Archive for category: Health

Information and stories on health topics.

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Ethiopia’s Health Workforce Shortage: Strategies To Train & Retain

Ethiopia’s Health Workforce ShortageEthiopia is one of the most populous nations in Africa. It is dealing with a severe shortage of trained medical providers, particularly in rural and low-income areas. This shortage reduces access to quality health care, undermines the effectiveness of public health initiatives and ultimately affects life expectancy.

Ethiopia’s Health Care Workforce Shortage

Ethiopia has one of the lowest health care worker-to-patient ratios in sub-Saharan Africa, with only one physician per 5,843 people. Many rural clinics operate with just one or two nurses and sometimes, no trained doctors. Programs like the Health Extension Program improve access to basic services.

However, a lack of trained health professionals continues to limit the success of health programming and the overall quality of health care for the population. Key factors contributing to the workforce shortage include a lack of medical training and vocational programs, low salaries, poor working conditions and limited opportunities for advancement. Together, these challenges drive many trained professionals to leave Ethiopia in search of work elsewhere.

Increasing Educational Opportunities

Increasing educational opportunities is an essential component to tackle Ethiopia’s workforce challenges. Ethiopia has made major strides in expanding medical schools and allied health programs nationwide. There has been some success in establishing higher outputs of trained doctors and nurses in a short time.

However, the need continues to grow for trained doctors, nurses and specialists. This requires investments in teaching hospitals, training facilities and qualified faculty. It also calls for partnerships with international universities and health institutions to create opportunities for knowledge transfer, skill development and student exposure to professional exchange programs in global health settings.

Such measures would strengthen medical education in Ethiopia and provide students with valuable pathways to gain experience.

Ethiopia’s Health Care Workers Retention Challenge

Retaining health care personnel is another significant challenge. Many health workers and other health care professionals are often under extreme stress due to a high patient load, old equipment and fluctuating salaries. Such conditions can lead to burnout and increase the likelihood of trained workers leaving their country to work elsewhere for relatively better conditions.

There are many solutions to these retention issues, such as improved standards of care, better health care systems, consistent supply chains for medical equipment and medicines and salaries that are compliant or more than the salaries in the region. Financial incentives such as bonuses for performance or relocation expenses for trained health professionals returning to work in Ethiopia can also boost recruitment and retention of trained health care professionals currently working abroad.

Ethiopia can build a healthier and more robust workforce if it can start to solve retention challenges.

Efforts To Boost the Health Workforce

Technology-based solutions exist to relieve tensions related to the health care workforce shortage in Ethiopia. Programs like the International Virtual e-Hospital Foundation’s (IVeH) telemedicine initiative aim to enhance health care access and education in Ethiopia.

Telemedicine cannot wholly substitute in-person care; however, it is a vital tool to deal with the burden of having limited staff to meet the health care needs of individuals in remote areas for timely consultations.

Public engagement and awareness are also important to create a sustainable health care workforce. Campaigns highlighting the benefits and importance of health care careers can motivate young Ethiopians to pursue medical training and lay a strong foundation for a commitment to service in their communities.

Schools, community settings and social media can all encourage students to consider health care professions. Indeed, by promoting health care as a respectable and impactful career, graduates will be more likely to remain in Ethiopia and support the development of the national health system.

Conclusion

Tackling Ethiopia’s health care workforce shortage has ramifications beyond public health, extending into national development. A stronger and more equitable workforce could expand access to care, prevent avoidable deaths and restore public confidence in the health system.

Training and retaining health care personnel is a health investment and an economic one, as improved health fosters a more productive population capable of advancing national development goals. Furthermore, by aligning efforts in medical education, workforce retention, technological innovation and public engagement, Ethiopia can build a sustainable health care system that meets the needs of its growing population.

– Sophia Scelza

Sophia is based in Lindenhurst, NY, US and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Expanding Access to Maternal Health Care in Tanzania

Maternal Health care in TanzaniaTanzania has made important progress in maternal health, yet preventable deaths remain a challenge, especially in rural areas. The maternal mortality ratio declined from about 980 deaths per 100,000 live births in 2000 to 276 in 2023. At the same time, the number of skilled birth attendants has risen sharply in recent years, with national surveys indicating that skilled health providers attended approximately 85% of live births in 2022. These gains show what is possible when facility delivery, trained staff, and essential supplies reach more mothers.

