Archive for category: Health

Information and stories on health topics.

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Examining the Threats to Global Health

Threats to Global Health
Mankind can often feel a state of invincibility. This might be due to ignorance or denial that one could become sick, but global health is constantly experiencing threats. Some of the biggest threats to global health include pollution, diseases and fragile locations. For people who live in developed and booming economies, this may mean nothing. However, those living in poverty are often in direct contact with the threats that can sometimes be fatal.

Air Pollution

Air pollution is one of the most widespread pollution problems and kills nearly 7 million people a year. According to the World Health Organization (WHO), nine out of 10 people breathe in contaminated air.

The most common forms of air pollution are smog and smoke. Smog can come from factories, industrial areas or vehicle emissions. The worst cases of smog often occur in major cities that have large populations. For example, several of the most highly polluted cities in China because of the population density and a large number of factories. Xingtai, named the most polluted city in the world, has a population of nearly 7 million.

Smoke is also a common air pollutant largely due to the large population of smokers. Inhalation of heavily polluted air can cause stroke, heart disease, chronic obstructive pulmonary disease, lung cancer and acute respiratory infections.

Diseases

Noncommunicable or noninfectious diseases are illnesses that do not transmit from one person to another, and in fact, people cannot transmit them at all. They include a wide number of disease but some of the most significant ones are stroke, cancer, diabetes and heart disease. The World Health Organization recognizes noncommunicable diseases as one of the biggest threats to global health. Air pollution can cause some forms of diseases, but environmental factors, lifestyle choices or genetics cause noncommunicable diseases.

According to WHO, noncommunicable diseases are the leading cause of death in the world as well as one of the biggest causes of poverty. In fact, 15 million people who have died from noninfectious diseases were living in poverty. This is often due to poor sanitation conditions as well as the inability to receive proper health care to treat said conditions.

Fragile Locations

Fragile locations are places that have poor sanitation, famine, drought or conflict (war or corruption). Living in fragile locations can lead to several complications especially due to poor health care. Often countries that have high unemployment and poverty rates are fragile locations. This is because the fragility of areas can put a risk on people’s health that may disable them or put them on the streets. Living in fragile locations can also increase the risk of developing noninfectious diseases.

Poverty

Nearly 36 percent of the world’s population lives in extreme poverty. When dealing with global health threats, a vast majority of those in need of care either cannot afford it or access it. People living in poverty frequently face the challenges of poor economic stability, poor or nonexistent health care and a weak education system. lack of education in developing countries can also lead to recklessness when caring for those with diseases, both noninfectious and infectious. According to the Office of Disease Prevention and Health Promotion, ODPHP, strategies that aim to increase the economic mobility of families may help to alleviate the negative effects of poverty.

Organizations’ Help on Global Health

The CDC closely monitors and researches global health threats and ways to prevent and respond to them. Whenever there is a serious global health threat, the CDC is on the front line to aid in recovery, however, aid is not always helpful. According to the CDC, 70 percent of the world’s countries report that they are not prepared to face an outbreak. However, the world can do its part to prevent air pollution by smoking less and relying more on economically friendly means of travel. Although people cannot alter genetics it is important to avoid factors that may cause noninfectious diseases. For those in fragile locations, organizations like the CDC and WHO are attempting to provide aid and support to those in need.

Threats to global health are everywhere. Some threats are inevitable but others are man-made. It is important to regulate and reduce people’s ecological footprints so global health can experience improvement as a whole.

– Sarah Mobarak
Photo: Flickr

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5 Facts About Eyesight in Nigeria

Eyesight in NigeriaAccording to the “World Report on Vision” by the World Health Organization (WHO), about one billion of the approximately 2.2 billion cases of visual impairment or blindness are preventable. Individuals still experience visual impairment because of the financial strain they would face for seeking medical help in sight-related issues. However, Nigeria has improved access to eye care. Considering there are about 4.25 million people over the age of 40 with vision impairment, the topic of eyesight in Nigeria is pertinent. To better understand Nigeria’s story and approach to battling vision impairment, here are some facts about eyesight in Nigeria:

