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

HIV/AIDS in Ukraine
Ukraine has one of the highest rates of HIV/AIDS in the world, with an estimated 260,000 people living with the disease. Odessa, the third-most populous city in Ukraine, has “the highest concentration of HIV/AIDS of anywhere in Europe.” Poverty exacerbates HIV/AIDS in Ukraine and primarily has links with injected drug use, threats to government funding, lack of access to antiretroviral treatment and social discrimination.

Poverty and HIV/AIDS in Ukraine

Ukraine is second to Moldova as the two poorest countries in Europe. The poverty rate in Ukraine increased during the COVID-19 pandemic, from 42.4% in 2020 to 50% as of February 2021. There is a strong connection between poverty and the spread of diseases; it could be both a cause and a result of poverty.

HIV/AIDS causes conditions of poverty when working adults become ill and can no longer support their families. The disease becomes a result of poverty when the conditions of poverty put people at greater risk of contracting it. As an example, women and girls who live in poverty are more vulnerable to sexual exploitation. They are more likely to resort to working in the sex trade. That could put them at dangerous risk for contracting HIV.

HIV/AIDS in Ukraine’s Women and Girls

UNAIDS estimates that out of all people with HIV/AIDS in Ukraine, 120,000 are women over the age of 15 and 2,900 are children aged 14 or younger. Gender inequality, poverty and violence against women and girls are significant factors in the spread of HIV. Women and girls who live in fear of violence may be reluctant to advocate for safe sex, receive testing or seek treatment for HIV and other diseases.

Gender inequality inhibits women’s access to resources for sexual and reproductive health. In rural Ukraine, where the poverty rate is highest, 36% of women do not participate in community or family decision-making. Only 46% are competent with a computer or the internet. Almost 48% do not have access to medical services.

The Lack of Access to Antiretrovirals

As Sky News reported, access to antiretrovirals is a major problem for many people living with HIV/AIDS in Ukraine. Although a law stipulates that antiretroviral therapy should be free to all citizens, limited national resources have resulted in restricted access.

Antiretrovirals are crucial for preventing the spread of HIV to children. The use of antiretrovirals during pregnancy and administered to an infant for four to six weeks after birth can result in a transmission rate of 1% or less. According to U.N. Women, the majority of women living with HIV/AIDS in Ukraine were between 18 and 45 years old. Out of these women, 39% discovered that they were HIV-positive during pregnancy.

Social Discrimination Against People Living With HIV/AIDS

According to WHO, discrimination against people who use drugs and people living with HIV presents a serious challenge to identifying those who need treatment. Harsh drug laws, fear of HIV/AIDS and systematic police abuse undermine efforts to provide HIV information and services such as testing and safe needle exchanges. In addition, the law requires drug treatment centers in Ukraine to register drug users and share the information with law enforcement. This protocol keeps people who use drugs from seeking medical help, which subsequently prevents them from testing and receiving treatment for HIV/AIDS.

The War in Donbas

The war in Donbas has made it difficult for people to receive treatment in a region that previously had one of the highest rates of HIV/AIDS in the country and was home to nearly one-quarter of all antiretroviral recipients. When the war began in March 2014, it displaced 1.7 million people. To compound this, unsafe sex has resulted in an increase of HIV/AIDS within the military. Combined with ongoing military conflict and a shortage of antiretrovirals, Ukraine is experiencing a crisis: the government has failed to keep up with infection rates.

Solutions

In July 2021, Ukraine received a grant of $35.8 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria. According to the Ukrainian government, it would use the funds to purchase personal protective equipment (PPE), reduce risks associated with COVID-19 and strengthen the health care system.

Ukraine is collaborating with the Centers for Disease Control (CDC), USAID and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). The country wants to implement prevention campaigns, increase access to antiretroviral treatment and target key risk groups, such as people who inject drugs, sex workers and men who have sex with men.

