Inflammation and stories on healthcare

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Health care in El Salvador

Health care in El SalvadorEl Salvador, the smallest yet most densely packed country in Central America, has historically only seen moderate poverty reduction and has suffered from constant low levels of economic growth. The population faces development challenges due to high out-of-pocket expenditures, which have greatly limited access to health care. Citizens living in rural, poorer areas of the country experience the most impact of the weak health care system. This results in increased morbidity, mortality and disability from diseases.

National Health Strategy

In recent years, poverty and inequality rates have significantly decreased. From 2007 to 2019, the poverty rate fell by 17% and extreme poverty dropped by 11.5%, making El Salvador one of the most equitable countries in Latin America. A significant contribution to the decline was the launch of the National Health Strategy in 2009. This governmental initiative aims to enhance the quality of care, reduce inequalities in access to care and improve the Ministry of Health’s overall system management.

Strengthening Public Health Care System

In support of El Salvador’s health reforms, the World Bank created the Strengthening Public Health Care System project, which focused on responding to the evolving needs of the nation. The project poured investments into more than 51 primary care hospitals and 30 secondary and tertiary hospitals, and this allowed for greater maintenance of clinical infrastructure and medical equipment. Additionally, the funding strengthened the National Institute of Health and the National Reference Laboratory, both of which are responsible for conducting surveys and collecting data required for monitoring public health during outbreaks of infectious diseases.

Project Results

The project targeted 2.1 million people across 92 municipalities in El Salvador. In regards to strengthening the Ministry of Health’s institutional capacity, it was able to improve safety standards and environmental regulations surrounding biohazard waste disposal. With respect to vaccination rates, the goal was to immunize 92.8% of children with a pentavalent vaccine by 2016 and by 2014, the nation had reached 95%. Additionally, in terms of child delivery, the aim was to have 84% of births take place in health care facilities by 2018. By the end of 2017, 99.8% of births were occurring in a clinical environment. Due to improved neonatal care and hospitalized deliveries, the rate of maternal mortality massively decreased from 65.4 deaths per 100,000 live births in 2006 to only 31 deaths in 2017. Also, the rate of infant mortality declined from 26.9 deaths per 100,000 live births in 2000 to only 12.5 deaths in 2017.

Looking Ahead

El Salvador has made significant strides in poverty reduction and health care access through initiatives such as the National Health Strategy. With investments from the World Bank’s Strengthening Public Health Care System project, the country has improved infrastructure, increased vaccination rates and achieved high rates of facility-based childbirth. These efforts have resulted in a substantial decrease in maternal and infant mortality rates, demonstrating the positive impact of strengthened health care systems on the well-being of the population.

– Divya Swaminathan
Photo: Flickr

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Health Care for Children in Guinea-Bissau

Health Care for Children in Guinea-BissauGuinea-Bissau suffers from high poverty rates, political instability, social disparity and health challenges. The United Nations International Children’s Emergency Fund (UNICEF) estimates that 66% of the population lives more than 5 km from the nearest health care facility. There is only one health center for more than 13,500 inhabitants, with most of the health care services located in Bissau and the regional capitals. This excludes the rural areas where people can’t benefit from health care.

Challenges

Child survival rates in Guinea-Bissau are on the low side. In fact, the European Commission reports that “Guinea-Bissau has particularly alarming indicators of maternal and child health, with the highest maternal and child mortality rates in the world.”According to UNICEF, the under-5 mortality rate is 74% per 1,000 births. This number represents 4,693 children who die between 0-4 years old (0-59 months).

Additionally, the lack of health care practitioners is a significant challenge to health care for children in Guinea-Bissau. According to a World Health Organization (WHO) report, there were only 7,890 health workers in Guinea-Bissau as of 2018. This inadequacy of health care practitioners results in the inability of children to access required health care services. Alongside this problem, many important health care facilities are unavailable.

Health Care for Children in Guinea-Bissau: Progress

Guinea-Bissau had a population of more than 2 million in 2021. The country has developed significantly in terms of providing health care for kids in recent times. The government made efforts to improve access to health care services, particularly in rural areas. One of the key initiatives is the Expanded Program on Immunization (EPI), which aims to provide essential vaccines to children under the age of 1. The country implemented the program in 2008 and this led to significant progress in the effort to minimize child mortality. According to the Lancet Global Health, “in 1999–2006, child mortality was higher in children who had not received measles vaccine than in those who had.”

The World Food Programme (WFP) and UNICEF have also implemented social protection programs to help vulnerable households cope with poverty. For example, cash transfer programs provide regular cash payments to low-income families so they can meet their basic needs. In addition, school feeding programs provide meals to schoolchildren, and this helps to improve their nutritional status and reduce absenteeism. These programs have positively impacted the health and well-being of children in Guinea-Bissau.

