Information and stories on health topics.

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The Growth of Telemedicine in Peru

Telemedicine in PeruThe COVID-19 pandemic accelerated the global shift to telehealth, enabling health care professionals and patients to connect remotely. However, resource disparities meant some countries faced greater challenges in transitioning. The shift to telemedicine was particularly difficult in Peru, which borders Chile and Bolivia, due to limited infrastructure and internet access, especially in rural areas.

Background of Telemedicine in Peru

Peru’s health system is divided into three practices, the first one being Social Security Hospitals (SSH), the second being the Federal Government Hospitals (FGH) and then private hospitals. The growth of internet access in Peru started in 2005. That year the first regulatory document related to telehealth was approved by the “Supreme Decree No. 028-2005-MTC.” Furthermore, in 2009, the first technical standards were approved to set guidelines for these online services. Later, in 2016, a framework was set for expanding telehealth, such as the ability to fill out prescriptions online.

When the pandemic hit, the full force of telemedicine and telecommunication services was set into motion. However, Peru is divided into three main geographical regions: the Coast, the Peruvian Andes and the Jungle. Internet access remains limited across these areas, with only 63.3% of residents on the Coast, 36% in the Andes and 33% in the Jungle having connectivity. This disparity poses a significant challenge to the advancement of telemedicine, as limited internet access hinders the reach of digital health care services to remote and underserved communities.

What Is Being Done?

“Teleatiendo,” created by the Ministry of Health of Peru, provides online consultations for those seeking virtual health care services. Other online resources, such as the “Cayetano Heredia National Hospital” teleconsultation application, specifically support diabetic patients. Looking toward the future, the incoming candidates for Congress and the presidential seat have promised to work on making the Internet more available nationwide.

Peru has the highest internet costs in Latin America, posing a barrier to equal access, especially in telemedicine advancements. More structured frameworks are being set in motion for mobile health apps (mHealth) based on different evaluations, such as effectiveness and security. Due to 60% of the population being in a lower socioeconomic sphere, accessing these technologies is difficult. However, the “WiLD multihop network” could improve connectivity in underserved areas, making health care access more feasible for those in remote or low-income communities.

Partners in Health

Partners in Health is an organization dedicated to creating “preferential options” for the impoverished in health care. The organization has developed seven telemedicine applications to improve health care access, each tailored to specific needs:

  1. Bienestár: Provides free mental health screenings and connects users to specialized psychologists.
  2. KUSKA: Offers similar mental health support but is available in Quechua, catering to Peru’s indigenous population.
  3. Soy Qhalikay: Detects type 2 diabetes and hypertension, prompting follow-up care from nursing and nutrition teams.
  4. Chatea con tu Nutri: Connects users to health facilities focused on diet and exercise improvements.
  5. ALMA: Supports breast cancer prevention by providing free mammograms to at-risk women.
  6. GESTamor: Assists pregnant individuals with referrals for prenatal care and health monitoring.
  7. CASITA: Offers free screenings and educational resources to detect infant developmental delays, with training and support for caregivers.

Each app is vital in expanding health care access across different demographics in Peru.

The Future of Telemedicine in Peru

As telemedicine expands in Peru, so does the push for broader internet access, ensuring that all citizens can access essential health care. Significant progress has been made in recent years, with the trajectory continuing upward as internet availability increases and telemedicine gains a stronger foothold in the country. These advancements promise a future where health care is more accessible and inclusive for all Peruvians.

– Isabella Chavez

Isabella is Swampscott, MA, USA and focuses on Technology and Global Health for The Borgen Project.

Photo: Flickr

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Bridging the Gap: Poverty and Maternal Health in Yemen

Maternal Health in YemenYemen is facing a catastrophic humanitarian crisis. Maternal health issues and extreme poverty have become some of the deadliest threats in the region. According to the United Nations Children’s Fund (UNICEF), one woman and six newborns die every two hours in Yemen due to complications during pregnancy or childbirth. The country’s health care system has been severely compromised by prolonged and intense fighting. Since the conflict escalated between the Saudi-led government coalition and Houthi rebels, maternal mortality rates have skyrocketed.

The ongoing conflict has not only destroyed medical facilities but also led to a severe shortage of medical supplies and personnel. As a result, only approximately half of the country’s health facilities are functional and even fewer are equipped to provide adequate maternal and child health services. This scarcity of resources has left millions of women without access to essential reproductive health care, including prenatal check-ups, safe delivery options and postnatal care.

