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Healthcare in Bangladesh
Healthcare in Bangladesh is not as sophisticated as in more developed countries; however, the country is working to improve and provide further funding to its healthcare system. So far Bangladesh has made great strides in increasing healthcare access for its people, but there is still a long way to go. Here are seven important facts about healthcare in Bangladesh.

7 Facts About Healthcare in Bangladesh

  1. Bangladesh has a pluralistic healthcare system. This healthcare system is highly decentralized. As a result, it is regulated and controlled by for-profit companies, NGOs, the national government and international welfare organizations. This shared power has caused many problems, including unequal treatment programs between social classes. Even though the laws and overall system are spearheaded and steered by the Ministry of Health and Family Welfare, other organizations have considerable influence on the decision-making.
  2. There is a shortage of physicians, specialists and clinical equipment. In Bangladesh, the number of physicians per 10,000 people is only about 3.06, which is significantly low. The number of nurses per 10,000 people is even lower, standing at 1.07. Additionally, only 35% of health and clinical facilities in the country have more than 75% of sanctioned staff working and there is a 36% vacancy in sanctioned healthcare workers. There is also a 50% vacancy in alternative medicine providers. These numbers are one of the reasons that Bangladesh’s quality of healthcare is low compared to many other Asian countries.
  3. Non-communicable diseases are the leading cause of death in Bangladesh. Most deaths are caused by cardiovascular diseases, cancers, diabetes, chronic respiratory diseases and malnutrition. There are almost no alcohol-related deaths due to alcohol consumption and sale being illegal in the country. A 2016 study by the World Health Organization (WHO) found that tobacco usage has decreased for both men and women, with only 23% of the population using tobacco products. Obesity has remained low, rising slightly, but still only affected 2% of adolescents and 3% of the adult population. However, poor nutrition is still prevalent, leading to diabetes and high blood pressure.
  4. Most physicians and healthcare workers are concentrated in urban areas. Rural areas often do not have proper healthcare facilities. To remedy this, the national government has set up many government-funded hospitals in rural areas that provide cheaper treatment for rural citizens. However, these hospitals are often poorly funded, understaffed and overly crowded due to a limited number of healthcare options in rural areas.
  5. Enrollment in medical colleges and healthcare training facilities has increased. This will benefit the country by increasing the number of healthcare workers in proportion to the population. However, this is only a recent trend and these future healthcare workers must complete their education and training before being able to fully practice their professions. The HPNSDP (Health, Population and Nutrition Sector Development Program) have already begun drafting and implementing a plan to further increase the number of nurses and midwives through training and education facilities.
  6. Socioeconomic inequality affects healthcare in Bangladesh. One area this can be seen in is infant mortality. The infant mortality rate for the lowest income quintile is 35 deaths per 1000 births, while infant mortality for the highest income quintile is only 14 deaths per 1000 births. One of the main reasons for this inequality is that most poor Bangladeshis live in rural areas that do not have adequate hospital facilities. However, even in urban areas, socioeconomic inequality has a large impact. A person with more money is generally able to receive better healthcare than someone who is poorer and cannot afford certain treatments or services. This is due to the fact that the healthcare system is decentralized and partially run by for-profit healthcare and pharmaceutical companies.
  7. Limited government funding has led to high out-of-pocket payments. One of the other reasons poorer citizens in Bangladesh cannot afford certain treatments or services is high out-of-pocket costs. On average, Bangladeshi citizens must pay 63.3% of the total cost, while the government pays the rest. This system creates a significant financial burden for impoverished families, sometimes forcing them to either forego treatment or go into debt. To reduce this burden, the government must increase healthcare funding.

These seven facts about healthcare in Bangladesh illustrate some of the barriers that Bangladesh must overcome to provide high-quality healthcare across the nation. The Bangladeshi Government’s constitution upholds that all citizens will be provided with equal treatment, including in healthcare. To achieve this, the government needs to address the current inequality and continue to make healthcare a focus of its efforts.