Initiatives

Through collaborations with international organizations like UNICEF and the WFP, efforts have been made to increase children’s access to health care services. The WFP “works to prevent and reduce malnutrition among children under 5 and pregnant and nursing women, providing nutritional support to 96,000 people. The organization also provides food to 6,500 people who are undergoing treatment for HIV or tuberculosis. This is to improve their general health and help minimize the side effects of the drugs.”

In the effort to combat malnutrition and its detrimental impact on children’s health and development, various nutrition programs have been implemented. One notable initiative is the provision of over 173,000 hot meals to school children by the WFP, which aims to encourage enrollment and regular attendance. Additionally, take-home food rations specifically targeted at female students have proven effective in promoting school attendance and retention among girls. The WFP is also actively involved in strengthening the government’s capacity to manage the school meals program, with the ultimate goal of transferring ownership to the government. As a result of these programs, the number of malnourished children in the country has significantly decreased.

Improving Livelihoods

The quality of health care services provided to children has improved as a result of investments in health care infrastructure, education and resources. Guinea-Bissau’s medical professionals can now detect and treat common ailments with more ease and as a result, are able to provide children with better care. Working with the Government and local NGOs, WFP helps to protect the livelihoods of vulnerable households and build their resilience to crises that could affect their food security.

The ongoing initiatives demonstrate the progressive advancement of children’s health care in Guinea-Bissau. With the continued investment and effort put into improving children’s healthcare in Guinea-Bissau, it is possible to advance the health and well-being of more children in the future.

– Lorraine Lin
Photo: Pixabay

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Health Care in Sri Lanka Calls on International Aid

Health Care in Sri LankaOnce a role model for health and development, Sri Lanka faces an escalating health crisis. The economic crisis in Sri Lanka has forced the health sector to decline, causing millions of people who rely on the free health care system to face loss of access to quality health care.

Sri Lanka imports 85% of its medical supplies. With the foreign currency reserves running low, essentials are becoming hard to obtain.

As the health care system is “nearing collapse,” patients are at risk due to shortages in equipment, medication and power. The United Nations News gave readers a first-hand experience from Ruchika, a pregnant Sri Lankan who has to scavenge for essentials. In her story, she explains what it is like to try to obtain fuel for a trip to the hospital and the possibility of her having to search for supplies to have a safe birth.

Exacerbating Health Crisis in Sri Lanka

The health crisis in Sri Lanka is draining doctors, leaving them to prepare for the worst. Without international help, they fear a health catastrophe is approaching soon.

The largest doctor’s union on the island, the Government Medical Officers’ Association (GMOA), calls on international outlets to donate supplies and places the blame for the health crisis in Sri Lanka on poor economic and financial management. The GMOA published a list of items the country’s health sector desperately needed, such as antibiotics, antidepressants, paracetamol and blood pressure medicine.

As supply numbers drop, medical staff in Sri Lanka are involuntarily suspending non-essential procedures. Low supplies force medical staff to reuse and ration equipment, which can raise sanitary concerns, placing many at risk.

Response to the Crisis

This health crisis in Sri Lanka has forced tens of thousands to protest as food and fuel prices skyrocket. Doctors, nurses and medical students are joining in these demonstrations as they are also frustrated with the government stating that they can’t speak openly to the media about the situation.

To respond to the escalating health crisis in Sri Lanka, the World Health Organization (WHO) is working to help the health care system. The WHO supports the delivery of essentials to “sustain the availability of critical lifesaving medical care for all.” This support is accomplished through financial assistance and donations of medications and supplies worth $7.1 million in 2022. The organization also provided an additional $1.5 million with assistance from the U.S. Department of State. The funding helps strengthen the Sri Lankan health care system.

Sri Lanka still faces a pressing demand to import essential medicine and supplies as well as help from partners.

Sri Lanka has a long way to go before it can reobtain its title as a role model for health and development. However, it is possible if international aid continues to help.

– Brianna Green
Photo: Flickr

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Health Care in the Republic of Moldova

Health Care in the Republic of MoldovaThe Republic of Moldova, a landlocked country between Ukraine and Romania, is considered to be one of the poorest countries in Europe. Unfortunately, the economic state of the country, coupled with a legacy of corrupt government practices, has made it difficult to fund and sustain its health care system. However, since 2007, several programs and legislation have targeted health care in Moldova.

The State of Health Care

The life expectancy in Moldova averaged 72.2 years as of 2018. It has improved significantly from the 2000s, when life expectancy fell to the mid-60s, but remains one of the lowest in the WHO European region.