On September 1, 2021, President Biden announced that the United States would provide more than $45 million in additional assistance for Ukraine. The aid would help people the COVID-19 pandemic and the war in Donbas affected. The U.S. is working with USAID-supported programs to provide supplies for Ukrainian health care centers, training for health care workers and psychosocial support for the most vulnerable populations.

– Jenny Rice
Photo: Unsplash

Mental Health in Guatemala 
Between 1960 and 1996, Guatemala fought in a civil war between the government of Guatemala and several leftist rebel groups, resulting in many deaths due to the destructive violence. This caused many mental health conditions and problems to arise in the people residing in the country. Unfortunately, violence and public security continue to be a concern in Guatemala, deteriorating Guatemalan’s mental health. 

What Does Mental Health Mean and Why is it Important?

The Centers for Disease Control and Prevention (CDC) defines mental health as someone’s emotional, psychological and social well-being, affecting how they experience and perform in their daily lives. To add, it can help determine how people cope with stress and make choices. Mental health is significant for one’s physical health because poor mental health can lead to diseases, such as diabetes, heart disease and stroke.

The Number of People in Guatemala that Have a Mental Health Disorder

More than 3,250,000 people in Guatemala could experience a mental health illness in their lifetime. However, unfortunately, many of them do not seek the help they need. In fact, one in four people between the ages of 18 and 65 have suffered or continue to suffer from a mental health disorder, but only 2.3% took the initiative to consult a psychiatrist to address their mental health issues. Commonly, people do not want to talk about their mental health. The reason is the lack of knowledge and the stigma around mental health in Guatemala.

Furthermore, Guatemala’s poverty rate increased from 45.6% to 47% in 2020. As a result, Guatemalans are at greater risk to develop mental health disorders because they endure more difficulties in their daily lives. The limited mental health sources available to them are insufficient to help alleviate the stress that socioeconomic disadvantages cause.

In the United States, most health care providers do not cover expenses for mental health care. Interestingly, Guatemala does not have a universal health care system, let alone dedicated mental health legislation. As a result, Guatemalans have difficulty seeking help because there is “0.54 psychiatrist available per 100,000 inhabitants,” according to American Psychological Association. Only five of them are outside of the main cities. Guatemala is a low-income country that does not have the resources to make mental health data available to the public. That is why there are not many studies or public data regarding this issue.

The Main Cause of Poor Mental Health in Guatemalan Children

A study that Rosalba Company-Cordoba and Diego Gomez-Baya conducted includes the issue of mental health of children in Guatemala. Interestingly, 50% of Guatemala’s total population is under 18 years old, making it a country with one of the youngest populations. A child’s mental health is valuable because it can have positive or negative long-lasting effects on their development.

Unfortunately, Guatemala’s high poverty rate has led to increased levels of violence because of the struggle to live in desperate conditions in the community. Exposure to violence showed significant effects on a child’s mental health, such as depression and anxiety. Although childhood poverty is prevalent in many areas of Guatemala, the quality of life showed little significance in the study. These symptoms were more common in adolescents than in children because they are more aware of their surroundings and environment. On the other hand, children exposed to low violence from urban areas with educated parents described higher qualities of life.

Violence rates have continued to increase with assaults, shootings, threats and robberies, causing many children to be afraid to go to school. Almost 60% of Guatemalan students would prefer not to go to school due to fear. Many students and teachers have received threats and experienced robberies or know someone who has been a victim of violence. Guatemala remains one of the poorest countries with high rates of violence, causing a higher risk of a child developing mental health disorders.

Living in these socioeconomic disadvantaged areas can cause children to become part of the gangs because there is no other option. The previously mentioned study showed the association between greater parental education level and higher income with lower food insecurity. However, many children do not attend higher education schooling because they have to help their families with household expenses. The number of children living in urban areas is increasing. This leads to more children in unsanitary conditions and a high cost of living. Almost all children attend primary school. However, the completion rate is 15%, which leads to low enrollment rates for secondary school.

