sanitation and hygiene. Together, the typhoid conjugate vaccine and sustainable WASH measures in Harare and other cities will help control and fight typhoid in Zimbabwe.

– Natalie Dell
Photo: Flickr

The West Bank and Gaza
The West Bank and Gaza are considered Palestinian territories that have struggled with political power since the Six-Day War in 1967. This dispute has been between Israel and Palestine and the end result of the war has left the country in political turmoil. This devastated economic opportunities, local livelihood, sanitation conditions and household food consumption. In 2017, the 50th anniversary of Israeli occupation and the 10th anniversary of the Gaza blockade were marked. This has been affecting all job opportunities and proper food aid from entering the region. All of these factors have only made it more difficult to live in already precarious conditions and more risk for the already struggling population.

Work of USAID

The U.S. government works closely with the authorities in Palestine to address the economic and humanitarian needs of the country. To improve economic growth, USAID has donated roughly $400 billion to improve in-house situations for companies and impoverished families in West Bank and Gaza. Providing basic needs like clean sanitation systems and safe work environments is essential to maximize productivity within the company and keep the workers healthy. Many companies suffer from a lack of resources and expertise for their products, so the project Compete will help business owners learn more about their product, how to maximize value for those products and increase employment within the surrounding areas. The goal is to increase competitiveness and revitalize the private sector, bringing to the table full-time jobs, part-time jobs, seasonal jobs and paid internships.

Food Sovereignty of West Bank and Gaza

Food insecurity is a huge issue in the West Bank and Gaza territory as over 70 percent of people in this area suffer from lack of food and proper nourishment. Some of the causes for this are also a global phenomenon, environmental degradation, rising food prices and Palestinian food sovereignty. With food sovereignty, a state can control its own food resources, though that state has to have a self-sufficient food source with the help of government-controlled policies.

Since the occupation in 1967, Israel has confiscated thousands of acres of farming land and then separated it with the West Bank wall. With the separation of land, farmers are struggling to keep up the health with crops due to vandalism and destruction from settlers and the military. In Gaza, 25 percent of fertile land has been destroyed by the buffer zone, a zone that borders Israel. Patrol boats in the area only allow fishermen 15 percent of their territorial waters, further reducing the areas self-sufficient food sources. With the limitations on trade, environmental issues, confiscation of land and destruction of land, food sovereignty is unachievable. This has hindered economic growth and social conditions to reduce the levels of food insecurity.

Clean Water Access

Access to clean, potable water is limited by the wall between the West Bank and Gaza. Beaches, rivers and lakes are polluted and overcrowded refugee camps create health hazards for the sanitation systems. About 26 percent of diseases in West Bank and Gaza are related to filthy water. During the winter months, household septic tanks overflow and mix with rainwater, flooding homes and streets in the area. During the summer, the heat dries the streets from the flood and the smell coming off the streets is so bad that families keep their windows shut. Mothers refuse to let their children out to play because of the rancid smell and infected water.

Diseases continue to spread as garbage continues to pile up in refugee camps. The Anera organization is working on building proper waste management systems across Palestine, improving sanitation systems in the process. In 2014, Anera reconstructed sewage lines damaged by bombs. In refugee camps, they are taking an approach where the youth take the lead. Through campaigns designed to clean and recycle, they have developed a staff to train on proper waste management and a new sorting facility. They are creating a cleaner environment for 13,000 members of their community so far and will continue to reach out and help their people.

Health System in West Bank and Gaza

The health system in West Bank and Gaza has been shaped by years of occupation, political stalemate, violence and human rights violations. The barrier placed between the two territories limits access to East Jerusalem, the closest area that has specialized hospitals. The placement of these hospitals is scattered due to the many health care providers in the country. With the blockade in place, Gaza’s health care locations are experiencing unstable power supply and recurring power cuts.

The medical equipment has been deteriorating because of inadequate maintenance and spare parts cannot reach them. The barrier has also made it difficult to transport proper medicines to treat patients. All of these factors are crushing the health care system in West Bank and Gaza, making people seek treatment elsewhere though traveling in and out of Gaza is heavily restricted. Even with these limitations, health care in these areas still thrives. With the help of the World Health Organization, technical support will be provided to health technicians and fund projects created for diseases affecting the population.

