healthcare centers in MadagascarSince the coup in 2009, Madagascar’s newly elected government has been working with outside organizations, such as Project HOPE, to improve healthcare centers in Madagascar. In 2020, the country partnered with the Ministry of Public Health and the United Nations Population Fund to provide free transportation for pregnant women during the COVID-19 pandemic.

Healthcare Centers in Madagascar

USAID reported that more than 60% of Madagascar’s population — 27.7 million people — lives more than five kilometers from a healthcare center. This distance takes about one hour to walk. According to the World Bank, the cost of treatment and transportation to healthcare centers can be a barrier for people in poverty to access healthcare. The World Bank reported that about 75% of Madagascar’s population lives below the international poverty line, on less than $1.90 per day. This directly impacts the ability of people to access and pay for treatment at healthcare centers. UN Women statistics show that 75.9% of employed women in Madagascar are below the international poverty line, compared to 73.7% of men.

Released in 2017, a Project HOPE study examined the effects of removing fees at health centers in Madagascar. According to the study, citizens located within five kilometers became more likely to seek treatment. They account for 15-35% of those who reported illness. Fee exemptions for certain medicines and treatments likewise increased the use of healthcare services for maternity consultations by 25%.

Impacts of Limited Transportation

In a report from June 2018, the World Bank wrote that many rural citizens of Madagascar are disconnected from main roads, which limits their access to healthcare centers. Madagascar has a low road density. This means the country’s complete network of roads is small compared to the country’s total land area. As a result, 25% of healthcare centers in Madagascar are located more than five kilometers from the road network.

According to the World Bank report, poor road conditions in rural areas also impact network connectivity. Transportation of medical supplies can be unreliable, specifically during rainy seasons, when roads can be flooded and hard to cross. This makes it difficult for health centers to consistently send supplies to those who cannot access the centers.

Lack of access to transportation can also contribute to keeping people in poverty. The World Bank and the Department for International Development wrote that isolation due to difficulty accessing roads and transportation can limit the ability of people in poverty to participate in local markets. This decreases their economic opportunity.

The Effects of COVID-19

With 908 confirmed cases and six total deaths from COVID-19, the Centers for Disease Control and Prevention has classified Madagascar as warning level three for the pandemic. The country is in partial lockdown. On April 5, President Andry Nirina Rajoelina announced that only vehicles transporting goods were allowed to circulate in the three regions impacted by COVID-19 — Matsiatra, Ambonym Analamanga and Atsinanana. All other public transport was suspended. For some, without public transport, the nearest health center is two hours away.


The United Nations Population Fund reported that 44% of women in Madagascar give birth with the help of healthcare professionals. Madagascar’s maternal death rate is 353 for every 100,000 births. According to UNFPA, this rate is high compared to the global average of 216 maternal deaths for every 100,000 births.

The Ministry of Public Health and the UN Population Fund partnered to help pregnant women access healthcare centers in Madagascar. These organizations are providing free, 24-hour transportation for women living in the cities of Antananarivo and Toamasina during COVID-19. By the end of Madagascar’s partial lockdown, this free transportation is projected to help around 5,000 pregnant women.

Poverty impacts peoples’ ability to access healthcare centers in Madagascar due to restricted transportation and high fees. Statistics show this lack of accessibility impacts women slightly more than men. With even fewer transportation options during COVID-19, free transportation for pregnant women is making a positive impact on healthcare accessibility.

Melody Kazel 
Photo: Flickr

10 Facts about Poverty in Latin America
Within the past decade, 70 million people were able to escape poverty in Latin America due to economic growth and a lessened income gap. However, millions still remain in the cycle of poverty. Presented below is key data about poverty in Latin America.