Solutions for Mental Health in Guatemala

Many people have taken action to improve the state of mental health in Guatemala, especially for children. First, many citizens are taking to the streets to protest against the continuation of violence. The implementation of the International Commission Against Impunity (CICIG) resulted in reductions in homicide rates. For example, there were fewer homicides per 100,000 each year. The CICIG provided Guatemala with $150 million in international support to help reform their justice system, but President Jimmy Morales thought this violated Guatemalan authority. As a result, he removed the CICIG mandate in 2019, causing a setback.

Next, people are beginning to seek support for their mental health in Guatemala due to more specialized centers offering psycho-emotional support services to the public, such as Federico Mora National Hospital for Mental Health, for a low cost. According to American Psychological Association, there are about seven psychologists for every 100,000 people, which is a number that continues to increase.

Lastly, schools are doing their part in fighting against gang violence to make children safer in Guatemala and other countries. With support from UNICEF and the Ministry of Education, the schools created a Peace and Coexistence Committee. The idea is to promote an environment where they do not tolerate violence, as Theirworld reported. The schools are trying to lead by example and show their students that violence is not always the answer. They found over the years that there are fewer arguments between the children because they have conversions to handle any dispute.

As Guatemala continues to be a low-income country, crime rates and violence will increase, leading to mental health problems. Mental health in Guatemala will suffer the consequences of the stigma and the lack of resources. The country is working toward a better future by spreading awareness about mental health and fighting violent trends.

– Kayla De Alba
Photo: Unsplash

Sanitation Facilities Empower Girls
About 2.3 billion people around the world lack access to basic sanitation facilities, according to UNICEF. A lack of sanitation facilities in schools can discourage girls from attending school. When girls have access to clean, enclosed sanitation facilities during their menstrual periods and potential pregnancies, they are less likely to skip school or drop out entirely. Sanitation facilities empower girls to attend school by allowing them to feel safer and more comfortable with access to adequate facilities to properly manage their menstruation. In turn, dropout rates decrease and girls’ education completion rates increase.

Private Changing Rooms

Private changing rooms for girls to bathe and change in can help girls feel more comfortable attending school and participating in lessons. Changing facilities with water supplies offer girls a place to change, wash and dry menstrual supplies during the school day. Some changing rooms may also provide students with free menstrual supplies, which is essential for impoverished girls who lack access to these products outside of school.

Without private changing rooms, female students may feel embarrassed to come to school during their periods, especially in countries where people stigmatize menstruation. According to a World Bank study in India, 80% of girls from rural areas in India thought menstrual blood carried harmful substances and 60% believed menstruation is a topic that people should discuss openly.

The availability of changing rooms in schools is also important for pregnant students who require privacy and good-quality sanitation. A lack of proper sanitation facilities stands as a barrier for many pregnant students who feel discouraged and uncomfortable coming to school otherwise. Hygienic sanitation facilities empower girls by helping them feel comfortable at school, even during menstruation or pregnancy.

Private Bathrooms

Much like changing rooms, private bathrooms in schools with modern urinals or toilets can benefit girls’ education. Private bathrooms may include menstrual supplies and waste disposal, which encourages girls to come to school even during their periods. In cultures that stigmatize menstruation, some girls pretend to be ill or come up with other excuses to avoid attending school during their periods due to shame or embarrassment. Many girls do not attend classes during their periods because their schools lack toilets with water facilities as well as discreet sanitary waste disposal areas. Enclosed and gender-specific bathrooms can also improve girls’ safety by giving them privacy when using the bathroom, which protects them from sexual assault and natural dangers such as snake attacks. Private bathrooms and sanitation facilities empower girls by increasing school attendance rates during menstruation.

Organizations Making a Difference

Many organizations around the world are helping girls remain in school during their menstrual periods by providing clean sanitation facilities and free menstrual hygiene products. For example, ZanaAfrica is a social enterprise that works in Kenya to provide girls with reproductive health education and sanitary pads. The enterprise also leads policy and advocacy programs to help break the silence and shame surrounding menstruation.