The European Health Observatory reported that in 2021, Moldova had mandatory health insurance that covered 88% of the population. The sanitation in Moldova is good, with 89.9% of Moldovan people using improved sanitation systems that direct waste into a sewer system.

However, according to The Moldova Project, Moldovan families only have $188 a month to access essentials, including but not limited to health care. Furthermore, 44% of the Moldovan population does not have access to improved water.

What the Government is Doing

The government launched health care reforms in 2004. Between 2007 and 2013, the priority of the Moldovan government’s health strategy was the prevention and mitigation of diseases and risk factors. The health strategy changed in 2014 and continued until 2020, placing focus on sustainable well-being through enhanced public health services.

The government sought to modernize the health care system in 2016, which continued to be a priority until 2018. The same year, the Ministry of Health created Public Health Councils to improve the quality of health care, to ensure the implementation of legislative acts and to coordinate the activities of medical facilities. These councils exist in each district under the Centres of Public Health.

The Republic of Moldova redirects 6.8% of the country’s GDP into health care. While this is not the lowest percentage spent on health care in Europe, it is less than the 9.83% average of the world and less than its neighboring country, Ukraine.

How Foreign Aid Helps

On top of the government prioritizing sustainable health and well-being, various organizations are extending help to improve health care in Moldova.

One example of this is The Health Services and Social Assistance Project, which set multiple targets to improve health care in the Republic of Moldova. The World Bank released a report on this project in 2015 that demonstrated notable success. The Health Services and Social Assistance Project achieved its goal of the National Health Insurance allocating 30% of its budget to primary care, implemented a training program for family doctors and introduced 75 new protocols, which surpassed its goal of 60.

It had aimed to construct 65 health centers but was only able to construct 38 as a result of unforeseen construction costs. It did surpass its goal of renovating 74 health facilities, as it had renovated 77. The Health Services and Social Assistance Project aimed to have 80% of the population with mandatory health insurance, and surpassed this target with 85% of the population having mandatory health insurance in 2014.

The Moldova Project Gives Aid Through Health Care

Established in 2008, The Moldova Project typically aids single-parent families with three or more children. Many of these parents experience addiction, unemployment and poor mental health. The Moldova Project takes a multifaceted approach by providing a range of services, such as subsistence packets, clothes, home repairs and health care.

The organization offers and provides medical assistance, including treatments for serious illnesses and surgeries, to all beneficiaries. Without intervention, these injuries and illnesses would worsen. Each year, the organization helps provide approximately 200 medical interventions in Moldova. Additionally, The Moldova Project has a psychological support program to aid health care in the Republic of Moldova. This program can provide up to 900 sessions a year, including round-the-clock support to families, psychological support for youths and counseling for parents.

How WHO Helps Moldovans Access Health Care

The World Health Organization also promotes health in the Republic of Moldova. The first WHO office in Moldova was established in 1995 and the Country Office profile was upgraded in 2011. The current Head of the Country Office for Moldova invests in activities that support national policy development.

The World Health Organization has mobilized young people and carried out multiple awareness campaigns in Moldova to promote the COVID-19 vaccination. It even has football players engaged in its efforts. In March 2023, they implemented a training course on health workforce leadership to maintain a strong health force. The course is also in Armenia, Romania, Georgia and North Macedonia, and allows participants to interpret and apply evidence to policy, along with other skills.

While there are difficulties for Moldovans accessing health and well-being facilities, the future looks optimistic. The country has seen overall improvements in health care in the last two decades. As long as organizations like WHO and The Moldova Project support the country, health care should continue to improve.

– Lachlan Griffiths
Photo: Flickr

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Muslim Hands Provides Maternal and Child Health Care

Child Health Care
Over the last three decades, maternal and children’s health has improved significantly worldwide. The newborn survival rate has almost doubled since 1990 and maternal mortality rates have seen a 34% decrease since the beginning of the century. However, progress in health care is not globally even. Maternal and child health care in developing nations is out of reach for many expectant mothers and young children, resulting in high mortality rates.

According to the World Health Organization (WHO), nearly 95% of women who died during pregnancy or labor in 2020 came from low and lower-middle-income countries. Furthermore, around 79% of neonatal deaths in the same year occurred in sub-Saharan Africa and Central and Southern Asia. In both instances, lack of quality health care is the leading cause of death. Poverty, low numbers of qualified medical professionals and poor sanitation and resources are among the key reasons that health care in developing nations has been slow to advance. Muslim Hands is working to improve maternal and child health care in developing nations through its maternal health clinics and educational programs.