The crisis is further emphasized by widespread food insecurity and malnutrition, which disproportionately affect pregnant women and new mothers. With the economy struggling, many families struggle to afford necessities, let alone specialized medical care. This economic hardship has created a vicious cycle where poverty and poor health outcomes reinforce each other, with devastating consequences for maternal and infant well-being.

Collapsed Health Care System

The conflict has caused a breakdown of Yemen’s health care system. As of 2024, 17.8 million people require health assistance, with one-quarter being women. Among them, 5.5 million of reproductive age, including pregnant and lactating women, struggle to access necessary health services. This is largely due to a shortage of female doctors and nurses, as well as a lack of essential medical supplies. Currently, only one in five functioning health clinics can provide maternal and child health services.

In addition, more than 2.7 million pregnant and breastfeeding women in Yemen are estimated to require treatment for acute malnutrition. Food shortages and insecurity increase the risks of giving birth to newborns with stunted growth and malnourished infants. The lack of medical infrastructure has left millions of women without access to essential health care services.

Economic Impact

The severe economic conditions in Yemen have left 80% of the population struggling to meet basic needs, which directly impacts maternal and infant health through malnutrition and lack of access to care. The economic crisis has worsened the situation for pregnant women and new mothers. The devaluation of the Yemeni Rial and high inflation rates have severely restricted families’ ability to afford nutritious food.

Additionally, the crisis has led to widespread displacement, with 73% of the 4.2 million displaced people being women and children. Despite the Ministry of Public Health and Population’s policy of free access to health care, Yemenis still pay more than 50% of their health expenditures out of pocket.

International Aid

The United Nations Population Fund (UNFPA) has played a crucial role in addressing Yemen’s maternal health crisis by:

  • Being the sole provider of life-saving reproductive health services in the country.
  • Leading the coordination and provision of women’s reproductive health and protection services nationwide.
  • Supporting emergency obstetric and maternal health care at more than 100 health facilities.
  • Offering services to prevent and respond to gender-based violence through 36 safe spaces, eight shelters and seven specialized mental health centers.
  • Leading a rapid response mechanism in partnership with the World Food Programme (WFP) and UNICEF to provide emergency relief to newly displaced persons.

The European Union (EU) has also been a significant contributor to Yemen’s humanitarian efforts by:

  • Allocating more than $130 million in humanitarian funding to address the most pressing needs in the country.
  • Contributing nearly $1.6 billion since 2015 to address the Yemeni crisis, including more than $1 billion in humanitarian aid.
  • Recognizing 13 humanitarian Air Bridge flights since February 2024 to respond to the urgent health crisis triggered by outbreaks of infectious diseases, including cholera.
  • Funding the refurbishment of health centers, such as the Shahir Health Center in Hadramout.

Additionally, the United States Agency for International Development (USAID) has been involved in improving maternal and child health in Yemen. The agency-funded Systems Health and Resiliency Project (SHARP) has made strides in improving maternal and child health services in 14 districts across three governorates. SHARP has reached more than 1.8 million Yemeni people with activities aimed at improving their health. The project has trained and partnered with community midwives, reproductive health volunteers, health facility workers and community members to provide essential health care and support.

Conclusion

Addressing Yemen’s maternal health and poverty crisis requires urgent via coordinated international assistance. Many organizations have contributed to aid and support, but the scale of the issue is demanding and requires a greater response to save lives and break the cycle of poverty and ill health.

– Hannah Ravariere-Moakes

Hannah is based in London, UK and focuses on Politics and Global Health for The Borgen Project.

Photo: Flickr

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Everything You Need to Know About Poverty in Libya

Poverty in LibyaLibya is a country in North Africa and has one of the largest oil reserves in Africa which is a primary influence in the country’s economic and political state. It was under dictatorship for 42 years and now faces the consequences of the 2011 civil war and NATO intervention. Libya’s economic state and political warfare continue to create instability for the population. Poverty in Libya is a growing issue driven by constant struggle. The country’s fragile economy and growing inflation have limited access to jobs and essential services like health care and education. The ongoing armed conflict in Libya is disrupting people’s livelihoods and fuels regional disputes, causing poverty amongst displaced populations affected by the current situation in Libya. 

