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Fighting Poverty With Soap OperasGlobally, it is estimated that at least 150 million people, or 2% of the world’s population, are homeless, with another 1.6 billion people, or over 20% of the world’s population, lacking adequate housing. However, at the end of 2018, 51.2% of people worldwide and 45% in developing countries were using the internet. Almost 60% of households had internet access in their homes in 2018, which is up from less than 20% in 2005, and broadband access continues to grow with a penetration rate of 69.3 per 100 participants. A report by the International Telecommunication Union found that almost 80% of households had a TV by the end of 2012. This percentage is 69% in developing countries, while “virtually all” households in the developed world have TVs. Over two-thirds of households with TVs took digital signals in Sub-Saharan African in 2016, and estimates report that TV penetration will reach 99% in 35 forecast countries by 2021. Especially in impoverished areas, internet and television, and more specifically soap operas available across many different providers, help people stay up-to-date on both current events and employment opportunities, learn more effectively and, rather surprisingly, escape poverty.

Soap Operas Aid Poor Turkish Women

In a study by Ozgun, Yurdakul and Atik, the researchers found soap operas affected young women’s self-perception and social advancement who lived in impoverished neighborhoods of Izmir, Turkey. The study found that due to their local income, the women overall viewed these soap operas as tools of information gathering without the emotional burden of heavier news. The study suggests that soap operas become their primary connection with the outside world, exposing them to consumer culture and marketing that are useful skills to have when entering the workforce.

More profoundly, these women were often able to connect on a cathartic level with the characters in these soap operas who endured the same economic struggles but were able to escape poverty. Some women noted that the soap operas reminded them of their difficult pasts, which prompted them to “review and assess” their current life conditions and deal with daily problems. The shows also revealed to the women what they lacked in life, whether it be a job or power, and exposed them to the affluent “other life,” which led some to feel dissatisfied with their condition and ultimately try to come up with solutions to escape from it.

However, the study also reveals that while soap operas empower some women, they can also exacerbate poverty even more, as some women try to mimic the lavish lifestyle of some characters without the finances to do so. Thus, the authors suggest that it may be more impactful for television networks to showcase culturally accessible public programming with more informative, advice-filled narrative content to better reduce poverty.

Combating Poverty Through “Edutainment”

Similar to the suggestions of Ozgun et al., Bilal Zia and Gunhild Berg experimented with “edutainment,” or entertainment with an educational aspect, by working together with the production company of “Scandal!,” a popular South African soap opera, to incorporate financial education messages throughout the plot. Since making financial decisions can be challenging for impoverished populations that lack education in finance, “Scandal!” hoped to develop better habits within viewers through a subplot about debt and gambling.

Zia and Berg ran a study in which one group of people would watch this soap opera while a control group watched another show, and the researchers found that viewers of “Scandal!” showed significant improvements in financial knowledge and behavior. Viewers of “Scandal!” started to borrow from others less and reduce unnecessary expenditures like gambling. Viewers reportedly connected with the main character of the show and ultimately made more economical life decisions that could in the future help them escape poverty.

Fighting HIV with Soap Operas

In addition to increasing financial literacy, soap operas can also improve health and medical awareness among impoverished populations. A study in Nigerian found that people who watched the soap opera “MTV Shuga” were twice as likely to get tested for HIV and were overall more knowledgeable about HIV transmission. The show, which has been broadcasted in more than 70 countries, focuses on an impoverished woman and her HIV-positive lover as she navigates the complex reality of HIV’s role in daily life.

The show, which has been supported by organizations like UNICEF and the Bill & Melinda Gates Foundation, raises awareness of the dangers of risky sexual behavior especially in regions like Sub-Saharan Africa, which has approximately 1.5 million new HIV/AIDS cases each year. In addition to HIV testing, “MTV Shuga” also contributed to a reduction of chlamydia infections by 58% and a reduction in having concurrent sex partners by 14%. The study reveals that edutainment like “MTV Shuga” is more influential and cost-effective than more traditional educational campaigns, which keeps people both entertained and informed.

Lowering Fertility Rates Through Soap Operas

A 2012 study by La Ferrara, Chong and Duryea explored the impacts of telenovelas, or Brazilian soap operas, on fertility rates in Brazil. After a year that the signal for Rede Globo, the main telenovela producer in Brazil, became available in municipalities across the country, the researchers found that fertility rates sharply declined. This effect was strongest for women of low socioeconomic backgrounds, many of whom lack proper education regarding safe sex and childbirth.

