chlorhexidine reduces neonatal mortality
Although the neonatal mortality rate across the globe has been consistently decreasing, neonatal death is still common in many regions. According to the World Health Organization (WHO), annual infant deaths were at an all-time low of 4.1 million deaths in 2017, decreasing from 8.8 million in 1990. However, the death rate in Africa is over six times higher than it is in Europe, illustrating a severe disparity. As such, there is still much more that people can do to lower neonatal mortality rates. One potential solution is chlorhexidine, which reduces neonatal mortality.

How Chlorhexidine Reduces Neonatal Mortality

To combat mortality rates, Save the Children and governments in Nepal and Nigeria have implemented chlorhexidine, an antiseptic found in mouthwash. When used to clean the umbilical cord as soon as possible after birth, chlorhexidine reduces neonatal mortality by preventing infection in newborns, which is among the top drivers of neonatal deaths across the globe. Save the Children and pharmaceutical company GlaxoSmithKline (GSK) partnered to create a chlorhexidine gel to distribute in wrapped pouches. Save the Children noted that this gel “was developed to be suitable for use in high temperatures, useful in sub-Saharan Africa and [South] Asia where the risk of newborn infections is high and temperatures are hot.”

Chlorhexidine gel has become wildly popular in Nepal, where USAID created the Chlorhexidine “Navi” Care Program to distribute chlorhexidine gel. In Nepal, around half of deliveries happen at home, making newborns even more exposed to infection if they are not delivered in a clean environment. In fact, a large majority of deaths in Nepal occur within the first month of life. Moreover, infections cause half of those deaths. In Nepal, chlorhexidine has reduced neonatal mortality by 24% and decreased the rate of infections in newborns by 68%. The Chlorhexidine “Navi” Care program’s objective aims to distribute chlorhexidine gel to all 75 districts of Nepal.

The Lifesaving Effects of Chlorhexidine

Nepal is not the only country to see chlorhexidine reduce neonatal mortality rates. Nigeria, one of the most populous countries in Africa, has also seen success. Its neonatal mortality rate has dropped from 48 deaths per 1,000 births in 2003 to 37 deaths per 1,000 live births in 2013. According to many estimates, infections cause at least one-third of newborn mortalities in Nigeria. In March 2016, Nigeria created a plan to scale-up the use of chlorhexidine to lower neonatal mortality rates. If this program succeeds, it will save 55,000 infants. Although this scaling up program started slowly, the Nigerian government has committed to continuing the use of chlorhexidine to prevent infection and fatalities. To do so, it has a plan in place to help local governments achieve their goals.

Across the globe, there are large imbalances in neonatal mortality rates. Countries like Pakistan, Afghanistan and Somalia have a much higher neonatal death rate than countries such as Australia, Canada or China. In developing countries where poverty rates are higher, neonatal death skyrockets due to a lack of resources. This simple, cheap and over-the-counter chlorhexidine gel is saving lives across the globe. As chlorhexidine becomes even more accessible to every community, it is hopeful that neonatal deaths will continue to decrease.

Hannah Kaufman
Photo: Flickr

healthcare in Eritrea Eritrea is a small country in Northeast Africa, with a population of 3.2 million people. Eritrea gained independence in 1993 and remains one of the poorest countries in the world. Considering the total population, 66% of Eritreans live below the poverty line. Also, almost 33% of the population lives in extreme poverty — surviving on less than $1 per day. Eritrea is also a politically unstable country and calamities, such as war and natural disasters have contributed to the poverty level in Eritrea. Healthcare in Eritrea is another area in which the country is struggling. Although Eritrea has made great strides in life expectancy, maternal health and disease control — it does not measure up to other countries’ healthcare around the world. To learn more about the country’s health system, here are five things everyone should know about healthcare in Eritrea.