Current State of Poverty in Libya

After the 2011 revolution and the death of Muammar Al-Gaddafi, the country faced a prolonged civil war, which weakened the state politically and economically. Now Libya faces power struggles, ongoing food insecurity and deteriorating infrastructure. Libya is home to an estimated 8.2 million people and more than 300,000 of the population is currently displaced, with more in need of humanitarian assistance.

Before the 2011 Civil War, Libyan families’ costs for food were offset by the welfare state that provided free education, housing, public services and health care. Since then, poverty in Libya increased with around 325,000 people in need of assistance, according to the World Food Programme (WFP). The impact of COVID-19 further toppled Libya’s economic state and led to its decline in 2020 revealing the severity of the pandemic. Countless people lost their jobs and livelihoods due to the economic downfall of Libya during the outbreak leading to many facing prolonged food insecurity and need for assistance.

Libya’s Economic and Political Situation

The conflict in Libya is the focal cause of Libya’s economic decline. The 2016 internal armed conflict, which lasted until 2018 had severe consequences, including civilian casualties and human rights violations. Security-related outbreaks have led to 2,240 fatalities in 12 months between 2019 and 2020; General Haftar’s Libyan National Army could be responsible for 80% of civilian casualties. Libya’s political struggles between East and West increase the risk of harm and reduce the efforts for stability. 

Libya is also struggling with a liquidity problem. Libya relies on oil production and international oil prices to fuel income. However, the instability in Libya has led to “inconsistent government revenues,” according to a 2020 report. This pressure has created liquidity problems for the country, severely impacting people’s ability to withdraw public wages and savings from banks. 

Moreover, Libya operates under a dual exchange rate system which causes distortions in currency value and rapid inflation and devaluation. The constant disruptions in the supply chain force Libyans to rely on black-market currency exchange for access to money, according to a 2020 report. This liquidity problem leads to higher living costs due to the limited access to cash, creating food instability for people in Libya.

Education and Health Care

Amongst the Libyan population, the new generations are the most vulnerable and affected by the ongoing unrest and economic instability. Although Libya has seen economic growth in 2023, health care and nutrition are still slowly progressing. According to UNICEF, Libya has seen a decline in child and infant mortality rates as well as a decrease in the population living below the poverty line to 7.1% in 2022. However, primary healthcare and nutrition services plummeted. Education enrolment rates increased to 92%, but many youths, including migrants and refugee children, lack learning opportunities. 

Additionally, the World Health Organization (WHO) and the Ministry of Health and Education in Libya revealed the complex situation of the overproduction of health care workers and the shortage of nurses, doctors and specialists. Medical education standards in Libya are rated below average, with low certification standards. This issue limits people from access to quality healthcare, especially for those in poor, rural or disrupted regions.

Solutions and Efforts to Poverty in Libya

The WFP built partnerships with the government of Libya, local NGOs and international organizations to fight poverty and food insecurity in contribution to the U.N. Sustainable Development Cooperation Framework. It has developed a 2023-2025 strategic plan that addresses the need for emergency food assistance and support for the most vulnerable communities in Libya.  

WHO and the Red Crescent are working to strengthen and repair the Libyan health care system by providing medical supplies and raining health care workers. This initiative mainly focused on Derna and other regions in Eastern Libya affected by the floods in 2023 that left many displaced and in need of medical and humanitarian assistance. 

In 2023, UNICEF and the Ministry of Health ensured the accessibility of primary health care, nutrition and medical support. After the Floods, efforts focused on nutritional screening for 5,461 children and malnutrition management. UNICEF also succeeded in installing 627 vaccination administration systems across Libya, reducing the risk of rising mortality rates, according to 2023 UNICEF report.

Conclusion

Poverty in Libya is deeply caused and rooted in the country’s ongoing conflict, political instability, inflation and economic decline. Limited access to employment and education combined with fragile political and economic structure continues to impact vulnerable populations significantly. Many NGOs and IGOs are addressing and putting in the effort to combat Poverty in Libya. However, the constant instability has made that difficult. Addressing these challenges requires governmental reforms and a stable economy to create a pathway away from poverty. 

– Gufran Elhrari 

Gufran is based in London, UK and focuses on Politics for The Borgen Project.

Photo: Flickr

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How the Global Fund Is Addressing TB in India

Tuberculosis in IndiaThe Global Fund is a nonprofit organization founded in 2002. Since then, it has provided treatment to people with HIV, tuberculosis (TB) and malaria around the world. As of the Summer of 2024, the Fund has invested almost $10 billion in TB prevention and treatment for patients worldwide.