5 Facts About Eyesight in Nigeria

  1. The healthcare system for eyesight in Nigeria is largely unequal for low-income and rural populations. Financially, the cost of eye exams and transportation to eye clinics are not affordable for many Nigerians. Moreover, people in rural communities lack education, information and resources that would better explain the facts behind vision impairment. This is amplified by the lack of trained, dispersed staff who would otherwise introduce the available resources for vision care. Overall, all of these factors disproportionally obstruct people in rural communities from getting the care that they need.
  2. The most common impairments for eyesight in Nigeria include cataracts, glaucoma and other preventable diseases. With early diagnosis, many of these diseases can be corrected with the use of medicines and glasses. Routine check-ups are not a norm in Nigeria. In turn, this has adversely impacted eyesight for many Nigerians. As a result, conducting studies, spreading awareness and international pressure have led Nigeria and other developing countries to create task forces that specifically focus on access to vision care.
  3. From 2005 to 2007, the “National Blindness and Visual Impairment Survey” was conducted to measure eyesight in Nigeria. This was the first survey to calculate vision data of individuals over 40 in the country. The survey results helped the state mobilize appropriate resources towards vision rehabilitation. Additionally, the study provided data for international initiatives, such as the World Health Organization’s “Vision 2020: The Right to Sight,” that also hope to alleviate impaired vision.
  4. WHO and The International Agency for the Prevention of Blindness (IAPB) launched “Vision 2020: The Right to Sight” in 1999. Over the past two decades, this project made eye care a primary public health issue. The project set a target to reduce avoidable visual impairment by 25 percent by 2019. Nigeria’s participation in Vision 2020 allowed it to increase vision care accessibility for low-income individuals. Due to Nigeria’s overwhelming success in vision care, it has established eye care standards that other developing countries are striving to achieve.
  5. Companies, such as VisionSpring, help to provide eyewear to low-income communities around the world. VisionSpring sees the earning potential of an individual with the proper eyewear. From being able to see course work as a student to being able to drive safely as an adult, there are many possibilities in adequate eyewear. The average cost of glasses that address nearsightedness in Nigeria is around $0.85 per pair. As of 2018, VisionSpring has distributed about 6.8 million glasses to 43 countries. The impact of companies that are focusing on affordable prices for underserved communities has been enormous in the effort to alleviate global vision impairment.

Eyesight is fundamental to the quality of life and productivity of an individual. Nonetheless, eye care still does not garner as much attention it should in low and middle-income countries. Fortunately, international organizations, companies and efforts from individual countries, like Nigeria, have emerged to ensure better access to eyesight for vulnerable populations.

– Ashleigh Litcofsky
Photo: Flickr

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Improving ENT Care in Zimbabwe 

ENT Care in Zimbabwe Zimbabwe is a country in Sub-Saharan Africa with an estimated population of 14.2 million people. As a developing country struggling from political and civil issues, their Human Development Index is at 0.509. This places the country in the low human development category. Lacking effective medical care access, the country has long struggled with managing several pandemics. This includes malaria, HIV, tuberculosis and widespread maternal and childhood illnesses. A particular medical issue that needs attention in Zimbabwe is ear, nose and throat (ENT) care.

Challenges in ENT and Audiology Care in Zimbabwe

According to a survey of 22 Sub-Saharan countries in Africa, it has been observed that there has been an overall lack of progress in ENT and audiology care between 2009 and 2015. Although there has been an increase in ENT surgeons by 43 percent and audiologists by 2.5 percent, these numbers cannot adequately serve the 23 percent population growth that occurred during that time. Since 2015, there has been a steady decline in ENT physicians and audiologists in Sub-Saharan Africa. Additionally, U.K. respondents have noted that there is a lack of proper medical equipment for ENT care, training facilities and audiological rehabilitation.

Importance of ENT Care in Zimbabwe

With the lack of ENT care available in African countries, physicians wondered how they can also provide social support to patients that have suffered hearing loss, speech impediments and other traumas relating to ENT illnesses. Dzongodzaand Chidziva, an ENT surgeon who works in Zimbabwe, has explained that many Zimbabweans believe that a runny nose or snoring are minor issues. However, those same symptoms could be the precursor for devastating illnesses.

To demonstrate the dangers of these misconceptions, Chidziva found that a common issue among patients he treated was respiratory papillomatosis, caused by the papilloma virus, otherwise known as the Human Papilloma Virus (HPV). The illness causes growths to build up in the upper respiratory tract, constricting breathing and damaging vocal cords. If left untreated, it is life-threatening, especially for young children. Invasive care and surgery has to be taken immediately in order to dislodge warts. It is illnesses like these that make adequate and proper ENT care paramount.

Improvements to ENT Care in Zimbabwe

Despite setbacks and social misconceptions in the field, improvements are underway to bring proper ENT care in Zimbabwe. In March 2017, Zimbabwe opened its doors of the first pediatric otolaryngology clinic. This is a public clinic that has two operating rooms and a recovery room for in-patient care. Within that first year, thousands of patients traveled from all over Zimbabwe to receive treatment from the clinic. Only one other clinic such as this one existed in Africa at the time.

Following the clinic’s outstanding success, in May 2018 the first international symposium to promote the expansion of pediatric otolaryngology across Africa took place. The  PENTAfrica symposium resided in Victoria Falls, Zimbabwe that year. Health care physicians and otolaryngologists from North America, Europe and Africa engaged in these ENT discussions. The purpose of the conference was to create a long-term plan to further extend ENT care to various African countries.