About Muslim Hands

Muslim Hands is a U.K.-based NGO that supports poverty-stricken communities in more than 30 developing nations. The organization, established in 1993, began as a volunteer movement in Nottingham to support victims of the Bosnian war. Muslim Hands’ work soon spiraled from grassroots activism into an international aid movement.

Muslim Hands tackles poverty in numerous ways, from training teachers to establishing schools to building water wells worldwide. Providing maternal and child health care in developing nations is among the organization’s highest priorities in the fight against global poverty.

The Motherkind Campaign

Motherkind is Muslim Hands’ maternal health campaign. It emphasizes educating women on health care and providing maternal health support in high-risk countries. For example, the organization has developed midwifery training courses in Niger and health workshops in Indian villages.

A key focus of the Motherkind campaign is running maternal health clinics in Somalia and Afghanistan. Afghanistan and Somalia are among the developing nations with the highest infant and maternal mortality rates because health care in general is largely inaccessible in these countries. Motherkind clinics offer services to give children and mothers the best possible chance of survival.

In both countries, malnutrition is rife due to rampant poverty and barriers created by political conflict. In Somalia, persistent droughts have caused food insecurity, increasing the likelihood of malnourishment. To address this issue and prevent pregnant women from developing micronutrient deficiency disorders, Motherkind clinics offer micronutrient supplements like Vitamin A, foliates and iron to pregnant and breastfeeding women. This supports healthier pregnancies and, for breastfeeding women, ensures that babies receive the nutrients necessary for healthy development.

The lack of health centers and medical professionals in Somalia and Afghanistan contributes to high rates of maternal and infant mortality. The WHO estimates that nations need a minimum of 23 medical professionals per 10,000 people to provide adequate health care services. In 2021, Afghanistan had just 4.6 medical professionals per 10,000 people, falling critically below WHO guidelines. Moreover, 43% of the Afghan population does not have a health center located within a half-hour’s travel, severely limiting access to vital health care. As a result, 57% of births in Afghanistan occur without any health care professionals present.

Improving Childbirth and Infant Development

Muslim Hands is working to end unattended births through its community outreach program. Motherkind clinics train health workers to conduct home visits during pregnancy, assist during labor and provide postnatal care for mothers and infants. This outreach program helps women give birth safely while building meaningful bonds and trust between mothers, babies and health workers. The Somalia clinic assists 15-20 births each month and the Afghanistan clinic treats approximately 44,000 people annually.

Muslim Hands also provides child health treatments. A critical service it provides is vaccinations to protect children from easily preventable but deadly diseases. This is especially important in Somalia where some children are not vaccinated at all. This is due to both a shortage of vaccines, especially in areas where ongoing conflict has led to restrictions and the fact that some parents are uninformed or misinformed about the importance of vaccinations.

Motherkind clinics offer vaccines to protect children against diseases including tuberculosis, measles and tetanus. The organization also gets to the root of vaccine distrust by hosting discussion sessions to inform parents about the necessity of immunization and dispel misinformation surrounding vaccination. To date, Muslim Hands has vaccinated upward of 70,000 infants and children in its clinics.

The Motherkind clinic in Somalia also conducts nutrition screenings for children and disseminates advice to mothers on how to provide a balanced, nutritious diet for their children using local ingredients.

Looking Forward

Muslim Hands hopes to open more Motherkind clinics to continue improving maternal and child health care in developing nations. The organization is currently building a new health center in Mauritania, which will serve almost 2,000 people from four different villages. Additionally, Muslim Hands plans to expand its current health services to offer mental health care to women and children.

Despite uneven global development in maternal and child health care, Muslim Hands is working to provide better health care, support and resources for mothers and children in developing nations. The organization’s efforts to ensure that improvements in maternal and children’s health are felt on a global scale are helping to pave the way toward a more equitable future.

– Mohsina Alam
Photo: Flickr

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The Current State of Global Maternal Health

Global Maternal HealthAccording to a new report released by the United Nations and partners, “approximately 800 women died from preventable causes related to pregnancy and childbirth” daily in 2020. The United Nations Maternal Mortality Estimation Inter-Agency Group studied global trends in maternal mortality between 2000 and 2020. Concerningly, the data shows that maternal deaths rose in several regions over the last few years. However, several organizations are working to improve global maternal health.

The Maternal Mortality Trends Report

Titled “Trends in maternal mortality 2000 to 2020,” the report is the combined effort of several U.N. agencies.  The report covers 185 countries and territories, most of which are WHO member states. It presents comprehensive data about global and regional trends relevant to maternal health over the past two decades.

