Infant Mortality in Afghanistan
When a child dies before his or her first birthday, that is a case of infant mortality. This statistic is most commonly measured in the number of infant deaths per 1,000 live births and gives insight into the general health of mothers and babies in a particular area. Here is information about infant mortality in Afghanistan.

One of the Highest in the World

Globally, as of 2020, Afghanistan has one of the highest infant mortality rates, with 45 deaths out of every 1,000 live births within the first year of life. For comparison, the infant mortality rate in Switzerland is only four deaths per 1,000 live births.

Inadequate Health Care and More

The extremely high infant mortality rate in Afghanistan is largely due to inadequate access to health care for women and mothers. Women often have to give birth at home without a doctor or with non-skilled birth attendants, which harms the baby’s chances at life. Not only is there a lack of health care professionals, but there is a lack of health care facilities in Afghanistan as well. More than 10% of Afghans have to travel more than two hours to reach a medical facility, leaving a lot of mothers in an unsanitary birthing environment. On top of that, illness, infection and poor nutrition couple together to create a rough environment for a newborn baby.

The Impact of the Taliban

With the recent laws the Taliban implemented since 2021, women have even more restrictions on receiving prenatal and postpartum care. According to Frontline, women are no longer allowed to travel more than 45 minutes without a male guardian, meaning that reaching medical facilities is nearly impossible for most women. In some cases, the law prohibits women from even receiving treatment from a male doctor unless their male escort is there, leaving a lot of women feeling shame or embarrassed to discuss their reproductive care in that setting.

Humanitarian Efforts

While all of these facts do not leave much hope for the infant mortality rates in Afghanistan to lower, UNICEF and the U.N. are currently working together to lower infant mortality rates.

One way of doing so is by providing necessary vaccines to newborn babies. Secondly, education is an invaluable resource. UNICEF specifically works with Afghan women to learn how to take care of themselves and their babies, so that they both can stay healthy. This involves getting to a proper medical facility for the birth, accessing methods to prevent future unwanted pregnancies and the provision of impactful interventions such as zinc and oral rehydration solution co-packs for the treatment of diarrhea at similar ailments affecting infants.

By combining these different approaches, groups like UNICEF and the United Nations hope to help lower maternal and infant mortality rates in Afghanistan. Hopefully, with continued efforts from humanitarian groups, more babies will be able to live past infancy and experience life to the fullest. It will be a hard battle due to the recent takeover of the Taliban but if these efforts continue, change will surely follow.

– Evelyn Breitbach
Photo: Flickr

Fetal Mortality Rate in Russia
The Russian Federation is the largest nation by land area in the world, and its approximately 146 million people, according to Worldometer, are remarkably diverse and varied across this vast territorial expanse. While this broad and beautiful nation has problems both similar and different to all nations of the world, one real issue that is relatable across all borders, regardless of culture, is the danger of losing one’s child at the time one gives birth. The fetal mortality rate in Russia is no exception.

This is a problem that purveys all species of animals, yet for humans, the struggle to survive childbirth has become easier in many places across the world with the succeeding decades. For Russia, remedying its fetal mortality rate will go hand in hand with fixing their nations own blighted poverty, as the two play off of one another in a Sisyphean loop.

The Poverty and Fetal Mortality Rate in Russia

The numbers across the board in 2021 are markedly better than those at the start of the century. However, in comparison to 50 years ago, the fetal mortality rate in Russia has actually been improving at a steady rate, even as national poverty, currently at just 13% nationally, continues on its own uneven road.

The U.N. Inter-Agency Group for Child Mortality Estimation estimates that nationally in 1970, approximately every 31 out of 1,000 births resulted in the death of the child in the Soviet Union. That number is today on par with the fetal mortality rate of far poorer nations, yet during this time, the Soviet Union was, under Leonid Brezhnev, still a powerful, if declining, force across the globe. The succeeding decades have since produced a consistent decline in these numbers, yet they have remained alarming to varying degrees, and for varying constituents, during this time.

By 2002, a bit more than a decade after the fall of the Soviet Union, the Russian Federation, now led by ex-KGB agent Vladimir Putin, had shaved the number of estimated infant deaths per 1,000 children nationally from approximately 31 to 14.8 across 30 years. However, regions and cities like Tula, amongst the poorest regions in Russia, still recorded nearly 17 per 1,000. But, as a scathing report on the conditions on the ground told at the time, even these numbers, high as they are, might yet be untrustworthy and lower than in reality.

