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Healthcare in Ghana
Healthcare in Ghana has many levels to it. There are three primary levels: national, regional and district. Within these, there are different types of providers: health posts, health centers/clinics, district hospitals, regional hospitals and tertiary hospitals. On average, Ghana spends 6% of its gross domestic product on healthcare, and the quality of healthcare varies by region. Here are four facts about healthcare in Ghana.

4 Facts About Healthcare in Ghana

  1. Ghana has a public insurance system. In 2003, Ghana made the switch from the “cash and carry” system to public insurance. The “cash and carry” health system required patients to pay for their treatments before receiving care. Because of this process, few people were able to afford treatment. In response, the government established the National Health Insurance Scheme (NHIS). This system provides wide coverage, covering 95% of the diseases that affect Ghana. The coverage includes treatment for malaria, respiratory diseases, diarrhea and more. Between 2006 and 2009, the proportion of the population registered to NHIS increased by 44%
  2. Child mortality rates have decreased. Data from 2019 showed that 50 out of 1000 babies die before the age of five. While this may appear unsettling at first, the twice as high a few decades earlier. In low-income communities, there is a higher risk of death because of limited access to healthcare. To help prevent this, the NHIS provides maternity care, including cesarean deliveries. In the 1990s, Dr. Ayaga Bawah began a study to provide healthcare in rural areas to see if it would decrease mortality rates. Between 1995 and 2005, the study showed that when qualified nurses were working in communities, there was an equal distribution of child mortality throughout the country, rather than mostly in rural communities.
  3. Access to health services has increased. In rural communities, health posts are the primary healthcare providers. A 2019 study found that 81.4% of the population had access to primary healthcare in Ghana, while 61.4% have access to secondary-level, and 14.3% to tertiary care. Despite these relatively high rates of accessibility, approximately 30% of the population has to travel far to access primary facilities or see a specialist. To increase access to services, Ghana’s president, Nana Akufo-Addo, stated in June 2020 that he intended to build 88 more district hospitals.
  4. More and more scientists are being trained. Throughout Africa, scientists are being trained to improve research and the dissemination of information. The World Economic Forum has pushed for research in programs such as Human Health and Heredity in Africa. This program is dedicated to helping local institutes manage the diseases and conditions that affect its area. Another group, H3-D, trains scientists in many African countries, including Ghana, to focus on conditions that are prevalent in Africa, such as malaria, tuberculosis and cardiovascular disease.

These four facts about healthcare in Ghana illuminate the progress that has been made, as well as the work that still needs to be done. While healthcare has improved, the government must take more steps to increase accessibility for all throughout the country. With a continued focus on healthcare, Ghana will hopefully continue to provide more communities with health services.

Sarah Kirchner
Photo: Flickr

4 Mobile Services Reducing Maternal and Child MortalityA woman in Africa is more likely to die from pregnancy or childbirth than a woman in Western Europe. The lack of nurses and midwives in comparison to Europe can make a significant impact on pregnancy and postpartum healthcare as well as maternal mortality in Africa. However, organizations and businesses are helping improve African women’s living conditions. Here are four mobile services reducing maternal and child mortality in Africa.

Springster

This mobile platform “connects marginalized and vulnerable girls to online content designed to equip them with knowledge, confidence and connections they need to navigate the complex choices of adolescence.”

Springster’s content can be accessed through social media channels like Facebook to provide a space for girls to engage in topics like puberty, education, money management and relationships. The app is based on sharing real-life experiences, helping girls make positive choices and change their lives for the better.

A major innovation with the app is Big Sis. Big Sis is a chatbot designed to provide personalized information about questions related to sexual health. This enables girls to find advice and answers 24/7. The app has impacted many girls’ lives with the reassurance and advice from shared stories and experiences from other girls like them. As a result, they are able to provide guidance and support from each other.

Mum & Baby

This service sends free health information via SMS three times a week to mothers, caregivers and partners. When people sign up for the service, they provide their age, location and stage of parenting they need help with from early pregnancy to taking care of a five-year-old.

After giving out personal information, Mum & Baby sends out personalized messages depending on the information given. Along with the messages, there is a free mobile site that does not use data. Instead, it offers articles, videos, tutorials and tools like the immunization calendar, due date calculator and pregnancy medicine checker.