The research found that among the telenovelas studied, 62.2% of main female protagonists did not have any children, while 19.8% only had one child. Data reveals that telenovelas contributed to the decline in the number of live births particularly among 30 to 34-year-old women from around 4.4 to around 3.2. The study concluded that these soap operas helped mothers make more educated decisions surrounding raising a family, which could lead mothers to seek future employment or save monetary resources for child education.

– Noah Sheidlower
Photo: Flickr

Poverty in the Central African Republic
The Central African Republic (CAR) is a landlocked country in Africa, neighboring Chad, Sudan, Cameroon and more. Although CAR has an abundance of natural resources, including gold, diamonds, uranium and oil, it is one of the poorest nations in the world. Following violence and political turmoil in 2013, the country is still recovering. Here are five important facts about poverty in the Central African Republic.

5 Facts About Poverty in the Central African Republic

  1. The Numbers: Approximately 71% of the Central African Republic’s population lives below the international poverty line. Additionally, due to violence and conflict, there are around 613,114 refugees from the Central African Republic and 641,292 internally displaced persons (IDPs) in the country. Health is also a major concern, with a maternal mortality rate of 890 per 100,000 live births.
  2. History of Poverty and Conflict: There are many reasons why the Central African Republic has such high poverty rates. The main reason lies in the history of the nation. After CAR gained independence from France in 1960, it had religious rivalries, a variety of ethnic groups and multiple political ideologies. Conflict between different religious and social groups as well as competition over resources caused widespread instability throughout the country. This culminated in a more recent outbreak of violence in 2013, which has left more than 2.5 million people in need of humanitarian assistance.
  3. Major Health Conditions: The leading causes of deaths in the Central African Republic include tuberculosis, diarrheal diseases, HIV/AIDS and malaria. In 2018, malaria, a mosquito-borne disease, was reported at a rate of 347.3 cases per 100,000 people. This represents a significant decrease from previous years, as there were approximately 434.5 cases per 100,000 people in 2010. Additionally, there are approximately 100,000 people living with HIV in CAR.
  4. Life Expectancy: Life expectancy in the Central African Republic is among the lowest in the world. As of 2020, it is only 53.35 years. This is a 0.64% increase since 2019, when the life expectancy was 53.01 years. Life expectancy is low in the CAR due to widespread violence and displacement as well as the aforementioned health concerns. In addition to malaria and HIV, 41% of the population suffers from chronic malnutrition. On a positive note, the life expectancy of the CAR has been steadily improving since 2002; in 2002, the life expectancy in the CAR was only 44.29 years.
  5. Education and Literacy: The literacy rate in the Central African Republic is also one of the lowest in the world, at 37.4%. The CAR is struggling to provide high-quality education for its children, particularly girls. Many girls find themselves dropping out of school because of the societal pressures to marry and have children. Only 65% of girls enter the first year of primary school and only 23% of them finish the 6 years of primary school.

Currently, organizations like the World Food Program, USAID and the International Rescue Committee are working to alleviate poverty in the Central African Republic and address the humanitarian crisis. Efforts include distributing food to internally displaced people, providing specialized nutrition packages for pregnant women, rebuilding educational infrastructure and recovering clean water sources. Moving forward, it is essential that these humanitarian organizations and others continue to provide aid and support to the nation.

Alison Choi
Photo: Flickr

Poverty in Lesotho
Lesotho is a small, mountainous nation surrounded entirely by South Africa. Since gaining independence from the United Kingdom in 1966, Lesotho has been plagued by political instability and slow economic development. A high prevalence of HIV further complicates efforts to end poverty in Lesotho. Despite an attempted military coup in 2014, conditions have been improving in the country in recent years. Here are 7 factors that affect poverty in Lesotho.