Zimbabwe is one of many countries in Africa that is in dire need of ear, nose and throat care. The effects of leaving ENT illnesses untreated has left lasting effects, including deafness, on populations in Zimbabwe. However, after the opening of their first ENT clinic, more clinics and treatment are underway  to treat patients suffering from ENT illnesses.

– Lucia Elmi 
Photo: Flickr

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3D Printing In Impoverished Nations

3D Printing in Impoverished Nations
3D printing is a technology that has existed since the 1980s. Over time, additive technology has increasingly progressed where various medical applications can use it. 3D printing in impoverished nations has several benefits specifically in medicine and medical services relating to the affordability for the general populous of these nations. 3D printing for medical applications is the process of utilizing a digital blueprint or digital model, slicing the model into manageable bits and then reconstructing it with various types of materials, typically plastic. Here are three examples of 3D printing in impoverished nations.

3 Examples of 3D Printing in Impoverished Nations

  1. Custom Surgical Elements: The use of 3D printing has significantly increased in the manufacturing of customized surgical elements, such as splints. Manufacturers can make these devices and components quickly at a relatively low cost, which would greatly reduce the price of sale to the consumer. The reason for the reduced cost of production compared to conventional manufacturing systems is primarily due to the additive nature of 3D printing. For example, 3D printing actually adds material onto each layer, rather than subtracting (cutting/slicing) and combining material. This results in smaller opportunities for error to occur and the wasting of fewer materials in the long run.
  2. 3D Printed Organs: Many know this particular field of 3D medical printing as bioprinting. According to The Smithsonian Magazine, bioprinting involves integrating human cells from the organ recipient into the “scaffolding” of the 3D printed organ. The scaffolding acts as the skeleton of the organ and the cells will grow and duplicate to support physiological function. Although this particular method is still in the experimental stages, there have been successful procedures performed in the past. Researchers at Wake Forest have found an effective method for bioprinting human organs; they have successfully implanted and grown skin, ears, bone, and muscle in lab animals. Further, scientists at Princeton University have 3D printed a bionic ear that can detect various frequencies, different than a biological, human ear. The researchers behind the creation of this bionic ear theorized that they could use a similar procedure for internal organs. Similar to surgical components, 3D printed organs would greatly reduce the cost of organ transplants. Additionally, it would increase the availability of organs, which are nearly impossible to find. Locating an appropriate match within a specific proximity of the patient has resulted in a global organ shortage. Whilst some have presented a solution in the form of international organ trade, WHO states that international organ trade could provide a significant health concern because of the lengthy trips the organs would experience. 3D printed organs may be a sustainable method to help impoverished nations with supply organs quickly and cheaply.
  3. Prosthetics: 3D printing in impoverished nations could also allow people to print custom prosthetics for those in need. The lack of access to current prosthetics creates a lot of obstacles for people living in impoverished nations. Creating prosthetics with 3D printing technology has the potential to provide a person the ability to accomplish basic, daily tasks in order to support a family. Not only are current prosthetics expensive, but they are also often inconvenient or they prohibit natural motion. For example, Cambodia treats a prosthetic hand as a cosmetic item, leading the majority of the population to refuse the prosthetic due to the lack of functionality. The Victoria Hand project is currently attempting to change this perspective by providing functional, 3D printed prosthetic hands to Cambodia and Nepal. The team has performed user trials, where the aim is to distribute the 3D printed hand to the general populace. Subsequently, the design will go to multiple fabrication services to maximize accessibility.

These three examples of 3D printing in impoverished nations show just how important 3D printing is and will continue to be to aiding those in need. With further development, 3D printing should allow people to receive prosthetics and organ transplants more easily.

– Jacob Creswell
Photo: Wikimedia

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Health Disparities During Apartheid in South Africa

Health Disparities During Apartheid
Apartheid was a system that law in South Africa enforced. It was based on racial classification that imposed a rigid hierarchy. The system classified people into categories of white, Indian, colored and black. These categories determined where people could live, work and go to school, as well as who they could marry and whether or not they could vote. The government displaced many people and decreased funding for social services such as education and health care for nonwhites.

Disparities During Apartheid

Health disparities during Apartheid reflected these racial categories. Non-communicable disease rates increased for whites while poverty-related diseases, such as infectious diseases or diseases that poor sanitation or living conditions caused, increased for blacks. Additionally, blacks faced much higher maternal, infant and child mortality rates which reflects access and quality to health care.