A study was conducted to see the impact Mum & Baby has on people using the service. The study found 96% of users found the information via texts helpful and 98% of users say they would take action to care for themselves or their children.

Of the mothers and pregnant women surveyed, 95% of them say the information they received influenced their decision to breastfeed. Moreover, 96% of the people surveyed were influenced to get their kids vaccinated. More than 650,000 children were immunized as a result of free text messages.

RapidSMS in Rwanda

This mobile service has a similar style to Mum & Baby in the sense that it shares information via SMS. However, with this mobile platform, community health workers are equipped with mobile devices to collect and use real-time data on key maternal, neonatal and child health indicators.

The data is collected within the first 1000 days of life from pregnancy to childbirth to up to two years. This also includes a broad range of areas of childcare such as antenatal care, delivery, postnatal care, growth monitoring and even death indicators such as maternal and child mortality.

The indicators are recorded using the mobile platform and generate reminders for appointments, delivery and postnatal care visits. There is also an emergency care platform called Red Alerts. There is also a creation of a database of clinical records on maternal care delivery.

UNICEF did a study on RapidSMS to measure its effects on maternal and child mortality. It has contributed to some changes in the use of healthcare services and maternal and child mortality but has overall made improvements on health outcomes for mothers and children in Rwanda.

M-Mama’s Ambulance Taxi

This application “uses mobile technology to connect women in rural areas of Africa to emergency transport.” The project started in 2013 to help women in rural Tanzania gain access to healthcare where almost half of the women there give birth at home without the assistance of a healthcare worker. Many mothers and children die from preventable birth complications due to the lack of health systems and delayed access to care.

The people of M-Mama intend to change that and reduce maternal mortality rates which is a challenge faced by the U.N.’s Sustainable Development Goals.

The process of M-Mama’s ambulance taxi project starts when a patient makes a call to a 24-hour dispatch center. A call handler will then access the condition of the patient using the app, which would indicate whether the patient needs a transfer to a health facility. If healthcare is required, the nearest taxi will be notified and identified through the app, requesting the taxi driver to take the patient to the hospital. This way, taxis act as a cost-effective ambulance for the patient. The driver will then be paid after safely escorting the patient to the hospital.

Since M-Mama’s start, there has been a reduction in maternal mortality of 27% in the Lake Zone regions of Tanzania.

Conclusion

These mobile apps are reducing maternal and child mortality rates in Africa. Through the mobile services’ resources and aid, young girls can make better decisions and expecting mothers can get the help they need, despite their remote locations. Reducing maternal and child mortality by 1% can increase GDP by about 4.6% in African countries.

However, one issue that stands in the way is the lack of access to mobile phones and the internet. Women in Sub-Saharan Africa are 13% less likely to own a phone and 37% less likely to access the internet on mobile.

The more investment there is to reduce maternal and child mortality in Africa, the more it will generate social and economic benefits for Sub-Saharan Africa. To do that, governments and non-profit organizations need to work to close the gender gap and develop mobile health services. These efforts will help women be informed and make healthier decisions.

– Jackson Lebedun
Photo: Flickr

demand for child rightsWith 25% of Latin America’s population being under the age of 15, an increased demand for child rights is inevitable. As a result, Latin America and the Caribbean have seen gradual implementations of protection for children under the law. Countries in these regions have seen improvements spanning from a growing economy to quality health care.

Health Improvements for Children

One immediate causes for the demand in children’s rights is because of the abuse that many children in impoverished countries endure. Some issues that exemplify the need for child rights are sexual abuse, drug and alcohol consumption and child labor. The health care systems in Latin American countries are responding.

For example, increased demand for child rights in places such as Argentina and Peru has resulted in more representation for children in health care services. Argentina has had children’s rights written in law since 1994. Now, with children included in health plans, child mortality rates have decreased to 9.9 deaths per 1,000 live births in 2018, compared to 12.6 just five years earlier.

Strengthening Written Law

Previously, many children in these countries were not seen as separate individuals until they reached adult age. However, increased children’s rights in certain Latin American and Caribbean countries have improved the livelihoods of the underaged. Children’s rights in Latin America and all across the world have moved to the forefront of many political agendas thanks to the UN Convention on the Rights of the Child and active citizens.

