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3 Diseases Caused by Malnutrition

Diseases Caused by MalnutritionMalnutrition is a public health problem that can be seen mostly in developing countries, especially in sub-Saharan Africa and Southern Asia. According to the WHO, malnutrition refers to deficiencies or excesses in nutrient intake, imbalance of essential nutrients or impaired nutrient utilization. People all over the world suffer from malnutrition, especially in places where there is war, economic crisis, drought, floods or other manners of human suffering. However, the focus of this article will be the diseases or syndromes that can stem from malnutrition. Malnutrition and disease often go hand in hand. Here are three diseases caused by malnutrition. 

Kwashiorkor

Kwashiorkor is a disease that stems from malnutrition and severe protein deficiency. Kwashiorkor causes fluid retention and swelling, especially in the abdomen. This disease most commonly affects children, especially in developing countries where there is food insecurity and high levels of poverty. 

If left untreated, Kwashiorkor can be fatal. This disease can cause immune system failure, liver failure, growth and development delays in children and can lead to starvation and death. 

Kwashiorkor primarily affects children, especially from ages 3 to 5. This disease is widely spread throughout sub-Saharan Africa and is also common in Southeast Asia and Central America. Kwashiorkor affects both girls and boys equally and remains a major threat in food-insecure countries. 

Marasmus 

Marasmus is a severe form of malnutrition. While kwashiorkor is a deficiency in protein, marasmus is a deficiency of all the macronutrients in the body. Marasmus causes the wasting of fat and muscle under the skin, making one look depleted and visibly underweight. 

Marasmus can be caused by starvation or not having enough nutrients. The body will start feeding on its own fat and muscle, then begin shutting down some functions to conserve energy. Marasmus causes low heart rate, blood pressure and body temperature. This form of malnutrition can be fatal, leading to heart failure. It also compromises the immune system making malnourished people more prone to infection and illnesses. 

It is thought that there are 18 million children living in low or middle-income countries who are suffering from Marasmus. It is more common in developing countries like some areas of Asia and Africa. Unfortunately, people in the nations have poor access to food, making it difficult to get the correct amount of nutrients, which leads to Marasmus.

Rickets 

Rickets is a condition that affects bone development in children. It specifically softens and weakens the bones typically due to an extreme deficiency of calcium and vitamin D. This condition only occurs in growing bones, so it occurs most commonly in infants and young children.

Any child who lacks these vitamins can develop rickets, however, children in areas of low food income may be more affected. Rickets is common in regions of Asia where there is pollution and a lack of sunlight or low intake of meat. Rickets is also common in Africa, partly because people tend to have darker skin, which reduces vitamin D absorption. 

In severe and untreated cases, the bone becomes more fragile and prone to fractures, and some children may develop heart diseases that can be fatal. 

All in all, malnourishment is a direct cause of 300,000 deaths per year while contributing to 50% of deaths in younger children. It’s thought to be around 852 million people globally that are starving, with the majority (815 million) in undeveloped countries. 

Victims of suffering hunger around the world can be threatened by many different variables. These are just a few examples of syndromes and diseases that can stem from malnutrition.

However, in 2019 a plan to reduce malnutrition in Africa was adopted by WHO. The strategic plan includes specific goals to be met by 2025 and strives to develop evidence-based policies and national capabilities. Priority interventions include enforcing laws and food safety regulations, utilizing financial incentives to promote healthy food selections, and incorporating crucial nutrition acts into systems for delivering health care services to reduce malnutrition and ultimately, reduce diseases caused by malnutrition. 

– Paige Falk
Photo: Flickr

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Access to Quality Health Care in Jamaica

quality health care in JamaicaIn an interview with The Borgen Project, native Jamaican Shamella Parker describes the dire consequences of a lack of access to quality health care in Jamaica. On an evening in February 2023 in Montego Bay, Jamaica, Parker’s aunt Mary, a live-in cook, shared a dish with her employer containing susumba, commonly known as gully bean, a type of green berry popular in Jamaica. Shortly after the meal, both Mary and her employer fell ill.

The man’s family took him to a nearby hospital. “The hospital that he went to, I believe they treated him on the spot because he was wealthy and I guess known in the neighborhood, but my aunt – not being as wealthy – went to another hospital in the area where she was from,” said Parker. In contrast, Mary went to a hospital in St. Catherine and spent a long time waiting to be attended to in the waiting room despite being an emergency case. Eventually, she lost consciousness and became unresponsive. Nurses and doctors attempted to revive her, but it was too late. Parker and Mary’s husband feel the hospital did not do all it could to save her.

According to Mary’s husband, the forensic pathologist was away at his wife’s time of death. For example, in 2015, the Jamaican government employed only two forensic pathologists who perform autopsies for everyone who does not have insurance. When Mary’s husband returned, the pathologist deemed Mary died of an accident – consumption of a poisonous seed. But, to Mary’s family, unequal access to prompt and quality health care in Jamaica stood as the true cause.