Several factors can increase the risk of maternal death. According to the WHO, some of the major ones are severe bleeding, infections, high blood pressure during pregnancy, unsafe abortions and delivery-related complications.  Most of these are avoidable through simple health care and medical attention. However, according to Dr. Natalia Kanem, executive director of the UNFPA, the world faces a shortage of 900,000 midwives. Furthermore, the WHO states that “roughly a third of women do not have even four of a recommended eight antenatal checks or receive essential postnatal care.”

The Impact of Poverty on Global Maternal Health

Poverty has a significant impact on global maternal health. Poverty-stricken regions lack the medical resources and qualified personnel to provide women with adequate care during the maternity period. According to the Pan American Health Organization, the prevalence of maternal deaths is highest in countries impacted by poverty and conflict.

Data shows that, in 2020, the maternal mortality rate in low-income countries stood at 430 per 100,00 live births. In contrast, this rate stood at 12 per 100,00 live births in countries that were financially better off. To further demonstrate the devastating impact of poverty, the report stated that despite only 13% of the global population living in the least developed countries, women in these countries accounted for 42% of maternal deaths worldwide in 2020.

Due to the impacts of poverty, 70% of global maternal deaths in 2020 occurred in sub-Saharan Africa. This means that out of 287,000 global maternal deaths, 202,000 occurred in the region. Countries such as South Sudan, Chad and Nigeria have extremely high maternal mortality rates, with Nigeria noting the most maternal deaths in 2020.

Central and Southern Asia is another region with a high maternal mortality rate. In particular, the region had 47,000 maternal deaths in 2020, which is the highest outside of sub-Saharan Africa.

The Progress

Fortunately, the world made a lot of progress toward reducing maternal deaths between 2000 and 2015, during which U.N. member states adopted the Millennium Development Goals. As a result, the global maternal mortality rate fell by 34.3% between 2000 and 2020. The number of global maternal deaths almost halved during the two decades.

Regions with some of the highest numbers of maternal deaths noted the most progress since 2000. The maternal mortality rate dropped by 33.1% in sub-Saharan Africa between 2000 and 2020. Northern Africa and Western Asia saw a drop of 46.8% while Central and Southern Asia saw a massive drop of 67.5%. Even the least developed countries reduced their maternal mortality rate by 47.4%, according to the U.N.’s report.

Current Efforts

U.N. Member States adopted the 17 Sustainable Development Goals in 2015. SDG 3 aims to “ensure healthy lives and promote well-being for all at all ages.” In particular, SDG 3.1 aims to “reduce the global maternal mortality ratio to less than 70 per 100,000 live births” by 2030. Many organizations are working to achieve this target.

The WHO runs a Maternal Health Unit that “provides leadership for improving maternal and perinatal health and well-being and ending preventable maternal mortality” through education, surveillance and advocacy.

The UNFPA, UNICEF, the WHO and the International Confederation of Midwives (ICM) created the Framework for Action to Strengthen Midwifery Education, which launched in 2019 at the 72nd World Health Assembly. It includes a comprehensive blueprint for building high-quality midwifery education systems.

The WHO developed a Midwifery Education Toolkit to provide “midwives with all the training required to care for healthy women and their newborns, prevent unnecessary interventions while ensuring lifesaving actions and enable health professionals to work effectively in a multi-disciplinary team.”

Additionally, the WHO is a partner organization in the French Muskoka Fund. Initiated in 2010 by the French government, the fund aims to improve maternal and child health in nine African countries. Besides supporting policies, the fund provides access to essential health care, medicines and professionals. The French government renewed commitments to the fund twice already since 2015 and Denmark pledged support for the fund in 2018. In 2021, the French government announced a commitment of €10 million annually until 2026 for the Muskoka Fund.

In order to achieve the target set by SDG 3.1, a global effort toward improving global maternal health is needed. Investment in health care and facilities along with education and advocacy will help reduce maternal mortality worldwide.

– Siddhant Bhatnagar
Photo: Flickr

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The Blended Finance Fund Shaping African Health Care

African Health CareThe Transform Health Fund announced at the U.S.-Africa Leaders Summit in December 2022 heralds a new age of private and public investment in African health care systems. A wide range of institutions has pledged either grant or private equity funding, including USAID, the U.S. International Development Finance Corporation (DFC), AfricInvest, private foundations, multinational corporations and the International Finance Corporation (IFC). The fund’s total commitments now amount to $50 million, capital which will go toward improving supply chains, health care delivery and the availability of digital tools to serve the unmet health care needs across sub-Saharan Africa.

The Financing Gap

Africa is home to 16% of the world’s population and bears 23% of the global disease burden, yet 1% of global health spending ends up in the continent, according to the Health Finance Coalition (HFC). Compared to their international counterparts, the Brookings Institute reports that Africans pay high out-of-pocket costs for health care — while also living in countries with some of the worst poverty rates in the world. Half of all Africans, according to DFC, currently lack access to modern medical facilities.

