Inflammation and stories on healthcare

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

Health Care and Hospital Systems

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

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

Universal Health Coverage (UHC)

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

Public View and Poverty Gap

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

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

Support and Challenges for UHC

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

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

– Hung Le
Photo: Flickr

Life expectancy in Grenada
Grenada is a country in the Caribbean composed of seven islands. This former British colony attained its independence in 1974, making Grenada one of the smallest independent nations in the western hemisphere. Nicknamed historically as the “spice isle,” Grenada’s traditional exports included sugar, chocolate and nutmeg. From 1979 to 1983, Grenada went through a period of political upheaval, which ended when a U.S.-led coalition invaded the island. Today, Grenada is a democratic nation that is working to ensure the health and well-being of its citizens. Here are nine facts about life expectancy in Grenada.

9 Facts About Life Expectancy in Grenada

  1. The World Bank’s data showed that, as of 2017, life expectancy in Grenada was 72.39 years. While there was a rapid increase in life expectancy from 1960 to 2006, life expectancy decreased from 2007 to 2017.  However, the CIA estimates that this metric will increase to 75.2 years in 2020.
  2. Non-communicable diseases constitute the leading cause of death in Grenada. According to 2016 WHO data, non-communicable diseases such as cardiovascular disease, cancer and diabetes constituted the majority of premature death in Grenada. Cardiovascular diseases, which constituted 32 percent of all premature deaths, were the leading cause of death in 2016.
  3. Grenada’s infant mortality rate stands at 8.9 deaths per 1,000 live births. This is a significant improvement from 21.2 infant deaths out of 1,000 in 1985 and 13.7 deaths out of 1,000 in 2018.
  4. Grenada has universal health care. Health care in Grenada is run by the Ministry of Health (MoH). Through the MoH, the Grenadan government helps finance medical care in public institutions. Furthermore, if an individual wishes to purchase private health insurance, there are several options to choose from.
  5. Around 98 percent of people in Grenada have access to improved drinking water. However, water scarcity still plagues many people in Grenada due to erratic rainfall, climate change and limited water storage. To remedy this, Grenada launched a $42 million project in 2019 with the goal of expanding its water infrastructure. This includes plans to retrofit existing systems.
  6. Hurricanes and cyclones pose a threat to life expectancy in Grenada. While in recent years Grenada has not been significantly affected by a hurricane, Grenadians still remember the devastation caused by Hurricane Ivan (2004) and Hurricane Emily (2005). Hurricane Ivan caused an estimated $800 million worth of damage. In the following year, Hurricane Emily caused an additional $110 million damage. On top of 30 deaths caused by these natural disasters, the damage they inflicted on Grenada’s infrastructure and agriculture can have further harmful ramifications for the people of Grenada.
  7. The Grenadian government is taking measures to improve the country’s disaster risk
    management (DRM). With the help of organizations such as the Global Facility for Disaster Reduction and Recovery (GFDRR), Grenada is recovering from the devastation of 2004 and 2005. In 2010, for example, GFDRR conducted a risk management analysis which helped the preparation of a $26.2 million public infrastructure investment project by the World Bank in Grenada.
  8. The Grenadian government’s 2016-2025 health plan aims to strengthen life expectancy in Grenada. One of the top priorities of this framework is to ensure that health services are available, accessible and affordable to all citizens. Another goal surrounds addressing challenges for the most vulnerable groups in society such as the elderly, children and women.
  9. Grenada received a vaccination award from the Pan American Health Organization (PAHO). In November of 2014, PAHO awarded Grenada the Henry C. Smith Award for Immunization, which is presented to the country that has made the most improvement in their immunization programs. PAHO attributed this success to Community Nursing Health teams and four private Pediatricians in Grenada.

The Grenadian government is committed to providing the best quality of life for its citizens. However, there is still room for improvement. The prevalence of premature death caused by cardiovascular diseases suggests that Grenada needs to promote healthier life choices for its citizens. With the continued support and observation by the Grenadian government, many hope that life expectancy in Grenada will increase in the future.

YongJin Yi
Photo: Flickr

Health Care Progress
The Democratic Republic of the Congo (DRC) has faced various issues surrounding health care in the past several decades and some have amounted to significant setbacks for the nation. However, the country has seen health care progress in the DRC in recent years and international organizations are looking forward to the future.