In Kenya, estimates indicate that 1 million Kenyan girls miss out on education every month due to a lack of menstrual products and sanitation facilities. ZanaAfrica’s approach to supporting girls in school consists of three key steps: integrating health education into schools, collaborating with local partners to provide sanitary pads and education and leading with advocacy and policy. Since 2013, ZanaAfrica has provided more than 50,000 Kenyan girls “with health education, sanitary pads, underwear and mentors.”

Sanitation facilities empower girls to attend school, dissolving barriers to education so that girls can develop the knowledge and skills necessary to rise out of poverty. Girls’ access to sanitation facilities in schools is a necessary step in fighting gender inequality. With an education, girls in developing countries can access skilled jobs and contribute to the growth of the economy, reducing global poverty overall.

– Cleo Hudson
Photo: Flickr

Low Health Literacy in Developing Countries
While developing countries often face pressing issues such as inadequate health care, a less obvious but equally threatening problem is low health literacy rates. In comparison to developed nations, health literacy rates in developing nations are significantly low. However, if society as a whole works to educate and empower individuals to make better choices regarding their health, low health literacy, also known as the “silent killer,” will see a drastic reduction. Here is some information about low health literacy in developing countries.

Defining Health Literacy

The World Health Organization (WHO) defines health literacy as an individual’s ability to adequately comprehend health information and to implement this knowledge into their everyday life in order to “maintain or improve quality of life.” An individual with lower health literacy is more likely to make questionable health choices and is less likely to take preventative action against manageable diseases.

Limited health literacy also correlates with unhealthy lifestyle choices, increased hospitalization rates and higher mortality rates. These impacts make it clear to understand how inadequate health literacy serves as a “silent killer,” especially within developing nations where these rates are prominently low.

The Situation in Developing Countries

Low health literacy rates link to inadequate education systems and health systems because these structures hold the responsibility of relaying health information to the general public. Thus, nations that lack these proper systems are more likely to have insufficient health education levels.

A survey of adult citizens in Isfahan, Iran, indicates that almost 80% of respondents did not have sufficient health literacy. Most of the respondents with inadequate health literacy were females with “low financial status” and limited education. This data suggests that an overwhelming number of individuals in developing nations lack satisfactory health education, particularly women. The reason for this is likely issues of gender equality — women lack access to education, essential services and employment opportunities. Furthermore, poverty disproportionately impacts women all over the world.

Taking Action

There are several ways to improve health literacy rates, and therefore, improve global health. It is crucial to educate the population on their health and to empower them to effectively manage their well-being. Several interventions have proven effective. In South Africa, providing individuals with informative yet easy-to-read pamphlets that include graphics is improving health education in the country. Meanwhile, in China, findings determined that “periodic training of health educators is essential for improving health knowledge” among the general public.

Media is yet another way to improve health education. In Uganda, “more than one in three used the internet to search for health information.” In Iran, secondary school students cited television as their most helpful source of information on HIV/AIDS. In Israel, “a model of Media Health Literacy (MHL)” showed potential in improving health literacy among younger citizens.

Across Asia, the Asian Health Literacy Association (AHLA) works to understand and improve health literacy rates. This organization aims to raise awareness of this issue “among researchers, officials, healthcare organizations as well as experts in health and education, corporations and media” in order to formulate effective interventions to improve these rates in Asia. AHLA sees this as an essential  part of improving the quality of healthcare “and reducing health disparities between communities, groups and nations.” Ultimately, the AHLA aims to improve global health, starting with Asia.

Moving Forward

Increasing health literacy rates in developing countries is an effective way to improve global health and eliminate inequalities. Through education programs, improved communication and dedicated organizations,  these rates can improve. By educating individuals on matters of health, people all over the world can live an improved quality of life.