Countries such as El Salvador have shown that the demand for child rights have proved their international leadership on the issue. There are more than 15 comprehensive laws within the country protecting children and almost 20 international laws protecting El Salvadoran children.

Though the numerous laws, in theory, protect the children, it is not as easy to enforce the laws. A large discrepancy still remains between the sentiment and enforcement of law for the protection of children. Legislature rendered ineffective through lack of enforcement “allows perpetrators of violence against children and adolescents to continue committing the same crimes with no fear of prosecution or punishment.

The BiCE

One organization that has made child rights in Latin America a priority is BiCE, the International Catholic Child Bureau. The organization’s main goal is the preservation of child rights in different countries in Latin American and around the world. Current field projects take place in countries such as Ecuador, Guatemala and Peru. Most of the projects focus on fighting sexual abuse of children.

BiCE’s projects have many goals that ensure the safety of a child. For the programs fighting sexual abuse, they offer therapy services for recovery. They also train people to learn advocacy techniques for children’s rights. Over 1,000 children in Peru have received help from BiCE and the organization continues to do more in other countries in Latin America.

Most countries in Latin America and the Caribbean have written laws and statutes that protect children. However, this has not proved to be enough for the safety of children in these countries. There have been health improvements and decreased poverty rates, but more still needs to be done to enforce the written laws.

Josie Collier
Photo: Flickr

Last Mile HealthLiberia borders Sierra Leone, Guinea, Cote d’Ivoire and the Atlantic Ocean. The West-African nation was established as a settlement by freed American slaves in 1820. Despite gaining independence in 1847, the country suffered from years of instability brought on by the military coup of 1980. Civil war broke out in Liberia in 1986 and endured until late 2003. With 14 years of civil war devastating both the population and the economy, Liberia, now home to nearly five million immigrant and indigenous peoples, has shifted its focus towards recovery. Many efforts acknowledge the inadequacies of healthcare in Liberia, one of them being Last Mile Health.

Founded by Liberian civil war survivors and American healthcare workers in 2007, Last Mile Health is a nonprofit organization dedicated to rebuilding healthcare in Liberia by creating a stronger, more resilient public health infrastructure within both urban and remote regions of the country. To date, Last Mile Health is responsible for a plethora of noteworthy improvements in healthcare and health outcomes in Liberia.

Healthcare in the Past

Between 1986 and 2003, 80% of healthcare clinics across Liberia closed their doors as a result of looting, destruction and the exodus of healthcare workers. Only 168 physicians remained in Liberia, predominantly in the capital city of Monrovia. Medical training systems stood on the verge of collapse. Today, nearly 1.2 million people throughout Liberia live more than an hour’s walk from the nearest healthcare facility.

Lack of access to quality healthcare in Liberia has resulted in poor health outcomes for Liberians. Alongside suffering from one of the world’s worst maternal and under-5 mortality rates, malaria, diarrhea, HIV/AIDS and other preventable and treatable illnesses are amongst the leading causes of death and disease in Liberia. A mere 39% of children under two in Liberia have received their recommended vaccinations.

Bringing Care to Patients

Last Mile Health builds community-based primary health systems within Liberia to bring healthcare to the poorest and hardest-to-reach regions. In 2012, Last Mile Health piloted a community health worker program in the Konobo District of Liberia that resulted in an unprecedented 100% coverage of the district by healthcare personnel. This pilot program has since been replicated, extending primary healthcare in Liberia to 1.2 million people.

Training Healthcare Workers

In 2017, Last Mile Health launched the Community Health Academy to strengthen the clinical skills of community health workers in Liberia. The Community Health Academy provides training to health care leaders to help them build resilient and effective public health infrastructure. As of 2019, more than 16,000 healthcare personnel from around the world have enrolled in the academy’s courses.

Improving Health Outcomes

In 2010, Last Mile Health launched Liberia’s first rural, public HIV/AIDS treatment program. The program exists in over 19 of Liberia’s public clinics.

By increasing access to and quality of healthcare in Liberia, Last Mile Health has increased the number of children receiving malaria, pneumonia and diarrhea treatment by over 40%, resulting in a significant reduction in under-5 mortality rates and improvement in child health outcomes. Maternal health outcomes have improved as more women can access skilled birth attendants and facilities for delivery and maternal care.