In this report, the infant mortality rate in St. Petersburg in 2001 was just 9.3 per 1,000 births. Meanwhile, in the region of Chuktskity Okrug, that number was actually more than four times higher than the national average at just over 42 per 1,000 live births. Therefore, one can surely conclude that the wealth and internal infrastructure of the region certainly has a part to play in the fetal mortality rate both regionally and nationally.

The Numbers Today

Today, the national number has continued to shrink in comparison to the old data, yet this onus remains a terrible burden on the massively expansive nation; in 2019, estimates determined that Russia had only 4.93 infant deaths on a national scale, which is a far cry from approximately 31 out of 1,000 just slightly more than 50 years ago. While Russia’s rates have officially dropped, again buoyed by the more readily available healthcare of the larger cities like Moscow, the country’s official standing regarding the fetal mortality rate is nuanced.

However, while some facts change across the decades, other things remain the same. Available reports from all of these periods show that the nation was not infrastructurally integrated enough to sustain mothers or their children with the necessary resources, education or medical attention. Today, like in 2010, 2000 and 1970, the poorest regions in the federation, as well as within cities themselves, continue to suffer this trauma and unfair indignity at higher rates than their city-dwelling fellow citizens.

Russia: Between a Proverbial Rock and Hard Place

With sanctions against Russia omnipresent and the nation’s government itself outwardly hostile towards global nonprofits since 2012, external as well as internal human rights and advocacy groups have struggled to positively affect change. Population and Development was a Russian NGO that focused primarily on the promotion and protection of the reproductive health of Russian citizens before it shut down alongside so many others. The United States Agency for International Development, which has previously invested time and energy towards the betterment of Russian society through education and health initiatives, has had limited power and prestige in Russia in the years since 2012, as the country kicked it out in September of that year. Vladimir Putin’s government’s newest crackdown in April 2021 has left still fewer external or internal options for advocates to effectively affect positive change across the society, apart from the World Bank.

While the Russian government has largely discontinued or silenced internal and external assistance, cooperation with the World Bank has continued and might be the surest recourse for the fetal mortality rate in Russia. While Vladimir Putin has said that “Russia’s fate and its historic prospects depend on how many of us there are…,” his government alone has not been up to fixing all that ails the nation’s fetal mortality rate, and so continues to place its population in the most dangerous of positions. On the other hand, since 1992, the World Bank has been helping the Russian Federation advance the internal dynamics of their nation, from the hard and soft infrastructure necessary to producing stable economic circumstances to the education and resources necessary to create healthy environments for mothers to have, and then subsequently care for, their children.

Helping Russia

In such an unforgiving natural environment, the people require all of the help they can to sustain themselves and their families from generation to generation. Ultimately, organizations like the United Nations, USAID, Population and Development and other organizations can still help Russia with its poverty and fetal mortality rate, should they only receive the chance to do so once again.

– Trent Nelson
Photo: Flickr

Healthcare in Cambodia
Healthcare in Cambodia has undergone numerous changes in the past century. Cambodia was possessed by France, which provided minimal and basic healthcare for Cambodian citizens. However, Cambodia received its independence from France in 1953. Soon after, the country became heavily involved in the Vietnam War until 1991 and then faced political turmoil. In 1997, the Cambodian People’s Party staged a coup and gained control of the government. This party still holds power in Cambodia and maintains political stability. These numerous government changes have impacted healthcare management and policies.

High Infant and Child Mortality

Cambodia has incredibly high rates of infant and child mortality in comparison to other countries. Mortality rates in Cambodia are among the highest worldwide, with 12% mortality for children under the age of one and 20% mortality for children aged one to five. Consequently, families are more inclined to have multiple children, as seen in other countries with high infant mortality. This decreases the overall quality of healthcare, among other issues. Between 40% and 50% of Cambodia’s population is below the age of 15. While these numbers are decreasing, they are still not at the level required to maximize the current healthcare system’s impact.

Lack of Access and Space

Another severe issue that affects Cambodian healthcare is disease and illness. Diseases arise from a lack of clean, running water as well as poor sanitation. Furthermore, much of Cambodia’s population lives in decentralized villages away from larger hospital systems and medical equipment. Lack of transportation and proximity hinder an individual’s ability to afford and access healthcare.