7 Factors Affecting Poverty in Lesotho

  1. Agriculture: Sixty-six percent of Lesotho’s population lives in rural areas where the economy is largely based on small scale agriculture. Many of these people engage in subsistence farming, meaning they rely on a good harvest to be able to feed their families. The success of each harvest makes a huge impact on the lives of millions in Lesotho. A drought from 2015 to 2016 crippled poverty reduction efforts for the next few years, proving the delicacy of this system.
  2. Gender: Households run by women have a poverty rate of 55.2%, compared to 46.3% for households run by men. This is because women are typically denied the same opportunities as men in Lesotho’s highly patriarchal society.
  3. Urbanization: Poverty in Lesotho is more prevalent in rural areas than in urban areas. Urban areas have a 28.5% poverty rate while rural areas face a 60.7% poverty rate. Despite Lesotho’s economic development in recent years, most improvements have been made in urban areas while rural areas have been left behind.
  4. Education: Achieving a college education is extremely rare in Lesotho – only 4.4% of people live in households with someone who has gone to a college or university. Those that do receive higher education have a low poverty rate of 8.7%.
  5. Government programs: Over the past 20 years, the government in Lesotho has been working with international organizations to expand protections for the poor and increase economic opportunity. As a result, the national poverty rate decreased from 56.6% to 49.7% from 2002 to 2017.
  6. HIV: Poverty and HIV are clearly connected in Lesotho. Almost 24% of adults are living with HIV and treatment is essential to stopping the spread and helping these people live normal lives. Lack of resources and awareness means that on average only 57% of people with HIV are currently getting help. This directly impacts their quality of life and makes it harder to land above the poverty line.
  7. NGOs: Though poverty in Lesotho is an important issue for the country’s government, NGOs are stepping in to fill gaps. Many international nonprofit groups such as Caritas Lesotho operate in the country. Caritas Lesotho is a group which seeks to help individuals escape poverty by teaching them technical skills. They focus on vulnerable children and teach them a trade such as farming or woodworking. Groups like Caritas Lesotho are slowly helping to improve the economic situation in the country.

Examining the causes of poverty in a country is essential in deciding how best to address the issue. It is clear that poverty in Lesotho will continue to be an issue for many years. However, the country is on the right track and will improve as education and economic opportunity increase.

– Jack McMahon
Photo: Flickr

healthcare in lesotho
Lesotho, a small nation in southern Africa, is continually improving its access to healthcare systems. Still, even with greater access to healthcare services in some of the areas that are more difficult to reach, long treks and expensive rides are necessary to receive essential care. Due to the state of remote villages being located far from hospitals, patients are not able to receive help immediately in case of an emergency.

Lesotho is also the only country in the world that has its entire elevation above 1,000 meters, which means the terrain may be harder to navigate and maneuver. The life expectancy for Lesotho averages around 53 years for both males and females and deaths under 5 occur 8.1% of the time. However, despite all these limitations, Lesotho has remained committed to improving the well-being of its citizens. Partnerships with private companies, expansions to the hospital network and increased government funding to aid programs have all been policies implemented to invest in Lesotho’s health infrastructure. These five facts about healthcare in Lesotho are integral to understanding the country’s changing health structures and transition out of poverty.

5 Facts About Healthcare in Lesotho

  1. Lesotho is at an elevated risk for HIV and Tuberculosis, consistently ranking in the top 20 countries by an estimated absolute number of incident cases. Predictions estimate that less than half of the approximate 12,000 cases of HIV/TB co-infected patients are even diagnosed each year, much less treated for their symptoms. Estimated TB incidence is about 724 per 100,000 individuals in the population, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) reports. Understanding that the necessary objective is to expand TB testing and treatment coverage, Lesotho is working to increase and optimize its GeneXpert equipment to meet the demand.
  2. Partners in Health, known locally to the people of Lesotho as Bo-mphato Litsebeletsong Tsa Bophelo, works directly with the government of Lesotho to reform and improve the healthcare infrastructure system as a whole. After a government invitation in 2006 to aid in Lesotho’s response to the HIV epidemic, Partners in Health expanded a primary healthcare program to reach over 90,000 people at mountain clinics in remote areas of the country. Partnered reform for HIV/TB co-infection began in 2014, with Partners in Health as the primary adviser to the government of Lesotho. Thus far, the expansion of health systems has reached more than 70 health centers and about 40% of Lesotho’s population. With special focuses on maternal and child health going forward, Partners in Health looks to continue Lesotho’s health development.
  3. One of the most unique government healthcare services in Lesotho, the Flying Doctor Service, provides aid by plane to rural areas. However, even in these hard-to-reach mountainous areas, the Flying Doctor Service does more than provide treatment. In addition to emergency medical service, the service also implements healthcare programs and brings essential medical supplies like vaccines to areas in need. The Flying Doctor Service uses Cessna 206 single-engine planes, stocked with stretchers and first aid kits, to deliver care to the people of Lesotho. Even countries like Ireland have supported the Flying Doctor Service in Lesotho, committing to provide flights to Lesotho to assist the aid efforts.
  4. Public-private partnerships have been an essential part of Lesotho’s healthcare development in the infrastructure department. The International Finance Corporation of the World Bank has recently been working with the government of Lesotho to develop hospitals and health centers around the mountainous regions. The Queen ‘Mamohato Memorial Hospital in the country’s capital, Maseru, was recently developed and opened for patients. Replacing the Queen Elizabeth II Hospital, where infrastructure was debilitating and services were poor, the new Queen ‘Mamohato Memorial Hospital is truly world-class. With state of the art operating rooms, a maternal ward, nursery, Intensive Care Unit and other services, the new hospital built with help from a $6.25 million grant from the World Bank Group.
  5. In 2016, the maternal mortality rate in Lesotho was about 618 deaths per 100,000 live births. Though this mortality rate is favorable when compared to the 2014 statistic of approximately 1,024 deaths per 100,000 live births, it is still too much too high for Lesotho. This exceptionally high maternal mortality rate is a result of the poor services provided during pregnancy, childbirth and after delivery (especially to those in rural areas of Lesotho). Postnatal care is also imperative to ensure the safety of the mother and child after delivery but only around 62% of mothers and 18% of newborns receive the recommended treatment.