Increasing Average Life Expectancy

The average life expectancy for Liberians continues to increase each year as healthcare in Liberia rebuilds and recovers. By linking community healthcare workers with nurses, doctors and midwives at community clinics and equipping workers with the knowledge and skills that they need, Last Mile Health continues to fulfill its mission of bringing life-saving care to people in even the most remote areas of the country.

Last Mile Health promises a future in which no patient is out of reach from quality healthcare in Liberia. In the years to come, the nonprofit organization intends to expand its reach within Liberia and across Africa.

– Alana Castle
Photo: Flickr

Hunger in Liberia
Liberia is a country on the West African coast. Neighboring the Ivory Coast, Guinea and Sierra Leone, it spans just under 100,000 square kilometers of land. A long civil war, consistent disease outbreaks and widespread economic instability have led to prevalent hunger and malnutrition. Here are six facts about hunger in Liberia.

6 Facts About Hunger in Liberia

  1. Human Development Index: Liberia ranks 176th out of 189 countries on the Human Development Index. The country is one of 14 African countries ranking within the lowest 15 on the index. This is largely because the country’s life expectancy at birth is quite low, being less than 64 years.
  2. Global Hunger Index: The country ranks 112th out of 117 countries on the 2019 Global Hunger Index (GHI). The index consists of a range of scores, 0.0-50.0, where Liberia holds a score of 34.9. The score indicates the country’s hunger levels are ‘serious’ and on the brink of becoming ‘alarming.’ According to the previous index scores, however, Liberia has consistently improved their conditions and lowered their GHI score by 13.7 points throughout a course of 19 years, from 48.6 in 2000 to 34.9 in 2019.
  3. Malnourishment: Approximately 45% of Liberia’s population is chronically or acutely malnourished. According to several experts and NGOs, the country’s destitute circumstances are due in part to the Ministry of Health undermining the severity of the situation. Additionally, in the country’s impoverished capital, Monrovia, 45% of deaths of children under the age of five are due to a lack of food and being underweight.
  4. Sustainable Development Goals: Liberia ranks 154th out of 157 countries on track to meet the Sustainable Development Goals. The country’s economic and social development has been stunted for a long period of time. The 14-year civil war, which formally ended in 2003, contributed to the country’s leading issues today: widespread economic instability and insecurity, destroyed infrastructure, poverty and poor living conditions. According to Famine Early Warning Systems Network, 32% of the country’s population is classified as having moderate or severe chronic food insecurity. This affects more than 1.55 million people.
  5. Economic Collapse: The country’s continued engagement in several internal and external conflicts led to a 90% drop in the GDP between 1987 and 1995. Liberia’s plummeting economic situation is amongst the biggest economic collapses ever recorded. The weak economy has continually increased the prices of products and decreased income, making it hard for families to sustain their basic needs. The rising cost of food has resulted in increased chronic food insecurity throughout Liberia. On average, 1 in 5 households in the country is food insecure. Moreover, 2 in 5 households are marginally food insecure. While the country has been successful in decreasing their chronic malnutrition rates from ‘critical’ to ‘serious’ levels according to the WHO classifications, food insecurity continues to remain an important issue.
  6. Child Hunger and Mortality: One in 11 Liberian children dies before the age of five. In 2007, an average Liberian woman had more than five children. This number decreased to just under five in 2013. While poor water sanitation and an alarming rate of food insecurity consistently claim the lives of approximately 10% of children under five, 60% of girls that survive tend to begin childbearing at the age of 19. These malnourished adolescent girls tend to give birth to malnourished babies with low birth weights. And as a result, the babies have an increased risk of illnesses and premature death.

Fighting Hunger in Liberia

While hunger, malnutrition and poverty are persistent issues, many humanitarian organizations such as the WHO, UNICEF and the Action Against Hunger are working toward improving Liberia’s living conditions. Action Against Hunger, for example, recently assisted more than 90,000 people and helped the country’s government implement policies to make progress in alleviating Liberia’s hunger.

Action Against Hunger started Liberian programs in 1990 and has continually improved the lives of hundreds of thousands in the country. One of the prominent programs started by the organization involved training of mother-to-mother support groups to ensure healthy child-feeding practices. With widespread malnutrition, Action Against Hunger also worked with Liberia’s Ministry of Health to implement clean water, sanitation and hygiene improvement programs.