Sadat Tashin
Photo: Flickr

Inventions Saving Infant LivesEven with the rapidly developing technology around today, giving birth and nursing are still some of the toughest experiences a mother can go through. Those experiences are, unfortunately, even tougher for mothers giving birth in developing countries. With fewer resources and more exposure to disease right out of the womb, developing countries have some of the highest mortality rates. Here is a list of five inventions saving infant lives worldwide.

5 Inventions Saving Infant Lives

  1. Neopenda: Neopenda is one of the inventions saving infant lives. It is a hat made for babies which helps monitor their vitals such as heart rate and breathing capacity. The company was founded in 2015 and was marketed for newborns in Uganda. The design was tested in Uganda since 2017 and was finally funded in 2019. Neopenda has since won multiple awards for its revolutionary concept and application.
  2. Khushi Baby: Khushi Baby is a digital necklace for newborns that can store all of their medical information at an inexpensive cost. Khushi Baby was designed as part of UNICEF’s Wearables for Good contest and won. The necklace, along with the mobile app, allows nurses to keep track of patient data that can get easily lost in their busy and often underfunded healthcare systems. The necklace has been lauded as an ingenious idea that helps to digitalize immunization records for babies. This helps ensure more accurate and faster readings. Khushi Baby is working with NGO Seva Mandir to run vaccination clinics in rural villages in India. The company has expressed interest in expanding to Africa and the Middle East as well.
  3. Solar Suitcase: Another one of the inventions saving infant lives is the Solar Suitcase. It is an invention designed by Dr. Laura Stachel. The suitcase is a miniature kit powered by solar energy from two panels which produces a light strong enough for child delivery for nearly 20 hours. The kit was inspired by a visit Dr. Satchel made to Nigeria in 2009. She witnessed multiple times power outages that could harm babies and mothers during birth. The kit was tested in Nigeria by Dr. Stachel herself and proven to be a huge success. Since then, her charity We Care Solar has been helping to decrease mortality rates in Africa, Central America and Asia.
  4. The Odon Device: The Odon Device is a plastic bag that inflates to help pull a newborn’s head during delivery. The Odon Device was developed by Jorge Odon, a car mechanic from Argentina and made into a prototype in 2013. Funded by the World Health Organization, the Odon Device is meant to save newborns and their mother’s lives by limiting complications during birth. The product was tested in Argentina and South Africa and achieved a success rate of over 70%.
  5. TermoTell: TermoTell is a bracelet designed to recognize malaria early on in newborn babies. Another design created for UNICEF’S Wearables for Good contest, TermoTell reads babies’ temperatures to safely detect malaria and alert the doctor. If a newborn has malaria, the bracelet will glow and send an alert to a doctor’s phone. The invention was targeted towards sub-Saharan Africa where malaria can cause the deaths of nearly a million children. TermoTell is still just a prototype. The invention is still in the process of improving the design for more accurate readings in the future.

These five designs are just a few of the inventions saving infant lives all around the world. Most inventions are aimed at larger developing countries to help decrease mortality rates. Sub-Saharan Africa still has one of the highest infant mortality rates in the world with more than 50 deaths per 1,000 births while India has close to 30 deaths per 1,000 births. Inventions such as the five listed above have the potential to save thousands of lives and improve the mortality rate for many less developed countries whose mothers and infants have suffered for far too long.

Hena Pejdah
Photo: Pixabay

Infant Mortality and Chlorhexidine in Liberia When applied to the umbilical cord and stump, the antiseptic chlorhexidine has been shown to reduce neonatal deaths by preventing infection. Liberia, which has high rates of infant mortality, has included chlorhexidine in its national health policy. As health is closely linked to poverty, this is an important measure in improving both the health and prosperity of Liberians. Chlorhexidine and infant mortality in Liberia represent a global health success story.  