In the fight against poverty and for a stronger healthcare system, Lesotho has much work to do. There has been progress on the infrastructure front and with public-private partnerships but many services to the rural population still lag behind what is necessary. However, with continued government support and increased foreign aid, the healthcare system will continue to develop and Lesotho can become a country that provides a robust healthcare system for its growing population.

– Pratik Koppikar
Photo: Pikist

HIV in Eswatini
Swaziland or Eswatini, as it was officially renamed in 2018 by King Mswati III, is a tiny landlocked country in Southern Africa. It has the highest prevalence of HIV in the world, with the disease infecting about 31% of its sexually-active population. In 2018, HIV infected about 8,000 new adults and caused approximately 3,000 new fatalities. However, recent data suggests that the country has found ways to slash the new rate of infections by almost 45%. Here are eight facts about the fight against HIV in Eswatini.

8 Facts About Eswatini’s Fight Against HIV

  1. Mode of transmission: Heterosexual sex is the primary way HIV is transmitted, with about 94% of all new cases coming from it. The disease affects sex workers, adolescent girls and young men and women significantly more than other demographics.
  2. Poverty and education: Almost 59% of people in Eswatini live below the poverty line. Some regions have still not been able to recover from the regional droughts of 2015 and 2016. Due to poor economic conditions, young girls are often unable to continue their education. As a result, they are less empowered to negotiate for safer sex and sometimes also have to resort to prostitution. Rampant poverty also means that many suffering from the disease cannot afford proper healthcare.
  3. Most affected age group: Adults between the ages of 15 and 49 are most affected by HIV. Over the long term, this has induced major cultural changes surrounding death and illness. It has also led to an expansion of services such as life insurance and mortuary.
  4. Impact on women: HIV has affected women disproportionately. 35.1% of women in Eswatini are living with HIV, compared to 19.3% of men. This stems from widespread gender inequality in the country. Gender-based violence and men indulging in more than one partnership at the same time increase the risk of women contracting HIV. King Mswati withheld royal assent on The 2015 Sexual Offences and Domestic Violence Bill, which could offer more protection to women. The bill finally passed in 2018, however. This is an essential first step for improving gender equality in Eswatini.
  5. Condition of children: About 11,000 children (0-14 years) were living with HIV in Eswatini as of 2018. Only 76% of these children were on ARV treatment. Approximately 45,000 children have also been orphaned due to AIDS-related illnesses. Fortunately, the number of new infections and AIDS-related deaths have reduced to fewer than 1,000 each year.
  6. Increase in circumcision: The proportion of men opting to be circumcised increased significantly in recent years. Circumcision is a scientifically-proven way of reducing the transmission of the virus. The rate of male circumcision in the productive age group (15-49 years) more than doubled from 7% in 2007 to 19% in 2010.
  7. The 90-90-90 model: UNAIDS has developed the 90–90–90 testing and treatment targets to help Eswatini and other countries across the world address HIV and AIDS. Local and national efforts are working towards the following three goals by 2020: 90% of people living with HIV will be aware of their HIV-positive status, 90% of those who have been diagnosed with HIV will continuously and consistently receive antiretroviral therapy (ART) and 90% of all people who are receiving ART will have viral suppression. The 90-90-90 model is a world-renowned global benchmark to curb the spread of HIV in geographies with high prevalence.
  8. Availability of condoms: Targeted mass media campaigns promote condom use and sexual health services distribute condoms across the county. These efforts have resulted in about 51 condoms per year per male available in Eswatini. However, in spite of increased availability, condom use has actually declined. This suggests that a change in mentality is more important than increasing the distribution of condoms.