Improving Vaccines for Citizens

International partners have been able to pair with the government in the DRC to initiate this health care progress, and the country has been polio-free for four years as a result. The lack of infrastructure and geographical size of the DRC makes it particularly difficult to reach milestones in health care progress. The United States Agency for International Development has been a vital component of health care progress in the DRC serving over 12 million people spanning a multitude of different provinces. The organization has additionally remained committed to providing HIV/AIDS support in 21 concentrated zones. These focused zones are crucial for health care progress in this region.

In addition to the international organizations doing their part to help health care progress in the DRC, the country’s Ministry of Health has been working diligently in recent years to improve vaccines and their means of storage. Keeping vaccines in the appropriate cooling storage containers and fridges has proved especially difficult due to the DRC’s tropical climate. In a 2018 plan, the Ministry of Health aimed to provide immunizations to almost 220,000 children and improve vaccine storage conditions. Partnerships with outside organizations have helped to deliver 5,000 solar-powered fridges specifically intended for vaccine storage and they will distribute more later on.

Progress in Hospital Conditions

One of the first dependable and reliably functional hospitals opened in Kavumu through an initiative called First Light. This hospital garnered a brand new electronic medical records system to make keeping track of patient history astronomically easier than before. The hospital staff received tablets to mobilize the system and expedite the process of patient diagnosis and care. With this technology, the hospital is able to treat nearly three times more patients than it was able to without these resources – originally, doctors were only able to see approximately six or seven patients per week.

The hospital also implemented a motorcycle ambulance program so patients no longer have to walk or have others carry them to emergency care in order to tackle the issue of having no ambulance access in the city. This program utilizes motorcycle sidecars specifically to transport patients, which was a successful method that people originally used in South Africa.

The Future of Health Care in the DRC

The World Health Organization (WHO) has continuously been an important player in the health care progress of the DRC. It has partnered with non-governmental organizations to deliver medicines and various other resources to hospitals and clinics in areas where people have limited health care access. In the interest of continuing the progression of the country and establishing a functional health care system, WHO also remains dedicated to analyzing and quantifying statistics within the country that gives organizations clues on what they need to do next. These statistics are able to pinpoint issues in specific areas, therefore making it easier for government and international organizations to act, provide aid and implement programs for improvement. The continuation of this data collection will hopefully allow for more health care progress in the future.

There is still a lot to do in the DRC when it comes to health care. There are organizations and efforts dedicated to treating all of the diseases and epidemics that threaten the country’s current health care progress like malaria, cholera, tuberculosis, HIV/AIDS and more. Some organizations involved in the nation even specifically focus on the care of mothers and children or improving sanitation conditions.

It will be small, incremental changes over time that will lead to continued health care progress within the region. The country cannot fix everything at once, but the collective efforts and partnerships of international organizations and governmental entities have already dragged the country out of its most difficult struggles with health care and access to health resources. The continuation of these practices will ensure the building and sustainment of a functional and reliable health care system, therefore alleviating the worries of so many citizens within the DRC.

For now, health care progress in the DRC is on track and only time will tell how these small initiatives eventually reform and reshape the country’s health care system entirely.

Hannah Easley
Photo: Flickr

Life Expectancy in Latvia
Latvia is a small country located in the Baltics, bordering Estonia, Lithuania, Belarus and Russia. In 2018, the life expectancy in Latvia was 75 years, slightly above the average global life expectancy of 72.6 years. Since 2006, the total life expectancy in Latvia has been slowly growing at a rate of about .35 per year. Here are 10 facts about life expectancy in Latvia.

