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Afghan Health Care
In Afghanistan, a woman dies every two hours due to pregnancy related problems. On top of that, each year 1 in 10 children die before reaching the age of five. Afghanistan has one of the highest child and maternal mortality rates worldwide. A large reason for this is the turmoil the country has been experiencing in the last few decades.

Many of Afghanistan’s citizens are refugees and its infrastructure and economy have been severely devastated because of the chronic instability and conflict that it has plagued the region in recent years. Now forming a resurgent force in the Southern and Eastern parts of the country, supporters of the tightly-strung Islamic movement have re-grouped since the fall of the Taliban administration in 2001. The government has been struggling to extend its authority to enhance national unity beyond the capital of Kabul. Despite its mountainous, landlocked terrain, Afghanistan has been fought over for a long time because of its strategic position between India, Central Asia, and the Middle East.

Despite many years of aid, Afghan health care is still extremely limited because of the high casualty rates from violence. The Afghan health care system is still functioning very poorly, but officials are attempting to conceal information on the topic. As Afghanistan is the 15th least developed country in the world, it is a struggle for much of the population just to access basic care. Research from the Medecins Sans Frontieres (MSF) shows just how grave and deadly it is for these people to seek medical help.

When sick, many citizens have to go past the public health facilities nearest to them because of conflict, causing them to travel much greater distances for help. Some people travel 50 miles or more, going through security checkpoints and military roadblocks just to be treated. Once they get to the health facilities that they actually can manage to visit, there is sometimes a shortage of medicine, experienced staff and/or electricity. Additionally, some hospitals are facing high amounts of debt and are unable to pay for better facilities and treatments.

Often times, people wait to go to the hospital until their condition has gotten extremely bad because they do not want to risk making the trek for something that is not that severe.  Some people also wait all night to take their ill and dying relatives to the hospital because they were so worried about their safeties while travelling overnight. According to the MSF, one in five of their patients had someone close to them die in the last year as a result of them not being able to acquire medical care. On the journeys of those who were fortunate enough to make it to the hospitals, 40% experienced land mines, fighting, military checkpoints or harassment.

However, there has been a lot of progress in the country with over 60% of citizens now living within an hour walk to their nearest health clinic (a significant increase from the 9% in 2002). Mortality rates are also being lowered with the child mortality rate having decreased by 62% and the infant mortality rate by 57%. Maternal mortality rates have also lowered substantially because of the increase in trained professionals. The international interest in Afghanistan is dwindling, meaning they are facing less aid, even though the country still has a long road of development to come.

– Kenneth W. Kliesner

Sources: BBC, USAID, BBC
Photo: TIME

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In order to improve and manage community health, health advocates help organize a plethora of services ranging from health events to educational experiences. Advocates come in many different forms and settings. For instance, health advocates are generally doctors and nurses though other health advocates may come from a different professional background, such as social work. However, health advocates can also come from a background unrelated to medicine, so long as the individual is burgeoning with a passion that centers on raising awareness of health-related issues.

Individuals who work as health advocates will typically aid clients in improving their health care experience by ensuring that clients not only learn about but also have an opportunity to access available programs and resources. According to SoCal Health Advocates, individuals in this field often endeavor to improve the lives of clients by breaking down barriers that prevent people from access to quality healthcare in order to prevent serious illness or prevent relapses.

However, health advocacy is not limited to only physical health. Due to its nature of stigmatization, great effort has been expended into improving mental health advocacy as well. According to the World Health Organization, it is crucial for advocacy efforts to continue educating the public about mental illness in order to truly revolutionize not only the manner in which mental health is perceived but also improve access to mental health treatments.

As part of its mental health advocacy efforts, the WHO has created MiNDbank, an online resource that has pooled together information regarding global policies and services regarding mental health. One of the goals of MiNDbank is to facilitate open debate and discussion about mental health topics in order to promote human rights for mental health patients as well as improving the mental healthcare system as a whole.

It is imperative for advocates to work towards eliminating the stigma and ignorance regarding mental illness, particularly since individuals with mental disabilities are subject to maltreatment and discrimination on a daily basis. Unfortunately, in many parts of the world, legal institutions have been unable to protect the basic human rights of these individuals.

Although the United States struggles with the burden of a stigmatized and under-funded mental healthcare system, many countries, lack adequate mental health facilities due to even greater stigma and a general lack of awareness. Therefore, mental health advocates strive to inform society about mental illness in order to reverse the disagreeable image of mental health patients, and ultimately, construct a more efficient, more understanding and more accessible global mental healthcare system.