The Global Fund has integrated numerous services into primary health care systems that use innovative technologies, such as mobile health solutions, to improve patient tracking and adherence to treatment. Health professionals will use vans with technology like X-rays and diagnosis kits to provide free health treatments in the most remote locations. The Fund has vastly increased community access to medicines, testing and protective equipment like mosquito nets.

The Global Fund and India’s Close Collaboration

The Global Fund utilizes various strategies to combat TB in India, which reported 1.96 million cases or one-third of TB cases globally in 2021. The Fund has worked closely with the Indian government since 2006 and multiple local nongovernmental organizations (NGOs) to implement effective TB screening, treatment and prevention programs. The government of India, especially Prime Minister Narendra Modi, has shown immense support for the initiative to end TB in India by next year.

Success in Perspective

In 2012, the Indian government implemented a law requiring all diagnosed cases of TB to be reported to public health officials. This policy has successfully reduced the number of unreported cases plaguing the country. One untreated case can spread the disease to 15-20 people in a year. Due to the highly infectious nature of TB, it is crucial to catch cases as early as possible.

Furthermore, through its close collaboration with the Global Fund, India has transitioned from having the highest tuberculosis population to becoming an innovative supporter of global health. In 2019, India hosted the organization’s Sixth Replenishment Preparatory Meeting. Today, thanks to the efforts of the Global Fund, India can support other global health care organizations by serving as a primary source of low-cost pharmaceuticals.

JEET

The Joint Effort to Eliminate TB (JEET), a nonprofit organization, partners with the Global Fund and NGOs in India to improve access to diagnoses and treatments across all communities. JEET works closely with community health professionals and hospitals to promote sustainable solutions that will continue to benefit the population in the future. Indeed, by collaborating with various NGOs, including TB Alert India and the NGO TB Consortium India (NTC), the organization can reach the most at-risk populations and manage cases and outbreaks efficiently.

India is among the countries with the highest number of private health care providers. Between 2018 and 2020, JEET expanded the Patient-Provider Support Agency model in more than 100 districts across nine high-TB-risk states. This model ensures widespread access to TB treatment and patient support in the most vulnerable communities.

Impact of the Global Fund on Poverty

In 2023, the Global Fund provided treatment to more than 2.4 million people in India, improving life expectancy in low-income communities. As of 2022, the Fund has reduced TB-related deaths by 36% since beginning its work in various countries. Ultimately, TB has a profound impact on poverty levels and economic productivity in India, highlighting how successful TB control can lead to healthier communities, reduced health care costs and enhanced economic opportunities for affected populations.

Impacted individuals struggle on different levels throughout day-to-day life, making access to treatment life-changing for families reliant on working income. Furthermore, reducing the impact of TB on health care systems leaves more time, staff and funding to address other health issues in low-income communities.

– Lauren Sellman

Lauren is based in Rochester Hills, MI, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Medical Reforms in Chile

Medical Reforms in ChileThe University of Chile, in 1842, began Chile’s strong devotion to medical education. Later, in the ’40s and ’50s, grants from the Rockafeller and Kellogg Foundations aided in academic programs for those learning about public health. Indeed, these investments led to the expansion of the School of Public Health at the University in 1958 to support incoming health care workers. In 1970, under President Allende, several medical reforms were enacted in Chile.

Reforms included a focus on rural and ambulatory services and increased community involvement in health care by the government. Furthermore, importance was placed on opening nationwide health centers, moving resources that the hospital sectors once controlled into the community and expanding the milk distribution program. This six-year health plan was a response to some of the previous health plan’s shortcomings, most notably the lack of comprehensive and complete health care coverage and lack of focus on primary care.

With the military coup in 1973, Allende’s “The National Health Service” was replaced by the “National System of Health Services” under the new leadership. Medical care could no longer be provided for free and competition within medical practice became the norm. The Secretary-General said at the time, “We want to incorporate into the health system certain aspects of the market economy…competition will allow the physician who provides the best care to gain a larger clientele.”

Problems With the Current System

Chile’s health care system is currently financed by two main entities: the Fondo Nacional de Salud (FONASA) and the Instituciones de Salud Previsional (ISAPRE). Approximately 80% of the population is covered by FONASA. The remaining 20% relies on ISAPRE, which includes additional charges based on risk assessments. This structure often leaves many elderly and chronically ill individuals unable to afford the necessary services.