Liberia and Public Health: A Brief Background 

Liberia is a country in western Africa with a population of around five million and a per capita income of $710. The country faces a variety of public health crises. For instance, life expectancy in Liberia is 64 years for women and 62 years for men, and the infant mortality rate was 50 per 1,000 live births as of 2018. Neonatal disorders are the third most common cause of death, exceeded only by malaria and diarrheal diseases, which also commonly affect infants and young children.

Chlorhexidine

Around the world, 21% of neonatal deaths are caused by severe bacterial infection. This amounts to over 500,000 neonatal deaths annually. Fortunately, simple and affordable interventions can greatly reduce the occurrence of neonatal infection. Chlorhexidine is a prime example. It is an affordable antiseptic that is easy to manufacture and use. Hospitals often use chlorhexidine as a preoperative skin disinfectant, as well as for sterilizing surgical instruments.

When chlorhexidine is applied to the umbilical cord stumps of newborns, it can prevent infection and the complications of infection. Studies demonstrate that using chlorhexidine on newborns can decrease the risk of severe infection by 68% and can decrease the risk of neonatal mortality by 23%. Chlorhexidine is now used in neonates in several countries around the world, including the Democratic Republic of the Congo, Malawi, Madagascar, Afghanistan, Pakistan, Nepal and Bangladesh.

Using Chlorhexidine in Liberia

In Liberia, the newborn mortality rate was 26 per 1,000 live births in 2013. Neonatal deaths accounted for 35% of deaths of children under the age of five, and severe infections were the cause of 28% of neonatal deaths. To address this problem, Liberia adopted a chlorhexidine policy in 2013 requiring the application of chlorhexidine. The Liberian Ministry of Health and Social Welfare stated, “Henceforth 7.1% chlorhexidine digluconate (4% free chlorhexidine) will be applied to the tip of the [umbilical] cord, the stump and around the base of the stump cord of all babies delivered in Liberia immediately after cutting the cord as with repeat application once daily until the cord separates.” The policy follows WHO guidelines for infants born in areas of high neonatal mortality. Chlorhexidine was also added to Liberia’s essential medicines list.

Liberia has benefitted from the support of the U.S. Agency for International Development (USAID) Maternal and Child Survival Program and NGO partners like Save the Children. These organizations have helped Liberian healthcare to implement chlorhexidine use, train health workers and ensure supply and intake. The policy reduced infant mortality in Liberia by 2.2% annually.

The Ministry of Health and various organizations have made important strides in reducing the rates of infant mortality in Liberia. Using chlorhexidine in Liberia is a powerful example of how simple interventions can effectively improve health, save lives and help to end poverty. 

 

– Isabelle Breier

Photo: Flickr

healthcare in Swaziland
Swaziland, a country bordering South Africa and Mozambique, has seen increased conflicts in regard to its healthcare system. With a population of 1.13 million, a majority of its citizens have faced trouble accessing quality healthcare. However, the government of Swaziland is focused on improving healthcare and the well-being of its citizens.

Deficiencies in the Healthcare System

The importance of healthcare to Swaziland’s citizens stems from the presence of numerous diseases. With an estimated 220,000 citizens living with HIV, as well as lower respiratory infections being the second most common cause of death, diseases have been an ongoing issue for decades. Furthermore, road traffic accidents have heavily hurt Swaziland citizens, as it difficult to recover from serious injury without sufficient medical care. There is also a high infant mortality rate, with 54.4 deaths per 1000 births.

With a majority of citizens burdened from disease, the need for improvements to Swaziland’s healthcare system is great. With outdated structuring and a lack of medical supplies, hospitals are becoming increasingly inaccessible to the public. Since the average salary for a citizen in Swaziland is only 6,000 SZL (341 USD), people cannot afford the cost of healthcare. These conditions leads many families to treat themselves. As diseases such as HIV continue to affect Swaziland’s citizens, the healthcare system must become accessible to all.

The Road to Change

In an attempt to combat the spread of disease and improve the accessibility to quality healthcare, Swaziland’s government has launched its Universal Health Coverage program. The government is now increasing spending on health services while improving access to resources.