10 Facts About Life Expectancy in Latvia

  1. Differences Based on Sex: The life expectancy for women in Latvia was 79.6 in 2018, as opposed to 70 for men. Generally, there is about a 10-year difference in life expectancy between men and women in Latvia, as opposed to the five-year difference which is the average in the European Union. The Baltic News Network has attributed this to greater rates of cancer and a general culture of ignoring health problems among men in Latvia. 
  2. Leading Causes of Death: The leading causes of death in Latvia are ischemic heart disease, stroke, Alzheimer’s disease and lung cancer. The only of these causes to increase in percentage from 2007-2017 is Alzheimer’s disease. The rest have decreased by at least 17 percent during that span.
  3. Risk Factors: There are several risk factors involved in Latvian fatalities. Among the leading risk factors are dietary risks, alcohol and tobacco use, high blood pressure and a high body-mass-index. In addition, there are environmental risk factors in Latvia. For example, estimates determine that air pollution is the eighth largest risk factor for Latvians in 2017. Recently Latvia has seen legislation geared at reducing some of these factors, such as a law passed in 2016 requiring health warnings on cigarette packaging.
  4. Spending: In 2016, the average Latvian spent $995 a year on health care. People spend around $437 out of pocket and $549 came from the government. By 2050 projections determine that the number will double. For reference, the average American, the world’s highest spender on health care, spends approximately $10,000 a year on health care.
  5. Self-harm: Self-harm is a major problem in Latvia, causing 729 deaths per 100,000, significantly above the mean in Europe. Likewise, Latvia had the lowest rate (31 percent) of people who reported being happy within the last four weeks of any European nation in 2018. In 2014, Latvia launched its first campaign called “Don’t Turn Away,” to address these issues, increase social awareness of self-harm and destigmatize talking about mental health issues. From 2014 to 2016, Latvia saw its suicide rate drop from 19.31 percent to 18.73 percent.
  6. Infant Mortality: The infant mortality rate in Latvia was 3.3 deaths per 1,000 births in 2018. This was a significant decrease from an infant mortality rate of 15.8 in 1994. Also, this is significantly lower than the global infant mortality rate of 29 deaths per 1,000 births in 2017.
  7. Health Care System: Though Latvia has universal health care, patients still have to pay out of pocket for a lot of treatments. Latvia has a negative list of benefits, which means that the government pays for all treatments except those specifically listed. General taxation pays for this universal health care plan.
  8. Physicians: Latvia currently has 3.19 physicians for every 1,000 people who live in the country. A steep drop off occurred between 2009 and 2010. Back then, the number of physicians dropped from around 3.7 physicians to 3.1 physicians per 1,000 people. However, since then, the number of physicians has been steadily rising. This is significantly higher than the world average of 1.5 physicians, but slightly below the average in the European Union of 3.57 physicians per 1,000 people.
  9. Government Treatment Towards Health Care: The Latvian government gives a low priority to health care, as it makes up only 5.5 percent of its annual budget. The average country in the E.U. spends about 10 percent of its budget on health care. Latvia has seen major reform in its health care system, which helps the country increases its overall life expectancy. The low wages in Latvia contribute to a lot of corruption within the health care system. This corruption comes in the form of out-of-pocket payments from individuals to doctors, who use it as a supplement to their salaries. Surprisingly, the general public is accepting of this practice, since many believe it promotes honesty and good service.
  10. Relationship with the European Union: The European Union has worked to invest in better infrastructure for Latvian hospitals. The European Union allocates 64 million euros for new equipment in Latvia’s biggest hospital located in Riga in 2017. This will increase access to high-quality health care for Latvia’s 2 million citizens by 2023.

These 10 facts about life expectancy in Latvia show that there needs to be an improvement in the Latvian health care system. On the other hand, there is a lot of promise in the betterment of this health care system. The steady increase in life expectancy has shown the positive effects of some reform. This will likely continue in the future as the government works to better address health problems, and the Latvian health care system receives aid from the European Union.

– Ronin Berzins
Photo: Flickr

7 Facts About Diabetes in Sub-Saharan AfricaDiabetes is a condition that has plagued sub-Saharan Africa for decades and has been on the rise in recent years. However, with technology constantly changing and Africans learning more about diabetes risk factors, the region is sure to make progress in curbing the disease. Below are seven facts about diabetes in sub-Saharan Africa.