Due to insufficient resources, many of those under the FONASA cannot take advantage of hospital services. Indeed this has led many to not be enrolled with a public health care facility, which has caused an increase in emergency care department visits. The current system faces several additional challenges, including:

  1. Outdated per capita calculation methodology
  2. Limited capacity to adjust capitations based on the epidemiological realities in different regions of the country
  3. Lack of accountability mechanisms

Program for Universal Primary Health Care

In December of 2023, the World Bank approved a loan of $200 million to aid Chile’s current efforts to reform its health care system. By 2027, it hopes to reach approximately 187 out of 346 municipalities with an emphasis on primary care. The program will have three main areas of focus:

  1. Free primary care services, regardless of insurance status.
  2. Prevention and preparation for the impacts of climate change and public health emergencies.
  3. Improvement of health care resources, including developing a virtual health system and enhancing the efficiency of existing systems.

All three focus areas aim to target the population not covered by FONASA. Those with coverage who are not currently in a Public Health Care (PHC) system. The goal is to reduce the number of patients seeking care directly in emergency services. Other medical reforms in Chile seek to further these objectives by expanding effective coverage in PHC. Additional reforms seek to establish a more resilient system, improving the model for both social and health care and optimizing resources for monitoring and evaluating the health care system.

Final Note

With these new implementations, the health care system in Chile aims to grow stronger. Furthermore, care could become more accessible and reliable for its citizens. Chile aims to build on the foundations established by the health care systems of the past and learn from past mistakes and shortcomings.

– Isabella Chavez

Isabella is based in Swampscott, MA, USA and focuses on Technology and Global Health for The Borgen Project.

Photo: Pexels

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DRC Begins Mpox Vaccination Program

Mpox Vaccination ProgramIn October 2024, the Democratic Republic of the Congo (DRC) began its official vaccination scheme against Mpox, following a nationwide outbreak. First detected in the country more than 50 years ago, Mpox is a viral infection that can cause fatal illness. The emergence of a new strain in 2023 led the World Health Organization (WHO) to declare the recent outbreak a “global health emergency” in August 2024. Two months later, following 30,000 recorded cases and more than 900 deaths as of October 2024, the DRC’s Ministry of Public Health is beginning the rollout of hundreds of thousands of vaccines as the start of its official Mpox vaccination program.

Provisions from the EU

To curb the spread of the virus, the DRC relies on the European Union (EU), donation of 265,000 MBA-BN vaccines, with the help of the U.S. Government, Gavi and Africa CDC. These vaccines require two shots administered one month apart and are available only to adults, according to UNICEF.

With a population of more than 100 million, this means there is a limited amount of doses, so officials have had to target the campaign to those most vulnerable to Mpox. So far, the campaign has focused on the country’s North Kivu and Equateur provinces, the two regions that have recorded the highest number of cases. Within these areas, the Ministry of Health will provide the doses to the most at-risk groups, such as those with existing health problems. UNICEF has coordinated the transport and delivery of the vaccines, as well as the storage and shipment across the DRC.

Further Expected Doses

Although officials in the DRC are currently working with a limited supply of vaccines, the nation has also signed an agreement with the government of Japan, which promises the supply of LC-16 vaccines. LC-16 only requires one shot for immunisation and is currently the only one that has approval for children. One of the most disproportionately impacted, children under 15 are some of the most vulnerable to the virus, accounting for 60% of all recorded cases and 80% of deaths in the DRC, according to UNICEF.

Logistical Difficulties

Alongside limited availability, officials have also faced difficulties when planning the implementation of the Mpox vaccination program itself. Vaccines must be kept as low as -20 degrees Celsius, and, once defrosted, need to be used within 40 days to be effective. Officials are therefore working with a limited time frame in which they can transport and administer doses from the central storage facility in Kinshasa. This poses particular difficulty for the nation’s more rural areas which take longer to reach, an issue that has only been exacerbated by the ongoing conflict in the DRC between the government and rebel groups. This has made access to rebel-controlled regions much more limited and therefore made the transportation of medical resources such as vaccines to these areas much more difficult.

Government efforts, educational campaigns and attempts to raise awareness about the virus, and vaccines are just some of the ways the DRC is currently working to combat the spread of Mpox. Its collaboration with international organizations has proved key to the start of the Mpox vaccination program, and further provisions from nations such as Japan will hopefully allow for the continued suppression of the virus.