Phoebe Pradhan

Sources: SoCal Health Advocates, World Health Organization
Photo: IIR Healthcare

Poverty in Mozambique

Mozambique is a vibrant and scenic country in Southeastern Africa with a population of nearly 30 million people. The nation has abundant natural resources and its coastal location provides strategic access to the maritime economy. After attaining independence in 1975, Mozambique fractured during the Mozambican Civil War, displacing nearly five million people and driving up the rate of poverty in Mozambique. Although the war ended in 1992, violence and instability greatly set back the nation’s economic development.

Despite facing tremendous adversity, Mozambique has made great progress in poverty reduction. The nation has decreased infant and maternal mortality and increased life expectancy as well as access to education, water and electricity. Over the last 15 years, the nation has reduced its multidimensional poverty rates from 92.8% to 71%, and its Human Development Index (HDI) has increased from 0.217 in 1990 to 0.446 in 2018. Mozambique has great potential, although almost 50% of its population continues to struggle with poverty. Mozambique still faces a variety of challenges as they strive to reduce poverty further, but innovative solutions provide hope for a brighter future.

Natural Disasters

Increasing disaster preparedness is central to combating poverty in Mozambique. The country is incredibly prone to natural disasters and experiences an average of one large-scale disaster every year. In 2019, two strong tropical cyclones hit Mozambique only six weeks apart from one another. The natural disasters left approximately 1.85 million people in need of urgent humanitarian assistance and had catastrophic effects on the nation’s development. In 2017, the Mozambique government established The National Disaster Risk Reduction Master Plan (PDRRD) to reduce risk, loss of lives and impact on infrastructure. Increasing funding and resources for this disaster management plan will help protect the most vulnerable from natural disasters and keep Mozambique on the development track.

Income Inequality

Combating inequality remains a key challenge to Mozambique’s development. Newfound growth has not been shared by all, as poverty continues to plague the country’s rural population. Welfare levels diverge greatly from the urban south to the rural north, largely due to increased connectedness to job markets in urban areas. Many rural Mozambicans remain stuck in a cycle of poverty because they are cut off from the larger economic landscape. The International Fund for Agricultural Development is working to fix this dilemma with its Rural Enterprise Finance Project. The initiative is dedicated to improving national and regional access for nearly 300,000 rural people involved in agriculture, fisheries and small to medium-sized enterprises.

Agriculture and Natural Resources

Investing in the agricultural and informal sectors helps support the rural poor and equalize welfare. Agriculture plays a vital role in reducing poverty, as it raises the income of farmers and lowers national food prices. Almost 80% of Mozambique’s population works in the agricultural sector, which accounts for nearly 25% of its GDP. However, low productivity has impeded farmers’ efforts to transition out of poverty.

Key inputs such as fertilizer can increase a farmer’s yield by nearly 40%, and higher connectivity links rural farmers to larger markets. The World Bank’s Agricultural Productivity Program for Southern Africa is working to increase the availability of agricultural technologies across the region and has aided more than one million Mozambicans throughout its seven-year existence.

Mozambique has an abundance of natural resources, particularly energy and minerals, and is home to the third-largest natural gas reserves in Africa. Extensive development in the extractive industry has led to economic growth in recent years, and the sector contributed 19.47% of the nation’s GDP in 2017. Although Mozambique’s economy slowed in 2019 due to a declining coal industry and infrastructure damage from cyclones, it is expected to revive by 2024 as natural gas production is established.

Tourism

Mozambique has become one of the fastest-growing travel destinations in Africa, so tourist sector growth is pivotal in reducing poverty levels. Tourists enjoy extensive safari parks, beautiful beaches and rich culture, yet specialists have concluded that Mozambique has not fully utilized its potential. The International Finance Corporation (IFC) is helping to grow Mozambique’s tourism sector to create employment opportunities for the nation’s poor. The IFC has made legal material on the country’s tourism industry free for potential investors and is working to sustainably develop Mozambique’s natural sights and biodiversity-rich areas.

Equal Opportunities

Investing in people—especially women—can transform Mozambique’s human capital and dramatically increase prosperity. Providing equal access to education, sanitation, electricity and health services helps combat inequality and creates opportunities for the rural poor and women of Mozambique. Women and girls are less likely to escape poverty and attain education and employment in comparison to their male counterparts. Reducing female drop-out-rates poses a great challenge to the educational sector. Although 94% of girls enroll in primary school, over half drop out by the fifth grade.