A Public Health Crisis

Jamaica’s iconic reggae and beaches backdrop a public health crisis. The legacy of the colonial slave-based economy birthed the traumatic, post-emancipation public health care system present in Jamaica today. Health care is a dimension of poverty on the island; the Multidisciplinary Poverty Index (MPI) of 2022 estimated that 78,000 Jamaicans lived in multidimensional poverty in 2020. The Index splits poverty into three dimensions – health, education and standard of living – and scales the intensity of deprivations for each. Compared to selected other Caribbean and Latin American countries at that time, health care deprivation was greatest in Jamaica, at 52.2%; the next highest was Trinidad and Tobago at 45.5%.

Insurance and Unequal Access to Quality Health Care in Jamaica

The National Health Plan estimates that 500,000 out of 2.7 million Jamaicans have insurance. This means roughly 80% of Jamaicans do not have it and have to rely on public hospitals. These hospitals do not have enough equipment to meet this demand, with World Data estimating that there are 1.32 primary care doctors per 1,000 civilians and 1.7 hospital beds.

Many Jamaicans do not have insurance due to inflated premiums, rendering insurance inaccessible. Even those who have it are discouraged from exceeding the lifetime maximum benefit. As a result of poor insurance or lack thereof, many reserve medical attention for emergencies.

Just taking her aunt to the hospital, Shamella Parker said, meant “it was a serious thing… we do not just go to the hospital for anything.”

Health Education

Non-communicable diseases (NCDs) comprise 79% of mortality in Jamaica. These include diseases such as diabetes, heart disease or cancer. Teaching healthy habits is one way to combat NCDs. Though there is a National School Feeding Programme, public schools increasingly apply the protocol with “unevenness,” according to the Ministry of Education and Youth (MOEY) report.

As it is, many schools are not mandated to provide nutritional food, exercise programs or health classes that destigmatize illness. According to the Jamaican Health and Wellness Minister Dr. Christopher Tufton: “…there is actually a lost generation around that crisis, a cohort of citizens who unfortunately will have to spend the rest of their lives trying to make themselves as comfortable as they can…”

Transportation Infrastructure

Hospitals are difficult to reach. People often live far away from health centers and hospitals. Reliable infrastructure is essential for continual access to health care in Jamaica. However, rural roads are often unpaved, secluded and vulnerable to climate damage. Bad weather resulting in landslides and flooding is common and may disrupt transportation by “cut[ting] off access to health care, education and other essential services,” according to a 2018 report. Blocked roads complicate transporting patients. Jamaica’s “limited funding” for transportation maintenance causes drawn-out repairs when roads erode and bridges collapse.

Ongoing Efforts

In 2020, the Jamaican government signed the Vision for Health 2030, a 10-year health improvement strategy to reorder Jamaica’s fragmented care. Alongside the Pan American Health Organization (PAHO), this plan tackles noncommunicable diseases and maternal health by increasing the number of hospitals on the island and modernizing services to boost equity and efficiency while delivering “higher technical quality.”

In 2019, the government introduced the National School Nutrition Policy. This legislation forms part of the government’s efforts to mandate healthy eating and exercise in young people. Its provisions include measures such as color-coding foods permitted in schools and providing competitions to incentivize healthy eating, according to the MOEY report.

Additionally, various efforts are underway to reform infrastructure, according to the National Development Plan (NDP). Goal 9 of the NDP includes the country’s largest infrastructure project worth up to $800 million to upgrade roads and access to water, sewage and internet.

In 2016, UNICEF began assisting the government in adopting regulated, cold-chain transport. It is a temperature-controlled supply chain essential for reducing waste and improving the integrity of goods necessary for health services.

Looking Ahead

Efforts to address the public health crisis and improve access to quality health care in Jamaica are underway. The government’s Vision for Health 2030 and collaboration with organizations like PAHO and UNICEF aim to modernize health care services, tackle noncommunicable diseases and enhance infrastructure. The introduction of the National School Nutrition Policy highlights efforts to promote healthy habits among young people. As these initiatives progress, there is hope for a more equitable healthcare system that prioritizes the well-being of all Jamaicans.

– Caroline Crider
Photo: Unsplash

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Strategies to Eradicate Tuberculosis

Strategies to Eradicate TuberculosisTuberculosis (TB) is an infectious disease that mainly affects an individual’s lungs and spreads when people with the infection cough or sneeze and release tiny droplets into the air. People in the surroundings inhale these droplets and they contract the same infection. Although the disease affects the lungs the most, in some rare cases the infection can affect the bones, glands or even the nervous system, causing severe symptoms that include fever, fatigue and a long-term cough that may be bloody. The World Health Organization (WHO) has implemented strategies to eradicate tuberculosis across the globe in order to reduce preventable deaths.