5 Things Everyone Should Know About Healthcare in Eritrea

  1. Resources are scarce. Eritrea currently has around six physicians and 75 midwives for every 100,000 people. While most of Eritrea’s healthcare providers are located in urban areas, 80% of the population that lives in rural areas is often omitted from healthcare provisions.
  2. Malaria is a major public health concern. Considering the total population, 70% live in areas that are at high risk for the disease. To rectify this, Eritrea’s government has been implementing widespread public health strategies. The government uses both national and community-based education programs to provide awareness of the disease. Besides this, the government is creating preventative strategies, such as the distribution of insecticide-treated nets (ITNs) to households across the country. Due to these efforts, more than 60% of people own at least two ITNs.
  3. Private healthcare facilities are few and far between. While private doctors are present in rural and urban areas, they are usually very expensive and only serve a small percentage of the population. There are two types of healthcare facilities in Eritrea — healthcare centers and emergency rooms. Only in emergencies can patients be admitted to hospitals without an appointment. For all other instances, people must consult with a local doctor in advance, to be admitted to a hospital.
  4. Infant mortality is decreasing and life expectancy is increasing. In Eritrea, infant mortality rates are lower than average (for sub-Saharan Africa). As the rest of the world watches global, infant mortality rates rise — the country has been taking steps to further decrease them. In 2018, the infant mortality rate was 31.3 deaths per 1,000 children born. In terms of life expectancy, Eritrea has made incredible strides. Since 1960, the life expectancy in Eritrea has increased by nearly 30 years and the average life expectancy is at 65 years (as of 2016).
  5. Healthcare in Eritrea is improving. In 2010, Eritrea published its National Health Policy, which outlined the country’s plans to improve its healthcare system. One goal of the policy includes hiring more healthcare workers (especially ones skilled in the treatment of non-communicable diseases). A second goal is to make technological improvements to allow for distanced training of healthcare workers. Final goals include increasing the quality and quantity of resources and adapting its healthcare worker distribution to be highly mobile and dispersed.

An Outstanding Record

While Eritrea is a relatively young country, it is making great strides in its healthcare system. It has one of the most robust healthcare infrastructures in the region. Eritrea’s response to COVID-19 shows the country’s ability to mobilize its government and healthcare system, to protect its people. Because of this, Eritrea has the lowest rate of infection and fewest deaths within the Horn of Africa. Hopefully, healthcare in Eritrea will only continue to improve.

Hannah Daniel
Photo: Pixnio

Infant Mortality in Côte d'Ivoire
When examining the whole of Africa, infant mortality is a matter of grave concern. The West African country of Côte d’Ivoire currently struggles in comparison with other countries in the same category. The World Bank recorded an infant mortality rate of 59.40 per 1,000 live births there in 2018. These deaths stem from several causes, with the primary issue being the lack of available infant care in the country. However, in recent years, these numbers have improved dramatically; the rate of infant mortality in Côte d’Ivoire is almost half of the 100.7 deaths recorded per 1,000 live births in 1998, according to the same source.

The Scope of the Problem

Despite the lower mortality rate, fundamental problems persist. A report by the Healthy Newborn Network (HNN) that used sources compiled from the WHO and the MCEE determined that skilled professionals attend only 74% of the country’s live births. Moreover, approximately 12% of children are pre-term (i.e. before 37 weeks of pregnancy). These issues are at the foundations of the nation’s present-day mortality numbers, which remain elevated.

Progress

Yet over the years, a variety of factors have contributed to the dramatic lowering of infant mortality in Côte d’Ivoire. One of the most important of these factors is the increased educational opportunities for medical professionals within the country. Côte d’Ivoire has a strict curriculum set for all aspiring midwives. A comprehensive U.N. report noted that the country’s standardized program requires graduation through the 12th grade and an additional three years of study, as well as other professional experiences in order to graduate.

A Look at the Numbers

Necessity accentuates the importance of these programs as events related to conception and preterm birth complications account for 58% of infant deaths. These include a lack of professional attention or postpartum care, both of which are very important to the large proportion of babies born preterm. The HNN report also points out other issues causing infant mortality, noting that either Tetanus or Sepsis causes an additional 21% of deaths. A notable similarity between these two issues is that many instances of them are avoidable. For example, tetanus issues typically stem from a lack of care regarding sanitation and the severing of the umbilical cord — which more professional, trained practice in various regions of the country would prevent.

Urban vs. Rural Births Pose a Problem

Côte d’Ivoire’s improvements, however, do not have even distribution throughout the country. According to previously mentioned U.N. statistics, while over 82% of urban births had a skilled birth attendant present, less than 50% of births in rural areas had the same professionals available. This problem extends further when considering that 2020 projections estimated that rural areas would account for nearly twice as many pregnancies as urban environments. While the report recorded over 6,000 trained physicians and midwives practicing within the country — few of these professionals practice in rural areas, where communities lack the resources to provide safe child-birthing to their populations.

Improvements Needed for Sustainable Population Growth

Although the country certainly has improved conditions for delivery in recent years, the fight against a rising infant mortality rate must persist. With sources like the World Population Review predicting the country’s population to double by 2050, the progressive improvement of infant care is essential for Côte d’Ivoire to continue its positive trend against high infant mortality.