A USAID-funded project called Nikhalamo (translating to “I am here to stay” in the Chuabo language) is working to reduce Mozambique’s female dropout rate by improving learning opportunities for girls and young women. Nikhalamo provides education and life-skills programs, community engagement and mentoring in the Namacurra district. The project continues to expand each year.

Mozambique has made astounding accomplishments in combating poverty. Since the 1990s, infrastructure development, increased access to essential services and economic growth have contributed to poverty reduction and improved quality of life. However, the economic effects of the COVID-19 pandemic threaten progress, especially as Mozambique continues to recover from the devastating cyclones in 2019. Social safety nets during the pandemic will be key to protecting the labor force, avoiding food insecurity, maintaining school enrollment, and thereby reducing poverty in Mozambique.

Claire Brenner
Photo: Flickr

Why Food is a Global Health Issue
Rebecca D. Onie, the founder of Health Leads, gave an interesting TED Talk on the state of the healthcare system in the United States. While her approach was aimed at reforming the U.S. healthcare system, her message is valuable for the international and global health care mentality as well.

Onie spoke about her experience working as a legal assistant for low-income Boston families and how her time there motivated her to found Health Leads. She discovered that, on the issue of hunger and malnutrition, doctors are told to follow a “don’t ask don’t tell policy.”

Onie tells the story of Dr. Jack Geiger who operated a community health center in Mississippi. Dr. Geiger began writing his malnourished patients prescriptions for food, attacking the root of many of their health problems. Onie suggests that if we want people to really get better, we need to first treat the underlying causes of individuals suffering health, which in many cases is hunger, malnutrition, and poverty.

Health Leads understands the impact malnutrition and poverty can have on a child. Poverty dramatically increases a child’s likelihood of hospitalization. Children whose families cannot afford to pay their utility bills are also more likely to be hospitalized.

Health Leads has experienced a great deal of success in the United States. Since 2010 Health Leads has helped over 23,000 people. The organization has provided access to food, utilities, legal assistance, employment, education, and benefits. Health Leads is supplying exactly the kind of resources necessary to lift people out of poverty and empower them to stand on their own two feet.

The question now becomes, what is stopping the United States from proposing the same kind of change in the developing world as well? What would happen if we were to provide stable nutrition and housing programs for children in developing countries? Would worldwide medical reform where doctors prescribed food alongside medication be more effective than medication alone? Rebecca D. Onie’s work provides an interesting perspective and idea to consider.

– Caitlin Zusy

Sources: TED Talk, Health Leads
Photo: npr

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Closing the gender gap is high on the priorities of those working in global development and one way to accomplish this is through increasing the availability of mobile technology to women according to Patricia Mechael, Executive Director of mHealthAlliance.  In her years working in global health and development, she saw first hand the realities of poverty and gender inequality. The social status of women has a negative effect on their health and ability to care for their families. Problems such as maternal mortality and unintended pregnancies are often the result of poor maternal health care and poor gender representation in countries.

Mobile technology is working to reduce the gender gap and provide women around the globe a chance at a healthy life. Women who would force abortions to save themselves from another mouth to feed now have access to vital family planning information and commodities through the increase of mobile technology. While less than a decade ago, the mobile penetration rate was in the single digits among low-income nations, today reports indicate it stands at 89%.  The digital divide is shrinking between low and high-income nations, but women are still 21% less likely to own a mobile device compared to men. Millennium Development Goal #3 is to promote gender equality and empower women and providing them with mobile technology is a way to get closer to accomplishing that goal.

Beyond meeting MDG3, mobile technology is key in accomplishing MDG5, improving maternal health. The mHealth Alliance and the World Health Organization have worked to bring about mobile technology to improve maternal health. These projects use a variety of mobile technologies to provide everything from information about vaccines to improving access to essential medicine through reducing depletion of stock.

The advances in mobile technology have come a long way and will continue to be essential to promoting global development and accomplishing the MDGs.  In addition, Mechael is working with her company to come up with ways to further include women in the development and discussion of mobile technology and applications to serve and assist them.

– Amanda Kloeppel
Source: Forbes
Photo: WAHA

Health Care Sector in Nigeria Receives $60M

The African Health Markets for Equity partnership is taking a $60 million investment from the Bill and Melinda Gates Foundation and the United Kingdom’s Department for International Development to work with the International Finance Corporation to improve the health care sector in Nigeria.