– River Simpson
Photo: Flickr

Cobalt Mining
In recent years, the world has seen a growing demand for mined materials because of the growing popularity of crystals and semiprecious gems. Included in the demand for mined materials is cobalt, which is increasingly necessary due to its role in electric vehicle (EV) manufacturing. In fact, about “24% of the total cobalt demand” stems from EV production and the demand will continue to increase as more people continue to buy EVs. A prominent stakeholder in the crystal and mineral industry is the Democratic Republic of Congo (DRC), which produces “more than 70% of the world’s cobalt,” along with other semi-precious gems, crystals and gold. Of the cobalt mined, smaller mining operations, many without licenses, produce 15%-30%. The DRC government has failed to enforce proper accountability and ethics within cobalt mining in the DRC. This, combined with years of strict rule and war, has resulted in many people in the mining sector suffering human rights issues.

Human Rights Violations in DRC Mines

Cobalt mining in the DRC is rife with human rights abuses, such as the use of child labor. According to Amnesty International, an estimated 40,000 children are employed in artisanal mining in the DRC. A lack of proper safety precautions is also common practice and accidents frequently occur. Additionally, miners are usually subject to opportunist, abusive and exploitative mining firms, earning unlivable wages.

While it would be ideal for people within the mining industry to look toward alternative work, conditions in the DRC mean employment opportunities are scarce. Data from 2018 indicates that about 73% of the DRC lives in extreme poverty, surviving on less than $1.90 per day — an effect of previous wars and dictatorships. These factors have led to skyrocketing costs of living in the DRC and ravaged land, leaving people desperate to take up any opportunity they can find to survive. Since the nation sits on top of a large cobalt reserve that experts estimate holds more than 50% of the world’s cobalt supply, working in the mining industry in the DRC has more financial promise than other sectors, which imports dominate.

The lack of industry regulation allows exploitative practices to continue, but it also presents a public health crisis. Without the proper safety gear, miners of all ages experience continuing exposure to dust and particles that result in lung and skin diseases, like tuberculosis or dermatitis.

Solutions to Mining Injustices

In recent years, awareness around mining exploitation has been increasing, largely due to the fact that the industry is expanding along with technology. In 2020, several online activists brought attention to the human rights abuses within the artisanal mining industry by creating “the hashtag #NoCongoNoPhone to fight against the cobalt supply chain that fosters child labor and the exploitation of small-scale artisanal miners.”

Additionally, cobalt mining in the DRC is about to experience a regulation shift. Reuters reported in May 2021 that the DRC government is working with the Enterprise Generale du Cobalt (EGC) to establish control over the artisanal cobalt mining sector and obtain a monopoly over Congolese cobalt production. EGC is also partnering with PACT, an NGO in the global artisanal mining industry, to oversee and implement mining condition reforms in the DRC. Furthermore, EGC is working with a commodity and logistics giant, Trafigura, in order to provide “support on traceability down the supply chain.” The EGC will create “a price sharing formula” that splits mining profits between the private company, the miners and the government.

This model underwent testing at the Mutoshi copper mine and proved to be extremely helpful to local economies while also bringing about socio-economic benefits. In the trial, about 5,000 workers were part of a formal system, with PACT and Trafigura regulating the mining activities and pay. Miners reported reduced health expenditure due to better working conditions and “reduced workplace harassment for women,” among other positive impacts.

Looking Ahead

The mining industry in the DRC has suffered because of the lack of mechanisms put in place for accountability. While NGOs do important work on advocacy and mitigating the effects of broken systems, they have not been able to reach the roots of mining exploitation. However, the efforts of NGOs are now combining with those of the government and offer much hope in tackling human rights abuses within the mining industry.

– Hariana Sethi
Photo: Flickr

Healthcare in the Marshall IslandsThe Marshall Islands is a country in Oceania. Known for its beautiful beaches, the country attracts many tourists in search of World War II ships that are in its waters. Tourists also visit the country for its abundant wildlife and coral reefs. According to the World Health Organization (WHO), though healthcare in the Marshall Islands is relatively organized, there are discrepancies and other indications of healthcare problems. These include high mortality rates, which WHO has indicated requires evaluation. Amid the ever-growing COVID-19 pandemic, healthcare is absolutely crucial in making sure that mortality remains low and quality of life is high.