Distance to facilities, shortages of midwives and nurses and inconsistent supplies continue to limit quality care for many women. National strategies highlight the need to strengthen the workforce and ensure integrated services from antenatal through postnatal care. Assessments indicate that Tanzania has not yet achieved the health worker density necessary to meet population needs, which impacts the availability and quality of care in remote districts.

World Bank Support

Through a results-based approach, the World Bank has supported primary health care programs in Tanzania with a strong focus on maternal, newborn and child health. A 2022 financing package under the Tanzania Maternal and Child Health Investment Program is helping improve the quality of essential services and scale up delivery, while 2023 documents outline support for expanding the Safer Births Bundle of Care (SBBC) from antenatal to postnatal services. These efforts aim to improve performance at the facility and local government levels and to strengthen supervision and data use.

Integrating Care Where Women Live

USAID’s Boresha Afya program supported the Government of Tanzania to provide integrated reproductive, maternal, newborn and child health services together with family planning, malaria, TB, HIV and nutrition. A midterm evaluation describes implementation across three zones and documents support to more than 1,800 health facilities in the Lake and Western zones, along with community outreach and system strengthening. Implementing partners include Deloitte, Jhpiego, EGPAF, and others working with regional and district teams to improve the quality and continuity of care.

More Facilities, Better Data, Safer Births

National health information shows rising institutional deliveries and better reporting from facilities, which supports targeted supervision and supply chains. Reported institutional deliveries increased substantially from 2016 to 2020, and by 2022, more facilities were consistently reporting on key maternal and newborn indicators. Expanding midwife training and respectful maternity care, together with improved logistics, is critical to sustaining these gains.

The Future

Investing in skilled birth attendance, timely referrals and postnatal care saves lives. Evidence links higher rates of facility delivery and skilled attendance to lower maternal and newborn mortality, and Tanzania’s recent progress reflects this pattern. Continued investment in primary care, workforce capacity, and integrated services can accelerate the decline in maternal deaths and close rural gaps.

World Bank and USAID-supported programs, in conjunction with national strategies such as One Plan III, are expanding access to quality prenatal and delivery care. Strengthening rural facilities, staffing them with trained midwives, and ensuring respectful, integrated services can transform outcomes for mothers and newborns in underserved regions. Indeed, with steady financing and local ownership, Tanzania can continue to reduce maternal deaths and deliver healthier starts for families.

– Joseph Hasty

Joseph is based in Winter Park, FL, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Children International: Lasting Poverty Relief

Children InternationalStarting with a meek beginning in 1936, an organization, not yet formally named Children International, began its outreach out of a one-room medical clinic to help families around Jerusalem.

Over the following decades, the initiative’s care expanded as its positive results increased with the growing care providers. Much of its growth included the development of its own global headquarters, child sponsorship programs, hospitals and many different specialized care opportunities.

By 1989, the organization formally named itself Children International. It began their full-fledged mission to give children poverty relief for a lifetime.

How Children International Works

Children International seeks to provide care and support to all children in need, helping to break the cycle of poverty. Its specialized programs are flexible, adapting to give each child the resources they need to flourish.

One of the organization’s most pertinent parts is sponsorship-supported interventions. These help children and adolescents reach critical milestones and create lasting pathways out of poverty.

Measuring Success

Children International supports its recipients in specific areas to help them achieve lifelong freedom from poverty. The organization’s outreach focuses on the following key aspects of life:

  • Medical Care and Access. Since 2021, Children International has provided more than 100,000 medical and dental services, nearly 40,000 more than in previous years. Additionally, it provided medical support to 20,000 adolescents, giving them access to addiction treatment, contraceptives and other essential services to protect their health and safety. This increased access to health care gave many lower-income families the support they needed to live healthily and adequately.
  • Education Quality and Access. Children International provides students with a wide range of educational resources, focusing on increasing school enrollment, boosting completion rates and improving learning outcomes. Since 2022, 92% of participants in a specialized course designed to help students finish school have completed it. Among youth sponsored by Children International, 99% complete their education. In addition, 150,000 children and youth have been given access to proper technology during their schooling to ensure quality education. Globally, almost two-thirds of children lack internet or technology access, making this service a powerful tool for breaking the cycle of poverty.
  • Empowerment and Quality of Life. Empowerment and Quality of Life. To lead a higher quality of life, Children International also implements many programs that help youth maintain high emotional well-being. As of 2022, the organization recorded having more than 60,000 participants in its Emotional Well-Being Program. This program aims to improve mental well-being through group settings. Its emotional support services help communities interact socially and strengthen social connections.
  • Into Employment Opportunities. As children and adolescents complete their programs with Children International, they are set up for a proper future that includes poverty relief for a lifetime. This relief includes many meaningful skill learning opportunities such as résumé writing, interview skills, job searching, job applying and other essential career skills. This training allows youth to break the cycle of poverty and gain a life that keeps improving.