– Izzy Tompkins

Izzy is based in Leeds, UK and focuses on Global Health and Politics for The Borgen Project.

Photo: Flickr

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Initiatives Supporting Mental Health in Zimbabwe

Mental Health in ZimbabweAs of 2024, Zimbabwe’s population stands at approximately 16 million, highlighting an urgent need to support mental health initiatives as more people require access to care. Currently, 54% of Zimbabweans lack access to health care and the suicide rate is 14 per 100,000 people. With less than 20 psychiatrists available for the citizens of Zimbabwe, the mental health care gap is stark.

However, with support from developed countries and effective government programs, Zimbabwe is making significant strides in addressing its mental health challenges. Key initiatives include the World Health Organization’s Special Initiative for Mental Health and the Zimbabwe Life Project. These efforts aim to improve mental health systems, foster successful global partnerships and offer individuals and nations the chance to contribute.

The WHO’s Special Initiative for Mental Health

In 2020, more than 100 stakeholders, including nonprofits and politicians, backed the strategy outlined by WHO’s Special Initiative for Mental Health. These programs provide training to equip mental health professionals and caregivers with the skills needed to offer effective mental health support. Between 2021 and 2022, the WHO’s Special Initiative for Mental Health increased investments in mental health.

Furthermore, it expanded the capacity of general health staff in primary health care centers to identify and assist Zimbabweans experiencing mental disorders. The initiative emphasizes the importance of human rights for those struggling with mental health, including access to information and the right to privacy. This approach fosters a more inclusive and supportive environment.

The Zimbabwe Life Project

The Zimbabwe Life Project (ZLP), established in 2018, is a nonprofit organization that promotes mental health, well-being and resilience in Zimbabwe. The organization seeks to develop a skills exchange program involving mental health professionals in Zimbabwe. This initiative will facilitate participatory exchanges of knowledge, skills and experiences.

A primary objective is to share specialized mental health expertise and foster positive partnerships between mental health professionals in the U.K. and Zimbabwe. Furthermore, ZLP initiatives focus on continuous, comprehensive mental health care in Zimbabwe. In 2019, the organization donated medical equipment worth more than $20,000 to the nation.

Conclusion

Supporting mental health initiatives in Zimbabwe is crucial as the country faces significant challenges in meeting the mental health needs of its population. A combination of limited resources and a shortage of trained professionals has made access to care difficult for many. However, focused efforts are underway to improve mental health systems, foster global collaboration and provide essential knowledge and resources to those in need.

International organizations like the WHO have supported Zimbabwe’s mental health sector. Indeed, programs like the WHO’s Special Initiative for Mental Health and the ZLP have made strides in increasing awareness, training health care providers and integrating mental health care with primary health services. These initiatives aim to treat mental illness and promote long-term resilience and well-being across communities.

– Alysha Miller

Alysha is based in Toronto, ON, Canada and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Poverty and Water Infrastructure in Vietnam

Water Pollution and Poverty in Vietnam Rapid economic development and inadequate water infrastructure pose significant public health challenges in Vietnam. Climate changes exacerbates these issues by increasing the frequency and intensity of extreme weather events. Vietnam, with its landscape rich in porous river systems, hosts more than 3,500 rivers longer than 10 kilometers. Around 70% of its population lives along these waterways, which are crucial to the nation’s culture and economy. These essential resources face threats from natural and human-induced challenges, putting the livelihoods, cultural heritage and economic stability of Vietnam at risk.

Water Threats in Vietnam

  • Freshwater Access and Pollution Threatening Public Health. Many critical water infrastructures are insufficient or in a state of disrepair. Water access from centralized supply systems has reached only about 48% of the rural population. This has led to poor handwashing and other hygienic practices in some disadvantaged areas. Nearly 30% of people in Dien Bien, Gia Lai, Kon Tum and Ninh Thuan provinces had limited availability of basic handwashing facilities at home—one of the fundamental practices to prevent COVID-19.
  • Groundwater Over-extraction. Groundwater over-extraction is recognized as the main driver of land subsidence. The decline in groundwater levels leads to the compaction of the aquifer, causing the land surface to sink. Over the past 25 years, the Mekong Delta has sunk by an average of 18 cm due to groundwater withdrawal. This sinking land has exacerbated the vulnerability of Delta residents to floods and storm surges.
  • Climate Threat. Vietnam ranks among the countries most susceptible to climate changes. Its extensive coastline and river deltas are highly exposed to rising sea levels. Flooding alone is projected to affect an estimated 10 million people. Over the next 15 years. This climate-induced flooding poses a significant long-term threat to Vietnam’s agricultural production, economic development, food security and poverty reduction efforts.
  • Salt Drought. Drought and saltwater intrusion further extend the threat to the river deltas of Vietnam. Saltwater has intruded up to 60 kilometers from the river mouth of Ben Tre province. Saltwater intrusion changes the salinity of groundwater, significantly impacting agricultural productivity and challenging the regional freshwater supply. Major infrastructural and landscape-scale interventions are necessary for the future sustainability of the deltas.