Moving Forward

Hunger in Liberia, while affecting millions every day, is on the path of improvement. With the help of numerous humanitarian organizations, hunger in Liberia will hopefully decrease. The United Nations aims to end hunger and diminish food insecurity in Liberia within the next ten years. Accomplishing this will require a continued focus on decreasing hunger in the nation.

Omer Syed
Photo: Flickr

Facts about overpopulation and poverty Overpopulation is defined as “the presence of excessive numbers of a species, which are then unable to be sustained by the space and resources available.” While many definitions of poverty exist, the simplest is that it all but guarantees struggle, deprivation and lost opportunity.

Contemporary understandings of poverty are more holistic, rather than just quantitative measures of income. Considering factors such as health care and education helps broaden the view of poverty and its causes. Here are 7 facts about overpopulation and poverty.

7 Facts About Overpopulation and Poverty

  1. Population growth and poverty present the classic “chicken or egg” dilemma. According to Dr. Donella Meadows, “poverty causes population growth causes poverty.” Her eponymous 1986 essay explains why the classic “chicken or the egg” dilemma regarding overpopulation and poverty leads to different conclusions on how best to intervene. Dr. Meadows ultimately concludes that the question itself is less of an “either/or” and more of a “both/and” question.
  2. There is a cycle of poverty and overpopulation. One factor causes the other and vice-versa. For example, when child mortality is high (usually due to living in impoverished conditions), the overall birth rate is also high. Therefore, it is in everyone’s best interest to lower the child mortality rate by reducing poverty.
  3. There is a correlation between declining birth rates and rising living standards. Declining birth rates and rising living standards have occurred simultaneously in the developing world for decades. This relationship between fertility and economic development results in a virtuous circle, meaning “improvements in one reinforce and accelerate improvements in the other.” As a result, this pattern between fertility and economic development helps reduce poverty.
  4. By the end of this century, the population is expected to grow by 3 billion people. Over the next 80 years, the majority of the increasing population will live in Africa.
  5. Although Africa has experienced record economic growth, the much faster rate of fertility still leaves much of the population impoverished. While Africa’s economy continues to grow, the Brookings Institute notes that “Africa’s high fertility and resulting high population growth mean that even high growth translates into less income per person.” The most effective strategy to combat this is to reduce fertility rates.
  6. The number of megacities has more than tripled since 1990. Megacities are cities with more than 10 million people. Although there are currently 33 megacities in the world, that number is expected to increase to 41 by the year 2030. Of those 41 megacities, five will appear in developing countries. Megacities are susceptible to overpopulation and concerns about disease control. Furthermore, some megacities relieve poverty while others exacerbate it.
  7. A sense of taboo surrounds discussions about overpopulation. Is talking about overpopulation still taboo? Some experts believe so, citing the 17 goals and 169 targets of the UN Sustainable Development Agenda that have been silent on the issue. Luckily, philanthropists and voters are leading the way in normalizing frank discussions regarding facts about overpopulation and poverty.

Despite gradually increasing developments, global overpopulation and poverty continue to remain prevalent. Steps such as viewing poverty holistically and working to end the stigmatization and taboo surrounding discussions about overpopulation help further the much-needed improvements for overpopulation and poverty.

– Sarah Wright 
Photo: Flickr

Healthcare in Nepal
Nepal remains one of the world’s poorest countries as well as one of the most prone to natural disasters. The country suffers from the effects of climate change and population increase, which further increases the damage caused by natural disasters. Landslides and floods are particularly common, especially during the monsoon season. These catastrophes kill more than 500 people a year. The healthcare in the country is often unequally distributed, with healthcare resources centralized around the country’s major urban centers. This unequal distribution hinders the quality and accessibility of healthcare provided in Nepal. Here are 10 facts about healthcare in Nepal.