A Lasting Impact

Children International aims to create connected, thriving communities for every child, family and individual. The charity allows communities to grow and prosper through programs supporting health, education and careers.

Using targeted outreach strategies, Children International works to break the cycle of poverty and provide families with lasting relief through essential resources.

– Angelina Tas

Angelina is based in Cleveland, OH, USA and focuses on Good News and Technology for The Borgen Project.

Photo: Flickr

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Health Care for Non-Communicable Diseases Impacting Ghana

Diseases In GhanaNon-communicable diseases (NCDs), such as cardiovascular diseases, diabetes, chronic lung diseases and cancers, have become one of the largest burdens to worldwide health care systems. Roughly 41 million people die of chronic non-communicable diseases (CNCDs) each year, with the majority of these deaths occurring in developing countries, despite the misconception that they are most common in developed countries. While CNCDs impact people from all walks of life, those living in poverty are disproportionately affected due to the high costs of care and limited health care knowledge, making this not just a health care issue, but a socio-economic one. Lack of adequate care also leads to a higher rate of complications and premature deaths as a result of CNCDs within poorer communities.

CNCDs in Ghana

Chronic non-communicable diseases impacting Ghana have hit epidemic proportions, accounting for nearly half of all deaths, and calls to reduce their growing health and economic burden have become increasingly urgent. The drivers of CNCDs are systemic within society and typically linked to behaviors in adolescence, with unhealthy food environments and limited access to physical health infrastructure being two pillars of the increase.

While there has been an attempt to control the rapid swell of these diseases, the August 2012 policy aimed at reducing cases of CNCDs was largely ineffective. With this policy, Ghana strove to prevent and control non-communicable diseases, and focused on strategies such as primary prevention, clinical care and strengthening the health system. However, there were many interconnected challenges which limited its efficacy. On a national level, poor awareness, inadequate coordination and a lack of funding inhibited the policy’s functioning. There was also limited attention afforded to the management of patients who already have CNCDs. In addition, on a sub-national level, inadequate clarity on translating the policy into action rendered ground-level operationalizing ineffective. What the 2012 CNCD policy made evident was the need for comprehensive structural and strategy development which focused on both preventive and curative care.

Recent Progress in CNCD Policy

Despite this, there have been fruitful strides towards constructing an overarching and effective policy to combat chronic non-communicable diseases impacting Ghana. Earlier this year, the Ministry of Health in Ghana, with support from the World Health Organization (WHO), convened a stakeholder agreement with more than 50 people from government ministries, regulatory agencies, academia, civil society and United Nations partners to galvanize support for legal reform which promoted healthier diets and physical activity – the two pillars of prevention. This was part of Phase II of the Global Regulatory and Fiscal Capacity Building Programme (Global RECAP), a program seeking to implement measures to reduce the occurrence of NCDs by creating healthier environments.

In addition, Ghana is preparing to roll out the 2025 Global School Health Survey, a nationally representative survey aimed at gathering critical data on the personal health behaviors of school-aged adolescents. To ensure the successful implementation of the survey, a national training program has been held in Kusami for collectors and administrators, equipping them with technical knowledge, ethical guidance and practical tools for survey administration. The questionnaire includes modules on nutrition, physical activity, mental health, alcohol and drug use and the role of familial support, as well as measuring height and weight. Illustrating the importance of this initiative, Dr Pascal Mwin, Technical Officer for Non-Communicable Diseases at the WHO Country Office, emphasized the “critical investment in building a stronger foundation for adolescent health in Ghana,” which will ultimately aid the effectiveness of the policies it will inform.

Looking Ahead

With continued aid from the WHO, there is cause for hope for encompassing and productive legislation to tackle the rising tide of chronic non-communicable diseases impacting Ghana, foster healthier school environments and increase access to adequate health care for those living in poverty.

– Libby Foxwell

Libby is based in Sherborne, Dorset, UK and focuses on Global Health for The Borgen Project.

Photo: Unsplash

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Diseases Impacting French Polynesia and Efforts to Combat them

Diseases Impacting French PolynesiaFrench Polynesia is an island chain nation in the South Pacific that is often described as a breathtaking tourist destination due to crystal clear waters, white sandy beaches and great resorts. However in recent years, the nation has been facing an influx of public health threats. Illnesses such as dengue fever and leptospirosis have begun to create health and economic concerns. While there continues to be concern, efforts from the government, NGOs and international partners are bringing progress. These are some of the diseases impacting French Polynesia.