Joe Clark
Photo: Flickr

Inventions Saving Infant LivesEven with the rapidly developing technology around today, giving birth and nursing are still some of the toughest experiences a mother can go through. Those experiences are, unfortunately, even tougher for mothers giving birth in developing countries. With fewer resources and more exposure to disease right out of the womb, developing countries have some of the highest mortality rates. Here is a list of five inventions saving infant lives worldwide.

5 Inventions Saving Infant Lives

  1. Neopenda: Neopenda is one of the inventions saving infant lives. It is a hat made for babies which helps monitor their vitals such as heart rate and breathing capacity. The company was founded in 2015 and was marketed for newborns in Uganda. The design was tested in Uganda since 2017 and was finally funded in 2019. Neopenda has since won multiple awards for its revolutionary concept and application.
  2. Khushi Baby: Khushi Baby is a digital necklace for newborns that can store all of their medical information at an inexpensive cost. Khushi Baby was designed as part of UNICEF’s Wearables for Good contest and won. The necklace, along with the mobile app, allows nurses to keep track of patient data that can get easily lost in their busy and often underfunded healthcare systems. The necklace has been lauded as an ingenious idea that helps to digitalize immunization records for babies. This helps ensure more accurate and faster readings. Khushi Baby is working with NGO Seva Mandir to run vaccination clinics in rural villages in India. The company has expressed interest in expanding to Africa and the Middle East as well.
  3. Solar Suitcase: Another one of the inventions saving infant lives is the Solar Suitcase. It is an invention designed by Dr. Laura Stachel. The suitcase is a miniature kit powered by solar energy from two panels which produces a light strong enough for child delivery for nearly 20 hours. The kit was inspired by a visit Dr. Satchel made to Nigeria in 2009. She witnessed multiple times power outages that could harm babies and mothers during birth. The kit was tested in Nigeria by Dr. Stachel herself and proven to be a huge success. Since then, her charity We Care Solar has been helping to decrease mortality rates in Africa, Central America and Asia.
  4. The Odon Device: The Odon Device is a plastic bag that inflates to help pull a newborn’s head during delivery. The Odon Device was developed by Jorge Odon, a car mechanic from Argentina and made into a prototype in 2013. Funded by the World Health Organization, the Odon Device is meant to save newborns and their mother’s lives by limiting complications during birth. The product was tested in Argentina and South Africa and achieved a success rate of over 70%.
  5. TermoTell: TermoTell is a bracelet designed to recognize malaria early on in newborn babies. Another design created for UNICEF’S Wearables for Good contest, TermoTell reads babies’ temperatures to safely detect malaria and alert the doctor. If a newborn has malaria, the bracelet will glow and send an alert to a doctor’s phone. The invention was targeted towards sub-Saharan Africa where malaria can cause the deaths of nearly a million children. TermoTell is still just a prototype. The invention is still in the process of improving the design for more accurate readings in the future.

These five designs are just a few of the inventions saving infant lives all around the world. Most inventions are aimed at larger developing countries to help decrease mortality rates. Sub-Saharan Africa still has one of the highest infant mortality rates in the world with more than 50 deaths per 1,000 births while India has close to 30 deaths per 1,000 births. Inventions such as the five listed above have the potential to save thousands of lives and improve the mortality rate for many less developed countries whose mothers and infants have suffered for far too long.

Hena Pejdah
Photo: Pixabay

Health Care in SwedenSweden has the highest income tax rate in the world. More than 57% is annually deducted from people’s incomes. However, Sweden placed seventh out of 156 countries in the World Happiness Report 2019, and its healthcare system is one of the best in the world.

In 1995, Sweden joined the European Union and its population recently reached over 10 million people. Healthcare is financed through taxes and most health fees are very low. Sweden operates on the principle that those who need medical care most urgently are treated first. Higher education is also free, not only to Swedes, but also to those who reside in the rest of the European Union, the European Economic Area, and Switzerland. Like healthcare, it is largely financed by tax revenue. Here are 10 facts about healthcare in Sweden.

 10 Facts About Healthcare in Sweden

  1. Sweden has a decentralized universal healthcare system for everyone. The Ministry of Health and Social Affairs dictates health policy and budgets, but the 21 regional councils finance health expenditures through tax funding; an additional 290 municipalities take care of individuals who are disabled or elderly. To service 10.23 million people, Sweden has 70 regionally-owned public hospitals, seven university hospitals, and six private hospitals.