To increase accessibility, Swaziland has decreased the costs related to healthcare tremendously. Families of any financial background can now have an equal opportunity to acquire affordable and quality healthcare.

In addition, honorable Minister of Health Senator Sibongile Ndlela-Simelane called for a national screening, so that all citizens will know their health numbers. These numbers include blood pressure and sugar and cholesterol levels. This program helps individuals detect health problems early, leading them to utilize Swaziland’s healthcare. Swaziland has also increased the quality of their technology by adopting x-ray machines.

Program Results

With the establishment of the campaign, over 2,000 people of all ages have received screening for diseases. In addition, health numbers were recorded for thousands for future reference.

For the rising problem with HIV, it is important to note that 87% of all individuals who tested positive received sustainable therapy. Additionally, deaths related to AIDS decreased by 50% and the infant mortality rate stooped to 43 deaths per 1,000 births.

Moving Forward

This accelerated growth has heavily boosted morale in Swaziland. With increased government spending in the healthcare sector and a boost in accessibility for healthcare, Swaziland likely has a bright future.

To continue this growth for the long term, Swaziland’s government must pay attention to the infant mortality rate. Despite improvements, Swaziland’s life expectancy rate for infants is among the lowest in the world. Moving forward, Swaziland must make this issue a priority as they continue to work toward providing access to high quality health care to all citizens.

– Aditya Padmaraj 
Photo: Flickr

Life expectancy in Papua New Guinea

Papua New Guinea (PNG) is a country known for its natural beauty, from Mount Wilhelm, the highest mountain in the country, to the cuscus, a marsupial that roams its rainforests. When it comes to its people, the government has made strides to improve life expectancy with life expectancy at birth totaling 64 years as of 2017 compared to only 39 years in 1960. Still, life expectancy in Papua New Guinea falls far below the global average of 72 years.

Here is a look at the factors that influence life expectancy in the country as well as efforts to further improve longevity in PNG.

Country Cooperation Strategy

The World Health Organization (WHO) launched the Country Cooperation Strategy (CCS) in 2016 to improve health facilities and access to health care in a country that is mainly rural. The CCS aims to tackle many issues that are standing in the way of attaining sustainable health outcomes for PNG citizens:

  • User fees: User fees refer to the cost of medical services, drugs and entrance fees when seeing a health care provider. In countries where the majority of the population lives in poverty, user fees serve as barriers to health care services for those who may need it the most. One of the goals of the CCS is to eliminate these fees so that that the poor will have equal access to services that are essential for good health.
  • Vaccinations: Better access to vaccinations is another way the CCS plans to ensure that the life expectancy in Papua New Guinea increases. To that end, the country’s National Department of Health, in coordination with the WHO and UNICEF started a three-week campaign in June 2019 with the goal of vaccinating 1 million children against measles-rubella and polio. As Prime Minister Marape stressed in an address to parents at the launch: “We must make Papua New Guinea polio-free again.”
  • Newborn and Maternal Health: PNG has one of the highest mortality rates in the world. The main cause of mortality in mothers is exposure to infections and high blood pressure, which can interfere with kidney and liver function and also cause anemia. Infant mortality is mainly caused by infection and asphyxia. By providing more supervision during deliveries and by promoting community-based support through non-governmental organizations, the CCS plans to change this. Care for mothers and newborns will be addressed in the CCS with a focus on support for mothers before, during and after birth.
  • Health Care Providers: A lack of health care providers is a large problem affecting life expectancy in Papua New Guinea because there are not enough doctors to care for the sick people in the country. In 2009, there were only 330 doctors nationwide for a country of 8 million. The CCS plans to work with the government to increase access to education and create better facilities for learning for those who wish to pursue careers in the medical field, therefore increasing the number of doctors.