Another significant issue that arose in the health system during Apartheid was the change in the doctor to patient ratio. Estimates in the early 1970s determined that the doctor to population ratio in the Bantustans, the areas the system specifically set aside for blacks to live, was 1 to every 15,000 rather than 1 to every 1,700 in the rest of the country. This highlights the lack of health care coverage and the extent to which black and non-whites suffered systematic discrimination both economically and in terms of health care. From 1980 to 1990, the number of doctors working in the private sector increased from 40 to 60 percent. By the time Apartheid ended in 1994, almost three-quarters of general doctors worked in the private sectors, making it even more difficult for people to afford health care.

Current Health Inequalities

Health disparities during Apartheid significantly impacted the health care situation in South Africa today. There are currently severe health disparities in South Africa stemming from economic inequalities. The wealthiest 10 percent of the country receives 51 percent of the income, while the poorest 10 percent receive .2 percent of the income.

Despite the fact that South Africa groups with middle-income countries in terms of economy, the health issues in South Africa are worse than in many low-income countries. Post-Apartheid, the burden of disease quadrupled due to an increase in diseases of poverty, non-communicable diseases, HIV/AIDs, tuberculosis and increased violence and injury. While the country has made significant progress, high tuberculosis and HIV prevalence remain major issues.

Improvements in South Africa

Many consider the 1996 Constitution that South Africa enacted after the end of Apartheid to be very inclusive and democratic even compared to other countries around the world. It reflects the difficult fight against lawful discrimination and segregation and includes a Bill of Rights, acknowledging the universal right to health care services, food, water and social security. This was a significant step towards progress despite the formation of severe health disparities during apartheid.

In addition to the 1996 Constitution, the national state pension system unified and new grants emerged such as child support grants. There have also been major improvements regarding providing basic services such as water and electricity to poor households. There has been significant progress with regard to legislation, but one should not overlook the social and economic factors.

Redistribution requires priority over growth in South Africa in order to address the issues of health inequality. Following Apartheid, President Mandela focused on growth through redistribution as a way of focusing on decreasing economic inequality. After Mandela, President Mbeki’s policies focused more on net economic growth rather than redistribution. In 2007, government revenue exceeded expenditure for the first time since the 1950s. The current president, Cyril Ramaphosa, has rallied behind National Health Insurance (NHI) and strongly advocates for universal health. care coverage. He acknowledges that there are enough resources in the country, so health insurance and care should be available to all regardless of ability to pay. This is a very important step for South Africa and suggests that progress will continue with regard to these health disparities.

– Maia Cullen
Photo: Flickr

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COVID-19: 3 Lessons from Past Pandemics

lessons from past pandemics
There are several lessons from past pandemics that apply to COVID-19 prevention today. With the rise of COVID-19, it is particularly important to look back at history to prevent similar detrimental results.

Spanish Flu and Social Distancing

One of the main lessons from past pandemics such as the Spanish Flu is that social distancing works. With cities around the world such as San Fransisco ordering social distancing, this lesson is as pertinent as ever. In 1918, Philadelphia threw a parade to support soldiers fighting in WWI that drew a crowd of 200,000 people. Just three days later, every bed in Philidalphia’s 31 hospitals comprised of people infected with the flu. Unfortunately, despite Philadelphia’s enforcement of social distancing after the infection rate rapidly increased, this response was too late.

St. Louis, on the other hand, was more proactive with enforcing city-wide social distancing regulations. Within just two days of detecting the first cases of the flu in St. Louis residents, the city enforced social distancing measures. This resulted in less than half of the flu’s death toll than in Philadelphia.

Social distancing is not just about staying away from others when ill but also about reducing the chances of becoming a carrier of the disease. Several people might have coronavirus and not even know it as only 19 percent of confirmed cases of COVID-19 become critical. Because of this, it is important to stick to social distancing regulations as much as possible.

HIV/AIDS and the Deadliness of Social Stigma

The ongoing HIV/AIDS pandemic faces a great amount of social stigma that has lead to insufficient government prevention methods. This stigma is due to discriminatory views that the virus infects those who are gay or drug addicts who use intravenous drugs.

Though governments are more responsive today, when the HIV/AIDS pandemic first arose, many including the U.S. were late to respond due to this stigma. This resulted in many protests and, eventually, the government became more responsive.

One of the main lessons from the HIV/AIDS pandemic that one can apply to the COVID-19 outbreak is the fatal impact of social stigma. There are several discriminatory sentiments toward the Asian community right now with the COVID-19 pandemic. This stigma has led to a rise in hate crimes. People of Asian descent are not the only community capable of suffering an infection from this virus, and discrimination towards them can be deadly just as the case with those that the HIV/AIDS pandemic affected.