It is clear that Eswatini has made great strides in the fight against HIV in recent years. However, the high HIV prevalence indicates the government needs to address significant problems such as poverty, gender inequality and risky cultural practices, which contribute to a high risk of HIV infection. Moving forward, a greater focus must be placed on combatting HIV in Eswatini.

Akshay Anand
Photo: Flickr

Mass Incarcerations in ColombiaThere is currently a problem of mass incarceration in Colombia. This South American country has a population of nearly 50 million people as of 2018. Currently, Colombian prisons have a capacity of 80,928 people. However, as of May 2020 the incarcerated population reached 112,864, or 139.5% of capacity. The Colombian prison system is known to be very overcrowded. Overcrowded prisons infer and amplify broader social issues. These prison environments amplify the spread of infectious diseases like HIV, tuberculosis and, most recently, COVID-19.

Effects of Mass Incarceration in Colombia on Health

  1. Capacity Rates: There are 132 prisons in Colombia with a total maximum capacity of just over 80,000 people. Despite this capacity, Colombian prisons have reached 139.5% of occupancy, or just over 112,000 people. Women make up about 6.9% of this number—about 7,700 women. Currently, there are no incarcerated in Colombia. Congress has actively fought against the release of prisoners, instead choosing to keep the prisons full.
  2. Effects of COVID-19: Prison riots are becoming increasingly common in Latin America with the spread of the COVID-19 virus. Mass incarceration in Colombia has created panic amongst prisoners, who have demanded more attention to their conditions. The Colombian Minister of Justice, Margarita Cabello, has not outwardly acknowledged the prison riots as demands for better care against COVID-19. Rather, Minister Cabello stated that the riots were an attempt to thwart security and escape from prison. Furthermore, due to the scarcity of doctors, prisoners continue to contract and/or die from complications of COVID-19.
  3. Infectious Diseases: Besides COVID-19, mass incarceration in Colombia has allowed the spread of diseases such as HIV and tuberculosis. Many Colombian prisons have a designated cell block for those who contract HIV, as it is common for prisoners to engage in sexual relationships with guards. Healthcare facilities are not readily available in prisons and condoms are in scarce supply. Active cases of tuberculosis also correlate with mass incarceration in Colombia. Approximately 1,000 per 100,000 prisoners have been diagnosed with tuberculosis. Unfortunately, mass incarceration has further limited prisoners’ access to affordable care.

Striving for Improved Conditions

Local citizens Mario Salazar and Tatiana Arango created the Salazar Arango Foundation for Colombian prisoners. After being imprisoned on fraud charges in 2012, Mario Salazar’s experience drove him to find ways to make prison sentences more tolerable. Salazar and Arango Foundation provides workshops for prisoners in the city of La Picota and puts on plays for fellow inmates. Prisoners have found the organization to be impactful to their self-esteem and their push for lower sentences.

Mass incarceration in the Colombian prison system is both a result and driver of poverty. Issues of food shortages and violence have created poverty-stricken conditions within prisons. Despite these conditions, organizations such as the Salazar Arango Foundation seek to improve the lives of prisoners. Hopefully, with time, external forces will help to reduce the rate of incarceration in Colombia. In essence, efforts to due so would have considerable impact on the lives of prisoners and their families.

– Alondra Belford
Photo: Flickr

Healthcare in Uganda
Uganda continues to have one of the best healthcare systems in Africa. In the 1980s, the nation had a reputation of possessing bottom tier medical management compared to the rest of the world. However, government officials worked tirelessly to provide the necessary medical equipment to combat diseases and curb infection rates. The Ugandan healthcare system eventually became one of the strongest on the continent. Here are 5 ways healthcare in Uganda is continuing to improve.