Even with all of these issues, West Bank and Gaza still work out solutions to everyday and past problems. If these areas can continue to receive the funding from developed countries and nongovernmental organizations, they can grow back into the self-sufficient economy they once had.
– Kayla Cammarota
Photo: Flickr

Elderly Care in Iran
The Iranian government recently turned an eye towards aiding development and putting the nation back on track after the Iraq war. There is still a great deal of room for social reform in this improved state of development, especially in the area of elderly care in Iran.

Aid for the elderly population in Iran is projected to become a large issue, as the country experienced a baby boom in the years of the Iraq-Iran war (1980 to 1988) which will lead to an increased elderly population in the future. The rising rate of unemployment in Iran has made it difficult for the elderly to find and hold jobs, and most elderly people are unable to provide for themselves in their old age.

Elderly People in Iran

One-third of the Iranian elderly population is not covered by any health insurance; meanwhile, the Iranian government diminished the elderly retirement pension — only one-third of the elderly population receives a pension — while 20 percent of families are economically dependent on the senior householder. The elderly demographic has a very low socioeconomic status and basic insurance policies fail to cover most elderly care costs. Without the money to afford the extra costs, older people often fail to receive the help they need.

There are currently five main governmental organizations taxed with elderly care in Iran:

  • The Social Security Organization
  • The State Welfare Organization
  • The Red Crescent
  • The Imam Khumeini Relief Foundation
  • The Martyrs Foundation

However, there are no clear developed policies on elderly care, and no single organization responsible for addressing this crucial societal need. As a result, ambiguity and uncertainty surround specific organizational responsibility.

Challenges of Elderly Care in Iran

Policy-making is one identified challenge of the elderly care process in addition to access, technical infrastructure, integrity and coordination and lastly, health-based care services. In regards to access, there are no transportation facilities and many of the elderly are entirely stuck at home due to physical reasons or an inability to pay for transportation costs.

Also, 70 percent of elderly people in Iran are illiterate, which impacts their awareness of access to resources. Currently, Iran does not have the physical, human and informational resources to implement an elderly care policy. This is concerning as the country is projected to experience fast demographic changes and a huge increase in the elderly population in the near future.

The country does have community-based services for the elderly such as nursing homes, adult daycare centers, cultural centers and meals on wheels; unfortunately, the distribution is sparse and these services are intended for mainly elderly people with disabilities. However, on a more positive note, the fact that this issue is being qualitatively and quantitatively studied is considered progress.

Need for Action

Historically, little attention has been paid to elderly care in Iran, but new studies and scenario exercises will thankfully aid the government in creating a sturdy policy framework for addressing elderly care in Iran.

The country is still developing and many other issues surrounding poverty are the main focus of the government right now. There is still time to address the problem of elderly care in Iran before it becomes too big to handle, but the Iranian government will need to start taking action immediately.

– Mary Spindler

Photo: Pixabay

Five solutions for reducing HIV in South Africa
South Africa has the largest HIV epidemic in the world with a prevalence of 18.8 percent of the country’s population aged from 15 to 49. Consequently, South Africa has some of the most comprehensive treatment and support systems for this issue. In addition to dedicated civil society organizations, the government has a guiding framework for reducing HIV in South Africa. One of such initiatives is the National Strategic Plan (NSP) for HIV, TB (tuberculosis) and STIs (sexually transmitted infections) 2017-2022 that aims to overcome barriers and set goals that could ultimately help influence global HIV infection management. In this article, five solutions for reducing HIV in South Africa that this country is implementing are presented.