 7 Facts About Diabetes in Sub-Saharan Africa

  1. The Diabetes Declaration for Africa is one of the first calls to action that the region has been exposed to. It calls on the governments of African nations to make efforts to prevent diabetes as well as reduce morbidity from the disease.
  2. One of the main reasons sub-Saharan Africa has seen such a large increase in diabetes cases is due to the lack of consistent data on diabetes rates among the general population as well as sensitive populations. One report shows that diabetes rates in the region increased by almost 90 percent between 1990 and 2010. However, immunological factors, environmental factors as well as genetic factors have only been researched in recent years.
  3. Physical activity plays a large factor in why diabetes is so prevalent in sub-Saharan Africa. While many other regions in Africa consist of rural communities, sub-Saharan Africa consists of many urban communities. Urban communities require less physical activity due to the increased use of public transportation. Rural communities require a lot more physical activity due to the number of tasks that involve walking outside or lifting and moving objects.
  4. There is a major lack of efficient healthcare workers in sub-Saharan Africa who are able to treat patients with diabetes. More than 50 percent of those living with diabetes in the region are undiagnosed. The region holds 13 percent of the world’s population and 24 percent of all global diseases, yet only 2 percent of the world’s doctors. Fortunately, however, countries in the region are making an effort to make more healthcare workers available to patients. In 2010, Tanzania enacted the Twiga Initiative, which would double the country’s trained healthcare workers from 3,850 per year to 7,500 per year.
  5. A lack of proper education in diabetes management and early warning signs is a large reason that diabetes instances have increased in sub-Saharan Africa. But, in order to improve education on the self-management of diabetes, the International Diabetes Federation Africa Region (AFR) has been working to provide training on the condition in the region. The AFR represents 34 diabetes organizations throughout Africa and provided training sessions in Kenya in 2019.
  6. Some countries in sub-Saharan Africa have easier access to blood glucose self-monitoring than others. While out of a sample size of 384, only 3 percent of Ethiopians were able to self-monitor their blood glucose at home. However, out of a sample size of 150, 43 percent of Nigerians were able to do so.
  7. In 2007, the U.N. General Assembly enacted World Diabetes. This was a milestone in acknowledging that diabetes is a global threat not just to sub-Saharan Africa but to partners and stakeholders that work to prevent diabetes and related diseases.

While diabetes in sub-Saharan Africa has been on the rise for decades, progress is being made in various countries throughout the region. With more improvements to technology, healthcare, education and self-management,sub-Saharan Africa could reduce the extreme rates of diabetes.

Alyson Kaufman
Photo: Pixabay

Development Projects in Honduras
Poverty remains an issue in Honduras, but it is making progress in rural infrastructure development, education improvement and agriculture income growth. As reported in 2017, Honduras has a poverty rate of about 52 percent, partly due to slow economic development, extreme violence and political corruption. Those in poverty rely heavily on outside aid from the World Bank, the U.S. and various non-governmental organizations (NGOs). Thanks to the World Bank and its partners, major development projects in Honduras were successful, such as the Social Protection Project and the Rural Infrastructure Project. Progress is currently ongoing to reduce poverty, develop the Honduran economy and improve life for those in poor rural areas.

Social Protection Project

The Social Protection Project cost $77 million, began in 2010 and ended in 2018. Although poverty reduced from 65 percent in 2005 to 52 percent in 2017, poverty remains an issue and is one of the main reasons for Hondurans fleeing the country. One major effect of Honduras’ poverty is parents taking their children out of school and having them work to help the household earn a sufficient income. Since income is low, poor Hondurans often cannot afford quality health care.

Malnutrition in children under 5 was 43 percent for those in poverty and school enrollment for ages 12 to 14 was 65 percent. To combat this, the World Bank and Honduras worked together to improve education and health care. At the end of the project, school attendance increased by 5 percent for 6 to 17-year-olds and school enrollment increased by 5 percent. Child labor reduced by 2.6 percent and about 50 percent of the recipients from 0 to 23 months of age received vaccinations. More than 300,000 families benefited from the Social Protection Project. Conditional cash transfers helped reduce poverty for those who participated in the project, which granted monthly income to the extreme poor.

Rural Infrastructure Project

The Rural Infrastructure Project began in 2005 and ended in 2016. Most roads in Honduras are unpaved and about 16 percent of people in rural areas lack a clean drinking water source, which increases the risk of contracting diseases. Also, about 22 percent of sanitation facilities remain unimproved and 30 percent of those in rural areas lack electricity. The Government of Honduras worked with the World Bank to improve its lagging infrastructure because of this. The project benefited more than 300,000 households.

Among many other infrastructure improvements, the project resulted in installing 4,893 latrines and constructing 113 water and sanitation projects. The project improved more than 413 miles of roadways and financed more than 8,550 rural electrification projects, with most of the electricity powered from solar photovoltaic energy. The project also improved more than 500 miles of power lines, which made it easier to develop remote areas of Honduras such as the slums in the western part of the country.