5 Facts About Healthcare in the Marshall Islands

  1. The physician density in the Marshall Islands per 1,000 people is 0.456. This number refers to the number of doctors relative to the size and population of the nation. For reference, the physician density in the United States was 2.57 as of 2014. Other countries in Oceania, like Fiji or Samoa, have physician densities of 0.84 and 0.34, respectively, according to their most recent data.
  2. Only two hospitals exist within the country. In addition to these two hospitals in urban areas of the country, there are approximately 60 health centers and clinics spread out around the Marshall Islands. This number may seem surprising, but the small population of 58,791 merits the limited number of hospitals. Providing primary and secondary care, these hospitals rely on larger centers in the Philippines or Hawaii for more tertiary care. Other clinics and health centers are equipped with primary care physicians and other health assistants.
  3. The Marshall Islands saw a 0.5% increase per year from 2010 to 2019 in providing adequate, effective and necessary healthcare. According to a study by Universal Health Coverage (UHC) collaborators, the effective coverage index in 2010 was 42.1% whereas there was an increase of 1.9% in 2019. These percentages are in reference to effective healthcare coverage in 204 territories and countries across the globe. This means that healthcare in the Marshall Islands overall increased in its effectiveness within the decade.
  4. The morbidity and mortality rates for the Marshall Islands for communicable and non-communicable diseases are relatively high. WHO has mentioned that non-communicable diseases have a high prevalence in the country for two reasons. First, the amount of imported and instant food products that people consume there is high. Second, people in the Marshall Islands overall lack exercise and utilize smoking products at a high level.
  5. The mortality rate for children under the age of 5 years old is 31.8 per 1,000 births in the Marshall Islands. This number, known as a country’s “under-five” mortality rate, is indicative of a nearly three-decade-long improvement in under-five mortality rates in the Marshall Islands. The country has seen a steady decline in the rate since 2004. Between 1990 and 2019, the rate decreased by 17.5%. The under-five mortality rate is slightly higher for boys than for girls.

Healthcare Potential

Some of these five facts may paint a harsh picture of healthcare in the Marshall Islands. However, there is still great potential for improvement in the future. The effectiveness of care, for starters, is a great opportunity for the country to excel in its healthcare coverage. With the intervention of organizations such as WHO and an ever-improving healthcare system overall, these statistics could one day be numbers of the past.

– Rebecca Fontana
Photo: Flickr

Maternal Healthcare Services in Spain
The foundations of the Spanish National Health System (SNS) are free access, equity of financing and funding from taxes. This allows the public sector to provide the most coverage. Oftentimes, this coverage is free of charge. Maternal healthcare services receive high regard in both public and private settings. However, this system faces many issues as well.

Healthcare is available to all Spanish residents for free. Social security payments guarantee almost everyone access to free healthcare. Moreover, some only need to pay a small percentage of fees. Furthermore, only non-residents with health insurance in other countries are not eligible for public healthcare in Spain.

Pros and Cons of Healthcare in Spain

The Spanish healthcare system generally offers high-quality services. There is a network of hospitals and medical centers with well-trained staff members. Additionally, the healthcare system also covers the direct family of a beneficiary. This includes dependents that are under 26 years of age and their siblings.

However, the waiting times for surgeries and treatment from specialist doctors can be extremely long. This is one of the main setbacks of public healthcare. Also, public healthcare services do not allow patients to choose their doctor or specialist. This is very troublesome for some people who wish to have a specific doctor.

Costs for Expecting Mothers

Mothers most often choose hospitals to have childbirth. However, the number of home births has been slowly increasing across Europe. In addition, the state health system does not cover home births in Spain. Moreover, less than 1% of Spanish midwives were registered to oversee home births legally in 2015.