The Health Crisis at Hand

Dengue fever, a flu-like disease, has been a consistent issue in the region. During the 2023 outbreak, the Dengue Visual Atlas estimated there were 306 reported cases. Aedes aegypti mosquitoes, which thrive in warm tropical environments, spread the disease. Spiking during the rainy season because stagnant water becomes a breeding ground for the mosquitos.

Leptospirosis, a bacterial disease that spreads via contaminated water or soil, has also caused concern. In 2023, health authorities reported 117 cases. This was substantially higher than the 12 during the same time period in 2022. Officials linked the increase to heavy flooding and rain in areas like Tahiti. Leptospirosis can have severe complications such as kidney damage, liver failure or even death if untreated.

Poverty in the country affects a lot of the outcome of disease spread. A study that the French Development Agency did in 2010 found that around 28% of the country lives in poverty, surviving on around $1,000 USD a month. A small elite population of the country also controls a disproportionate share of resources, placing even greater strain on lower income families. Many of the islands in the nation are also isolated and underdeveloped, lacking even basic health care. This causes many to travel just to receive simple treatment.

Community-Based Solutions

To combat diseases impacting French Polynesia, the nation’s government has implemented proactive and science based policies. According to the World Health Organization (WHO), scientists in Tahiti are initiating a Sterile Insect Technique project of releasing sterilized male mosquitoes to combat dengue transmission. This method targets the mosquitos directly instead of using chemical pesticides, resulting in a more positive effect on the environment.

NGOs

The Institut Louis Malardé (ILM) established itself in 1949 in Tahiti, the nation’s largest island. It is a public research institute dedicated to progressing public health in French Polynesia. It initially focused on combating lymphatic filariasis. Since then, it has expanded its focus to address a spectrum of health challenges.

The ILM is a leader in research on dengue fever. Using more than 35-years of data, its researchers have developed models to analyze dengue surveillance, providing insights into immunity and transmission dynamics. The ILM has also conducted serosurveys, contributing to a larger understanding of viral circulation in the region.

Looking Ahead

French Polynesia continues to face the risks of viral infections and waterborne diseases, but its strategies are beginning to show results. Collaborative, community-based health solutions backed by data and research are helping residents stay informed and remain safe. With continued and consistent funding, ongoing education and continued cooperation, French Polynesia’s public health system will build resilience, not only with today’s epidemics and illnesses, but for future ones as well. In an isolated region with a tropical climate, health care can be challenging. The efforts are proving that prevention, rapid response and local leadership can form effective control on the diseases impacting French Polynesia.

– Brody L. Gates

Brody is based in Fort Worth, TX, USA and focuses on Good News and Politics for The Borgen Project.

Photo: Wikimedia Commons

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HIV/AIDS in Slovakia: How Prevention Keeps Rates Low

HIV/AIDS in SlovakiaHIV/AIDS in Slovakia remains among the lowest in Europe, demonstrating how prevention, testing and treatment can keep infection rates under control. Strong public health policies, accessible care and community initiatives continue to drive this success story. Yet, some vulnerable groups facing poverty may still struggle to receive support. However, Slovakia’s progress demonstrates how addressing inequality is key to sustaining low infection rates.

Low Infection Rates Provide a Strong Foundation

  • Slovaks between the ages of 15-49 have an incredibly low rate of HIV, falling below 0.1%.
  • While the incidence rate doubled from 2014 to 2015, new infection rates have stabilized at approximately 0.02 per 1,000 uninfected individuals, reflecting effective public health efforts.
  • From 2019 to 2023, Slovakia’s HIV rate averaged 2.44 per 100,000, exactly half the EU/EEA average of 4.88.      
  • In 2022, a total of 67% of HIV diagnoses were previous positives (already diagnosed beforehand), meaning around 19% were newly diagnosed. Slovakia ranked the second lowest for newly diagnosed rates in Europe, just after Ireland; this was consistent in 2023, too.      
  • The EU/EEA reported 24,731 HIV diagnoses in 2023, while Slovakia reported only 142 cases (similar to 2022 data), highlighting Slovakia’s low contribution to the total. Additionally, there has been a decrease of 61 Slovakian diagnoses between 2023 and 2022.