10 Leading Facts on Poverty in Latin America


  1. One in five Latin Americans lives in chronic poverty conditions. Latin Americans account for 130 million of the nearly 500 million who live in chronic poverty worldwide.
  2. Poverty rates vary from country to country in the Latin American region. With estimated poverty rates floating around 10 percent, Uruguay, Argentina and Chile have the lowest chronic poverty rates. Meanwhile, Nicaragua with 37 percent and Guatemala with 50 percent have the highest chronic poverty rates in Latin America, which are well above the regional average of 21 percent.
  3. Poverty rates can also vary within a country. A single country can have both ends of the spectrum with the highest poverty rate that is eight times higher than the lowest. For example, Brazil has a chronic poverty rate of 5 percent in Santa Catarina, but 40 percent in Ceará.
  4. Poverty in Latin America encompasses both urban and rural areas. Most assume that rural areas have higher poverty rates than urban areas, like in Bolivia, where the amount of people living in rural poverty is 20 percentage points higher than those living in urban poverty. However, the number of the urban poor is higher than the number of rural poor in Chile, Brazil, Mexico, Colombia and the Dominican Republic.
  5. Poor Latin Americans lack access to basic health care services. Approximately 20 percent of the Latin American and Caribbean population lack access to health care due to their poverty conditions. The region also has high rates of non-communicable diseases (NCDs) such as hypertension, diabetes, obesity and cancer.
  6. Those living in poverty in Latin America lack access to safe water and sanitation. The World Water Council reported that 77 million people lack access to safe water or live without a water source in their homes. Of the 77 million, 51 million live in rural areas and 26 million live in urban areas. An estimated 256 million rely on latrines and septic tanks as an alternative to basic sanitation.
  7. The lack of education in Latin America lowers prospects of rising out of poverty. One in 12 young people ages 15 to 24 have not completed primary school, and therefore lack the skills necessary to find decent jobs. The same age group represents 40 percent of the total number of unemployed in many Latin American countries. When they are employed, six out of 10 jobs are informal, lacking decent wages, contract agreements and social security rights.
  8. Limited economic opportunities keep the poor in poverty. The biggest factor that led to poverty reduction from 2004-2012 was labor income. The Huffington Post reported that in poor households every Latin American country had an average of 20 percent “fewer human resources to generate income” than non-poor households and those households who managed to escape poverty.
  9. Chronic poverty levels are falling. Between 2000 and 2014, the number of Latin Americans living on under $4 a day decreased from 45 percent to 25 percent. The Latin American population living on $2.5 per day fell from 28 percent to 14 percent.
  10. The falling poverty levels in Latin America can be attributed to improved public policy. Latin American governments created conditional cash transfers (CCT), which substituted subsidies for money transfers for the poor who invested in human capital beginning in the late 1990s. As a result, child attendance in schools has risen and families have more food and more diversity in diets.

In 2010, the middle-class population exceeded the low-income population for the first time in the region. However, with one-fifth of the population still in poverty, there is much work to be done.

Ashley Leon

Photo: Flickr

Global poverty is nothing new, but some of its causes might be commonly overlooked or forgotten. Though there are many reasons for the manifestation of poverty, there are five largely important causes that need more attention from those who can make a difference.

1. Inadequate education is a highly agreed upon cause of poverty, both in first world nations as well as poverty stricken developing countries. Commonly, education quality differs between urban and rural areas, as well as between wealthy neighborhoods and poorer parts of cities. According to Project Partner of China, rural children are more likely to attend deteriorating school facilities and face insufficient materials. Meanwhile, urban children typically have outstanding educational experiences that allow them to prosper throughout their lives. Without a proper education, the cycle of poverty often continues. Children born into poverty have a difficult time receiving an education that will support them throughout life and pull them out of poverty.

2. Healthcare access varies around the world, but in a majority of poverty stricken countries little to no healthcare is provided, especially to those in extreme poverty. Inverse care, where those better off have more access to healthcare but fewer needs for it, benefits the wealthy and worsens conditions for the poor. Global Issues reported that “2.2 million children died each year because they are not immunized” due to lack of healthcare.

3. Disease goes hand in hand with healthcare, or lack thereof, and that makes it all the more obvious why healthcare is critical. Diseases quickly spread through areas that lack proper health education and offer little healthcare. As these diseases spread, it becomes more difficult for families to take care of themselves, much less thrive. According to Global Issues, “40 million people are living with HIV/AIDS, [resulting in] 3 million deaths in 2004,” leaving 15 million children orphaned. Though HIV/AIDS causes an extremely high number of fatalities, there are 350-500 million cases of malaria each year, with 1 million of those ending fatally. Notably, 90 percent of deaths from malaria are found in Africa alone. While prevention is desirable, a cure is needed to truly make a lasting difference.

4. Dependency is possibly the most overlooked issue on this list. Dependency is often associated with laziness or the concept that those dependent cannot support themselves, but it goes much deeper than that. First-world countries have created a system that keeps poverty riddled countries from being able to provide for themselves. That, however, does not mean the system was intended to push third-world countries further into poverty. Rather, the truck loads of secondhand items that are continuously shipped into third-world countries have crippled their industries, and thus made them dependent on aid. By investing in these countries to help them rebuild an economy that can flourish, more developed countries will no longer be handing them momentary help, but making a lasting impact on their livelihood.

5. Ignorance and apathy, though two different notions, result in similar outcomes. Lacking the knowledge to care or to make a difference is a sad reality among many people in the world. Apathy, on the other hand, is not wanting to gain the knowledge to improve the lives of others. It is often easiest to live a life of ignorance, so many do. Occasionally donating to your local food drive or clothing shelter are great ways to start improving the lives of others, but going the distance to educate yourself and learning how to permanently aid those less fortunate will make a lasting difference. All of the manifestations of poverty cannot simply be numbered to five, but these causes play a large role in the sad reality. Gaining education over what needs to be done to help the human race is the perfect place to start and improve the conditions of those in need.

– Katherine Wyant

Sources: Community Empowerment Collective, Project Partner of China Global Issues
Photo: Steve McCurry

While medication treats an ailment, it is the rapid diagnosis of the ailment that is critical to saving many lives. With the rising rate of antibiotic-resistant infections, the need to diagnose quickly and correctly to facilitate accurate choice of medication has grown exponentially. The rapid diagnosis issue is compounded in resource-poor settings that are mired with lack of easy access to affordable healthcare and infrastructure.