Being the world’s leading infectious disease, impacting a quarter of the population, TB claimed the lives of more than 1.6 million people in 2021, according to WHO. Even though TB is present in all countries and in all age groups, it is curable and preventable.

Understanding TB: Most Affected Countries and Why?

According to the Centers for Disease Control and Prevention (CDC), countries in sub-Saharan Africa, Eastern Europe and Asia are most susceptible to TB. There are many reasons why some countries have higher rated of TB infections than others:

  • Weak Health Systems: Low-income and middle-income countries have a lower standard of medical care due to a lack of funds, resources and availability of medical professionals, which leads to fewer clinics and hospitals where individuals can get tests or treatments for TB.
  • Poverty: Low funds in underdeveloped countries and an increased financial burden on individuals mean people often have to make the decision between buying food or life-saving medications. Additionally, due to a lack of sufficient funds, people tend to live together in cramped quarters, making it easier for the disease to spread to the residents.
  • Diseases: Pre-existing diseases such as HIV, diabetes, malnutrition and the frequent use of tobacco can make individuals more susceptible to TB, according to the WHO.

These factors combined make it extremely difficult to screen for TB in low-income countries and most people do not have access to medical facilities, and those who do, are unable to use them because they cannot afford to.

The Fight Against TB

There have been many strategies to eradicate TB in LMCs and one of the most recent and most impactful has been the WHO’s End TB Strategy “to reduce TB incidence by 50% and mortality by 75% by 2025,” according to The Lancet Global Health. Through a multi-step initiative, WHO aims to eradicate TB by 2035.

  • Vaccination at Birth: The first step toward ending TB is through immunizing children against the disease from birth. In 2018, after extensive research WHO established a new criterion for vaccination against TB which stated, “For infants, a vaccine should be either better than BCG or at least 80% effective in preventing TB.”
  • Vaccination for Children and Teens: As part of a trial, routine vaccination was implemented for children who were 9 years old, and a one-time vaccination was implemented for children more than 10 years old. This trial lasted five years and the results revealed that both routine vaccination and a one-time vaccination were effective against the disease, but the routine vaccinations had a higher success rate.
  • Vaccination for Adults: A newly-developed vaccine known medically as the M72/AS01 vaccine has been 49.7% efficient in preventing the progression of TB.

Looking Ahead

In the fight against tuberculosis, significant strides have been made through initiatives like the WHO’s End TB Strategy. Vaccination efforts targeting children and teens have proven effective, while a newly-developed vaccine for adults shows promise in preventing the progression of TB. These advancements offer hope in reducing the incidence and mortality rates of this infectious disease, bringing us closer to a world free from the burden of tuberculosis.

– Vahisté Sinor
Photo: Flickr

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Efforts to Address HIV/AIDS in Ghana

HIV/AIDS in GhanaThe Ghana AIDS Commission reports that 346,120 people are living with HIV/AIDS in Ghana. The HIV prevalence rate stood at 1.7% among people aged 15-49 in 2021, the World Bank says, marking a steady decrease since 2000. However, infections among females are almost double the rate of infections among males. Organizations are committed to reducing the number of people infected with HIV/AIDS in Ghana.

HIV/AIDS and Poverty

HIV and poverty have a two-way connection. Conditions of poverty increase the risk of contracting HIV and HIV contributes to the condition of living in poverty. According to the International Labour Office, “Poverty also drives girls and women to exchange sex for food and to resort to sex work for survival when they are excluded from formal sector employment and all other work options are too low-paying to cover their basic needs.”

HIV/AIDS can also push people into poverty due to the expense of medical care/treatment. “HIV/AIDS causes impoverishment when working-age adults in poor households become ill and need treatment and care because income is lost when the earners are no longer able to work,” the ILO explains. Losses of human capital and reductions in the labor force also slow a country’s economic growth.

The far-reaching impacts of HIV/AIDS show that the epidemic stands as a significant obstacle to poverty reduction and progress toward the 17 Sustainable Development Goals, particularly in the poorest countries.

Ghana’s Progress

In 2020, UNAIDS announced a new set of targets for countries to strive toward in the fight against HIV/AIDS. The goals, with a target date of 2025, aim for “95% of all people living with HIV to know their HIV status, 95% of all people with diagnosed HIV infection to receive sustained antiretroviral therapy and 95% of all people receiving antiretroviral therapy to have viral suppression.”

According to the Ghana Aids Commission, currently, 71% of individuals living with HIV are aware of their status, 99% of HIV-positive individuals are on sustained antiretroviral treatment and 79% of those individuals have achieved viral suppression. With just two years to go, significant action is necessary to ensure that Ghana meets these goals.

A Differentiated Service Delivery (DSD) Approach

According to the World Health Organization, Ghana is working toward these UNAIDS goals with the use of a Differentiated Service Delivery (DSD) approach. This person-centered approach adapts health services for people with HIV/AIDS so that service delivery is improved and the health care system does not become overburdened.