Early Testing Detects Cases Sooner

Early diagnosis and effective antiretroviral therapy (ART) are two key benefits of early testing. Slovakia emphasizes voluntary testing through mobile clinics and testing centers located throughout the country, which is crucial for preventing transmission.

Five HIV/AIDS treatment centers operate in Bratislava, Košice, Martin, Nitra and Banská Bystrica. Bratislava accounts for 68% of patients. Services are free of charge regardless of insurance or employment, including for refugees.

Treatment Coverage Continues to Grow

The five centers provide life-saving treatment to those living with HIV/AIDS in Slovakia, ensuring care is accessible and available. A 2021 case study of 117 Slovaks with HIV showed that 89.4% received ART, and 85.1% expressed satisfied with it.

In October 2019, health care providers treated 895 individuals in Slovakia for HIV. Worldwide, researchers and health care providers have made much progress in HIV treatment over the past four decades.

Education and Awareness Campaigns Reach Key Groups

Despite progress, stigma is high surrounding HIV/AIDS in Slovakia. Many people do not share their diagnosis or attempt to ignore and hide their symptoms.

Out of 117 individuals, 60% hide their HIV medication, with only 2.9% willing to openly talk about it. Meanwhile, about 31.6% reported that people stigmatized and discriminated against them, especially dentists who refused to treat them.

People may discriminate against those living with HIV/AIDS in Slovakia through physical abuse, harassment and denial of housing, which can cause severe mental health challenges. However, public individuals, such as former Princess Diana of the U.K., have often fought the stigma surrounding the diseases. Princess Diana challenged these views when she opened the U.K.’s first dedicated HIV/AIDS unit in London in 1987, showing compassion towards patients and challenging misconceptions.

NGOS and Community Initiatives Make an Impact

NGOs addressing HIV/AIDS in Slovakia also play a vital role in reducing stigma and supporting vulnerable groups. These include:

  • Dom Svelta Slovakia: Formed in 2013, this organization fights stigma, educates communities and enforces the human rights of those living with HIV. In 2024, it provided 2,610 tests with 886 specifically being for HIV.
  • Odyseus: Odyseus formed in 1997 and provides outreach to sex workers, young people and other vulnerable groups living with HIV/AIDS, contributing to social inclusion through activities. It had 472 new visitors in 2024.
  • Prima: Prima formed in 1998 and offers anonymous HIV rapid testing with test counselling and result counselling from its trained medical staff, as well as social assistance. It also provides informative materials for schools and teachers on preventative activities for students.

All the services at these NGOs are free of charge, meaning that even those experiencing poverty can still access support and treatment. These NGOs play vital roles in reducing stigma, encouraging treatment and helping those whom traditional health care facilities may not, all while keeping infection rates low through direct community engagement.

Poverty and HIV/AIDS in Slovakia

Poverty and inequality influence HIV/AIDS in Slovakia. Migrants, sex workers and individuals with low incomes often face barriers accessing health care and sufficient education, consequently increasing their vulnerability to catching HIV/AIDS. However, the above NGOs and many more bridge this gap by offering their free support programs and tests.

Slovakia was found to be the second-poorest country in the EU in 2023, with senior individuals affected the most. Poverty and HIV/AIDS are interconnected, where poverty increases the chances of HIV/AIDS and HIV/AIDS increases poverty. Individuals with lower income or education are more prone to catching HIV/AIDS due to a lack of information and prevention or due to being homeless. Then, HIV/AIDS can easily slow economic growth, resulting in poverty.

Looking Ahead

HIV/AIDS in Slovakia remains low, with infection rates under control. Strong public health policies, accessible treatment and active community engagement drive this success story. For those facing poverty and inequality, access to care can be more challenging. However, NGOs are supporting these vulnerable groups.

– Rebecca Lamb-Busby

Rebecca is based in Hull, UK and focuses on Good News and Global Health for The Borgen Project.

Photo: Wikimedia Commons

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Philippines’ Nurse Migration is Fueling a Health Care Crisis

Philippines' nurse migrationThe Philippines is the world’s leading exporter of nurses. While Filipinos account for only 1% of the U.S. population, they comprise 4% of the nursing workforce. Although the U.S. has relied on the heroic contributions of Filipino nurses for centuries, their continuous migration is fueling a crisis at home. Hospitals and clinics across the Philippines struggle with staff shortages and the country’s continued nurse migration has gradually widened the global health care gap.