AHME’s focus is on increasing coverage of priority health technologies and interventions for poor Nigerians by building on past investments. The partnership works with organizations that are already strong in specific areas, including: Marie Stopes International, Grameen Foundation, SafeCare, Population Services International, PharmAccess, and the Society for Family Health Nigeria. IFC will give technical support to AHME’s partners in Nigeria.

According to the AHME website, the five-year program will focus on increasing the scope and scale of franchised health care. This will mean expanding from family planning and sexual and reproductive health to also focus on malaria, acute respiratory infections, nutrition, maternal care, diarrhea, HIV and tuberculosis. AHME also operates in Kenya and Ghana.

In Nigeria the investment will target health care providers like hospitals, pharmacies, and clinics. By the end of the five year program the World Bank said it expects at least 300 rural health facilities will have benefitted from the support funneled through the AHME project. More than 60 percent of health care in Nigeria is currently supplied by private providers.

Khama Rogo, the lead health sector specialist with the World Bank said in a World Bank Facebook post about the Nigerian partnership, “there is a big health market in Nigeria that’s untapped, leveraging on this through private providers would improve access to the poor… Nigerians have specialists all over the world. If these needed facilities are here, there is nothing stopping them from coming to be of service here. “

Rogo estimated that 1 million people over the next five years could gain access to healthcare through the project. Currently many potential patients are effectively denied healthcare because they must pay for it at the point of delivery.

The project will invest in upgrading health facilities and supporting staff strength and resources by strategically working in several different areas, including policy, quality improvement, and health care provider access to capital and demand-side financing in the form of innovative ways to address how patients can afford healthcare.

– Liza Casabona

Sources: World Bank Nigeria, African Health Markets for Equity, The Eagle Online
Photo: Telegraph

Aid Workers Cut Off From Afghans in Need Due to Increased Fighting
The Red Cross is warning that a growing number of Afghan civilians are being deprived of medical care because of increasing violence throughout the country, just days after two aid workers were killed in an unprovoked attack.

A group from the Afghan Red Crescent was driving a mobile clinic in a northern province of Afghanistan when the group – including a pharmacist, doctor, and vaccination worker – was attacked by two men with firearms. The Red Crescent said that the route had been used previously and was never considered dangerous for aid workers.

Although the Red Cross has maintained a presence in Afghanistan for the last 25 years and has pledged to remain after the U.S. military presence withdrawals in 2014. Increased fighting in various regions has severely limited the organization’s capacity to reach Afghans in need of medical care.

The Red Cross stated that roadblocks, roadside bombs, and random attacks on civilians are making it increasingly difficult for aid workers and doctors to travel to civilians in need of medical attention in rural areas, and are also stopping those in need from traveling to doctors and hospitals as well. In addition, the aid organization asserted that as NATO and U.S. troops withdrew from the country, “dwindling international attention” will drive resources and healthcare away from Afghan civilians.

Christina Kindlon

Source: Guardian

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Over the last decade, Malawi has reduced its rate of HIV/AIDS infections by 72 percent, more than any other African country. US agencies that combat the virus hope to build on these successes with a five-year effort to improve HIV/AIDS care in Malawi. The effort is coordinated with Malawi’s government and will target seven districts across the country.

The Elizabeth Glaser Pediatric AIDS Foundation, an NGO that focuses its anti-HIV work on mothers and children, is spearheading the effort. Funding is provided by the US President’s Emergency Plan for AIDS Relief (PEPFAR) and the Centers for US Disease Control and Prevention (CDC).

One of the biggest successes to date for HIV/AIDS care in Malawi has been the prevention of virus transmission to at least 7,000 babies. This has been accomplished through lifelong anti-retroviral treatment for all pregnant and breastfeeding women who are HIV-positive. The Foundation’s efforts continue to focus on pediatric preventive care. Its goal to achieve less than a five percent transmission rate from mother to child is well within reach.

Over the next five years, US organizations plan to provide other health care services in addition to HIV/AIDS care in Malawi. One million Malawians will receive counseling, 50,000 adult men and 400,000 pregnant women will receive HIV testing, and lifelong treatment will be provided to at least 25,000 women expected to test positive for the virus.

Despite gains over the last decade, AIDS remains the number one cause of death in Malawi, with about 100 deaths and 30 new infant infections each day. The Malawian minister of health, Catherine Hara, expressed hope that the seven targeted districts will serve as a model for widespread improvements in HIV/AIDS care in Malawi.

– Kat Henrichs

Source: Relief Web
Photo: [email protected]