Alleviating Water-related Poverty in Vietnam

The World Bank has been instrumental in supporting Vietnam’s water and sanitation sector. Through the Vietnam Urban Water Supply and Wastewater Project, the World Bank has aimed to improve water services in major cities while addressing the needs of low-income households. This project includes developing sustainable water management practices and enhancing wastewater treatment to improve both health and environmental conditions. In addition, UNICEF has played a key role in promoting water, sanitation and hygiene (WASH) programs in Vietnam, particularly in remote areas and schools. The organization works with the Vietnamese government to improve access to safe drinking water and sanitation facilities, emphasizing hygiene education to reduce water-borne diseases, particularly in children.

Looking Forward

Efforts to improve the water infrastructure and promote sustainable practices are vital for reducing poverty in Vietnam. International support, such as initiatives by the World Bank and UNICEF, plays a significant role in enhancing access to clean water and sanitation facilities, particularly for vulnerable populations. Building resilience to climate impacts and prioritizing long-term water management could help safeguard the country’s health, economy and natural resources.

– Yuhan Ji

Yuhan is based in Cambridge, MA, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Improving Access to Health Care for Marginalized Groups in Nigeria

Marginalized Groups in Nigeria
Nigeria, despite its significant economic potential, faces severe health care challenges, particularly in marginalized communities. About 40% of Nigerians live in poverty, limiting their access to quality health care services. Addressing these disparities is critical to improving access to health care for marginalized groups in Nigeria.

Barriers to Health care Access

  1. Insufficient Primary Health Centers (PHCs): In rural communities where disease burden is high, many primary health centers (PHCs) are either non-functional or under-equipped. This is a significant barrier, as PHCs are the main access points for health care in rural areas. The absence of functioning PHCs means that patients either go without care or must travel long distances, often to urban areas, to receive treatment.
  2. Out-of-Pocket Payments: Around 90% of Nigerians pay for health care services out of pocket, placing an enormous financial burden on poor families. This creates a cycle where poverty exacerbates poor health, and poor health leads to further poverty. According to the International Journal of Health and Management, catastrophic health expenditures have driven many households deeper into poverty. Only about 3% of Nigeria’s population has health insurance, and most of this coverage is employer-provided, leaving low-income earners and rural populations particularly vulnerable.
  3. Corruption and Mismanagement: Corrupt practices, which drain resources meant for public health facilities, worsen the inefficiency of Nigeria’s health care system. Funds intended for PHCs and other health services are often misappropriated, resulting in dilapidated facilities and a lack of essential medications and staff.

Here are some strategies for improving health care access.

Mobile Health Clinics

Bringing health care directly to communities is one effective solution to overcome physical barriers. Mobile health clinics and telemedicine services allow health care providers to reach remote or rural populations, reducing the need for travel and ensuring that patients receive care without excessive costs. For example, in states like Kaduna and Lagos, the government, in partnership with non-governmental organizations, has deployed mobile health units to provide essential health services such as maternal care, vaccinations and treatment for common diseases like malaria and tuberculosis. These clinics travel to remote areas, reaching populations that lack access to functioning PHCs.

This directly tackles the issue of insufficient primary health centers and ensures health care is more accessible, improving access to health care for marginalized groups in Nigeria. Mobile clinics have proven effective in bridging the gap in healthcare delivery by providing both preventive and curative services to Nigeria’s rural and underserved populations.

Insufficient Primary Health Centers

To tackle the lack of functioning PHCs, Nigeria must prioritize their revitalization. Strengthening these facilities can significantly improve access to health care for rural populations as they are the first point of contact for most vulnerable populations. 