Small Pox and Global Cooperation

The World Health Organization (WHO) ran a vaccination campaign to eradicate smallpox from 1966-1977. It jumped through many government hoops in order to run the campaign, which was eventually successful. The current coronavirus outbreak will require similar action. Following government orders and keeping up with guidelines and news from the CDC and WHO will greatly help with global cooperation to slow the spread of COVID-19.

A critical issue that requires immediate and rapid cooperation is the stocking up of medical masks and other medical supplies such as hand sanitizer in a frenzy. While buying these supplies might seem helpful at the moment, it is actually having consequential effects. Doctors have reported shortages of masks that could lead to a dire situation if buying habits like this continue. Additionally, reports state that masks for healthy people are ineffective as a means of prevention.

Another form of cooperation that will help prevent those that the virus affects is joining local activist coalitions in helping those vulnerable to COVID-19, such as unemployed or food insecure individuals. In Seattle, COVID-19 Mutual Aid is a coalition that is helping out in solidarity with those most vulnerable. One can obtain further information about its work by visiting its Instagram page.

Hope for the Future

Social distancing, destigmatization and global cooperation are key lessons from past pandemics that easily apply to COVID-19. Not only learning but applying these lessons to the current pandemic is key to beating this virus.

– Emily Joy Oomen
Photo: Pixabay

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Eradicating Food Insecurity in Brazil

Food Insecurities Decrease Around Brazil
Brazil is the largest country in South America. It also has the largest economy, which has been a key contributor to agriculture and business all over Latin America. Even with improvements in income distribution, poverty remains widespread, as income inequality remains an unsolved issue at the root of rural poverty. Thirty-five percent of the population lives on less than $2 per day, which is a reason for the food insecurity in Brazil. Additionally, 19 percent of Brazil’s population lives in rural areas, which means that Brazil has 18 million poor rural people. Meanwhile, the country’s northeast region has the single largest concentration of rural poverty in Latin America. In this region alone, 58 percent of the total population and 67 percent of the rural population live in poverty.

Food Insecurity

Food insecurity is an important subtopic coinciding with global poverty. When someone is food insecure, it means that they lack access to enough safe and nutritious food to give them the growth and development necessary to be active and in good health. Food insecurity might include a lack of resources or availability altogether.

The Food and Agriculture Organization has implemented the Food Insecurity Experience Scale (FIES) which explains the differences between the following categories:

  • Food Security to Mild Food Insecurity is uncertainty regarding the ability to obtain food.
  • Moderate Food Insecurity is the reduced quality and/or quantity of food, as well as uncertainty about how to obtain food due to little or no money or other resources. Moderate food insecurity can also lead to malnutrition. An example of this is stunting in children, which is where they do not have adequate nutrition for necessary growth and physical development. Micronutrient deficiencies are another hazard where children do not receive enough nourishment to give them the proper nutrients they require for growth.
  • Severe Food Insecurity is when one has simply run out of food, and at the most, has gone a number of days without eating.

How Fome Zero Has Decreased Food Insecurity

Brazil, which is the largest country in South America, has been able to combat food insecurity, along with poverty, through government spending on social welfare programs. For instance, one way that poverty and food insecurities have decreased around Brazil is through Fome Zero or Zero Hunger. It launched in 2003 under President Lul da Silva and has been successful in leading the nation out of poverty and improving its food security conditions. Fome Zero has been able to provide meals that have nutritious value and can support the poor’s overall health in order to combat food insecurity in Brazil.

Stunting and Food Insecurity

From the standpoint of public policy, the program has also implemented other ways of protection for those under the poverty line. These include providing not only meals and overall health improvement but also education reform, food production, health services, water, sanitation services and the prevention of growth stunting in children under the age of 5. Stunting has resulted in malnutrition, impaired cognitive ability and declining school performance later on in their lives. With Fome Zero as a premiere social-welfare program, stunting has also declined by almost 20 percent in the last quarter-century. From 1996 to 2007, stunting reduced by half from 14 percent to 7 percent.

These improvements happened because of optimal breastfeeding practices, ensuring a child’s healthy growth and development. Initiating breastfeeding for six months provides protection against gastrointestinal infections, which can lead to severe nutrient depletion, causing the process of stunting to begin. Setting a daily diet and schedule for children, as well as diversity in diet, has improved their health and overall growth.

Stunting results from a household, environmental, socioeconomic and cultural standpoint that requires that interventions for better nutrition integrate in conjunction with nutrition-sensitive interventions. One example is that one can prevent infections by hand-washing with soap, the success of which depends on behavior change to adopt the practice, the availability of safe water and sanitation needs and the affordability of personal hygiene products. Available high-quality foods and affordability of nutrient-rich foods will affect a family’s ability to provide healthier foods to prevent stunting.