U.S. Involvement

The U.S. is one of the main donors to Honduras. Through the Millennium Challenge Corporation (MCC), the U.S. grants aid to those in need of foreign assistance. The U.S. Congress created the MCC in 2004 with strong bipartisan support. The MCC spent more than $200 million in infrastructure and agriculture improvements through four major projects in Honduras from 2005 to 2010. Some of the results include more than 350 miles of rural roads improved and paved. The biggest result was increasing monthly agriculture income by $3.50. The increase in income might seem small, but not for those in poverty, especially Hondurans who live in extreme poverty, off of less than $2 a day. For reference, the middle-income country poverty rate is around $5.50.

Poverty is slow to decline in Honduras, yet successful development projects in Honduras show improvement in other areas. Infrastructure is improving through the help of the U.S. and the World Bank. Poverty declined gradually from about 65 percent in 2005 to 52 percent in 2017. Development projects in Honduras in rural areas, such as through electrification, education and health care improvements and road construction shows promise for improving livelihoods for Hondurans in poverty.

– Lucas Schmidt
Photo: Flickr

10 Facts About Life Expectancy in Dominica 
Dominica, a 290-square-mile piece of paradise, is picturesque and surprisingly untouched. This small island has a population of 73,286 and has supported itself on its own agriculture rather than tourism. Its life expectancy is high and a record number of residents live well into their 100s. Here are 10 facts about life expectancy in Dominica.

1o Facts About Life Expectancy in Dominica

  1. Dominica boasts the sixth-highest life expectancy in the Americas, which stood at 77.4 years for the total population in 2018. The average male lives 74.4 years and the average female lives for 80.5 years.
  2. Historically, Dominica has had low mortality rates although those numbers have been fluctuating over the years. In 2000, mortality rates were 7.3 per 1,000 in the population. This number rose in 2007 to 8.44 and came back down to 7.9 in 2018.
  3. From 1990 to 2017, the mortality rate of children under age 5 has increased from 18.8 to 30.3. In addition, the mortality rate rose from 15.7 to 26.4 for children under age 1. These numbers seem high, but when one considers the island’s small population, the combined number of deaths is surprisingly low. For instance, the three leading causes of death for children and infants under 5-years-old from 2006 and 2010 were respiratory disorders specific to the perinatal period, congenital malformations and bacterial sepsis of the newborn. This resulted in only 99 deaths amongst this age group in those four years.
  4. Since 2000, trained health personnel has seen all pregnant women. No cases of vaccine-preventable diseases in children occurred between 2006 and 2010. Immunization coverage in 2009 remained at 100 percent for MMR, 99.4 percent for polio and 98.6 percent for BCG. In 2009, 96.8 percent of women visited public health facilities. In addition, around 3.4 percent visited private medical practitioners for prenatal care. Around 99 percent of births took place in a hospital. Moreover, mothers exclusively breastfed around 26 percent of babies for six months.
  5. From 2007 to 2009, there were 296 adult deaths between ages 20 and 59 and there were 40 deaths of young adults ages 15-24 from 2005 to 2009. Fifty percent of these deaths were from external causes like car accidents and homicides.
  6. Thirteen percent of Dominica’s total population was reportedly elderly in 2010 and the number is steadily increasing. The Yes We Care program launched in 2009. It provides relief to the members of the elderly population that need it the most. This program offers income-tax-free pensions, free hospitalization and a minimum pension for all non-pensionable persons retiring from the public service.
  7. People have cited Dominica’s pristine, unspoiled environment as the main reason for longevity on the island. Dominica’s waters are unpolluted and its vegetation is pesticide-free. A healthy diet also contributes to a high life expectancy. Traditionally, Dominicans’ diets include natural products from the forest, herbs and herbal medicines.
  8. Dominica holds the record for the highest number of centenarians in the world. Some call this island the home of the fountain of youth. At one point there were four centenarians on the same street. Surprisingly, there were 27 centenarians on the island. That is nearly four people per 10,000, 50 percent higher than Japan, and three times as many as in Britain. Moreover, the U.S. Dominica was the home of the oldest documented person, Ma Pampo who died in 2003 at age 128.
  9. Most of the physical fitness that some attribute to the people of Dominica is due to the mountainous nature of the island with its interior covered in thick rainforest. The islanders worked the land for years and today’s elderly had to walk long distances on rough terrain in their youth because there were few roads until well into the 1960s. Walking was a necessity of everyday life, along with hard physical work.
  10. Some fear that the story of Dominica’s remarkable centenarians will come to an end in another decade. This is because of the lifestyle changes of the island’s younger generation including American-style fast-food restaurants popping up and televisions in even the poorest households. One in four of the population owns a car and toiling on the land is a last choice job for the young. Benefiting from better medical care and improved public health, while living a pre-modern lifestyle is coming to an end. The new generation is becoming obese. In contrast, Dominica still has a large number of the older generation who have not known bad habits.