The Basic Health care Provision Fund (BHCPF), a key initiative under the 2014 National Health Act, aims to ensure every Nigerian has access to a minimum package of health care services, particularly at the primary care level. 

However, inconsistent funding and state-level delays in implementation have limited its effectiveness. Ensuring that states contribute their share of the funds and improving oversight are essential to making the BHCPF work.

Expanding Micro Health Insurance

To reduce the reliance on out-of-pocket payments, micro health insurance has emerged as a solution tailored to the needs of low-income populations.

Providers like WellaHealth offer affordable packages that cover common illnesses such as malaria and typhoid, with access to doctors through telemedicine. These insurance models are particularly promising for rural and underserved communities, offering a pathway to affordable health care without the risk of financial ruin. They are part of the key to improving access to health care for marginalized groups in Nigeria. 

Addressing Corruption

Tackling corruption in the health care system is critical. Strengthening governance, improving transparency in the disbursement of health care funds, and increasing community oversight are necessary steps to ensure that resources intended for health care reach the people who need them most.

Improving access to health care for marginalized groups in Nigeria requires a multi-faceted approach that addresses the key barriers of insufficient primary health centers, out-of-pocket payments and systemic corruption. Strengthening primary health facilities, expanding micro health insurance, deploying mobile health clinics, and enhancing governance are critical steps toward ensuring equitable healthcare access. By prioritizing these strategies and ensuring proper implementation, significant progress can be made towards improving access to healthcare for marginalized groups in Nigeria. 

– Edzhe Miteva

Edzhe is based in London, UK and focuses on Global Health and Politics for The Borgen Project.

Photo: Flickr

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LIF: UK-Mexico Relations and Medical Innovation

LIFMexico’s economy is on the rise after a 3.2% growth in 2023 and boasts the second-largest economy in Latin America. The shock of COVID-19 failed to stunt the country’s ongoing efforts to reduce poverty since rates continued to fall from 43.9% in 2020 to 36.3% in 2022. Although Mexico is exceeding in development, clear income divides remain between rural and urban areas, which is evident in its health care system. The Leaders in Innovation Fellowships (LIF), a U.K. program, worked with Mexican innovators to help provide solutions to health care disparities.

What Is the LIF program?

The Royal Academy of Engineering (RAEng) began the LIF program more than 10 years ago to promote global entrepreneurship through the use of technological innovation. Alongside Mexico, the program has partners in 16 countries, including Brazil, Vietnam, and Romania. The LIF was launched thanks to funding from the Newton Fund, which is part of the U.K.’s official development assistance and fosters international science and innovation partnerships.

Health Care in Mexico

The Mexican health care system operates on a combination of public, private, and employer-funded schemes. Prior to the introduction of Seguro Popular in 2004, a government program that ensured universal access to health care, three-quarters of the population could not access health care through the Ministry of Health. However, high poverty rates in rural areas of Mexico often leave these populations without adequate access to health care. Services are typically concentrated in the country’s largest cities.

In fact, 88% of dentists in Mexico are located in urban centers. Despite multiple reforms, health care infrastructure in rural municipalities remains insufficient, forcing locals to rely on out-of-pocket expenses. These areas also represent two-thirds of Mexico’s extremely poor. The removal of Seguro Popular in 2020 further increased out-of-pocket health care costs, which indicates the need for further health care security and reform to aid the most inadequate.

The LIF Program in Mexico

In February 2024, LIF joined efforts with technological innovators in Mexico to help the Xicotepec, one of the municipalities that make up the Puebla state. The program funded the use of these medical inventions and services in the communities of Xicotepec. The team operating there organized a Community Health Services (CHS) Week, where 265 people received medical care.

The program covered a variety of training and medical care. Indeed, 90 mothers attended breast cancer screenings, 40 doctors were trained in wound healing, and more than 200 people were trained in disease prevention. The program was well received by its beneficiaries: “The service was very good and necessary. The truth is that we don’t go to the doctor often because we can’t afford it.”

Final Note

Positive partnerships like the LIF program enable medical innovation and treatment to reach the communities that need it most. They can help resolve the negative effects of recent changes in Mexico’s health care system. The capacity of the RAEng to reach remote communities like Xicotepec shows how far-reaching international collaboration is.

– Sofia Brooke

Sofia is based in Oxfordshire, UK and focuses on Global Health for The Borgen Project.

Photo: Pexels