5 Improvements to Healthcare in Uganda

  1. HIV Reduction: Uganda is one of a small number of countries that was able to reverse the harmful infection rates of the HIV epidemic. At one point during the 1990s, the nation had an infection rate of 18-30% in its population. However, this number slowly went down to as low as 6.5% in 2016. The Government of Uganda worked with multiple organizations, including UNAIDS, to help maintain a low number of infections. Officials also invested in properly educating the people on how to better protect themselves from contracting the virus.
  2. Maternal Mortality Rate (MMR): The nation has started to see a major reduction in MMR over the last several years. This is due to a few factors, including adopting the Saving Mother Giving Life or SMGL model. According to the WHO, Africa has an MMR average of 561 per 100,000 births while Uganda’s rate is only 343 per 100,000 births.
  3. CDC Assistance: The CDC has aided healthcare in Uganda in many ways. In 2018, the organization helped an estimated 608,000 people by providing them with life-saving antiretroviral treatment. Moreover, the CDC’s team helped implement a national biosafety level 3 reference laboratory for viral hemorrhagic fevers. The lab assisted in the detection and providing confirmation about VHF outbreaks in the nation.
  4. Poverty Line Reduction: A lack of resources due to poverty still limits the progression of healthcare in Uganda. The poorest of the country make up a majority of visitations facilities receive because they are more susceptible to diseases. However, Uganda took steps to lower the effects of poverty starting around 2006. Over the next seven years, the poverty rate declined from 31.1% in 2006 to 19.7% in 2013. Moreover, Uganda continues to work on providing healthcare to the poor in rural areas. The country is focused on ensuring medical treatment access to non-Urban Ugandans.
  5. Combating COVID-19: The Ministry of Health in Uganda placed guidelines to prevent COVID-19 from spreading throughout the nation. The country experiences very low numbers in confirmed cases compared to the rest of the world. The officials made several posts on their website about health guidelines they should follow when visiting the hospital to seek treatment if infected.

While Uganda has witnessed improvements to their healthcare system, there remain obstacles. One of the primary ones is the lack of medical resources needed to be placed at the top tier level with countries like the United States in medical advancement. The Government of Uganda continues to seek aid and find other ways to help its people receive the best treatment they can provide. With these efforts, hopefully healthcare in Uganda will continue to improve.

Donovan Baxter
Photo: Flickr

tuberculosis in ZambiaThe South African country of Zambia has a population of around 17 million. Over the last 30 years, it has experienced a rise in tuberculosis cases, an infectious bacterial disease in the lungs. Estimates show the mortality of the disease as approximately 30 deaths due to tuberculosis per 100,000 people. Below are seven important facts about tuberculosis in Zambia.

7 Facts About Tuberculosis in Zambia

  1. Co-infection: HIV patients have a high risk of contracting tuberculosis. In Zambia, 59% of tuberculosis patients have also tested positive for HIV. Though there are healthcare systems for the prevention and treatment of tuberculosis among patients with HIV, overpopulation, poverty, cultural beliefs and sanitation conditions can make a diagnosis of both HIV and tuberculosis a challenge.
  2. Limited Access to Treatment: There is a greater prevalence of tuberculosis mortality in rural areas of Zambia. The commute to a clinic is often greater than a two-hour walk for a person living in a rural home, which puts a strain on those with the disease and on the family or friends who need to take time off of work to travel with their loved one.
  3. Economic Burden: Tuberculosis is extremely costly for individuals and for Zambia as a nation. Medications and other services like x-rays can be expensive for individual families. Furthermore, the overall loss of a workforce can impact the greater economy. This can be seen in mining communities, where tuberculosis is especially prevalent. Because the mining industry plays an important role in Zambia’s economy, there have been negative economic impacts in losing a percentage of the workforce due to tuberculosis. A 2016 study on tuberculosis in Zambian mines advocates for greater regulatory legislation for mining conditions and better health systems to create a healthier population and a more stable economy.
  4. Improving the Cure Rate: Tuberculosis is a serious disease and can be fatal. The Ministry of Health finds that 62,000 Zambians contract tuberculosis and 16,000 people die each year from the disease. Though there are still many fatalities, there has been great progress in treating the disease. Today, around 88% of people treated are cured, exceeding the WHO recommended cure rate of 85%, and the pooled cure rate of between 55% and 73% for Africa.
  5. Better Management: World Tuberculosis Day, observed each year on March 24, commemorates the discovery of the bacteria that causes tuberculosis in 1882. During the 2019 World Tuberculosis Day, the Ministry of Health Announced the new guidelines for “Management of Latent Tuberculosis Infection.” This was the launch of greater efforts towards the elimination of tuberculosis and emphasizes early detection.
  6. Improved Surveillance: Though tuberculosis is a severe health issue, there have been limited health surveys to find an accurate prevalence of the disease. In 2013, the Government of the Republic of Zambia (GRZ) through the Ministry of Health (MoH) and USAID conducted a survey on the tuberculosis rate in Zambian regions. The surveys showed a higher prevalence of tuberculosis than estimated. They also revealed improved techniques for tuberculosis detection. For example, the use of digital systems and the integration of HIV testing in tuberculosis surveys (HIV is common comorbidity) can help estimate the rate of incidence and help improve the efficiency of tuberculosis healthcare.
  7. More Accurate Diagnoses: Founded in 2006, the Center For Infectious Disease Research in Zambia (CIDRZ) has provided many services for combating tuberculosis in Zambia including research on diagnostic techniques. CIDRZ tested some novel techniques of tuberculosis diagnosis such as LED fluorescence microscopes and computer-assisted digital x-ray interpretation technology. CIDRZ helps mobilize these techniques and train community members in the identification of tuberculosis.