For example, a “multi-month dispensing approach” can allow virally suppressed patients to receive their medications for multiple months at a time. This lowers the workload of health workers as patients need to visit less frequently and also saves patients from making multiple trips to the clinic.

The implementation of the DSD approach has seen positive results. For example, Kpone Polyclinic in Ghana has increased its success rate of providing ART from 85% to 99% in just one year as of March 2023.

PEPFAR’s Efforts

The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has worked in Ghana for 20 years. Over the last 14 years, PEPFAR has invested $140 million in efforts to address HIV/AIDS in Ghana. PEPFAR Ghana supports community organizations in dissolving stigmas surrounding the disease, encouraging people to undergo HIV testing and for infected individuals to begin a treatment program promptly.

Looking Forward

Ghana aims to achieve universal health care. Its vision for 2030 is for all of the country’s people to have “timely access to high-quality health services irrespective of their ability to pay at the point of use.” Although conditions in Ghana are improving, large gaps are still present in the control of HIV/AIDS in Ghana. With the continued assistance from supporting countries and ongoing work in Ghana, incidents of HIV/AIDS in Ghana can reduce along with poverty.

– Leah Smith
Photo: Flickr

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3 Facts About Measles

About MeaslesMeasles is a communicable disease caused by a virus. Persian physician and scholar Abū Bakr Muhammad Zakariyyā Rāzī discovered the disease in the ninth century but it became a global term in the 16th century. In 1757, measles-infected blood was transmitted to healthy donors where Scottish doctor Francis Home discovered that a highly infectious bacterium causes measles. Measles only become a nationally recognized disease in the United States in 1912, when there were 6,000 deaths annually. To this day, measles is considered to be one of the world’s deadliest diseases, especially in developing nations, despite treatment efforts. Here are three facts about measles.

3 Facts About Measles

  1. In 2022, the creator of the measles vaccine Samuel L. Katz passed away at the age of 95. Before the development of the vaccine, almost every child had measles by the age of 15 and nearly 4 million people were infected every year. Five hundred people died from measles each year, there were 48,000 hospitalizations and 1,000 people had swelling of the brain due to the infection, according to the Centers for Disease Control and Prevention (CDC). In 1956, there was a disease breakout at a school in Boston, Massachusetts, where John F. Enders and Dr. Thomas C. Peebles collected blood samples from infected students and isolated the disease within David Edmonton’s blood. In 1963, they developed Edmonton’s virus into a vaccine and it officially received a license in the United States, where Maurice Hilleman and his research team further improved it in 1968.
  2. Before the vaccine, there was an epidemic every two to three years that caused around 2.6 million deaths each year worldwide, according to the World Health Organization (WHO). Even after the vaccine, in 2018, 140,000 people died from measles, most of which were children under 5. Unvaccinated children, pregnant women and non-immune people are most at risk of getting measles, though it is particularly common in developing nations, such as countries in Africa and Asia. In addition, more than 95% of deaths happen in low-income households and countries with underdeveloped health services, WHO reports. Once one has measles, there is no anti-treatment available. However, vitamin A can reduce the complications and risk of death from measles after taking two doses a day apart. The vaccine is a routine procedure in the U.S. and costs $1 per vaccine. However, many developing nations cannot afford the vaccine. This has led to 19.2 million infants not receiving a single dose in 2018. Around 6 million of these infants were from India, Nigeria and Pakistan, where the number of cases is significantly rising.
  3. According to the WHO, measles spreads through coughing, sneezing and being in close contact with infected patients. It can stay airborne and on infected surfaces for as long as two hours and can infect people four days before and after a rash occurs. The first symptoms of measles show 10 to 12 days after exposure to the virus, lasting for four to seven days. It initially has cold-like symptoms, such as a runny nose, cough, red and watery eyes and a fever. Patients also develop small white spots on their cheeks. This develops into a rash after 14 days, which could last for six days. Without treatment, complications could occur, such as blindness, brain swelling, diarrhea, dehydration and ear and respiratory infections. Though, complications occur more in malnourished children with a lack of vitamin A or those who have weak immune systems from other diseases.

Looking Ahead

In 2010, the World Health Assembly stated three targets to eradicate measles by 2015. First, to enable more first-dose vaccines during routine coverage to more than 90%. Second, to reduce case numbers to less than five cases per million annually. Third, to reduce measles-related deaths by at least 95%. Furthermore, in 2012, the World Health Assembly supported the Global Vaccine Action Plan of “eliminating measles in four WHO regions by 2015 and five regions by 2020,” the WHO reports. These goals were successful and as of 2018, mortality rates had decreased by 73% with the development of the vaccine coverage. The Measles and Rubella Initiative, founded in 2001 and the Gavi Vaccine Alliance also supported this by preventing 23.2 million deaths, where most of the deaths would have been in Africa and the countries that the Gavi Alliance support.