Moreover, the current healthcare system is not adequate to treat the numerous patients in Cambodia. Many hospitals turn away patients, citing a shortage of resources and beds. In fact, during the Stung Treng dengue fever outbreak, the Cambodian Red Cross had to assemble a makeshift hospital. The organization set up beds for patients, as the present hospitals and clinics simply could not accommodate more patients. This deficit is especially threatening in a country where access to clean water and sanitation services is not guaranteed.

Cambodia also has had many cases of malaria, as is typical of countries located in Southeast Asia. There is always a chance for spikes in malaria cases. Operating at full capacity on a normal basis makes it nearly impossible to handle spikes when they occur.

Improving Health

Emphasis on illness prevention, rather than just treatment, will help improve healthcare in Cambodia. The Cambodian government must identify resources that have been successful in improving healthcare systems and lowering mortality rates in other countries.

Additionally, the amount that the Cambodian government has been spending on healthcare has decreased from 7.2% in 2013 to 6.6% in 2019. Healthcare funding should increase, specifically in preventive medicine and care. Rather than viewing these funds as a permanent spending increase, the government should see that the investment into healthcare will eventually lead to lowered costs as overall health in Cambodia improves. The country has already made large strides over the past few decades. As more individuals gain better healthcare treatment necessary for a healthy lifestyle, the overall state of living in Cambodia will also improve.

Coordinating NGOs

An NGO that is making significant improvements in healthcare in Cambodia is the Health Action Coordinating Committee (HACC). This organization focuses on addressing healthcare issues primarily by coordinating NGO activity in Cambodia in order to create the best system of resources, information and services available.

HACC has worked on enhancing healthcare since 1995, after noticing the lack of NGO coordination in the healthcare field. Now, the nonprofit is able to connect with other organizations to focus on community empowerment, advocacy and networking to improve healthcare systems. So far, HACC Cambodia has brought together 78 nonprofit organizations and has succeeded in providing a platform for these organizations to unite and advocate for common goals through different training, symposiums and other conferences.

Healthcare in Cambodia has gone through many changes over the past few decades and it is moving in the right direction; however, there is still a long way to go. The country suffers from illnesses and diseases that result in high infant and child mortality, and the healthcare system is still not able to take care of an aging population. In order to address this, the government must make healthcare a priority and collaborate with NGOs, such as HACC, to provide better healthcare in Cambodia.

Manasi Singh
Photo: Flickr

10 Years of Helping Babies Breathe
The first few minutes of a baby’s life have a significant impact on their chances of survival and their life quality. Statistically speaking, risks for newborn deaths are at their highest at that time. A main reason for the increased risk is asphyxia, a dangerous lack of oxygen right after birth. Every year, approximately 10 million newborns are unable to breathe on their own and require immediate help. In 2010, as a response to the medical issue, Helping Babies Breathe (HBB) was born. Recently, Helping Babies Breathe celebrated its anniversary for 10 years of work. Here is some information about the successes during the 10 years of Helping Babies Breathe.

USAID: An Important Partner

A partnership of many different agencies and organizations like Save the Children, Laerdal Global Health and the World Health Organization (WHO) launched the program Helping Babies Breathe. Another very important partner in the creation of HBB was the United States government’s agency USAID. After receiving Congress-approved funds from the federal government, USAID was able to be a key figure in establishing the program. The agency contributed significantly to HBB’s success by mobilizing more than $120 million to save newborns over the last decade.

Educating People

When HBB launched, its approach to fighting newborn mortality was based on creating a global movement. The goal was to raise awareness for the complications of asphyxia and to educate and train medics around the world. Thus, HBB focused on making educational materials and necessary equipment accessible for everyone. Furthermore, it supported training people in the resuscitation of newborns. When the program began, all the partners involved agreed on one ultimate goal. The plan was to assure that every infant started life with access to at least one person with the training to resuscitate babies after birth.

When HBB taught medics all around the globe how to reduce the risks of newborn mortality, it addressed several different approaches. One of HBB’s top priorities was to increase general hygiene and, thus, prevent potential infections. Helping Babies Breathe further gave clear instructions for the evaluation of a newborn. These included understanding crying as an indicator for whether or not a baby was receiving enough oxygen and examining the baby’s breathing more thoroughly. The program also taught providers how to react in the case of a newborn not being able to breathe. In order to do so, HBB focused specifically on the method of drying the baby to facilitate breathing. It also encouraged using ventilation and chest compression if drying was not enough.