Bolsa Familia

Another program that da Silva started in 2003 is Bolsa Familia, or Family Allowance, which has helped decrease poverty and food insecurity in Brazil. The conditional cash transfer program supplies low-income families with a minimum level of income. However, there are two stipulations that go with the deal: their children must attend school daily and they must schedule doctor’s appointments in order to receive aid from the government. More than 20 percent of Brazil’s global domestic program went towards education, health care and protection for all low-income families. From 2003 to 2013, the extreme poverty line population has decreased from 9.7 percent to 4.3, with Bolsa Familia reaching 14 million households, equaling 50 million people. As such, many consider the program to be the most successful in the world.

More than 50 million people receive payments from the program. This depends on family earnings that range from $14 to $140, whether people work part-time or full-time, as well as the number of dependents. As the largest conditional cash transfer in the world, Bolsa Familia reaches more than a quarter of the nation’s population and has lifted more than half out of poverty.

BF has also started a trend globally that has expanded conditional cash transfer programs, alongside Latin America, where over 40 countries have adopted this model to aid those on the poverty line and who are food insecure. Brazil’s next step to put a halt to poverty included the Brazil Learning Initiative for a World without Poverty (WWP), launched in partnership with the Ministry of Social Development, Ipea and UNDP’s International Policy Center in 2013. The Initiative helped support continuous innovation.

The endgame of these program developments is to sustain, if not overachieve, in providing aid to families in Brazil. The levels of success and vast improvements of these programs have helped the country come close to eradicating food insecurity in Brazil, as well as poverty.

– Tom Cintula
Photo: Flickr

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UN Program Aiding Women’s and Children’s Health

Women’s and Children’s health
In 2000, all 191 members of the United Nations officially ratified the Millennium Development Goals (MDG) which are eight, interdependent goals to improve the modern world. One of these goals included “promot[ing] gender equality and empower women; to reduce child mortality; [and] to improve maternal health,” emphasizing the need for increased focus on women’s and children’s health across the globe. In 2015, the Millennium Development Goals ended and the U.N. published a comprehensive report detailing the success of the MDGs. The report concluded that, during the length of the program, women’s employment increased dramatically, childhood mortality decreased by half and maternal mortality declined by nearly 45 percent.

Such success is, in part, due to another initiative, the 2010 Global Strategy for Women’s and Children’s Health, that aimed to intensify efforts to improve women’s and children’s health. Upon conclusion, the U.N. began developing a new program, the Sustainable Development Goals (SDGs), which includes 17 interconnected goals. Expanding on the success of the MDGs, the U.N. aims to tackle each goal by 2030. Similar to supportive programming to the MDGs, the U.N. has created another push for women’s and children’s health by establishing the 2016 Global Strategy for Women’s, Children’s and Adolescent’s Health.

The Global Strategy for Women’s, Children’s and Adolescent’s Health

The 2016 Global Strategy for Women’s, Children’s and Adolescent’s Health tackles a variety of critical global issues including maternal and childhood death, women’s workforce participation, women’s and children’s health care coverage, childhood development and childhood education. Being more robust, the 2016 Global Strategy is distinguished from the previous program as it “is much broader, more ambitious and more focused on equity than [the 2010] predecessor,” according to a U.N. report. The 2016 Global Strategy specifically addresses adolescents with the objective of encouraging youth to recognize personal potential and three human rights of health, education and participation within society.

Initiatives Supporting the SDGs

Many anticipate that achieving these global objectives will be a complex challenge. Therefore, the U.N. has established two groups to address women’s, children’s and adolescent’s health advancement: The High-level Steering Group for Every Woman Every Child and The Working Group on the Health and Human Rights of Women, Children and Adolescents.

The U.N. Secretary-General created the High-level Steering Group for Every Woman and Every Child in 2015. Seven areas of focus within the 2016 Global Strategy define the overall aim of this group. These include early child development, adolescent health, quality, equity, dignity in health services, sexual and reproductive health and rights, empowerment, financing, humanitarian and fragile settings.

The World Health Organization and the U.N. Human Rights Council created the Working Group on the Health and Human Rights of Women, Children and Adolescents in 2016, and it delivered recommendations to improve methods to achieving the 2016 Global Strategy. The group provides insight to “better operationalize” the human rights goals of the Steering Group in the report. 

In conjunction, these groups have accelerated and promoted the effectiveness of the 2016 Global Strategy. These groups effectively outline the idea that it is crucial to work as a team to tackle some of the world’s most complex problems concerning global poverty and health. U.N. Secretary-General, Ban Ki-Moon, believes these programs and groups will guide individuals and societies to claim human rights, create substantial change and hold leaders accountable.