  2. Most medical fees are capped and have a high-cost ceiling. According to the Swedish law, hospitalization fees are not allowed to surpass 100 kr (Swedish Krona), which is equivalent to $10.88, a day and, in most regions, the charge for ambulance or helicopter service is capped at 1,100 kr ($120). Prescription drugs have a fee cap and patients never pay more than 2,350 kr ($255) in a one-year period. In the course of one year, the maximum out-of-pocket cost is 1,150 kr ($125) for all medical consultations. If the person exceeds the cap, all other consultations will be free. Additionally, medical services are free for all people under the age of 18.

  3. The cost for medical consultations not only has a price cap, but is generally low. The average cost of a primary care visit is 150 kr-300 kr ($16-$33) and the cost of a specialist consultation, including mental health services, ranges from 200 kr-400 kr ($22-$42). The cost of hospitalization, including pharmaceuticals, does not exceed 100 kr ($11) per day and people under the age of 20 are exempt from all co-payments. Healthcare services, such as immunizations, cancer screenings, and maternity care, are also free and have no co-payments.

  4. All dental care for people under the age of 23 is free. When a person turns 23, they no longer qualify for free dental health care in Sweden and must pay out of pocket. However, the government pays them annual subsidies, or an allowance, of 600 kr ($65) to pay for dental expenses. In Sweden, the cost of a tooth extraction is 950 kr ($103) and the cleaning and root filling for a single root canal costs 3,150 kr ($342). If dental care costs total anywhere between 3,000 kr-15,000 kr ($326-$1,632), the patient is reimbursed 50% of the cost. If it exceeds 15,000 kr, 85% of the cost is reimbursed.

  5. To battle its large medical waiting lists, Sweden has implemented a 0-30-90-90 rule. The wait-time guarantee, or the 0-30-90-90 rule, ensures that there will be zero delays, meaning patients will receive immediate access to health care advice and a seven-day waiting period to see a general practitioner. The rule also guarantees that a patient will not wait more than 90 days to see a specialist and will receive surgical treatment, like cataract removal or hip-replacement surgery, a maximum of 90 days after diagnosis. Sweden’s government also committed 500 kr million ($55 million) to significantly decrease wait time for all cancer treatments. In 2016, Sweden developed a plan to further improve its health services by 2025 through the adoption of e-health.

  6. In 2010, Sweden made private healthcare insurance available. The use of private health insurance has been increasing due to the low number of hospitals, long waiting times to receive healthcare, and Sweden’s priority treatment of emergency cases first. In Sweden, one in 10 people do not rely on Sweden’s universal healthcare but instead purchase private health insurance. While the costs for private plans vary, one can expect to pay 4,000 kr ($435) annually for one person, on average.

  7. Sweden’s life expectancy is 82.40 years old. This surpasses the life expectancies in Germany, the UK, and the United States. Maternal healthcare in Sweden is particularly strong because both parents are entitled to a 480-day leave at 80% salary and their job is guaranteed when they come back. Sweden also has one of the lowest maternal and child mortality rates in the world. Four in 100,000 women die during childbirth and there are 2.6 deaths per 1,000 live births. There are 5.4 physicians per 1,000 people, which is twice as great as in the U.S and the U.K, and 100% of births are assisted by medical personnel.

  8. The leading causes of death are Ischemic heart disease, Alzheimer’s disease, stroke, lung cancer, chronic obstructive pulmonary disease and colorectal cancer. While the biggest risk factors that drive most deaths are tobacco, dietary risks, high blood pressure and high body-mass index, only 20.6% of the Swedish population is obese and 85% of Swedes do not smoke. The Healthcare Access and Quality Index (HAQ Index) also estimates that, in 2016, the rate of amenable mortality, or people with potentially preventable diseases, were saved at a rate of 95.5% in Sweden. The HAQ Index estimates how well healthcare in Sweden functions; the index shows that it is one of the best in the world.

  9. Sweden’s health expenditure represents a little over 11% of its GDP, most of which is funded by municipal and regional taxes. Additionally, in Sweden, all higher education is free, including medical schools. There are no tuition fees and a physician can expect to have an average monthly salary of 77,900 kr ($8,500).

  10. In Sweden, 1 in 5 people is 65 or older, but the birth rate and population size are still growing. Because Sweden has one of the best social welfare and healthcare systems in the world, people live longer and therefore 20% of the population does not generate income or pay taxes from their salary. This dynamic stagnates social welfare benefits and slows down the economy. Increasing immigration and a rise in births are the two solutions to ensure that the younger generations will receive the same benefits. Swedish-born women have an average of 1.7 children and foreign-born women have an average of 2.1 children. In 1990, Sweden broke the 2.1 children fertility rate but quickly dropped below 2.0 in 2010. Since 2010, Sweden has seen an increase of 100,000-150,000 immigrants and has seen 45,000 citizens emigrate.