Decreasing the Number of Newborn Deaths

In the last 10 years of Helping Babies Breathe, the program has successfully increased the chances for newborn survival. HBB has trained approximately 1 million people in more than 80 countries in resuscitating babies right after birth. A study in several different countries like Tanzania and Nepal has shown the huge impact of the program on the lives of infants. The number of stillborn babies has gone down by 34% and the number of newborns that die on their first day has reduced by 30% in places that have been working with HBB.

Governmental Independence

After initially investing in equipment and training birth attendants to help babies breathe, many places no longer need HBB. Seeing how successfully the program increased newborn survival, many of the countries that HBB was working with started to include the resuscitation techniques and new standards for medical providers into their governmental budgets. Since many countries now have the knowledge and determination to fight newborn deaths on their own, HBB partner and important sponsor USAID is able to slowly stop the financial support that the agency has been giving to the program for the last 10 years.

Bianca Adelman
Photo: Wikimedia Commons

3 Inventions Saving Babies in Developing Countries
A baby’s first, sole focus should be on growing. Babies with low birth weight and pre-term babies in developing countries face a higher risk of developmental disorders and neonatal death due to lack of access to healthcare. Devices such as the Pumani bCPAP, the NIFTY cup and the Embrace Warmer are inventions saving babies throughout developing countries.

The Pumani bCPAP

The primary cause of death in preterm babies is Respiratory Distress Syndrome (RDS). As such, the lungs are one of the last organs to develop in utero. Jocelyn Brown, a bioengineering student studying in Malawi created an affordable solution: the Pumani Bubble Continuous Positive Airway Pressure Device (Pumani bCPAP). The English word “breath” translates to “pumani” in the language of Chichewa.

A traditional bCPAP device is among these inventions saving babies because it is readily available in developed countries. However, it costs $6,000 and is not affordable to people in Malawi. Brown collaborated with physicians at Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi. The hospital had access to bottled oxygen, which administers low-flow oxygen through a tube connected to nasal prongs. Unfortunately, when treating neonatal RDS, it only had a success rate of 25%. On the other hand, the Pumani bCPAP almost triples the survival rate for preterm babies and costs less than $400 to manufacture.

The device uses a type of air pump that makes this innovation affordable. The Pumani bCPAP replaces the traditional high-tech commercial flow generator with a simple aquarium pump. Aquarium pumps are easy to repair and low-cost. Furthermore, it provides the exact airflow pressure necessary for the bCPAP device.

The Saving Lives at Birth Transition grant aided in distributing the Pumani bCPAP to hospitals throughout Malawi in 2012. Additionally, funding from the global healthcare company GSK and Save the Children helped roll out the device in Tanzania, Zambia and South Africa.

The NIFTY Cup

The World Health Organization (WHO) recommends using a small cup to feed newborns who are unable to breastfeed. However, no such cup existed until Seattle Children’s hospital, PATH and Laerdal Global Health and the University of Washington worked together to develop The NIFTY Cup.

The NIFTY cup is a handheld, flexible cup made from silicone rubber. It has a design specifically for babies lacking the ability to breastfeed due to prematurity or craniofacial birth defects like a cleft palate or lip.

Mothers who do not have a NIFTY cup make do with whatever they have. Instead, mothers commonly use spoons, gravy boats, shot glasses or coffee cups. However, they can waste a lot of milk due to spillage and it is often challenging to monitor the amount the baby is drinking. Moreover, too much or too little milk can be dangerous for a newborn.

A mother is able to easily fill the NIFTY cup directly from the breast. There are volume markings on the side to monitor the amount the baby consumes. Furthermore, the cup’s design allows babies to suckle from the spout at a controlled pace. In addition, the cup is easy to clean, reusable and only costs $1.

The developers share a mission to save the lives of newborns in developing countries all around the world. PATH’s Trish Coffey said, “We know there are potentially millions of babies who need it. So we just kept at it.”

The Embrace Warmer

The Embrace Warmer is one of many inventions saving babies in developing nations as well. Four Stanford graduate students had the task of inventing a cost-effective device to treat premature and underweight babies who are unable to regulate their body temperature. The invention looks like a baby-sized sleeping bag but functions similarly to a traditional medical incubator. Additionally, it costs less than 1% of what an incubator costs. This is extremely important for developing communities in rural villages.