Brain Drain of Nurses

“Brain drain” refers to the mass emigration of the most highly educated or skilled individuals from a particular country. For many developing countries, the inability to retain such professionals across various sectors, due to sociopolitical or economic factors, can trigger a cyclical downfall of infrastructure and human capital. In the Philippines, decades of nurse migration to the U.S. have resulted in a catastrophic shortage.

The Department of Health sets a standard 1:12 Nurse-to-Patient Ratio. In the Philippines, the ratio regularly stands at 1:20 and has even escalated to 1:50. The nation faces a nurse shortage of roughly 127,000 nurses, with nearly 4,500 posts at public hospitals remaining unfilled, a figure expected to rise to 250,000 by 2030.

Many Filipino nurses are emigrating to the U.S. due to poor working conditions at home, leaving the nation’s health care system understaffed and worsening nurse burnout. While a series of mental health programs and interventions have been suggested as a way to remediate this threat, the problem seems to stem from several structural challenges.

Most notably, these include extremely low salaries, heavy and imbalanced workload and hours, job insecurity and a common delay in the disbursement of benefits. All of this plagues the Philippine health care system amid rising costs of living, inflation, economic hardship and a tense political climate, fueling pressing issues both domestically and geopolitically.

Solution-Oriented Policies and Strategies

The Commission on Higher Education (CHED) has approved many new programs and state universities aim to expand access to medical education, especially for those in the country’s underserved regions. The Medical Scholarship and Return Service Program (MSRS), also known as the Doktor Para sa Bayan Act, is an example of an initiative recently signed into Filipino law to fund medical education in exchange for mandatory local service upon graduation.

The program provides full tuition coverage along with allowances for textbooks, housing, uniforms, transportation, medical insurance and other related expenses. Each year they receive the scholarship, scholars must work for at least one year in hospitals or public health offices in their hometowns or other underserved areas. Students from indigenous, geographically isolated, disadvantaged, or understaffed regions are given priority.

The CHED and the Department of Health implement the program as a direct response to the shortage of medical professionals in such underserved areas. It aims to increase the number of available and qualified health professionals in these areas.

As part of a retention evaluation, the Philippines is also making concerted efforts to address burnout and recruiting practices. The country has begun to mobilize resources and improve policies so that working and living conditions for these nurses are sufficient in their home country. Increasing salaries, providing benefits on time and encouraging and incentivizing filling vacant government positions, particularly in underserved regions, are all critical steps towards change. House Bill No. 5276 and Senate Bill No. 2694 are two examples of proposed legislation to reduce nurse migration and the resulting “brain drain” in the Philippines. Both seek to amend Filipino nursing laws to raise nurses’ monthly basic salary and minimum salary grade.

Organizations Supporting Filipino Nurses at Home and Abroad

Countless organizations also focus on mitigating the Philippines’ nurse migration and brain drain crisis. The Philippine Nurses Association (PNA) is the Philippines’ national organization of nurses, promoting high standards of practice and supporting the welfare of Filipino nurses. Filipino Nurses United (FNU) and The Philippine Nurses Association of America (PNAA) are organizations assisting Filipino nurses based in the U.S.

In addition to facilitating networking and professional development, these organizations advocate for labor rights, social justice and fair working conditions. While addressing domestic retention problems to reduce emigration, ensuring support for Filipino nurses overseas remains crucial.

Filipino nurses in the U.S. often send a large portion of their earnings back home in remittances. Maintaining a higher retention rate for those working abroad helps sustain this economic support, which funds education, local investments and small businesses in the Philippines.

Well-supported Filipino nurses in the U.S. are also more likely to return periodically to assist in their home country. They may donate supplies or share advanced medical knowledge with their communities. These contributions help counter the effects of “brain drain.”

– Kaitlin Reed

Kaitlin is based in Austin, TX, USA and focuses on Technology and Global Health for The Borgen Project.

Photo: Flickr

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Screening Success and HPV Vaccination in Thailand

HPV VaccinationCervical cancer is a serious global public health concern. However, the World Health Organization (WHO) has launched a strategy to reduce the number of cervical cancer cases to four per 100,000 in all populations by 2030.

The Scale of the Problem in Thailand

In Thailand, human papillomavirus (HPV) has posed a significant threat. In many cases, it is harmless, but certain strands, namely 16 and 18, can lead to aggressive forms of cervical cancer. Globally, these two strands make up 70% of cervical cancer cases. Between 2001 and 2003, there were an estimated 18.1 cases per 100,000 women. This makes cervical cancer the second most common cancer in Thailand.