Five Solutions for Reducing HIV in South Africa

  1. Address inclusivity. Reducing the HIV epidemic in South Africa requires caring for the most vulnerable populations in society: sex workers, men who have sex with men, transgender women and people who inject drugs. Discrimination, intolerance and neglect culminate in intense stigma consequently keeping these cohorts out of the research and clinics where valuable testing and treatment are available. In addition, up until recently, nationally available programs like the National Sex Worker HIV Plan and the South African National AIDS Council’s LGBTQ HIV Framework were unavailable. The creation of specialized programs to address the unique needs of a chronically abused population is a valuable first step towards reducing HIV in South Africa.
  2. Support women. Women and girls comprise more than half of the 36.7 million people living with HIV around the world. This statistic is even worse in South Africa where HIV prevalence is nearly four times greater for women and girls than that of men of the same age. These staggering high numbers are the result of poverty, systemic gender-based violence and intergenerational marriage. In addition to the programs identified above, nationally deployed resources like the She Conquers campaign provide multiple societal interventions like reducing teenage pregnancy and gender-based violence as well as providing educational support and business opportunities.
  3. Prioritize prophylactics. A little over three years ago, South Africa became the first country in Africa south of the Sahara to completely approve pre-exposure prophylaxis (PrEP), which stands for the use of antiretroviral drugs to protect HIV-negative people from infection. This initiative is a primary tenet in the NSP‘s first goal to acceleration HIV prevention, especially for the most vulnerable population. The goal is to increase PrEP treatments to nearly 100,000 participants in the coming years. In addition, campaigns to distribute condoms, educate the population and even encourage male circumcision are operating to reduce initial transmission by providing means to encourage safe sex thus keeping the entire population safer from infection.
  4. Deliver ART. South Africa has the largest antiretroviral treatment (ART) program in the world and UNAIDS estimates that 61 percent of South Africans living with HIV are receiving treatment in 2017. This figure has more than doubled since 2010. This success is largely due to the latest “test and treat” strategy that makes anyone who has tested HIV positive immediately eligible for ART treatment. Moreover, this strategy incentivizes the population to get tested which is a major barrier to reducing HIV in South Africa. Additional work is needed to encourage South Africans, specifically men, to get tested, as men tend to get tested and start treatment much later and at a more progressed stage of infection thus reducing effectiveness and placing the population, especially women, at risk. It is important to note that South Africa has made tremendous strides in reducing mother-to-child transmission (MTCT) largely because of the ubiquity and delivery of ART therapies. As a result, MTCT rates have been reduced by more than half between 2011 and 2016, achieving the national target for 2015 of a transmission rate below 2 percent.
  5. Treat Tuberculosis (TB). Tuberculosis is the leading cause of death in South Africa. HIV severely suppresses the immune system leaving victims vulnerable to all infections, however, TB is particularly difficult and without treatment, fatal. It is estimated that two-thirds of HIV-positive South Africans have TB. In response, South Africa’s NSP incorporated TB reduction strategies and sets forth priorities for reducing TB mortality.

These five solutions for reducing HIV in South Africa have been a successful start for the country as they tackle the world’s largest HIV epidemic. The government has developed a comprehensive, multi-dimensional plan that shows a lot of promise, however, following through remains questionable. National organizations like the Treatment Action Campaign question the government’s ability to remain engaged and accountable.

Addressing HIV requires relentless attention and civil society participation, especially since UNAIDS’ ambitious 90-90-90 (90 percent of all people know their HIV status, 90 percent HIV-positive patients will receive ART therapy and 90 percent of ART therapy patients will have viral suppression) goal to suppress and eliminate HIV and AIDS, all by 2020, is right around the corner.

– Sarah Fodero

Photo: Flickr

PA 10 Facts about Life Expectancy in Tanzania
Tanzania is home to Africa’s highest peak and borders the continent’s deepest lake, but among these geographical wonders lives East Africa’s largest population struggling to reach adulthood. According to the United Nations, Tanzania has the world’s largest youth population in modern history that, if cultivated with proper programmatic support, could result in unprecedented societal growth and progress as the population ages.

However, surviving childhood and staying healthy are major threats to an aging Tanzanian population where life expectancy is low. Lack of quality health care and poor sanitation contribute to high infant mortality and lives lost to preventable diseases. International aid is bolstering local and government-sponsored programs to address some of the most critical issues contributing to life expectancy in Tanzania, but more support is needed. In the article below, these and other issues are discussed in a form of 10 facts about life expectancy in Tanzania.