The inventors gathered research in a rural, poverty-stricken area of Nepal. They saw firsthand the importance of adapting the invention to make it accessible to communities that needed it the most. The team relocated and launched the first model in rural India. It is common practice in these rural areas for parents to not name their baby until it is a month. This is so parents do not get too attached to newborns in case they do not survive.

Additionally, the team developed a washable, affordable model that is seamless on the inside to avoid bacteria. Placing the wax insert into boiling water for a few minutes heats it up. The wax’s melting point is the human body temperature. Furthermore, it maintains its temperature of 98 degrees Fahrenheit for four to six hours. Fortunately, it does not require electricity. It is reusable and mothers can hold their babies while they are inside an Embrace Warmer.

The founders of Embrace debuted the invention in rural India in 2011. Then, Embrace joined forces with Thrive Health in 2015. Thrive Health is an international nonprofit with an accomplished newborn health program. Embrace Warm has aided more than 200,000 babies.

These inventions save babies’ lives in vulnerable, developing nations and aid in the reduction of population growth. Parents are more likely to have fewer children if they are confident in their survival. According to Bill Gates, “As children survive, parents feel like they’ll have enough kids to support them in their old age. And so they choose to have less children.”

– Sarah Ottosen
Photo: Flickr

Malnutrition in Children
The first 1,000 days of pregnancy to the infant’s second birthday are the most important for the children’s growth. The effects of malnutrition in children between the first two years of birth are irreversible. Malnourished infants are more prone to dying during infancy, susceptible to chronic health issues and likely to face development issues. Additionally, acute hunger has a serious effect on infants. Poor nutrition is responsible for 45% of the causalities of children under the age of 5. That is 3.1 million children each year.

However, hope exists. A dynamic duo –RUTF (Ready-To-Use Therapeutic Food) and CMAM (Community-Based Management of Acute Malnutrition)– has revolutionized the way healthcare systems function in low-middle-income countries.

Life Before

During the hunger crisis of the 1980s and 1990s, centralized Therapeutic Feeding Centers (TFCs) emerged to nurse malnourished children back to health. The TFCs delivered nourishments through therapeutic milk, which needed clean water and on-site preparations. Additionally, the TFCs had to operate around the clock, making them scarce and distant from local communities as it was difficult to find 24-hours staffing. Mothers would often have to leave home for weeks, endangering their livelihood and possibly the lives of their other children.

TFCs proved ineffective as mothers would withdraw their kids in between treatments to return home in time for work. The children in the centers were also more vulnerable to infections due to unsanitary conditions, resulting in millions of relapses. Consequentially, some died due to the shortened treatments and exposure to deadly diseases.

Also, for countries going through civil unrest, it is dangerous to set up feeding centers out in the open. The centers could fall victim to airstrikes or ground attacks. Thus, the idea of centralized systems appeared increasingly self-defeating.

What is RUTF?

RUTFs are energy-dense, micronutrient-rich pastes used in therapeutic feeding. These soft foods are a homogeneous blend of lipid-rich foods that have a nutrient profile close to the WHO-recommended therapeutic milk formula that some in patient therapeutic feeding services use. Typical ingredients for RUTF include peanuts, oil, sugar, milk powder, vitamin and mineral supplements. RUFTs are a safe and cost-effective therapeutic food. It provides malnourished children with the essential nutrients needed for development in a single serving.

Not only does it provide all of the nutrients necessary for recovery, but even after opening it has a long shelf life and does not spoil quickly. Since RUTFs are not dependent on water, the chance of bacterial growth is very low, making it safe to use at home without refrigeration. Youngsters enjoy RUTF, being healthy and convenient to use without medical supervision. Finally, people should use it in accordance with breastfeeding and other baby and young child feeding best practices.

What is CMAM?

The primary objective of therapeutic food was to spare mothers from traveling long distances and instead enable them to feed their children at home. Therefore, the former system underwent decentralization and became fragmented into community-based programs.

This approach became known as the Community-Based Management of Acute Malnutrition (CMAM), which transformed the entire healthcare system, along with RUTF. The primary purpose of this scheme was to bring food closer to the communities so that the children who were not suffering from serious complications could receive treatment at home. As a result, the system became safer, less crowded and hassle-free.