Dominica is the perfect example of how lifestyle affects longevity. The fact that Dominicans have found ways to sustain themselves without giving into large scale tourism has preserved their way of life and extended many of their lives. These 10 facts about life expectancy in Dominica highlight and support the importance of a healthy diet and proper exercise.

– Janice Athill
Photo: Flickr

North Korea Health Care
Despite North Korea having universal health care, many of its citizens struggle to obtain basic health care. The health care system has been in a state of crisis since the 1990s, so the little health care that is available goes to high-income Koreans. Here are five facts about health in North Korea.

5 Facts About Health in North Korea

  1. North Korea spent the least on health care in the world in 2019. The total amount of money that the country did use for health care equaled less than $1 USD. The lack of funding makes the quality of health care lower which prompts citizens to bypass doctors altogether and buy medicinal products from markets and self-medicate.
  2. Two out of every five North Koreans suffer undernourishment. Mission East, a Danish NGO, is the only U.N. exception sending agricultural machinery into the country – which the country has banned alongside metal objects. Mission East emerged in 1991 and was finally able to establish a country office in Pyongyang in the summer of 2019. It helps the rural population with food security and health in North Korea.
  3. Out of the 131,000 cases of tuberculosis in North Korea, 16,000 citizens died throughout 2017. Multi-drug resistant strains are becoming more and more common in recent years. The Eugene Bell Foundation has been giving health care aid to North Korea since its beginning in 1995. The Foundation returns to North Korea every six months and has initiated a multi-drug resistant tuberculosis program as well as a tuberculosis care program. The program has cured over 70 percent of the patients in North Korea with multi-drug resistant tuberculosis.
  4. Sixty-one percent of North Koreans have access to safe water. UNICEF in North Korea has implemented a Water, Sanitation and Hygiene program (WASH). NGOs such as the Swiss Humanitarian Aid and World Vision International have received approval from the U.N. to send shipments related to the WASH program into the country. UNICEF works to promote good hygiene, provide technical support and support delivery of supplies.
  5. The infant mortality rate is 33 percent in North Korea. People often neglect children with disabilities and do not report their deaths in most cases, so the number could be up to five times higher than reported. Minimal access to health care, good sanitation and healthy foods play a huge role in the deaths of infants and their mothers. The Korea Foundation for International Healthcare, established in 2006, has partnered with The Partnership for Maternal, Newborn and Child Health to provide medicine, procedures and surgeries to citizens regardless of gender, ethnicity or religion. Recently, a vaccination campaign has immunized millions of North Korean children.

It is not easy to obtain information on North Korea due to the isolated nature of the country. A lot of organizations have to fight to provide aid to the citizens and the ban on equipment and metal shipments into the country makes it hard to provide proper care to people in the country. Since the country prevents citizens from leaving the country without permission, these organizations are the saving grace for many. Health in North Korea is not as successful as it may seem at first glance, but the recent decisions the U.N. has made leaves room for optimism and change.

Taylor Pittman
Photo: Flickr

Malta is a small island republic in the central Mediterranean Sea. Like most other EU member states, the Maltese government operates a socialized health care scheme. However, life expectancy in Malta is a full year higher than the European Union average, for both males and females. Keep reading to learn the top 10 facts about life expectancy in Malta.