Benefiting the Global Community

While the objective of the 2016 Global Strategy is to provide women, children and adolescents with essential resources and opportunities, the benefits of this integrated approach reach far beyond these groups. Developing strategic interventions produces a high return on resource investment. The reduction of poverty and increased public health leads to stimulated economic growth, thus increasing productivity and job creation.

Further, projections determine that the 2016 Global Strategy’s investments in the health and nutrition of women, children and adolescents will procure a 10-fold return by 2030, yielding roughly $100 billion in demographic dividends.

These high returns provide a powerful impetus for program support by local communities and government officials. Projected financial return can shed light on the global benefits of localized poverty reduction efforts. While the aim of poverty reduction should be in the interest of those most affected, understanding that such programs can provide a country with increased long-term growth is a major factor in the success of such initiatives, specifically in women’s and children’s health. 

The 2016 Global Strategy for Women’s, Children’s and Adolescent’s Health is indispensable during a time when women and children are providing the world with new innovations and perspectives. Each day, women across the world promote cooperation, peace and conversations within communities. Children will come to define the wellbeing of our world in the future. The success of U.N. programs today is a new reality for the world tomorrow.

– Aly Hill
Photo: Flickr

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Vietnam’s Health Care System

Vietnam's Health Care System
As Vietnam has grown and developed over the last two to three decades, so has its health care system. There is a decrease in the number of deaths due to health issues and an increased rate of vaccination through Universal Health Coverage (UHC). With much success for the UHC implementation, Vietnam’s health system has become a model to other countries. However, there is still a difference in the level of care between the rich and poor in Vietnam’s health care system.

Health Care and Hospital Systems

Business Monitor International (BMI) stated that health care spending in Vietnam in 2017 increased to 7.5 percent of gross domestic production, which is $16.1 billion. Meanwhile, experts forecasted it to grow 12.5 percent annually during a four-year period from 2017-2021, which would be approximately $20 billion according to KPMG. Public health care spending is expanding with social health insurance programs that projections determine will 58.1 percent of all health care spending.

Vietnam’s health care system is decentralized with the Ministry of Health at the central level. Meanwhile, the provinces, cities, districts and communities connect to the Ministry of Health. The four groups implement their own health policies and manage their own health care system and facilities. The Ministry of Health (central level) manages the health care system for the government as well as hospitals, medical education and research. Provinces and cities run hospitals, other health care facilities and health care-education programs with central oversight. Finally, health care facilities at the district and commune-level provide basic medical care with preventative services.

Universal Health Coverage (UHC)

Vietnam is a leader in implementing universal health coverage. This would cover medical and dental services as well as medicine and vaccines. The Global Monitoring Report on UHC by both the World Health Organization and the World Bank states that almost 88 percent of people in Vietnam have health coverage and 97 percent of the children received vaccinations. There is also a 75 percent decrease in the death of mothers through universal health coverage. Vietnam has reached health care goals (as recommended by the United Nations’ Sustainable Development Goals) earlier as compared to other countries due to its strategy on using all that is available, including staffing and administration.

Public View and Poverty Gap

Vietnamese’s traditional viewpoint on health care services affects health care delivery. It is a common belief that larger health care facilities in big cities would provide better health care services through more specialized staffing and more robust technology and equipment. Therefore, people tend to overlook smaller local facilities in the countryside or in rural areas. This, in turn, is impeding faster and necessary care while incurring unnecessary, unknowing or avoidable high costs. Such a barrier would ultimately contradict the proposed health care strategy above.

Vietnam’s health governance body is working to change the public viewpoint on local community health by educating the public about the programs and charging local health offices to provide excellent care in order to build trust. Wealthy patients have better access and higher quality health care. As wealthy patients tend to live in big cities, they are closer to big health care facilities that are well equipped. Meanwhile, poorer patients often have to travel hundreds of miles from rural areas to reach better care. While private insurance gives patients primary and preventative medicine that would avoid high health care expenditures due to medical emergencies, wealthy patients have more opportunity to purchase private insurance for better care. Health care inequity leaves the poor at a disadvantage with higher chances for illness and a lower quality of care.

Support and Challenges for UHC

Vietnam’s universal health care is receiving support from the Working Group for Primary Healthcare Transformation. The group works to present and emphasize primary care services in provinces around Vietnam, as well as improve and expand those services moving forward. Harvard Medical School, a member of the group, helps with primary care structuring and management. Another member, Novartis, provides rural community health education outreach as well as technology and rural medicine education for health care professionals. For instance, Novartis’ Cung Song Khoe Program has provided treatment for many conditions such as diabetes, hypertension and respiratory disease, as well as education for local rural communities and health care professionals, totaling 570,000 people served in 16 provinces. However, there are still challenges that are holding back Vietnam’s health care system including a high number of smokers and adults with alcohol usage, as well as extreme air pollution and aging populations.