– Deanna Barratt
Photo: Flickr

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New Insights into Oceania’s Health Challenges

Oceania's Health ChallengesRecent genetic studies of Pacific Islanders are revealing new insights into Oceania’s health challenges. In turn, these insights may drive sustainable solutions that improve community health and save lives.

Convenience-food diets, obesity, lack of resources and the health challenges that result from these conditions are escalating in many island nations in the Pacific. Worse, the resulting non-communicable diseases (NCDs) are leading to an increase in preventable deaths. Activists from many nations are working to better protect many Pacific Island populations from Oceania’s health challenges.

Oceania

Oceania is a group of countries and territories that share a border with the Pacific Ocean. These 14 countries and territories are diverse culturally, economically, geographically and demographically. Oceania includes the large and wealthy countries of Australia and New Zealand and smaller and less affluent countries including Figi, Tonga and Palau.

Vulnerability

Indigenous people in Oceania are more genetically prone to gut issues and certain NCDs that evolved during colonization. While traditionally, Oceania diets were low-energy-density, the introduction of processed foods and more modern snacks brought obesity and linking issues. Before colonization, there was little to no obesity in the Pacific Islands. According to a 2019 study published in Frontiers in Immunology, “During the period of nutritional transition, the people came to consume energy-dense foods imported from Australia and New Zealand.”

The study reports that certain health conditions disproportionately affect specific indigenous populations including the Polynesians in Hawaii, the Maoris in New Zealand, and the Aboriginal and Torres Straits Islanders in Australia compared to non-indigenous people in the same places.  Mortality rates, NCDs and fertility decline are all issues that disproportionately affect these populations. Studying Pacific Islanders’ health data more closely, as this study did, may lead to sustainable solutions.

Environmental factors such as urbanization, sanitation and pathogen exposure also have the potential to increase disease susceptibility. Genetic vulnerability in the form of microbiome genetic mutations and immune function justifies population-specific medical studies and consideration in regards to nutrition. Accessibility and food insecurity have also driven people to foods that are low in nutrition.

Solutions

There are several specific solutions to combat the sharp rise in NCDs in the Pacific Islands. One strategy is better health monitoring. Current medical data surrounding nutrition is almost nonexistent and therefore Pacific Islander nutrition lacks proper evaluation. Increasing data and enhancing research in this area can better inform people about their eating habits.

The George Institute for Global Health, Fiji National University, Sydney University and Deakin University have created the Global Alliance for Chronic Diseases project. This effort hopes to collect data on preventable deaths and possible food policy initiatives for the future. The researchers already found that decreasing salt intake by one gram a day for a year would prevent heart attacks and strokes and save 131 lives a year.

A second strategy is creating a sustainable interest and consumer demand for fresh and healthy foods.  Since COVID-19, Fiji’s Ministry of Agriculture has distributed seeds for people to grow their own food at home. Additional countries could benefit from a program like this as well.

Other strategies include projects and policies that focus on building a stronger market for healthy foods. Finally, the study suggests applying a gender lens to improve Oceania’s health challenges.  While more women are joining the workforce, they continue to play the primary role in caring for and feeding their families.  They do not have the time to prepare complicated meals so they are turning to convenience foods.

World Bank Showcases Oceania Women Leaders

The 2019 genetic study, others like it and the projects mentioned above are setting a trend of focus on the nutritional health of Pacific Islanders. Sustainable change and progress are occurring throughout Oceania. This progress prompted the World Bank to showcase some inspiring women who are starting to implement solutions to Oceania’s health challenges. In Samoa, Lenara Tupa’i-Fui is the assistant CEO of Health Information Technology and Communications at the Somoa Ministry of Health. She is helping lead the Samoan eHealth system that will better track medical records and provide accessible health monitoring and data. As program director of the Partnership of Human Development in Timor-Leste, Armandian Gusmão Amaral advocates for better health care, especially for women and children. She also focuses on mentoring women to pursue careers in the medical profession.

Looking Ahead

Advocating for better data tracking and health communication, increasing the understanding of and demand for healthy foods and applying a gender lens to improving eating habits are all steps that are helping the vulnerable in Oceania take action on their health.

– Karen Krosky
Photo: Flickr

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Health Care in Mauritius

Health Care in Mauritius
Mauritius, an African island nation in the Indian Ocean, had been an agrarian society with high unemployment rates and low per capita GDP for much of its history as an independent nation. However, in recent years, the country has shifted to having a diversified economy, high employment rates and higher life expectancy. Mauritius reached a per capita GDP of around $11,000 in 2018, and in 2020, achieved an all-time-high employment rate of 93.63%. In an April 2020 Poverty and Equity Brief, the World Bank highlights that Mauritius has eradicated extreme poverty. Along with these milestones, health care in Mauritius has also shown tremendous progress as the main cause of mortality shifted from infectious diseases to degenerative diseases, signaling the advancement of health care technology and policies.