Other Factors Affecting Life Expectancy in PNG

  • Natural Disasters: PNG is in an area that is susceptible to natural disasters and the CCS plans on implementing new strategies for dealing with these kinds of events when they occur. After a 7.5 magnitude earthquake in PNG in 2018, the death toll was estimated to be 145 and about 270,000 people needed aid. Be it a volcanic eruption, earthquake or drought, the CCS wants to make sure that the people of PNG are ready for these disasters when they inevitably occur. More surveillance of these natural occurrences and emergency planning is necessary to make sure the country is secure in case of a natural disaster.

  • Tuberculosis: Protection against epidemics is another issue affecting the life expectancy in Papua New Guinea, malaria and tuberculosis (TB) being two of the most pressing. In 2017, there were 27,935 cases of tuberculosis. The WHO plans to investigate the causes of outbreaks by identifying TB early on and reducing the transmission of the disease. The WHO also plans to strengthen training programs that deal with treating conditions like these.

– Joslin Hughson and Kim Thelwell
Photo: Pixabay

10 Facts About Life Expectancy in The Gambia
The Gambia is a small West African country that people know for its diverse ecosystems around the Gambia River. It is the smallest country within mainland Africa and farming, fishing and tourism drive its economy. The Gambia has a life expectancy of 65 years which is relatively low when considering that the global average life expectancy is 72 years. The Gambia also faces problems associated with poverty that can have serious effects on population and life expectancy. Here are 10 facts about life expectancy in The Gambia.

10 Facts About Life Expectancy in The Gambia

  1. HIV/AIDS – Twenty-one thousand people are currently living with HIV or AIDS in The Gambia with only 30 percent seeking treatment. Since 2010, The Gambia has been working towards lowering the rate of transmission between mothers and children. With the establishment of the National AIDS Control Programme, HIV infections have decreased by 3 percent and AIDS-related deaths have decreased by 23 percent.
  2. Lack of Health Care Providers – The Gambia faces a lack of health care providers. According to a 2009 World Health Organization report, The Gambia had only 156 physicians. The World Health Organization recommends two doctors for every 10,000 people, whereas The Gambia only has one doctor for every 10,000. The International Organization for Migration, in partnership with the World Health Organization, is attempting to increase the amount of health care providers through its program, Migration for Development in Africa.
  3. Infant Mortality Rate – The infant mortality rate in The Gambia is at 58 deaths per 1,000 live births, severely affecting the life expectancy in The Gambia. Malaria is the cause for 4 percent of infant deaths under the age of 1, and 25 percent between the ages of 1 and 4. The National Malaria Control Programme launched in 2014 and prevents 75 percent of all malaria and severe malaria episodes.
  4. Maternal Mortality Rate – The maternal mortality rate in The Gambia is 706 deaths per 100,000 live births. The major cause behind maternal mortality is a lack of prompt response to emergencies combined with disorganized health care. Improving accessibility is necessary for preventing maternal deaths.
  5. Income – The average gross salary is $0.57 per hour with 75 percent of the labor force working in agriculture. Longterm challenges that the economy of The Gambia faces include an undiversified economy, limited access to resources and high population growth.
  6. Malnutrition – Approximately 11 percent of the country is chronically food insecure and 21 percent of children under 5 are malnourished which impacts the life expectancy in The Gambia. Thirty percent of the population do not have proper nourishment–a number that has increased over the past decade. The Gambia relies heavily on imports of food staples along with low agricultural production has made it easy to become food deficient. UNICEF has begun treating cases of malnutrition through preventative and curative services.
  7. Water – Only 32 percent of households have access to clean water with unprotected wells being more common in rural areas. With 4 percent of the rural population practicing open defecation, water, sanitation and hygiene-related diseases account for 20 percent of under-5 deaths. Water for Africa has begun to send aid to The Gambia in the form of building wells.
  8. Education – The Gambia sends its children to six years of primary school and three years of upper basic education, but there are still gaps in education. With aid from the United States and the World Bank, The Gambia launched its Education Sector Support Program to promote early childhood development and boost access to basic education. The project also provides for the building of 40 schools in remote areas.
  9. Malaria Endemic – Peak season for malaria is during the rainy season from June to October. The Catholic Relief Services (CRS) works to provide relief to malaria outbreaks in The Gambia with cases that have declined by 50 percent from 2011 to 2016. The CRS works by distributing bed nets and focusing its aid on children under 5 and pregnant women.
  10. Employment – Farming employs at least 70 percent of the population. Farmers are reliant on rain-fed agriculture. Most cannot afford improved seeds and fertilizers. Between 2011 and 2013, poverty, food shortages and malnutrition have increased due to crop failures that droughts caused.