10 Facts About Life Expectancy in Malta

  1. Trends: Life expectancy in Malta ranks 15th globally and continues to rise; the current average life expectancy is 82.6, an improvement of 4.6 percent this millennium. Median life expectancy on the archipelago is expected to improve at that same rate through 2050, reaching an average death age of 86.4.
  2. Leading Causes of Death: The WHO pinpointed coronary heart disease as the republic’s number one killer, accounting for 32.46 percent of all deaths in 2018. Additional top killers include stroke (10.01 percent) and breast cancer (3.07 percent).
  3. Health Care System: Malta’s sophisticated and comprehensive state-managed health care system embodies universal coverage for the population. Although population growth and an aging workforce present long-term challenges, the Maltese have access to universal public health care as well as private hospitals. Malta’s health care spending and doctors per capita are above the EU average. Despite this, specialists remain fairly low. Currently, the government is working to address this lack of specialized care.
  4. Infant and Maternal Health: The high life expectancy in Malta is positively impacted by low infant and maternal mortality rates. Malta’s infant and maternal mortality rates are among the lowest in the world, ranking at 181 and 161, respectively. The Maltese universal health care system provides free delivery and postpartum care for all expectant mothers. These measures provided as the standard of care have minimized the expectant death rates of new mothers to 3.3 out of 100,000.
  5. Women’s Health: Like most other developed nations, Maltese women experience longer lives than men. Comparatively, WHO data predicts that women will live nearly four years longer, an average of 83.3 years to 79.6. Interestingly, the estimated gender ratio for 2020 indicates that the Malta population will skew to be slightly more male, specifically in the 65-and-over age bracket. 
  6. Sexual and Reproductive Health: Sexual health services, including family planning and STD treatment, are free of cost in Malta. Additionally, HIV prevalence is very low, at only 0.1 percent in 2016. These measures have certainly played a role in life expectancy in Malta.
  7. Violent Crime: Although crime rates typically spike during the summer, Malta’s tourist season, violence is generally not a concern. Despite fluctuations throughout the year, the national homicide rate remains low. Currently, homicide is resting at 0.9 incidents per 100,000 citizens.
  8. Obesity: Recently, 29.8 percent of the population was found to be obese, one of the highest figures in the EU. Even higher rates of obesity have been found in Maltese adolescents: 38 percent of 11-year-old boys and 32 percent of 11-year-old girls qualify as obese.
  9. Birth Rates: Sluggish population growth is typical throughout the developed world and Malta is no exception. Current data places the population growth rate at an estimated 0.87 percent. Out of 229 sovereign nations, Malta’s birth rate was ranked 192nd with 9.9 births per 1,000 citizens.
  10. Access to Medical Facilities: The competitive health care system supports high life expectancy in Malta by providing an abundant availability of hospitals and physicians per capita. Due to the archipelago’s small population, 4.7 hospital beds and 3.8 doctors exist for every 1,000 citizens.

These 10 facts about life expectancy in Malta highlight the strength of the health care system in the country. While rising rates of obesity are concerning, Malta has a strong track record of investing in the well-being of its citizens.

Dan Zamarelli
Photo: Flickr

10 Facts About Life Expectancy in Guinea-Bissau
Guinea-Bissau, a small country in Western Africa, has a low life expectancy of 57.67 years.  However, life expectancy in Guinea-Bissau of both men and women increased by seven years over the last 17 years. In 2001, life expectancy in Guinea-Bissau was 50.368. Currently, men in Guinea-Bissau have a life expectancy of 55.6 while women have a life expectancy of 59.62. The increase in life expectancy in Guinea-Bissau is due to improvement in health care services, education, preventive measures and a reduction in child mortality.