5 Facts About Health Care in Mauritius

  1. Free Public Health Care. Public health care in Mauritius is free for its residents. In 2017, public health institutions provided for around 73% of the health requirements of the population while private institutions addressed 27% of these needs. The number of physicians per 1,000 people has also increased from 1.2 in 2010 to 2.5 in 2018. Additionally, as of 2021, Mauritius’ health care infrastructure consists of “five major regional public hospitals, four specialized public hospitals, two public district hospitals, two cardiac centers, 19 private clinics and hospitals and 30 medical laboratories.”
  2. The Health Care System Shifts to Develop High-Value Activities. Mauritius is promoting an increase in medical tourism, seeking to reign in more profit for its health industry. In fact, “in 2017, Mauritius attracted more than 11,500 foreign patients for treatment” in cosmetic surgery, orthopedics, fertility treatment and other specialized areas. As more investment pours into the sector, advancements in infrastructure can potentially attract more foreign patients.
  3. Health Care is One of the Government’s Main Priorities. Health care in Mauritius is Prime Minister Pravind Kumar Jugnauth’s main priority as he looks to improve the health care system by further addressing non-communicable diseases. Mauritius’ minister of finance, Renganaden Padayachy, whose role is to manage economic activities, is also prioritizing health care in Mauritius by expanding the public health care budget. In 2019-2020, 9.5% of the total budget went to the public health sector, marking a 7.4% increase from the previous year.
  4. Government Commitment in Addressing Health Care Challenges. One of the main challenges health care in Mauritius faces is ineffective distribution and mix of human resources in terms of numbers and skillsets of health workers. In response, the government recruited 538 medical and non-medical personnel in 2020 to receive training on primary health care services, such as immunization programs. Another challenge is Mauritius’ reliance on a paper-based administration form that proved to be inefficient. In January 2021, Mauritius launched an e-health project “to modernize the actual health care system and to make a transition to a technologically-based medical service.”
  5. Advancements in Medical Equipment. Mauritius is promoting the development of high-tech medical tools in the industry. In 2020, Mauritius imported around $30.5 million worth of medical equipment and exported $32 million of medical equipment. In 2021, Mauritius had six medical device manufacturers providing job opportunities to about 600 people.

Looking Ahead

At the onset of the pandemic, the World Health Organization (WHO) placed Mauritius among the African nations at significant “risk of a public health disaster” due to its dense population, a high proportion of elderly citizens and high rate of chronic illnesses. However, Mauritius’ progress and commitment to protecting the health and wellness of its citizens proved to be key in combating COVID-19 as Mauritius emerged as one of the few coronavirus-free places on Earth. Mauritius avoided WHO’s prediction by immediately implementing public health safety measures such as lockdowns, mass testing and contact tracing.

With continued progress in the health care arena, Mauritius stands as a beacon of hope and inspiration to post-colonial countries that progress is possible.

– Samyukta Gaddam
Photo: Wikimedia Commons

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Impact of The War on Ukraine’s Public Health

Ukraine’s Public Health
The war in Ukraine has had several impacts on the world but most importantly on the Ukrainian people through Ukraine’s public health sector. In fact, the Russian army shelled many hospitals which strongly limited the people’s access to medication and proper health care services. Not to forget that war, the movement of big masses of people from one place to another and the lack of access to clean water, create a favorable environment to increase the spread of viruses and diseases. Ukraine has also had a fragile health sector before the war, being one of the countries with the highest number of HIV-infected people in Eastern Europe. Not to forget the COVID-19 pandemic and most recently a poliovirus outbreak that the government did not have time to handle properly.

HIV and Tuberculosis

Two of the main issues in Ukraine’s public health are HIV and tuberculosis viruses. More than 1% of the Ukrainian population is infected with HIV and the ongoing war caused a disruption in the health care system, leading to a potential lack of medicines used to treat HIV and tuberculosis patients. Tuberculosis is the main cause of death among HIV patients in Ukraine, which underlines the importance of providing proper medication for it. Especially since the country has the world’s highest number of multidrug-resistant tuberculosis, meaning that patients must regularly take their medication or else their situation will degrade quickly.

Many people with tuberculosis are seeing their symptoms worsening because of the bad air quality they must deal with in the shelters. This also means that they can transmit the virus to other people present with them, according to Al Jazeera.

Polio

Back in October 2021, a few months before the beginning of the war and 19 years after Europe was declared polio-free, a young Ukrainian child received the diagnosis of polio. Later, positive polio cases started to increase and the government in collaboration with the World Health Organization (WHO) started a vaccination campaign on February 1, 2022. Unfortunately, this campaign has stopped with the start of the war and although many children received their vaccines there remain around 100,00 who need to receive vaccines to consider this outbreak under control, TIME reports. Polio which was already a serious threat to Ukraine’s public health, given the low vaccination rate during COVID-19, is now very difficult to handle due to the war and its highly contagious characteristic.