10 Facts About Healthcare in Nepal

  1. The 1978 Alma Ata Declaration: In an effort to improve healthcare, Nepal was influenced by the 1978 Alma Ata Declaration. The declaration emphasized community-oriented preventive, promotive and curative healthcare services. Nepal also took steps to improve the lives of its citizens by establishing a network of primary healthcare facilities. In addition, the nation deployed community healthcare workers to provide healthcare at the community level.
  2. Life expectancy: As a result of improving healthcare in Nepal, life expectancy has seen a dramatic increase. According to the Nepali Times, life expectancy went up 12.3 years between 1991 and 2011. Currently, the country has the second-highest life expectancy in South Asia, largely due to the fact that the country has seen a sharp decrease is birth rate mortality. The Central Bureau of Statistics reported that 295,459 Nepalis were more than 75 years old in 2001 and in 2011 that number increased to 437,981.
  3. Accessibility: Most of Nepal’s healthcare resources are located in or around Kathmandu, the capital city of Nepal. This centralization leads to other areas of Nepal being neglected. In 2015, however, Nepal’s government formed a Social Health Security Development Committee as a legal framework in an effort to start implementing a social health security scheme. The program’s goal was to increase the accessibility of healthcare services to Nepal’s poor and marginalized communities. It was also aimed to increase access to people who live in hard to reach areas of the country. Problems, however, remain with financing the effort.
  4. Healthcare as a human right: In 2007, the Nepalese Government endorsed healthcare as a basic human right in its Interim Constitution. Despite this, only 61.8 percent of Nepalese have access to healthcare facilities within a 30-minute radius. Nepal also suffers from an inadequate supply of essential drugs and poorly regulated private healthcare providers. Statistically, Nepal also only has 0.67 doctors and nurses per 1,000 people. This is less than the World Health Organization’s recommendation of 2.3 doctors, nurses and midwives per 1,000 people.
  5. Lack of basic health facilities: Around 22 percent of Nepalis do not have access to basic health facilities. The groups who lack healthcare in Nepal tend to be the Dalits from Terai and Muslims. However, there has been a 19 percent increase in the usage of outpatient care by Dalits.
  6. Common diseases in Nepal: The top diseases in Nepal are ischemic heart disease, COPD, lower respiratory infection, diarrheal disease, stroke and diabetes.
  7.  Oral health: More than half of adults in Nepal suffer from bacterial tooth decay. Bacterial tooth decay can lead to chronic pain, heart disease and diabetes. Many in rural villages do not have access to tooth filling, toothpaste or water. There is a belief among some Nepalese that tooth extraction causes blindness.
  8. Maternal and child mortality rates: There has been a reduction in maternal and child mortality rates.  The rates have decreased from 539 per 100,000 to 281 per 100,000 live births in 2006, according to the DHS survey. The 5 and under mortality rate decreased in rural areas from 143 per 1000 to 50 per 1000 live births in 2009.
  9. Earthquakes: The earthquakes that hit Nepal in April of 2015 are one of the greatest natural disasters in Nepal’s modern history, destroying over 1,100 healthcare facilities. Possible Health.org, a global team of people committed to the belief that everyone deserves access to quality healthcare without financial burden, signed a 10-year agreement with their government partners to attempt to rebuild the healthcare system in the Dolokah district, which suffered the destruction of 85 percent of their healthcare facilities.
  10. Government corruption: While there are efforts to improve the lives of Nepalis, corruption exists, according to the Himalayan Times. The Corruption Perceptions Index ranks Nepal 124 out of 175 countries worldwide. This corruption leads to a lack of resources dedicated to healthcare. The Nepali government only allocations 5 percent of its national budget toward healthcare, not enough to create significant improvements.

These 10 facts about healthcare in Nepal illustrate the challenges the nation has faced, as well as the progress that has been made. To help improve healthcare, the European Union provides continual support. In 2019, they gave 2 million pounds of assistance to the country. Moving forward, continued work by humanitarian organizations and the Nepali government is needed to continue improving healthcare in Nepal.

Robert Forsyth
Photo: U.N. Multimedia

Helps Ethiopean ChildrenAfrica has the highest child mortality rate of any continent. Ethiopia sits in the middle of the child mortality ranking of countries throughout Africa with 59 out of 1,000 children dying before the age of five. While it is not as high as the rate of 76 per 1,000 children found in sub-Saharan Africa, it is much worse than many developed nations, which average around 6 deaths per 1,000 children annually. New research, however, shows that childhood mortality can be significantly lowered in Africa using an antibiotic that could help Ethiopian children prevent blindness.