10 Facts About Life Expectancy in Guinea-Bissau

  1. Child Mortality: The infant mortality rate in Guinea-Bissau continues to decrease. Child mortality was 125 for every 1,000 children in 2008 and that number decreased to 81.5 for every 1,000 children in 2018. Guinea-Bissau’s investments to provide mothers with children under the age of 5 with better access to health care contributed to the reduced child mortality rate. In addition, a U.N. report determined that an increase in vaccinations was extremely effective in reducing the child mortality rate. This was possible because of collaboration from organizations like the United Nations Children’s Fund, the World Health Organization and GAVI. However, there is still more that people can do to improve life expectancy in Guinea-Bissau, such as training more medical professionals to help with childbirth. In 2014, only 45 percent of childbirth had trained professionals available. The leading causes of death for children under 5 are communicable diseases, particularly malaria, diarrheal diseases and respiratory illnesses.
  2. The Leading Causes of Death: The leading causes of death in Guinea-Bissau in 2012 were lower respiratory infections including whooping cough and infection of the lung alveoli, along with HIV/AIDs, malaria and diarrheal diseases. Although malaria-related death is common, that number is declining due to both government and donor efforts from organizations like the Global Fund. These efforts include providing insecticide-treated bed nets and increasing education about malaria.
  3. Spending on Health Care: In Guinea-Bissau, both the government and individuals spend little money on health care. In 2016, the per capita average that people spent on health care was $39 while the government spent 6 percent of its GDP on health care. A U.N. report stated that in 2001, the African government pledged to increase health care expenditures to 15 percent. However, Guinea-Bissau has not yet reached that goal. In addition, the most vulnerable population that suffers from preventable illness and diseases, women and children, receive less than 1 percent of health care funds.
  4. Politics: One of the reasons the government faces difficulty in increasing health care funding is because of instability in Guinea-Bissau’s politics. Since Guinea-Bissau’s independence in 1974, the country has had four successful coups and 16 failed coups. The instability causes constant changes in government officials who are responsible for policies.
  5. National Institute of Public Health: In 2011, the creation of the Instituto Nacional de Saúde Pública (INASA) or the National Institute of Public Health helped bring different components of Guinea-Bissau health care together in order to provide adequate services. INASA works with both international donors, institution and the government to help with disease surveillance and preparation for health emergencies. The responsibility of INASA is to help create health policy in the country as well as to help place health care workers and officials throughout the country.
  6. Lack of Trained Medical Personnel: Guinea-Bissau does not have enough health care workers. It has 1.7 doctors for every 10,000 people, 1.4 midwives and nurses for every 1,000 people, three pediatricians and four obstetricians. For example, in 2014, Guinea-Bissau lost some of its health care workers due to brain drain (trained medical personal moving to other countries). In addition, the lack of adequate pay and failure by the government to pay its medical workers on time have led to strikes. According to a U.N. report, Guinea-Bissau would need to create incentives in order to better retain its health care workers.
  7. Training of Health Care Workers: Training health care workers in Guinea-Bissau is difficult because the country relies on international help from countries like Cuba. One of the main problems is that the training material is in Spanish instead of Portuguese. In addition, some of the reading materials are in e-book formats and students may not have access to computers to read the content. Furthermore, during medical training, there are not enough specialists to oversee or conduct the necessary training. There is hope, however, as the United Nations Population Fund (UNFPA) is helping provide some advanced training for medical professionals who require it.
  8. Vaccine Coverage: Although the lack of political instability has limited government spending in health care, Guinea-Bissau’s coverage rate is 80 percent due to help from the World Health Organization (WHO) and other non-government agencies. Children receive rotavirus and pneumococcal vaccines to help with respiratory and diarrheal illnesses.
  9. Accessibility to Health Care Facilities: In Guinea-Bissau, it can be difficult to visit a medical facility because of the lack of adequate roads. Although there are motorized boat ambulances, it can still be difficult to get to a medical facility in some regions in Guinea-Bissau. However, there are plans to build surgical centers in places like the Bijagos region to provide better access to health care.
  10. Community Health Programs and Workers: Community health programs and outreach have been effective in helping with the Guinea-Bissau health care system. These programs that community health workers (CHW) administer provide a community-based approach in helping with the health needs in Guinea-Bissau. Programs include spreading knowledge of childhood nutrition, malaria prevention, pneumonia and household hygiene, and providing several health services. There are around 4,000 community health workers and they are each responsible for visiting 50 households every month. During their visits, community health workers encourage families to adopt the 16 key family practices that can help reduce the number of diseases children may experience. These family practices include the promotion of mosquito nets and six months of breastfeeding, and handwashing, etc.  Community health workers also play a vital role in helping with literacy because of the high illiteracy rate in the country.

Although Guinea-Bissau’s life expectancy is low, there is hope that it will continue to increase due to continuous investment by international donors and non-government organizations. One of the best ways that Guinea-Bissau can provide better health care for its citizens is to strive to be more politically stable.

– Joshua Meribole
Photo: Flickr