The danger of these infectious diseases in times of war and displacement of many individuals all around Ukraine but also the rest of the world is the spread of these viruses without the capacity to track the refugees who might be carrying them and thus transmit them to other populations.

Solutions

When the war started, the UNAIDS stated that Ukraine has only a few weeks of medicines in reserve for its HIV patients. To preserve Ukraine’s public health and avoid the spread of the virus, the WHO along with the United States President’s Emergency Plan for AIDS Relief provided the Ukrainian government with enough antiretroviral medication for the next 12 months. Without forgetting of course the civil society in Ukraine and the help it is providing to make sure that medicines reach every patient on time.

Concerning polio, UNICEF along with Ukrainian health workers is setting up “blue dot centers” all along the refugees’ route, vaccinating a maximum of people against polio, according to TIME. Thus, limiting its spread in the countries, they are fleeing to.

Hence, among the numerous impacts that the Russian invasion of Ukraine had on the country is the destabilization of Ukraine’s public health. With an already fragile health sector, Ukraine had to deal with several health issues with relatively no proper means due to the war. Nonetheless, the country can count on foreign aid to preserve the health condition of its people and also prevent from spreading of different illnesses around the globe.

– Youssef Yazbek
Photo: Flickr

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A Closer Look at Malaria in Nigeria

Malaria in NigeriaNigeria has the largest population in Africa with more than 200 million people. About 40% of Nigerians survive on less than $2 per day. The poverty rate in the country has led to an increase in unhygienic living conditions. Poor standards of living contribute to outbreaks of diseases. Malaria in Nigeria is endemic and stands as a life-threatening condition. Bites from an infected mosquito transmit malaria to a living host. Malaria is one of the leading disease burdens with high fatality rates in the country. Globally, reports of 627,000 malaria-related deaths occurred out of 241 million malaria cases in 2020. Pregnant women and children who are younger than 5 risk contracting the disease. Several factors contribute to the prevalence of malaria in Nigeria.

Weather Conditions

Nigeria experiences a tropical climate with rainy and dry weather conditions. In fact, “reports estimate that change in weather was responsible for 6% of malaria cases in some low and middle-income countries in the year 2000.” Weather influences the reproductive rate and life span of insect vectors that transmit diseases. There is an established association between weather and the incidence of malaria in Nigeria. The country experiences high levels of rainfall between June and September each year and there is a reported increase in malaria transmission during these humid months. Malaria is especially prevalent in the rural northern region of the country.

Overcrowded Living Conditions

Housing deficits in Nigeria lead to overcrowded living conditions. Nigeria noted 22 million housing shortages in 2018. The vector that transmits malaria spreads from an infected host through a mosquito bite. Overcrowded spaces serve as a conduit for disease outbreaks and can increase the risk of malaria because higher concentrations of carbon dioxide and other chemicals in crowded houses attract mosquitoes. In addition, reports suggest that poorly ventilated dwellings allow mosquitoes to enter more easily than well-constructed housing with screened windows, thus increasing disease transmission.

Poor Sanitary Conditions

Unhygienic living conditions serve as breeding sites for malaria-carrying mosquitoes. About 60 million Nigerians in 2021 lacked access to clean water and safe sanitary facilities. Lack of access to basic amenities hinders compliance to public health measures of proper handwashing and waste disposal. Poor sanitary conditions continue to hinder efforts in eliminating the disease across Nigeria.

Access to Quality Health Care

Malaria is a mosquito-borne disease that continues to stand as a significant public health crisis in Nigeria. It accounts for 30% of infant mortality and 11% of mortality cases, respectively. Nigeria shouldered 31.9% of global malaria deaths in 2020, ranking as the most malaria burdened nation in Africa. Prevention is key in controlling and eliminating malaria. However, about 83 million Nigerians lack access to health care services, resulting in high morbidity rates for those who have poorer health outcomes. 

Malaria Treatment

Concerted efforts from stakeholders to eradicate malaria in Nigeria have faced daunting challenges due partly to insurgent attacks on health workers. However, Nigeria is making progress in preventing new infections with the use of insecticide-treated mosquito nets and residual indoor spraying with special consideration for vulnerable groups such as pregnant women and children.

A collaboration between global partners and the Nigerian government in mitigating the effects of malaria accounts for the nation’s malaria progress. Initiatives from the Global Fund, Malaria Consortium, USAID, GAVI and Roll-Back Malaria have been successful in improving global health outcomes by reducing malaria deaths by 60% and saving 7.6 million lives. An estimated 100 million insecticide-treated mosquito nets have undergone distribution between 2017 and 2020 to control malaria in Nigeria. Impressively, malaria prevalence declined to 23% in 2018 from 42% in 2010.

In 2021, the World Health Organization (WHO) approved a vaccine as part of an effort toward eradicating malaria. Mosquirix vaccines are useful as part of malaria prevention strategies but funding from the global health community is necessary for a broader rollout. Access to Mosquirix vaccines will be effective in the fight against the spread of malaria in Nigeria and globally.