Azithromycin Helps Ethiopian Children

Trachoma is the leading bacterial infection that causes blindness. In an effort to lower the number of cases of trachoma, researchers preemptively gave azithromycin, an antibiotic effective at fighting trachoma, to thousands of children under the age of nine in Ethiopia. The researchers administered these doses of azithromycin to children twice a year.

After observing the children for several years, they came to a shocking discovery: azithromycin will help Ethiopian children live longer. Not only did the bi-annual antibiotic prevent against trachoma, as the researchers believed it would, but it also protected against many other common ailments as well. For those children in the case study, the childhood mortality rate was cut in half.

The discovery seemed too good to be true, so this group of researchers tried to replicate their findings in other African nations with higher child mortality rates. Close to 200,000 children were given azithromycin in Tanzania, Malawi and Niger. While the results were not quite as impressive as cutting the child mortality rate in half, as seen with Ethiopia, the results were still high. The twice-yearly drug lowered child mortality rates between 14 to 19 percent in each country.

Research Into Other Illnesses

Research must continue before Africa will see widespread use of azithromycin for children. If approved for widespread use, this antibiotic could help prevent some of the common illnesses that lead to child mortality. These common illnesses include:

  • Pneumonia: Pneumonia kills nearly 100,000 children per year in Africa. This accounts for 16 percent of childhood death under the age of five. Currently, when children contract pneumonia, only one third are able to receive lifesaving antibiotic treatment.
  • Diarrhoeal disease: Diarrhea is the leading cause of death in children under the age of five. Diarrhea is a common infection in the bowels. It is completely preventable and treatable, yet it is estimated that 525,000 children in Africa die annually from this illness.
  • Malnutrition: Malnutrition contributes to childhood mortality rates. While the use of azithromycin will not be able to prevent malnutrition, it may be able to help prevent other ailments that the body is not able to fight off because of the lack of nutrients and calories.

Long term effects of azithromycin used to prevent ailments in children are not known. However, the studies have shown promising results in saving the lives of hundreds of thousands of African children. With a few more years of research and more funding, these researchers may be able to permanently lower the childhood mortality rate in Africa. Not only will this research continue to help Ethiopian children but it will also help children of other nations, ensuring they live into adulthood.

Kathryn Moffet
Photo: Pexels

USAID's support for children
Among the groups that the U.S. Agency for International Development (USAID) aims to support, children across the world are a top priority. From health-related aid to education opportunities and protection from violence, USAID’s support for children employs a variety of means to help kids survive and grow despite poverty and other adversities.

USAID Addresses Preventable Child Mortality

An important aspect of USAID’s support for children is access to medical assistance. An overwhelming 75 percent of child deaths under the age of five results from newborn deaths and treatable diseases: pneumonia, diarrhea and malaria. These illnesses could be effectively countered by timely low-technology treatments, which USAID attempts to provide on the local level by bolstering public-private engagement and promoting Integrated Community Case Management (iCCM).

USAID strengthens iCCM programs that train and assist with local community members treating children. Such programs provide vital medical care on the ground in communities that are often hard to reach. USAID helps construct sustainable networks of monitoring and evaluation, clinical referral, supportive supervision and more, which in turn ensure the functioning of iCCM programs.

A USAID-supported iCCM program in Zambia led to a 68 percent early treatment rate of childhood pneumonia. USAID’s efforts to treat malaria have reached millions of children in Tanzania alone, where 70,000 people die from the disease annually. Within a decade, simple preventative action and treatment by community health workers have contributed to a 28 percent decrease of child mortality rate.

USAID’s Support for Children: A Comprehensive Action Plan

USAID’s efforts to help children around the world are not limited to medical care. USAID, together with other U.S. government departments and agencies, launched the ambitious and comprehensive five-year U.S. Government Action Plan on Children in Adversity in 2012. Backing the plan is Public Law (PL) 109-95, signed in 2005 to amend the Foreign Assistance Act of 1961, which asks the U.S. government to effectively respond to vulnerable youths in low and middle-income nations.