Consider the example of tuberculosis (TB), a deadly infectious disease that can take up to six months or more to treat completely. In 2013, there were more than nine million new cases of TB. Most of these occurred in Africa and Asia. The standard-of-care diagnostic, a sputum smear, is slow and can take multiple health visits, which many people can ill afford. Additionally, the sensitivity of the test is variable and is worse when the patient is HIV positive, which almost 13 percent of TB patients are.

Now multiple-drug resistant TB (MDR-TB) infections, where most of the available antibiotics are no longer effective, are a huge concern. MDR-TB develops because of the incorrect use of antibiotics. The more rapidly TB is diagnosed and the more often correct treatment is prescribed, the less the incidence of MDR-TB and the less the chance of it spreading. As the ceiling of new antibiotic development is being pushed, drug-resistant infections urgently need to be controlled.

Rapid and accurate diagnosis is a necessity not just for TB but for everything ranging from malaria to diabetes. Both academics and the industry are hard at work to develop techniques that can provide results in a matter of hours. Some, especially those related to telemedicine like new iPhone blood glucose testing, can do this from the convenience of one’s home. However, the real conundrum has been how to make this cheap to manufacture, affordable to buy for resource-poor populations who need it and easy to use when there is no infrastructure in place.

Diagnostics For All is a nonprofit organization that aims to produce technology particularly for the 60 percent of the developing world that lack easy access to healthcare. Its projects range from a simple, easy-to-use liver function test to monitor the efficacy of HIV anti-retroviral therapy, to detecting micronutrient levels in children so that appropriate nutritional supplements can be provided. Its systems are based on a patterned paper technology developed at Harvard University. Since the paper takes up the test sample easily and micro channels made on the paper allow the sample to flow into tiny wells of chemical indicators, there is no need for any external power. The indicator changes color based on a component in the sample, allowing an easy read out. The patterned paper can be manufactured cheaply on large scale. Diagnostics For All supports its work with philanthropic grants and partnerships with the for-profit sector.

Foundation for Innovative New Diagnostics (FIND) is another international nonprofit organization that builds partnerships with enterprises and assists in developing novel diagnostic techniques through expertise and capacity building. It supports the discovery and scale-up of diagnostic tools bridging the gap between development and delivery, and ensures that these technologies are made available to high-burden countries at preferential pricing. It has developed several techniques among which are an HIV viral load detection system co-developed with California based, Cepheid and malaria and sleeping sickness diagnosis methods with Massachusetts based, Alere.

There are several other organizations out there, including those making strides in telemedicine, that are working to make diagnosis faster, cheaper and more accurate. As science makes progresses towards developing these new techniques, markets, nonprofit and for-profit business models, and governments all have to play their part in keeping up with strides being made and ensuring that these new methods are realized in practice.

– Mithila Rajagopal

Sources: Alere, NCBI, Sanofi, San Francisco Business Times, WHO 1, WHO 2
Photo: Fashion For A Cause

Australia is considered to have one of the best healthcare systems in the world. Universal healthcare is provided to their citizens in the form of the government run ‘medicare’ program as well as a vast private healthcare system. In addition to covering its own residents, Australia sold over 26 million dollars in medical care to tourists from all over the world.

Behind the seemingly successful exterior, there is a deep disparity in how Aborigines are treated in the healthcare system.

Many suffer from diseases that are preventable and not seen anywhere else in the developed world. The average life expectancy of an Aborigine is over a decade less than a non-indigenous Australian. Aborigine children are ten times more likely to commit suicide and the prevalence of other diseases such as depression, gastroenteritis and kidney disease are much higher than in non-indigenous people.

It is not surprising that without access to healthcare for preventable diseases, many indigenous people live in poverty. Homes are made from carcinogenic asbestos and many do not have access to clean water or proper sanitation. Many also suffer from debilitating diseases that make work impossible to get to or employment difficult to obtain.

This level of poverty and lack of access to healthcare in a wealthy country has been described as shocking.

This glaring failure in the Australian healthcare system can be in part attributed to the amount of spending spent on citizens. Hospital spending on indigenous citizens in 2010 was AUS $3,630 as compared to AUS $1860 for non-indigenous people. This means many indigenous citizens were relying on hospital visits when they were sick, due to the lack of access to preventative care.

Much of this disparity in healthcare is attributed to the lack of representation of indigenous people in the decision-making process.

There also needs to be improvements made to the public health initiatives aimed at promoting cultural awareness.

University of West Australia professor Pat Dudgeon said, “For there to be an improvement in indigenous health, there has to be a cultural aspect present in health programmes. Studies from around the world have shown when you engage indigenous people in cultural reclamation and self-identification, there is far more retention.”

– Colleen Eckvahl

Sources: Al Jazeera, NCBI
Photo: You Should Know