Residents of Spain who use state healthcare can give birth for free. Yet, there may be additional costs with private insurance depending on the insurance plan. Thus, this option makes it easier to find a plan to fully cover the cost of childbirth. The cost of giving birth in Spain is about $1,950 without insurance. This is one of the lowest costs in the world.

Women must hold a private insurance policy for 6-12 months in order to have maternity costs covered. As such, the European Health Insurance Card does not include maternity care.

Maternity Leave

There is also a complicated process in receiving maternity leave. In order to have a standard maternity leave of 16 weeks, mothers must have been paying contributions for a set period of time depending on their age. Mothers are eligible for 18 weeks of maternity leave if they have twins and 20 weeks for triplets. Additionally, maternity leave can receive an extension to 18 weeks if the child has special needs or if the mother is a single parent.

Spain’s Social Security System (Seguridad Social) pays for maternal healthcare services. Mothers must receive paid contributions for at least 180 days within the last seven years to qualify.

The Spanish maternal healthcare system helps many people living in poverty. This system provides a way for people to receive care regardless of their socioeconomic status or salary. Furthermore, it provides a way for residents to choose between public and private options. These options gear towards those who want personalized treatments with a specific doctor.

Expecting mothers benefit from these affordable and accessible maternal healthcare services. Although aspects of the process are difficult and intricate, this service provides a way for Spanish women to give birth easily. This public healthcare system has made Spain a highly rated country for quality care and service.

– Miranda Kargol
Photo: Flickr

World Food Programme Solutions for 2021
A United Nations General Assembly meeting took place on December 4, 2020. Its primary focus concerned the trajectory of the COVID-19 pandemic as precautionary measures continued and vaccines emerged. With 2020 nearly over, the resounding political, social and economic effects of the pandemic began to materialize. But all did not disappear despite the grim outlook. A handful of humanitarian organizations are busy strategizing solutions for 2021.

Closing 2020

The last few months of 2020 showed the world that the pandemic is just the beginning. The disease itself constitutes merely one of a myriad of societal problems that a pandemic can bring. COVID-19 has had an unpredictable ripple effect. PPE loans in the United States, damaged food supply chains in Africa and the closings of borders all over the world demonstrate the pandemic’s extent.

Earlier in December 2020, before the General Assembly meeting, the UN estimated that the pandemic, the resulting economic impact and the concurrent precautionary and protective measures that governments were taking had already caused a 40% rise in the number of people in need of humanitarian assistance. What may be the most evident incoming challenge is global famine. David Beasley, chief of the World Food Programme (WFP), warned that famines “of biblical proportions” are imminent for dozens of countries.

2021 Predictions

David Beasley spoke at length at the General Assembly meeting. His prediction for a catastrophe in 2021 made headlines and effectively set the tone for the entirety of the 193-nation conference. The upcoming COVID-19 vaccines constituted a positive note, though greater concerns regarding distribution overshadowed them. Speakers at the meeting warned against a stampede for vaccines that could result in wealthier countries crushing others in the race to eradicate COVID-19. While the pandemic is global, the UN fears that the fight against it may become individualistic and needlessly competitive.

The head of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, echoed fears of the COVID-19 vaccine competition. He called for $4.3 billion USD to go into a global vaccine-sharing program, saying “solutions must be shared equitably as global public goods.”

Solutions for 2021

Despite the dire circumstances, Beasley and his organization have the leverage to play a crucial role in manifesting solutions for 2021. The World Food Programme works as more than just an international food bank: it enjoys the global spotlight after winning the 2020 Nobel Peace Prize for “bettering conditions for peace in conflict-affected areas and for acting as a driving force to prevent the use of hunger as a weapon of war and conflict.”

The achievements that landed the World Food Programme this coveted prize also provided some positivity at the December conference. The General Assembly served as the WFP’s proverbial megaphone to world leaders. Thanks to the publicity surrounding the meeting, the WFP could grab the world’s attention.