USAID’s support for children is wide-ranged and well-coordinated under the Action Plan, focusing on the value of investing in boys and girls in order to achieve long-term economic and social progress. Among those receiving aid are children affected by HIV/AIDS, those living outside of family care, those who have been trafficked, those under sexual violence or exploitation and more.

Interventions employed by the Action Plan are evidence-based, meaning they are both effective and instructive for further action in the future. Such actions include improving the families’ socioeconomic status, rescuing youths suffering from the worst forms of child labor, promoting protective family care and protecting the education of both children and their surrounding communities.

According to the most recent annual report for Congress, the plan has reached millions of young lives since 2012. Understanding the significance of nutrition, especially in the first thousand days of life, USAID and Food for Peace sent food assistance to approximately 20 million children in 61 countries with funds from Fiscal Year 2015. Children separated from their families in 11 countries received help from USAID to return to family care.

Effective Utilization of the Private Sector

Many of USAID’s support for children take place in the private sector, via public-private engagement as well as recent “development impact bonds.” Public-private engagement is manifest in USAID’s Strengthening Health Outcomes through the Private Sector (SHOPS), which increases the ready supply of diagnostic and treatment-related products. The program works with local manufacturers and importers and also informs health workers regarding the appropriate use of medical knowledge and tools.

In December of 2017, USAID launched a new development impact bond for India, the Utkrisht Bond, that mobilizes private capital to make improved healthcare accessible to 600,000 women, aiming to save up to 10,000 mothers and their newborns. With private capital enabling an initial investment, USAID and Merck for Mothers will only follow up with its $4.5 million commitment after the development goals are realized, ensuring the effectiveness of aid.

Innovative, sustainable and replicable efforts such as these are consistent with USAID’s mission to help developing countries so that they eventually grow out of the need for aid. Continued assistance from the U.S. agency will ensure that millions of children around the world are given the help they need for a better future.

– Feng Ye
Photo: Flickr

The widespread poverty, hunger and disease in Central Africa has consistently resulted in the lowest life expectancy in the world. While the global average of life expectancy has risen by roughly five years in the past two decades, central African countries continue to dwell at the statistical bottom. At a typical life expectancy of 50 years, the global community must increase funding and accountability to ensure that poverty and disease cease their decimation of central African populations.

The central African country of Chad was estimated to have the lowest life expectancy in the world for 2017. Chad is a country of 12 million people, 40 percent of which live below the poverty line. While the country began oil production in the early 2000s, Chad’s poverty rate is expected to continue its rise. In part, this is due to the country’s high mortality rate and low life expectancy. To gauge the ability of the U.S. and other developed nations to help increase Chadians’ average lifespan of only 50.60 years, it is first necessary to examine the causes of death.

Early Deaths

Children in Chad die from all sorts of illnesses, from malaria and respiratory infections to prematurity and diarrhea. Because so few Chadians have access to birth control, as only approximately five percent use contraception, the birth rate in Chad is growing. 43 percent of the population is aged 14 or younger, and that figure is rising. The risk of dying by this young age is 44 percent for boys and 39 for girls, as of 2012.

Furthermore, Chad has the third highest maternal mortality rate in the world. Extreme poverty, poor to no maternal health care and adolescent pregnancy has contributed greatly to the high maternal death rates. In a country with the lowest life expectancy in the world, the extreme poverty rates must decrease and better access to maternal healthcare is essential if the country is to improve.

Diseases

Chad, like many African nations, is no stranger to disease. Lower respiratory diseases, malaria, HIV/AIDS and diarrhoeal infections are dangerously common. Lower respiratory infections alone killed 24,700 people in 2012. The risk factors for falling prey to these diseases are lack of adequate healthcare, a rarity of potable water and the hot and arid climate. As the largest of Africa’s landlocked countries, Chadians are forced to walk long distances for water.

As only 28 percent of the population lives in urban areas, the vast majority of Chadians do not have quick access to necessities such as water and healthcare. As the country with the world’s lowest life expectancy, it is vital that Chad provide better access to these basic human needs to the entirety of its landscape.

The U.S. is in a unique position to provide monetary and medicinal assistance. Maintaining accountability with the Chadian government regarding these resources would be the most effective way to ensure that taxpayer dollars are going to good use and can be reflected by a rising life expectancy for the people of Chad, and all over Central Africa.

– Eric Paulsen

Photo: Flickr