Typically, healthcare workers diagnosed malnutrition in children using the weight and height ratio. However, this is very time-consuming, expensive and labor-intensive to do on a community level. The solution to this problem was using a simple plastic strip that measured the mid-upper-arm circumference to inspect for malnutrition. Usage of the plastic MUAC tape made it increasingly easier to carry out the diagnosis quickly.

Helping Malnourished Children

After the initial skepticism upon the efficacy of the treatment, the idea of quick and easily accessible treatments grew popular among mothers. Together, CMAM and RUTF were able to curb the impact of famine. Usually, during a famine, the standard aim is to keep the child mortality rate under 10%. However, it commonly exceeds the goal, recording a 20% to 30% child mortality rate. But with the combination of CMAM and RUTF, the child mortality rate reduced to below 4.5%. The World Health Organization (WHO) declared CMAM as an effective system to fight malnutrition, which spurred a revolution in the healthcare system, saving the lives of millions of children worldwide.

Malnutrition in children can have a lifelong impact on their well-being if not treated properly. Luckily, the invention of RUTF, teamed up with the efficiency of the CMAM, is helping save the lives of millions of children while ensuring they live healthy and prosperous lives.

Prathamesh Mantri
Photo: Flickr

Healthcare in MozambiqueThe state of healthcare in Mozambique has drastically changed in the last few decades. While Mozambique was once a country with little access to healthcare services, the country has decreased mortality rates since the launch of its Health Sector Recovery Program after the Mozambican civil war, with assistance from the World Bank.

History of Mozambique

The Mozambican civil war that took place from 1977-1992 had lasting effects on the country’s healthcare system and economy, resulting in limited funding for health services and insufficient access to care providers.

The Health Sector Recovery Program was launched in 1996 in order to refocus on funding healthcare in Mozambique, which desperately needed expanded resources to address the growing health crises. New health facilities were constructed throughout the country increasing accessibility to healthcare. The number of health facilities in Mozambique from the start of the civil war to 2012 quadrupled from 362 to 1,432 and the number of healthcare workers increased along with it.

Improvements to Healthcare and Accessibility

About 30 years ago, Mozambique had one of the highest mortality rates for children under 5 but was able to significantly reduce this number after the success of the Health Sector Policy Program. In 1990, this rate was 243.1 mortalities per 1,000 children. The rate has been reduced to 74.2 mortalities as of 2019. Maternal health was also targeted by the program, with increased health facility births from 2003 to 2011.

Conflict in Cabo Delgado

Despite these improvements to healthcare in Mozambique, Cabo Delgado, a northeastern province, is facing one of the worst healthcare crises in the country since violence struck the area in October 2017. Conflict between non-state armed forces clashing with security forces and other armed groups has caused more than 200,000 people in the area to become internally displaced. Coupled with the aftermath of Hurricane Kenneth, one of the strongest hurricanes to hit Africa, the area is facing severe food shortages and lack of shelter for people.

Cabo Delgado has also seen a rise in COVID-19 cases and other diseases such as cholera, diarrhea and measles, resulting from inadequate clean water and sanitation.

Intervention by UNICEF

On December 22, 2020, UNICEF shared a press release on the increased need for healthcare in Cabo Delgado. As the rainy season begins, there is an increased risk for deadly disease outbreaks. It appealed for $52.8 million in humanitarian assistance for 2021 projects aimed at aiding Mozambique.

UNICEF is expanding its water and sanitation response in order to prevent the outbreak of water-borne diseases like cholera and the further spread of COVID-19.

UNICEF also aims to give crucial vaccines to children in Mozambique, increasing its numbers from 2020. The 2021 targets include vaccinating more than 67,000 children against polio and more than 400,000 measles vaccinations. Children will also be treated for nutritional deficiencies from food insecurity and UNICEF plans to screen more than 380,000 children under 5 for malnourishment and enroll them in nutritional treatment programs.

Mental health support services will be provided to more than 37,000 children and caregivers in need, especially those experiencing displacement from armed conflict and those affected by COVID-19.

The Future of Healthcare in Mozambique

While healthcare in Mozambique has significantly improved in the last few decades, a lack of health services still affects the country’s most vulnerable populations. Aid from international organizations like UNICEF aims to tackle these issues to improve healthcare in Mozambique.

– June Noyes
Photo: Flickr

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