These facts show that the health crisis of tuberculosis in Zambia exposes a dire need for increased accessibility of healthcare and better methods of diagnosis and treatment. The recent efforts in management and care of tuberculosis show promise of effective tuberculosis management and an overall healthier population.

– Jennifer Long
Photo: Flickr

The Pratt PouchThose living in poverty often have limited access to basic necessities such as food, water and shelter. Beyond these basic necessities lies the need for free or affordable healthcare, yet so many countries are still lacking in that regard. Insufficient health centers and medical treatments do little to stop the spread of life-threatening diseases such as HIV. Mothers with HIV have up to a 45 percent chance of transmitting the disease to their babies during childbirth and breastfeeding. The invention of the Pratt Pouch has helped in the reduction of that risk to just 5 percent.

How It Works

Every year, 400,000 children are diagnosed with HIV as a result of their mothers being HIV positive. Robert Malkin of Duke University hopes that the Pratt Pouch will reduce that number to fewer than 100,000 cases a year. Malkin and his team created the Pratt Pouch at the Pratt School of Engineering. The “foilized, polyethylene pouch” is filled with pediatric doses of antiretrovirals. The pouch gives the medication to have a shelf- life of up to twelve months. Other containers such as cups, spoons or syringes have a much shorter shelf-life because the containers absorb the water inside the medication, causing it to solidify.

The medication is provided to mothers during prenatal visits, but it is usually administered to the baby at home. The Pratt Pouch has a perforation, so it easily tears open. Since it contains a pre-measured dose, there is no need for a syringe, and it is taken orally. To be effective, the medication should be administered within seventy-two hours of birth; however, the ideal window of time is in the first twenty-four hours. The child takes the medication for six weeks.

The makers of the Pratt Pouch have partnered with IntraHealth International, which is providing training for pharmacists and community health workers. These trained individuals then go out and educate mothers about the proper methods to use to treat their children.

Who Is Using It?

So far, Uganda and Ecuador use the pouches. Malkin partnered with Fundación VIHDA in 2012. Since then, they have distributed the pouches to four hospitals in Guayaquil and Quito. Humberto Mata, the co-founder of Fundación VIHDA, estimates that more than 1,000 babies have received antiretroviral medication through the use of the pouches.

In Ecuador, a pharmacist manually fills and seals the pouches. However, a high-tech facility constructed at Hospice Uganda in Kampala is equipped with special machines that fill and seal the pouches in four seconds. That is a fraction of the time it takes a pharmacist to fill by hand.

Future Goals

It is one of Malkin’s goals to help medicate 40,000 infants in Uganda over the course of the next three years. In addition, Malkin hopes to use the pouches to deliver treatments for diseases besides HIV. “For example, HIV and pneumonia often occur together, so I could imagine giving mothers two sets of color-coded pouches, one set for HIV and one for pneumonia,” said Malkin.

The Pratt Pouch has been effective in decreasing the chance of an HIV positive mother transmitting the disease to her baby during birth. By making the antiretroviral medication easily accessible and easy-to-use, the creators of the Pratt Pouch have helped put the minds of worried mothers at ease. A mother can be at peace knowing she has done everything she can to keep her child healthy.

– Sareen Mekhitarian
Photo: Pixabay

Eliminating HIV In Kenya

The HIV/AIDS epidemic in Africa affects adolescent girls more than any other group within the population. As a public health response, a new approach for the elimination of HIV in Kenya emerged which addresses the gender and economic inequality that aid in spreading the disease. This new approach is related to female empowerment eliminating HIV in Kenya with new effective methods.

Health Care System in Kenya

Kenya is home to the world’s third-largest HIV epidemic. Kenya’s diverse population of 39 million encompasses an estimate of 42 ethnic tribes, with most people living in urban areas. Research shows that about 1.5 million, or 7.1 percent of Kenya’s population live with HIV. The first reported cases of the disease in Kenya were reported by the World Health Organization between 1983 to 1985. During that time, many global health organizations increased their efforts to spread awareness about prevention methods for the disease and gave antiretroviral therapy (ART) to those who were already infected with the disease. In the 1990s, the rise of the HIV infected population in Kenya had risen to 100,000 which led to the development of the National AIDS Control Council. The elimination of HIV in Kenya then became a priority for every global health organization.