Despite drawbacks from public views, health challenges and the environment, Vietnam’s universal health coverage is holding strong and progressing with ongoing program evaluations, strategic planning, improved care quality and partnerships. Therefore, Vietnam’s health care system has also been growing and is standing tall among that of other well-mentioned countries. With that said, eliminating health inequity is the focus to improve Vietnam’s health care.

– Hung Le
Photo: Flickr

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ICT and eHealth in Developing Countries

ICTS and eHealth in Developing Countries
Information Communication Technology (ICT) supports medical workers when physicians are absent. They manage patient records and keep accurate accounts in medical supplies and medication inventory. ICTs increase lab information management and create algorithms for effective treatment plans including the distribution of medications and immunizations. As a laundry list of medical conveniences, ICT in eHealth has a lot of advantages. Yet, the concept of eHealth in developing countries is more about connecting rural and resource-poor communities with specialists. So, how does ICT and eHealth in developing countries work?

Asynchronous Medical Exchanges

The obvious advantage is that health information is easily accessible, regardless of time, location or occupation. Asynchronous medical exchanges bridge physical and time-complying barriers between multiple personnel. This could be between a doctor and patient or doctor and specialists or all three. There are various forms of ICT (email, video conference and audio), all of which offer an array of services including teledermatology, telepathology and teleradiology, to name a few.

Maternal and child health care is of primary concern in many countries, and India has shown particular promise in women and children eHealth platforms.

Successful ICT Programs in India’s Mobile Health Initiative

The use of cell phones, home patient monitoring devices and other wireless devices closed the gap between India’s poorest communities and health care. The National Informatics Centre developed MCTS (Mother and Child Tracking System), which utilizes information technology (IT or ICT) to access a full spectrum of health services for pregnant women and children. MCTS operates on an alert-notification platform for medical workers. Services include antenatal, post-op and post-natal care for mom as well as guaranteed immunizations and check-ups for the first five years.

At the state level, eHealth programs like PICME (Pregnancy Infant Cohort Monitoring Evaluation) in Tamil Nadu, Arogyam in Uttar Pradesh and the 2018 Digital LifeCare initiative all provide working platforms for physicians to screen, manage and care for patients in resource-poor areas on or off-site.

The use of ICT in eHealth has impacted developing countries and progress, as illustrated in India, has occurred. However, reliable internet access is necessary for the successful implementation of ICT in eHealth. In addition, eHealth development varies by country and has unequal distribution among the poorest of countries.

Serbia has a population of 7 million with about 37 percent seeking health information online; only 33 percent have access to reliable internet. Similarly, Turkey has a population of 80.3 million with reliable internet access for more than half. Algeria, Guatemala and Zambia’s populations have less than 20 percent internet access respectively and Afghanistan only 5 percent. Many challenges threaten the successful implementation of eHealth, chief among them access to reliable internet.

A Digital Divide

If global society continues daily reliance on digital technology and services, resource-poor countries will be in the wake of information communication technology. Gaps in supportive infrastructure cripple developing countries’ chances of successful eHealth platforms.

Rapid technological advances over the last decade impede resource-poor locations’ ability to remain up-to-date with medical equipment and treatment plans, disallowing use of the technology. Likewise, unstable power supplies and insufficient or unreliable communication networks fundamentally limit the potential of eHealth integration.

A cross-sectional survey conducted in Brazil reported 81.4 percent of medical physicians believed EHR (electronic health records) response time was unsatisfactory. Eighty-six percent complained of technical difficulties and 35 percent had an insufficient supply of equipment in clinics—a direct result of insufficient funding.

Information Communication Technology is expensive and insurance packages, private party investments and individual donors or clients provide the majority of funding.

Deputy Director of the Digital Health Solutions Programme Skye Gilbert speaks caution and vigilance to collaborators when considering solutions for the digital divide, stating that “Being excluded from the digital domain will have more and more implications for someone’s health status…So the digital divide will become more and more tied to health equity over time.”

A Symbiotic Relationship

Overall, health improvement for resource-poor settings will not improve unless health technologies are accessible to all. The way in which ICT impacts eHealth in developing countries is quantifiable in that the countries with proper resources and pre-existing conducive technological platforms have measurable success in the implementation of eHealth programs. But for those countries struggling to fill in a widening digital gap, eHealth and, by consequence, people will always underrepresent and neglect public health.

Countries like Bangladesh, Paraguay, Qatar and Rwanda officially adopted eHealth strategies—four of 73 with eHealth initiative plans. Until medical information communication technology is accessible to everyone, health will only ever be a privilege for those able to afford it.

– Marissa Taylor
Photo: Flickr