One challenge to building system resilience, exposed during the coronavirus pandemic, is the lack of African-made health care products: the continent imports more than 90% of pharmaceutical equipment and supplies to meet its health needs, according to Brookings. During the pandemic, Africa established local production firms and intra-governmental funds and partnerships, such as the African Medical Supplies Platform. Yet, there remain ample opportunities for improvements in disease prevention and treatment, pandemic preparedness and health commodity production throughout Africa. The IFC estimates that $25-$30 billion is necessary to ensure African health care systems can meet the continent’s rising demand.

Bridging Public and Private Financing

The Transform Health Fund is one example of an increasingly popular strategy of resilience-building in Africa’s health care system known as blended financing, or a capital stack approach. The primary feature of this model is public-private partnerships, where institutions, including government institutions like the DFC, nonprofit organizations and investment firms, leverage their resources to make an impact on a shared goal.

Virtues of the approach, according to agencies like Wilton Park, the International Monetary Fund (IMF) and IFC, lie in its distribution of risk among funders and its ability to achieve a balance between donor and commercial investments in the face of dramatic need. While donor institutions can help bolster emerging industries, health systems in capitalist, globalized economies require private sector buy-in to decrease dependency upon aid and strained state budgets.

Toward Universal Health Coverage

HFC and AfricInvest, key contributors to the Fund, state that the ultimate goal of the Transform Health Fund is to achieve Universal Health Coverage (UHC). The role of public-private partnerships in achieving this social impact is unique and complex. A Health and Human Rights Journal article warns of possible conflicts between the goals and priorities of private and public health care institutions, particularly as related to human rights-based conceptions of health care. Such conflicts are more likely to be avoided if collaborators can ensure African leadership of the initiative and both strong coordination, according to Wilton Park and effective regulation, according to Brookings, of Africa’s blossoming health care sector.

Given the widely documented link between health and poverty, stakeholders of the Fund hope that industries serving populations in need can also prove to be sustainable and profitable. With a target amount of $100 million, the Fund will primarily inject investments into eight countries in sub-Saharan Africa, including Kenya, Uganda, South Africa and Nigeria, according to the DFC report. However, with a diverse set of stakeholders and a strong focus on transformation, as its name suggests, the Transform Health Fund ushers a new future for the broader African health care landscape and, if successful, the well-being of all African people.

– Hannah Carrigan
Photo: Wikipedia Commons

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Elderly Poverty in Brazil: Where To Go From Here?

Elderly Poverty in BrazilOver the past few decades, Brazil has experienced explosive development. Increased exports driven by increased growth within its manufacturing center, combined with a newly developing service sector and a rise in foreign investment have contributed to an increase in its citizens’ well-being and life expectancy. That said, as Brazilians are living longer, more attention is needed to address elderly poverty as the country’s social safety nets are already strained.

Daily Struggles

Currently, only around 4% of Brazilians aged 60 and older live in poverty. Though this is lower proportionately than other age demographics within Brazil, due to its social safety net and poverty reduction programs, the impoverished elderly within Brazil struggle greatly on a day-to-day basis. Brazil lacks age-friendly cities for its elder citizens, and while San Paulo and other cities have pushed for change, efforts have been slow to catch on across the country. Disability and illness affect many and worse health outcomes have been shown time and time again to disproportionately affect the elderly who are in poverty.

Though policy experts, data analysts and advocacy organizations warn of potential negative consequences in the future, multiple policy suggestions could prevent an overwhelming of Brazil’s social safety nets. Furthermore, private companies and non-governmental organizations are working right now to alleviate said consequences.

Prolonged Engagement With The Workforce

Policymakers have recommended that Brazil ought to encourage its elderly citizens to remain a part of the workforce as they age, according to the AARP International report. They have noted later retirement as a priority in order to prevent the rise of elderly poverty in Brazil because it reduces the number of people who are relying on Brazil’s social programs at any one time. Data has consistently shown that Brazil’s safety net and poverty reduction programs have been incredibly effective in reducing poverty and helping people in Brazil obtain their basic needs.

Most notable is the Continuing Benefits Program (BPC). These cash transfer programs contribute significantly to reductions in elderly poverty within Brazil and an increase in financial independence among those who receive payments from it. However, if people in Brazil continue to retire early, the BPC could have to spread its resources more thinly and thus become less effective in reducing poverty.