Despite problems people associate with agriculture, income and health, life expectancy in The Gambia is rising while infant and maternal mortality rates are declining.

– Darci Flatley
Photo: Flickr

ChlorhexidineAn estimated 390,000 babies die within their first months of life annually due to severe infections. For the past decade or so, USAID has been combating this number with a low-cost yet highly effective antiseptic called Chlorhexidine. The chemical is typically used in hospitals to either disinfect the skin before a surgery or to sterilize surgical equipment, but USAID says that the antiseptic “can also be used to protect the umbilical stumps of newborns to prevent life-threatening complications from an infection.” These infections, USAID explains, can in part be a regular consequence of the traditional home birthing practices found in poorer countries. After conducting multiple studies, it has been shown that even a “one-time chlorhexidine treatment can lower the risk of severe infection [in infants] by 68 percent and infant death by 23 percent.”

Countries Adopting Chlorhexidine

Because it is relatively cheap, easy to manufacture and proven to be effective, around 30 nations throughout Africa and Asia either expressed interest in the antiseptic or have begun working with USAID to integrate the antiseptic into their healthcare system over the past several years.

Case Study: Nepal

Nepal was the first nation to implement the treatment back in 2011. It has since reduced the likelihood of infant illness and mortality by 34 percent. The success in Nepal is what inspired a chain-reaction that lead to the antiseptic being adopted into a variety of different countries—but the success of the disinfectant did not come without its challenges.

Before Chlorhexidine was initiated into their health system, the World Health Organization (WHO) recommended that the nation adopt a dry care system to treat the umbilical cord; this system required that the mother keep her child’s umbilical stump clean and dry until the stump fell off on its own while she kept an eye out for any signs of infection.

Due to cultural barriers, this suggestion was not followed. USAID said that mothers in Nepal had been used to routinely applying unsanitary substances such as turmeric, ash, cow dung or a mercury-based red cosmetic powder used by Hindu women to the umbilical stump by hand. Thankfully Nepal has been impressed with the results Chlorhexidine has supplied but the earlier setbacks in treatment shed an important light for USAID and its partners on how complex assimilating a scientifically safe treatment into impoverished nation’s culture can actually be.

Today, both single-dose tubes of the antiseptic are freely distributed to all expecting mothers in their eighth month of pregnancy and a one-on-one training session explaining how to safely apply the gel after cutting the umbilical cord.

Case Study: Pakistan

Pakistan implemented the treatment in 2014. Pakistan reportedly has the third-highest newborn mortality rate in the world, with umbilical cord infections serving as the second leading cause of death to Pakistani newborns. Seeing as Pakistan is a much larger and complex country, it faced a different set of challenges than Nepal when it came to making the antiseptic widespread.

There were some cultural barriers to overcome in Pakistan as well—many Pakistani women used to treat umbilical cords with surma, a lead-based concoction)—but the main challenge the nation had to overcome was to bring together all the government and private offices working towards a Chlorhexidine treatment program independently. To convene all of these health offices together and collaborate on an implementation plan was no small feat and took around a full year, and then the plans were formally adopted another year later, in 2016.

Of course, Chlorhexidine comes with its own set of risks. Although it has been found to reduce infections, it has also been discovered to cause rashes and burns on some skin types. Even so, the use of Chlorhexidine in both Nepal and Pakistan shows that although the process of assimilating treatment is not always easy or quick, it yields hopeful results that encourage nations in the surrounding areas to adopt the life-saving drug as well.