Public Health Minister Cholnan Srikaew acknowledged the threat these figures posed to women and introduced a national health strategy aligned with WHO’s 2030 targets: vaccinating 90% of girls by age 15, screening 70% of women aged 35–45 and ensuring timely detection of cervical lesions in 90% of affected women.

Success of the HPV Vaccination Scheme in Thailand

Since 2017, Thailand has offered two free doses of the HPV vaccine to all girls aged 11-12. While the country has not yet met the WHO targets, progress is clear. Before the scheme began, only 1.6% of all girls in this age group in Thailand had received the HPV vaccination; now, 83.6% have received at least one dose.

The uptake of the second dose is low. Only 59.3% have received it, but the figure is expected to rise as the national rollout scheme continues. The uptake of vaccines in the entire population is unknown, mainly due to a lack of nationwide HPV coverage data.

It is known, however, that specific communities are hesitant about the vaccine despite the rollout scheme. Studies indicate that many factors influence individuals’ decisions to receive it, including health literacy, education and socioeconomic status.

Resolving the Doubt

To tackle this hesitancy, the Thai government has launched targeted initiatives. One example is the Mother–Daughter Initiative (MDI). Mothers are encouraged to undergo cervical cancer screening, while daughters receive the HPV vaccine. Nurses and community health workers provided advocacy and education, leading to highly successful uptake rates of almost 100% in pilot districts.

Similarly, in July 2025, Thailand’s Ministry of Public Health launched a pilot initiative. It offers free single-dose HPV vaccinations to female students aged 20–26 at 24 universities, including Chulalongkorn, Mahidol and Chiang Mai. This rollout scheme resulted from surveys showing low vaccination uptake alongside limited knowledge of the disease.

Many cited cost and low perceived personal risk as reasons for lack of immunisation. These findings underscore the need for more comprehensive HPV education. However, this new program nicely complements the existing policy for girls aged 11–12, gathering data to support a potential nationwide rollout.

Expanding Cervical Cancer Screening

Screening women aged 35-60 has been a key priority alongside vaccination. It aligns with the WHO’s goal of screening 70% of women every five years through visual inspections and pap smears.

Seventy-seven percent of women have had at least one screening across Thailand. However, data indicate regular follow-up appointments are rare. Tracking is limited due to gaps in data systems. However, linking screening to ID numbers has improved follow-ups in some areas.

Overcoming Barriers

Across the country, there are clinics in every province and 186 laboratories nationwide, making screening broadly accessible. However, poverty, lack of transportation and poor road access still prevent many women from accessing these services. To improve access, the government has introduced self-administered HPV testing kits, offering greater convenience and privacy. Widespread awareness remains a challenge, however and is something that is being worked on.

While there is still work to be done, Thailand’s strategy has shown strong results. With continued effort, the country is well-positioned to meet the 2030 cervical cancer reduction goals set by the WHO.

– Niamh Trinder

Niamh is based in Leicester, UK and focuses on Global Health for The Borgen Project.

Photo: Unsplash

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Health Improvements in Malawi: A Revised Health Care Budget

Health Improvements in MalawiMalawi is a small country near the Eastern coast of Africa, nestled between Tanzania, Mozambique and Zambia. The nation found freedom from Britain on July 6, 1964 and has since become an agricultural nation. The country itself is nearly 46,000 square miles, boasting mountains and lakes. The most well-known lake is Lake Malawi, the ninth-largest lake in the world and the third-largest in Africa. As of 2025, Malawi has a population of 19 million and an expanded health budget, leading to significant improvements in the country’s health care system.

Why Did the Budget Increase Now?

Several organizations focused on financial assistance and health financing supported the Ministry of Finance and Economic Affairs in drafting Malawi’s 2025/2026 health budget. Their involvement extended beyond health and contributed to shaping the entire national budget. Key organizations included the Partners in Population and Development Africa Regional Office (PPD-ARO), the Advancing Domestic Health Financing (ADHF) project, well-equipped civil society organizations (CSOs) and the African Institute for Development Policy (AFIDEP).

Another factor behind Malawi’s increased health budget is the Lusaka Agenda, launched on Universal Health Coverage Day, after a 14-month global consultative process. It outlines five strategic shifts to better align external support with a single national plan, budget and monitoring framework. Indeed, as the foundation of Malawi’s new budget, it is expected to drive sustainable health improvements nationwide.

The Scale of the Health Budget Increase

The overall health care budget for Malawi for 2025 and 2026 has risen by 8.5%, from $421 million to $456 million. Funding for family planning commodities rose by 10%, increasing from about $404,000 to $445,000. Direct Facility Financing saw a sharp 150% rise, from around $115,000 to $288,000.