Increasing Job Availability

Many of the elderly people in Brazil choose to retire early because there is a lack of stable, good-paying jobs for people in their 50s and above. While both the government and the private sector have been slow to respond to this demand, when they have done so, there has been real success. The Ministry of Education launched the National Program of Access to Professional Education and Employment (PRONATEC). Although the elderly population is not primarily a target of the program, it still focuses on “promoting social and productive inclusion and offers financial assistance to low-income individuals” by providing them with educational opportunities through the program, according to the AARP International report.

Furthermore, the companies that choose to give the elderly a chance or create positions for elderly employees, notably Dotz and Pizza Hut, received a barrage of applications and have indicated that they want to tap further into the workforce of older applicants. While there undoubtedly ought to be more growth within this realm, the progress that has been made shows real promise.

On-the-Ground Solutions

Advocates have suggested several direct policy solutions in order to help the impoverished elderly within Brazil, there are NGOs in Brazil also playing their part in the solution. Velho Amigo is a notable nonprofit organization that advocates for elder rights as well as social inclusion of the socially and economically vulnerable elderly through its Heliopolis Coexistence Center. In 2019, it developed the Revitaliza program, which engages directly with shelter centers and long-stay institutions for the elderly, assisting in the improvement of service quality, engagement and sustainability.

Although there is uncertainty about whether Brazil’s social programs will be able to support the expected increase in the elderly population, the work of agencies and nonprofits is helping to stem further increases in elderly poverty rates.

– Alexander Pommells
Photo: Flickr

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Investing in International Mental Health Aid

International Mental Health Aid
Although widely underreported in many countries, the World Health Organization’s (WHO) 2022 World Mental Health Report, identifies one in eight people in the world currently living with mental illness. Between 2000 and 2019, people living with mental disorders increased by 25%. Mental illness is a burden on both the person experiencing mental illness and on society. Those who live with mental illness deal with impacts on their education and relationships and can lead to disability. The broader economic impact of mental health disorders and illnesses includes the costs associated with individuals, communities and nations. These costs relate directly to health services, as well as the indirect costs resulting from loss of work, education and social opportunities, which lead to “stigma, discrimination and reduced life expectancy.”

Reasons to invest in international mental health aid include lowering the costs for nations and individuals and protecting peoples’ quality of life while increasing healthy years lived. In addition, mental health conditions continue to increase across the world as global threats like growing social and economic equality and public health emergencies remain prominent, according to WHO.

The Costs of Mental Illness

The global cost of mental illness was $2.5 trillion in 2010 with projections of the cost to increase to $6 trillion by 2030, according to WHO. A 2020 cost-of-illness global study found that the annual average societal cost of mental illness is between $1,180 to $18,313 per person treated. These costs include the cost of treatment and other costs like lost production and income. Depression and anxiety alone cost the global economy $1 trillion a year, yet the median of government health expenditures toward mental health globally is less than 2%. Other costs of mental illness include loss of life and opportunities.

The burden of mental health and substance use disorders is best described as a “disease burden,” which focuses on the impacts of both mortality and morbidity. Disease burden is measured by Disability Adjusted Life Years (DALYs), which measures deaths plus the years lived with the disease. The metric of one DALY equates to losing one healthy year. According to Our World in Data, in 2019 mental disorders caused 125.31 million DALYs globally. Global DALYs attributed to mental illness have increased to 4.9% in 2019. In addition to the loss of healthy years and opportunities, as of 2019, about 703,000 people lost their lives to suicide globally making the global suicide rate nine per 100,000, according to WHO.

Global Benefits of Investing in Mental Health Aid

International mental health aid reduces human suffering, advances public health and stops human rights violations experienced by those living with mental health conditions. According to WHO. improving people’s mental health also improves educational outcomes and leads to more participation and productivity in the workforce, which benefits all of society. It also improves people’s physical health, which expands people’s lifespan, ability to work and general happiness. Investment in mental health means ensuring access to quality, affordable mental health care, addressing stigma, discrimination and abuse and addressing the underlying economic and social inequalities that shape citizens’ mental health.

Investing in international mental health aid is that it leads to extra years of a healthy life, which generates productivity gains for the country that is investing in mental health care. The countries to benefit the most from investing in mental health care are lower-middle-income countries. Jamaica, a middle-income country, is an example of a country that invested in mental health care and received economic benefits. Jamaica invested $115 million into treatment for depression, anxiety and psychosis from 2015 to 2030. The benefits of this investment include an increase in psychosocial treatment from 15% to 50%, WHO reports. The economy has seen $434 million in saved money due to mental health care.