Ten Facts About Life Expectancy in Tanzania

  1. Overall, life expectancy in Tanzania has increased by nearly 10 years in the past decade. According to the most recent data, Tanzanians are expected to reach nearly 66 years of age, compared to 57 years of age in the mid-2000s. Several factors contributing to this success include socioeconomic growth through employment, higher incomes and more education.
  2. Nearly 20 percent of deaths in Tanzania are preventable with proper access to surgical care. The Tanzanian government is aware of the gap in health care access and has launched the National Surgical, Obstetric and Anesthesia Plan, dedicated to improving access to surgical, anesthesia and obstetric services by 2025.
  3. Malaria is the leading cause of hospitalization and death of children in Tanzania and one of the leading causes of all deaths in the country. Tanzania’s malaria epidemic has sparked decades of solution-driven support and strategic oversight from the Millennium Development Goals and Roll Back Malaria Partnership. Both initiatives have helped address this preventable disease and allowed Tanzanian children to live longer.
  4. Every day, 270 Tanzanian children under the age of 5 succumb to preventable diseases such as malaria, pneumonia and diarrhea. The need for a stronger health system and service delivery is reflected in the high rates of childhood mortality. The childhood mortality rate is, however, improving and has dropped by nearly half since the early 1990s due to concerted efforts from Tanzania’s government and international aid.
  5. Seventy-five percent of Tanzanian children have received all basic immunizations. With global immunization coverage consistent at 85 percent, Tanzania is taking health security for children seriously. One major barrier to higher coverage is the disparity between regions. International aid efforts like those from the U.S. Agency for International Development (USAID) offer support for childhood vaccination which is a contributing factor for a drop of two-thirds since 2000 in child mortality.
  6. Tanzanian children born to mothers with little education are 1.3 times more likely to die before their fifth birthday than children whose mothers have secondary or higher education. Further, adolescent women in Tanzania who have not been able to access education are five times more likely to be mothers than those with secondary or higher education. Programs from the Girls Educative Collaborative like Launch a Leader, that prepares girls heading to secondary school, help break down barriers and expand access to continuing education for young women.
  7. Two-thirds of women in the country give birth in a facility with a skilled practitioner. The assistance of an attendant reduces the chances of maternal mortality during birth, however, large gaps in skill among delivery attendants leave women at risk for maternal mortality.
  8. Twenty-seven million Tanzanians lack access to safe drinking water and 35 million Tanzanians rely on unimproved sanitation. These unsafe water and sanitation conditions disproportionately affect children and rural communities. But, there is hope. Organizations like Water.org have begun tapping into Tanzania’s existing technology infrastructure to improve the country’s water and sanitation infrastructure through digital finance and the company’s WaterCredits program.
  9. Tanzania has one of the world’s lowest physician-to-population ratios. WHO estimates that there are three doctors, nurses or midwives for every 10,000 Tanzanians. With a population of over 50 million and a recommended minimum threshold of 23 providers for every 10,000 people in low-income countries, these numbers highlight a significant gap in health care coverage. One USAID program, in collaboration with Tanzania’s government, has trained over 500 health providers in more than 400 facilities to address critical needs.
  10. Almost 1.5 million Tanzanians living with HIV, the AIDS epidemic are being well managed. Tanzania’s extensive roll out of antiretroviral medications has helped minimize the impact of the country’s epidemic over the last decade and improved life expectancy in the country.

The above presented 10 facts about life expectancy in Tanzania speak about the positive outcomes international and government solutions have on Tanzania’s population, but also highlight areas for further growth. Malaria is one of the leading deterrents for economic development and foreign investment in the country, and Tanzania did not meet the 2015 Millennium Development Goal targets for childhood or maternal mortality. With the proper support, Tanzania is on track to excel. The country’s future looks brighter (and older) than it did a mere decade ago.