The government also pledged roughly $11.5 million to build 55 new health posts. Meanwhile, the national drug budget expanded by 25%, reaching nearly $40.4 million and the vaccine budget grew substantially by 150%, climbing from about $577,000 to $1.44 million.

What New Programs Will Be Added?

According to the AFIDEP, the newly improved budget will focus on sexual and reproductive wellness, family planning and strengthening things on the administrative side. However, these improvements are not the only steps being taken; general health care in Malawi will also improve. These efforts will assist people wanting to start families and keep themselves safe.

Other Ways the Increased Budget Will Help

The increase in Malawi’s health budget is expected to improve health care nationwide. Young people are mobilizing to learn more about health issues, equipping themselves to make informed decisions and influence how the system serves them.

Furthermore, through the READY Movement, an organization focused on youth empowerment, young people are being educated about HIV prevention and the funding gaps in this area of the new budget. They are better positioned to influence their communities and advocate for stronger health care responses by raising awareness.

– Zoe Felder

Zoe is based in Charlotte, NC, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Elderly Poverty in the Marshall Islands

Elderly Poverty in Republic of the Marshall IslandsFor those living in elderly poverty in the Marshall Islands, the challenges and hardships they face may have roots in the country’s economy and society. People within the Republic of the Marshall Islands (RMI) view economic insecurity as a problem as it controls the availability of social security or pension systems. These systems are very limited or inadequate, leaving many of the elderly vulnerable. For example, although health care has improved in RMI, it may be difficult for elders in poverty to access it as a great number of the population is dispersed around the islands.

Elderly poverty in the Marshall Islands also has links to food insecurity. Droughts and increased storms impact the RMI, with both causing a decrease in natural food and water supplies, as well as limiting imports of food and triggering disease outbreaks. Those living in elderly poverty may also experience inadequate housing or loss of coastal homes due to the sea levels rising and storm patterns.

The main cause of elderly poverty in the Republic of the Marshall Islands (RMI) is due to the dependence on the United States for jobs. Due to the Compact of Free Association between the United States and the Republic of the Marshall Islands, the citizens of the Marshall Islands can live and work in the U.S. without visas.

This dependence on the U.S. to provide jobs creates no gainful employment opportunities for Marshallese citizens on-island. Some citizens rely on those migrating out for jobs to send out goods as their support.

Changing Weather Patterns

Major natural hazards due to changing weather patterns in the Marshall islands are sea level rise, droughts and tropical storms and typhoons. Threats from droughts and saltwater intrusion make freshwater scarce throughout the islands. This lack of water undermines food security, which increases reliance on imports to supplement nutrients. The imported food can often be unhealthy and are a risk for those already living with certain health risks such as diabetes, obesity or other infectious diseases.

Limited Health Care Access

The RMI population is strewn across the various islands, making it difficult to provide the citizens with proper health care. Stigmas surrounding illnesses and a trust in traditional healing also encourages the Marshallese to delay seeking proper care.

The Marshallese hold certain cultural values that prevent them from receiving proper medical aid as they may not seek treatment until symptoms become severe. Illnesses such as leprosy, HIV and tuberculosis can cause the afflicted Marshallese to experience discrimination due to the severe stigmas surrounding the illnesses. This also causes the afflicted to avoid seeking proper care. 

Lack of Formal Social Security

While the Marshall Islands has a social insurance system providing old-age benefits, it is not the same as the universal old-age benefit system. The key difference is the availability to all residents regardless of contribution. The old-age pension benefit system within the Marshall Islands outlines a qualifying age of 61, each qualifier would receive a three-month period of coverage earned by a certain amount of work under social security.

Solutions

The Senior Citizens Act of 2018 in the RMI establishes a government policy of supporting senior citizens and promoting elderly well-being as well as societal participation.

Developing formal social security as a solution can help elderly poverty in the Marshall Islands, as eligible retirees receive regular payments that will supply a crucial source of income. Along with this, benefits can extend to a wider range of people in vulnerable groups such as older women, those with lower income and those with less access to private retirement savings or pensions.

A wider availability of benefits will also provide more freedom when it comes to retirement choices. A formal social security system will also incorporate life insurance and disability insurance components. This system would also extend to the younger population, as well as to individuals with severe disabilities.

– Eva Wakelin

Eva is based in Atlanta, GA, USA and focuses on Technology and Solutions for The Borgen Project.

Photo: Unsplash