Supporting Sustainable Development Goals

According to WHO, not only is providing mental health aid beneficial to a country’s economy, but it also supports the U.N.’s Sustainable Development Goals, specifically SDG 1 to eliminate global poverty. Mental illness and poverty create a “cycle of disadvantage” because those living in poverty lack the finances to maintain basic necessities, have fewer educational and employment opportunities and are less likely to have access to quality health care. All of these stresses lead to a higher chance of experiencing a mental health condition. In addition, those experiencing severe mental health conditions are more likely to experience poverty due to increased health expenses and stigma and discrimination in the workforce, which leads to unemployment. “More than 80% of all people with mental disorders live in low- and middle-income countries,” WHO reports. These people lack access to welfare and effective treatment.

Moving Forward

In 2019, WHO began the Special Initiative for Mental Health: Universal Health Coverage for Mental Health, which works to make affordable, quality mental health care accessible in nine countries, covering 100 million people. This program focuses on the prevention of mental disorders, suicide prevention, mental health policy and legislation, mental health support in humanitarian emergencies and workforce development for mental health.

In Jordan, WHO’s Special Initiative for Mental Health is supporting the Ministry of Health’s efforts to implement Jordan’s National Mental Health Plan. This involves increasing community-based services and expanding the Caregiver Training Skills organization for families of children living with developmental disabilities. In addition, Jordan’s Special Initiative for Mental Health is supporting inpatient units in general hospitals and scaling up the implementation of the WHO regional School Mental Health program.

With more legislation, prevention, intervention and support for mental health conditions, mental health aid internationally could decrease lives lost, productivity losses and DALYs for countries, as well as increase productivity and economic gains, increase quality of life and further the SDGs.

– Arden Schraff
Photo: Flickr

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Bright Hope’s Mission

Bright Hope’s Mission
Bright Hope is a Christian Organization working to bring hope to those who live on less than $2 a day. The organization hopes to transform communities and encourage self-sustainability by starting churches throughout impoverished communities. For over 50 years, Bright Hope has worked to provide community infrastructure through church planting and creating goals for today, tomorrow and eternity. Bright Hope’s mission is to eradicate poverty both physically and spiritually.

History of Bright Hope

Bright Hope began in 1968 after founder Dr. Kevin Dyer traveled through Eastern Europe and the Soviet Union and saw the state of the poor and persecuted Christians. The organization focused primarily on immediate relief for those suffering and has since extended to include more long-term goals.

Bright Hope’s Mission

Bright Hope’s mission includes goals for today, tomorrow and eternity. Its mission for today focuses on smaller and more urgent tasks, such as providing clean water, care for abandoned children, food programs in schools, medical care and strengthening family bonds. The mission for tomorrow extends to more long-term impacts, including better education for children, job training for adults, more sustainable agricultural practices and animal rearing. Lastly, its eternal goals bring the mission’s Christian background and focus on developing church leadership, ministries and community discipleship support. About 43.7% of funding is focused on the hope for tomorrow’s goals, working to end the cycle of poverty. In contrast, 20.1% goes toward short-term relief for those already in poverty and the remaining 36.2% goes to the mission’s evangelical goals and eternal mission.

The Urgent Needs

Bright Hope’s mission continues to extend throughout Bolivia, Haiti, Kenya, Uganda and Zambia. The organization focuses on aid in each of these countries without fostering dependence. Empowering the people in each community encourages individuals to raise themselves out of physical, economic and spiritual poverty. Some of its programs urgently need help, including its mission to help Haitian families provide food for themselves, the project to bring food security to Kenya by supporting Natoot farmers and their long-term goal of ending abuse in Bolivia to prevent future poverty.

The Impact Catalog

Brighthope.org allows monetary donations and prayer donations and offers an impact catalog. Its impact catalog allows those who donate to see a more visual representation of where their money is going. Those who donate can choose between funding loans for Haitian rice farmers, supporting print and copy centers, giving books to children and even donating animals such as chickens and rabbits.

Bright Hope also offers the opportunity to donate “Mama Kits,” bags full of the basic essentials to care for a newborn for struggling parents. The kits directly support expecting mothers and include baby clothing, blankets, soap, oil and carrying bags.

The bags have transformed the lives of many in Uganda. Bright Hope’s blog details the story of one expectant mother, Desire, who gained the confidence and peace she needed to continue her pregnancy through the efforts of the Bright Hope program and its Mama Kits. Uganda hospitals often require women to bring their own medical birthing supplies, which can be challenging to obtain. The Mama Kit works to support mothers in Uganda and other countries to ease the financial burden that pregnancy often causes.

Looking Ahead

Through projects such as Mama Kits, Bright Hope’s mission impacts individual lives throughout the work to provide essential assistance for those in poverty. Bright Hope also works to connect and celebrate the impact that all donors make and promises to provide regular updates on its programs and impact reports to those who choose to support its mission financially.

– Brooklynn Rich
Photo: Flickr