The health care system in Kenya is a referral system of hospitals, health clinics, and dispensaries that extends from Nairobi to rural areas. There are only about 7,000 physicians in total that work within the public and private sector of Kenya’s health care system. As the population increases and the HIV epidemic intensifies, it creates more strenuous conditions for most of the population in Kenya to get the healthcare they desperately need. It is estimated that more than 53 percent of people living with HIV in Kenya are uninformed of their HIV status.

In addition, HIV disproportionately affects women and young people. After an initiative implemented by UNAIDS in 2013 to eliminate mother-to-child transmission of HIV through increased access to sex education and contraceptives, significantly fewer children are born with HIV. Today, 61 percent of children with HIV are receiving treatment. However, the young women (ages 15-24) in Kenya are still twice as likely to be infected with HIV as men their age. Overall HIV rates are continuing to decrease for other groups within the population, but studies show that 74 percent of new HIV cases in Kenya continue to be adolescent girls.

Female Empowerment Eliminating HIV in Kenya

Women’s empowerment is an overarching theme for the reasons that HIV is heavily impacting the young women in Kenya. A woman’s security in the idea that she is able to dictate personal choices for herself has the ability to hinder or help her well-being.
Female empowerment eliminating HIV in Kenya uses these four common conditions to eliminate HIV:

  1. Health Information – Many girls in Kenya lack adequate information and services about sexual and reproductive health. Some health services even require an age of consent, which only perpetuates the stigma towards sexual rights. Also, the few health services available are out of reach for poor girls in urban areas.
  2. Education – A lack of secondary education for young women and girls in Kenya often means that they are unaware of modern contraceptives. A girl that does not receive a secondary education is twice as likely to get HIV. To ensure that adolescent girls have access to sexuality education, the 2013 Ministerial Commitment on Comprehensive Sexuality Education and Sexual and Reproductive Health and Rights in Eastern and Southern Africa guaranteed that African leaders will commit to these specific needs for young people.
  3. Intimate partner violence –  Countless young women and girls have reported domestic and sexual violence that led to them contracting HIV. Something as simple as trying to negotiate contraceptive use with their partners often prompts a violent response. There has been an increased effort to erase the social acceptability of violence in many Kenyan communities. An organization called, The Raising Voices of SASA! consists of over 25 organizations in sub-Saharan Africa that work to prevent violence against women and HIV.
  4. Societal norms – Some communities in Kenya still practice the tradition of arranged marriages, and often at very young ages for girls. The marriages usually result in early pregnancy and without proper sex education, women and babies are being infected with HIV at a higher rate. In 2014, the African Union Commission accelerated the end to child marriages by setting up a 2-year campaign in 10 African Countries to advocate for Law against child marriages. Research suggests that eliminating child marriages would decrease HIV cases, along with domestic violence, premature pregnancies by over 50 percent.

Young women in Kenya face various obstacles in order to live a healthy life, and poverty acts as a comprehensive factor. Studies show that a lack of limited job opportunities leads to an increase in high-risk behavior. Transactional sex becomes increasingly common for women under these conditions, while they also become more at risk for sexual violence. An estimated 29.3 percent of female sex workers in Kenya live with HIV.

Solution

The most practical solution to tackling the elimination of HIV in Kenya combines HIV prevention with economic empowerment for young girls. The Global Fund to fight AIDS, Tuberculosis and Malaria is an organization that has worked hard at implementing strategies, and interventions across Africa that highlight women’s access to job opportunities and education. In 10 different countries in Africa (including Kenya), young women can attend interventions in which they learn about small business loans, vocational training and entrepreneurship training. One way that more women in Kenya are able to gain control over their financial resources is by receiving village saving loans. To participate in village saving loans it requires a group of 20-30 to make deposits into a group fund each week. Women within these groups can access small loans, which enables them to increase their financial skills while gaining economic independence. The Global Fund to fight AIDS has cultivated a space for numerous empowerment groups for young women out of school called the RISE Young Women Club. The young women in these clubs often live in poverty and receive HIV testing as well as sexual health education.

Overall, the global health programs that aid in the elimination of HIV in Kenya are continuously improving their strategies by including young women in poverty. The HIV/AIDS epidemic in Kenya steadily sees progress thanks to the collective efforts of programs that empower young women.

– Nia Coleman
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