As COVID-19 continues to rise and economies across the world take a resounding hit, humanitarian budgets stretching thin. Low- and middle-income countries particularly suffer. Beasley predicts that the WFP needs $15 billion in 2021 to address the global famine conditions that the pandemic has caused. Beasley says that the inability to meet leaders or address parliaments in person may hinder fundraising efforts. It will be difficult to sensitize those in charge of financial allocations.

Nonetheless, the World Food Programme and similar organizations are working tirelessly to raise money and create frameworks for solutions to the pandemic and its concurrent issues. Events as routine as a UN General Assembly meeting have provided the podia necessary for titans of humanitarian aid to make their causes known. With any luck, their solutions for 2021 will keep millions afloat.

– Stirling MacDougall
Photo: Flickr

Sickle Cell Anemia in Sub-Saharan AfricaThere are a total of 46 countries that compose sub-Saharan Africa. These countries account for 75% of the total cases of sickle cell anemia. Due to the high concentration of this disease in one area of the globe, high rates of early mortality have devastated sub-Saharan Africa. Researchers estimate that 50-90% of infants born with the disorder will die by the age of 5. In response, methodologies have been developed in hopes of eradicating sickle cell anemia in sub-Saharan Africa.

Early Screening

It is crucial to provide screening for newborns in order to diagnose children with sickle cell anemia as early as possible. Early detection of the disease is proven to increase survival rates. In under-resourced communities, many children have died without ever being diagnosed. Early detection allows for the initiation of treatments, therapies, physician follow-ups and medical attention. Previously, diagnoses of patients happened through isoelectric focusing and liquid chromatography, but they have shown to be inaccurate and expensive. Now, there are “point-of-care” diagnostic methods available that are affordable and provide accurate results.

Vaccinations

A consequence of sickle cell disease (SCD) is an exponential increase in the transmission of bacterial infections. The main vaccination that has resulted in improvement for patients with sickle cell disease is penicillin prophylaxis. With the increased availability of penicillin and medical monitoring, mortality rates for patients with sickle cell anemia in sub-Saharan Africa will significantly decrease.

Treatment Therapies

Once diagnosed, there are numerous preventive and therapeutic measurements that can alleviate the symptoms of SCD. Data collected through years of research have proven that hydroxyurea is the most effective therapy for patients with SCD. In addition, proper hydration and nutritious supplements are key to curing non-critical patients. The most critical patients receive blood transfusions. Lastly, stem cell transplantations provide great improvements in SCD patients; however, its high cost often prevents utilization of this method.

Health Education

A simple method to increase the life expectancy of SCD patients is to provide accurate and useful information about the disease. Parents well-informed on this condition can properly identify symptoms their children display and can seek immediate medical attention. This leads to early detection so their child can receive necessary medications, therapies, vaccinations and treatments.

Global Advocacy

In recent years, more institutions have recognized the prevalence of sickle cell anemia in African and have shifted their focus to aiding those countries. The U.S. National Institutes of Health and the Gates Foundation created joint efforts in order to cultivate gene-based cures for both sickle cell disease and HIV.

The National Heart, Lung, and Blood Institute (NHLBI) and American Society of Hematology announced one of their priorities is to support the impoverished, disadvantaged countries across Africa in regard to sickle cell anemia. Also, the NHLBI Small Business Innovation research grant allowed for the utilization of the affordable, precise “point-of-care” diagnostic methods for SCD patients. Further advocacy for underprivileged, poor families is necessary to continue the fight in reducing sickle cell anemia in sub-Saharan Africa.

Despite its challenges, Africa has made major strides in improving sickle cell anemia in the last forty years. Continuing to utilize these methods would not only save vulnerable children, but their economy would flourish as well. A higher life expectancy has a direct correlation with an increase in projected lifetime incomes. This would result in more people contributing to their country’s economy and mobilizing their personal socioeconomic statuses. It is vital to take the above approaches to support patients with sickle cell anemia in sub-Saharan Africa.

Bolorzul Dorjsuren
Photo: Flickr