The Nigerian government launched the Malaria Eradication Fund to strengthen the country’s public health system in response to the challenge of the disease in 2021. Expectations determine that these resources will aid efforts geared toward the elimination of the disease in the country so that Nigeria can be certified malaria-free by the WHO in 2030.

– Sylvia Eimieho
Photo: Flickr

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Expanding Health Insurance in Morocco

Health Insurance in Morocco
By the end of 2021, health insurance in Morocco covered 11 million citizens. With the final count of covered citizens, the Moroccan government announced its expansion of health insurance to unconsidered sector workers. The number of protected citizens will grow in 2022 as proposals are under review to expand health insurance to uncovered workers, such as artisans, taxi drivers, farmers and more.

Morocco’s Health Insurance System

Morocco’s health insurance system is a mixture of government-run and privately owned insurance businesses. Most in Morocco have coverage through the primary source of health insurance. This is the Mandatory Health Insurance, L’Assurance Maladie Obligatoire (AMO).

Morocco implemented its first health care policy in 1959 and established free health services in the public sector. After 1959, the Moroccan health care system went through various changes. However, in 2005, it established and stabilized with the implementation of new programs to regulate and differentiate between the private and public health insurance systems.

In 2005, the Moroccan government created a mandatory, payroll-based health insurance plan that increased coverage from 16% of the Moroccan population to 30%. The payroll-based system is the AMO. The AMO covers the costs of general medicine and medical and surgical specialties, pregnancy, childbirth and postnatal care, laboratory tests, radiology and medical imaging, optical care, oral health treatment and paramedics.

The Regime d’Assistance Medicale (RAMED)

The second insurance policy that Morocco implemented is the Regime d’Assistance Medicale (RAMED). RAMED is a public, government-financed program to fund insurance for those living in poverty and without the income needed to access the AMO.

The private insurance sector, which people often choose simply due to availability, is a system based on a fee-for-service policy. For whatever the service may be, private insurance requires the individual to pay a minimum of 20% of the fees due. However, fees sometimes range as high as 50%.

Morocco’s health insurance system guarantees free care to anyone. However, it is specifically free for anyone living in poverty at any clinic that Morocco’s government runs, as long as the clinics obtain a certificat d’indigence. Thankfully, the poverty rate in Morocco is as low as 3.6%. However, health care remains concentrated in the cities leaving the rural population without easy access to health care.

The rural population often remains uncovered and without the funds to be a part of the private insurance operations. The impending health insurance expansion promises to cover the rural workers. This will ease the economic burden of health insurance from their income.

Impending Expansion of the System

The expansion to cover more workers is not the first one the government has made since 2019. In 2020, the Moroccan government expanded its health insurance system to cover all costs, for every citizen, for COVID-19 treatment. The treatment coverage is available through the AMO.

Morocco’s health insurance system will expand pending the implementation of six drafted policy proposals. The overarching plan for Morocco’s health insurance system is to generalize all health insurance for uncovered workers. The first step in this plan is the creation of coverage beginning with the farmers in the outlying reaches of Morocco, the taxi drivers in the cities and the artisans spread around the country.

The Need for Health Insurance in Rural Communities in Morocco

Morocco’s rural and farming areas are often unconsidered, with doctors and clinics needing to open in said rural areas. The average salary of a Moroccan farmer is 11,700 Moroccan Dirham (MAD) per month, which translates to slightly more than $1,200.

Unfortunately, since the AMO did not cover the farmers, the farmers were often unable to afford private insurance due to having little income to spare. Therefore, with the flexibility of the cost of services due, the farmers could not risk paying anything that might exceed their income.

The Single Professional Contribution System (SPC)

The farmers are only one of the groups that will benefit from the expanded insurance availability. The Moroccan health insurance system’s expansion also covers artisans, who are part of the Single Professional Contribution system (SPC). The SPC allows workers reliant on a flat rate of income to pay fixed taxes and receive health insurance under the new expansion.

The workers who are part of the SPC do not have high incomes and often live on less than the living minimum wage. Much like the farmers, the AMO would not consider them, leaving them unable to afford the private insurance system.

The Moroccan health insurance system’s expansion allows access to basic health care that many could not access before. The government is increasing the annual amount spent on health care as well. The private and public systems will receive additional funding to hire more doctors. Hopefully, more clinics will open in the rural areas to help these newly insured farmers and rural dwellers.

The Moroccan health insurance system will help both the individual and the public. Expanded health insurance could reduce debt, both health-related and non-health-related. It could permit more opportunities to spend money in the local economy.

Increased economic flow can increase income and wages for all business sectors, including the lower-paid individuals, like the farmers. It can also decrease the poverty rate and the number of individuals at risk of poverty.

– Clara Mulvihill
Photo: Pixabay