– Sarah Fodero
Photo: Flickr

Elderly Care in Bosnia and Herzegovina
Bosnia and Herzegovina has been slowly recovering from the conflict that took place in the country during the late 1990s. The war took a toll on the country economically, politically, socially and physically. On top of its high levels of poverty, the country is also becoming a victim of the aging population epidemic and elderly care in Bosnia and Herzegovina is a huge concern. The country is facing issues of a dip in fertility rate and an increase in the rate of the elderly people, leaving a large number of older population with a small population of working-age people to support them. This issue coming from the uneven age distribution grew due to a fall in birth rates, a decrease in population from deaths during the war years and an increase in life expectancy.

The Increase of Elderly Population

Currently, people over the age of 65 make up 17 percent of the total population. Moreover, the United Nations Department of Economic and Social Affairs estimated that the number of persons aged 65 and more than 65 will reach 30 percent of the population in 2060, comparative with the 15 percent it sat at in 2010. With a population of only 3.5 million, this is a daunting number.

The older population in Bosnia and Herzegovina is extremely vulnerable for many reasons. Some of the issues they face include low income and increased living expenses. Obtaining employment is difficult as well. Due to the high unemployment rate the country faces, many employers prefer younger workers. This means that many of the elderly face poverty and have been unemployed since before retirement age, leaving them with subsequently less to provide for themselves as they age.

The situation for elderly women is worse than it is for men, as women lose rights with the loss of a husband. They also face higher rates of poverty as they are usually unable to economically provide for themselves alone. The elderly are ailed by illnesses such as cardiovascular and malignant diseases, neurological and mental disorders like Alzheimer’s, as well as sensory and physical disabilities. Many of these diseases and the lack of care for them result in a higher rate of depression amongst the elderly.

The Exodus of Medical Workers

On top of all this, Bosnia and Herzegovina is facing an exodus of its medical workers. Many young doctors and medical professionals are leaving the country after their schooling is complete and migrating toward Germany and other Western countries because these countries offer better job opportunities and more competitive salaries. More than 10,000 nurses, doctors, caregivers have gone to Germany alone. Only about 6,000 doctors work in Bosnia, meaning for every six doctors, one works in Germany. Not only is this leading to a lack of medical professionals, but the country is also losing money as they put millions into medical training facilities that students use and then leave behind as they migrate their services.

Bosnia is being forced to send patients abroad for care, so in the last two years, the country has spent around $37 million on patients that were sent outwards. Not only is this epidemic draining the country’s money, leaving it with less available funding to put towards elderly care in Bosnia and Herzegovina, it also means there are not enough doctors to perform geriatric care. It’s a negative feedback loop that hinders the country’s ability to care for its citizens, especially the elderly ones.

The Solutions for the Problems

The growing number of the elderly population in combination with the exodus of medical workers leaves the country with many people suffering and few resources to help them. Thankfully though, Bosnia and Herzegovina has not turned a blind eye towards these issues and instead has begun to search for solutions. Members of the United Nations adopted the Madrid International Plan of Action on Ageing that aims to address the issues of aging in the 21st century. The plan focuses on three main aspects: older persons and development, advancing health and well-being into old age and ensuring enabling and supportive environments.

With support from the United Nations Population Fund, United Nations Department for Economic and Social Affairs and the Swiss Cooperation in Bosnia and Herzegovina, the country has developed its own strategies, inspired by the structure of the Madrid International Plan of Action on Ageing. It plans to improve social and health protections, promote activism and volunteerism in local communities, as well as inter-generational support. The country aims to improve access to public services, especially for those in rural areas and prevent violence, neglect and abuse against older persons. The execution of this initiative will require a great deal of money and resources, but the government is dedicated to the improvement of elderly care in Bosnia and Herzegovina.

This plan of action shows that the government is making this issue a focal point in national policy and beginning to address the problems that will address the aging population. Elderly care in Bosnia and Herzegovina has a long way to go before the older population is secure and comfortable. With initiative from the government to care for the elderly, social attention will be turned towards this problem that will encourage the younger generation to aid the older and make room for various organizations to provide help and resources to the country’s older population.

– Mary Spindler
Photo: Flickr