In 2018, Sweden reached its record highest GDP (PPP) per capita of almost $50,000. Despite having the highest taxes in the world, the living conditions and healthcare in Sweden are some of the best. With time, its population will continue to grow and the healthcare system will continue to advance.

Anna Sharudenko
Photo: Flickr

10 Facts About Life Expectancy in the Dominican RepublicSituated in the Caribbean and sharing the island of Hispaniola with Haiti, the Dominican Republic is home to nearly 11 million inhabitants. While health challenges persist, there have been many positive signs of progress in the past few decades in health care, funding, implementation and education that have resulted in a trend of higher life expectancy every year. Here are 10 facts about life expectancy in the Dominican Republic.

10 Facts About Life Expectancy in the Dominican Republic

  1. Life expectancy in the Dominican Republic has steadily increased over time. The average life expectancy will increase 6.99 percent from 2000 to 2020 according to projections by the U.N. Life expectancy from the time of birth in the country is currently 74.15 years of age.
  2. According to 2018 data collected by the World Health Organization, the leading causes of death in the Dominican Republic are coronary heart disease (19.85 percent), stroke (10.65 percent), prostate cancer (3.57 percent), HIV/AIDS-related illnesses (5.45 percent) and violence (5.51 percent).
  3. Infant mortality rates have dropped dramatically. Between 1990 and 2015, the infant mortality rate in the Dominican Republic fell by 50.3 percent due to expanded health coverage and immunization campaigns. However, the World Health Organization (WHO) has identified a priority gap for infant mortality rates of children under age 5 and maternal mortality. Infant mortality rates also decreased by 2.32 percent from 2019 to 2020.
  4. An increasing number of people are covered by health insurance. Between 2011 and 2015, 22 percent more of the population was covered by government-provided health insurance. In spite of higher out-of-pocket expenditures and gaps in services for a large portion of the population, the country is on track to universal coverage.
  5. There is greater access to safe drinking water. National and international groups developed programs in the past five years to improve coverage of clean and safe drinking water in the Dominican Republic, including the Drinking Water Monitoring System in 2015, which expanded monitoring in five provinces. On average, 86.8 percent of homes (urban and rural) have an improved water source.
  6. Natural disasters are being mitigated by better risk management systems. Because of its location, the Dominican Republic is ranked among the top 10 countries experiencing extreme weather due to hurricanes, tropical storms and seismic risk along tectonic plates. Since 2013, the incorporation of “disaster risk reduction” into laws and government systems has made the country a safer place to live, including Law 147-02 on risk management and the National Plan for Comprehensive Disaster Risk Management.
  7. Dominicans are more educated than ever before. As of 2016, the Dominican Republic had a literacy rate of 93.78 percent, up 1.79 percent from 2015. The mean number of years of schooling in 1990 was five. In 2014, it was recorded at 7.7 years.
  8. Greater attention is being placed on family planning and contraceptives. Around 99 percent of pregnant women in 2013 received prenatal care by a medical professional and 72 percent of partnered women used some form of contraception. Government resources combat adolescent pregnancies and promote family planning for women and couples. U.N. projections show the fertility rate (births per woman) declined 1.07 percent between 2019 and 2020, in line with yearly trends.
  9. Health services have been expanded to cover HIV treatment and prevention. Programs through the United States Agency for International Development (USAID) has offered assistance and services to the Dominican Ministry of Health for the past few decades to help prevent the transmission of HIV and offer treatment to those living with HIV. Between 2010 and 2014, the country increased antiretroviral coverage for populations living with HIV from 51 percent to 63 percent.
  10. Death by violence has declined over the past decade. Figures from the World Bank show that homicide rates decreased by 12.72 percent from 2014 to 2016 in the Dominic Republic. Since 2014, death by violence or other external causes has become a major concern, sparking the creation of public initiatives such as the Public Safety 9-1-1 Emergency Systems launched in Santo Domingo.

Considerable progress in life expectancy and quality of life have been made in the Dominican Republic in spite of new and old challenges to health and wellbeing. Data shows that in all these areas, overall improvements on the part of the Dominican government, as well as international organizations, have contributed to a steady improvement of living conditions.

– Caleb Cummings
Photo: Flickr