– Haley Hiday
Photo: Flickr

Life Expectancy in Nepal

Nestled in the heart of the Himalayan mountains, Nepal has long been praised for its beauty and local culture. As the country continues to develop, there have been trends and statistics that show the true physical well-being of the population as a whole, particularly regarding the life expectancy in Nepal. As with all countries, there are many pieces that come into play when determining a country’s life expectancy, and they vary wildly depending on the region. Here we will take a look at 10 facts about life expectancy in Nepal and the contributing factors that affect those numbers.

10 Facts About Life Expectancy in Nepal

  1. Twenty-five percent of the population in Nepal lives below the poverty line. There are many things that influence life expectancy rates, and many of those are attributed to financial insecurity. With one-quarter of Nepal’s population living in classified poverty, they are unable to afford the most basic of healthcare and even food, leading to shorter and more difficult lives.
  2. Nepal has high infant mortality rates. In Nepal, 35 out of every 1,000 children die in infancy. Due to a lack of proper facilities and practitioners qualified for natal and infant care, over three percent of children die before they reach the age of five.
  3. Almost 1,000,000 Nepali people are unemployed. Unemployment can affect many people in many ways; without access to jobs and the consequent benefits, it can make life a struggle similar to that of those living in poverty.
  4. Malnourishment rates are high. Approximately 5 million Nepali children are malnourished. Studies conducted within the last decade have shown that nutrition directly correlates to certain health conditions, and that malnourishment is linked with lower life expectancy.
  5. Nepal is prone to natural disasters. Despite being in one of the most scenic parts of the world, Nepal’s mountain location in the heart of the Himalayas poses risk to the population. Its location leaves the Nepali people vulnerable to a host of different natural disasters, including floods, landslides and earthquakes. These natural disasters are another factor to take into account when calculating life expectancy.
  6. Regardless of negative factors, life expectancy numbers in Nepal are rising. Data obtained from British medical journal Lancet shows recent findings of life expectancy increasing among the Nepali population. Going up over 12 years within two decades, the numbers are rising and show no signs of stopping. This noticeable increase has several causes such as improvements in health care, job access rates and better living conditions.
  7. Nepal’s public health care system is improving. Another reason for rising life expectancy rates in Nepal is the continuing development of their public health care system. The Nepal government has committed to enacting a universal health coverage plan and is a crucial factor in raising life expectancy. While the government and donor-funded health care plan is still in the early stages, once fully developed it will open up a world of benefits to those in need, particularly affecting people with chronic illnesses and diseases and allowing them to receive better care.
  8. Maternal mortality rates are lowering. Going hand-in-hand with Nepal’s expanding health care system, studies are showing that maternal mortality rates are dropping. Within 25 years, the country has reduced the national maternal mortality rate drastically, going from 901 deaths per 100,000 births down to 258. That seventy-one percent decrease is largely due to more equipped facilities and trained medical personnel, which in turn minimizes the number of unsupervised home births.
  9. Educational systems are improving. According to the United Nations International Children’s Emergency Fund (UNICEF), the enrollment rate in primary schools has risen to 97 percent over the last 20 years. These numbers show the slow elevation of educational access in Nepal, but there is still a long way to go. UNICEF has partnered with the country’s government to initiate a four-year improvement plan in hopes of providing even higher quality education to more students across the country. Increasing these educational opportunities allow for jobs and other options otherwise inaccessible, leading to higher quality and longer lives.
  10. Nepal is beginning to manage the future. Ensuring that the elderly citizens of Nepal are being well taken care of is essential for a thriving population and will increase life expectancy. By spending more of the budget on pension and medical care for the elderly, Nepal has displayed a commitment to safeguarding the wellbeing of future generations.

In a recent study of more than 188 countries, Nepal was in the top 10 countries to have significantly improved life expectancy rates. The many factors that are consistently being improved upon—such as health care, job access, educational opportunities and positive lifestyle influences—are proving their worth. Despite facing many challenges to still overcome, Nepal is making many improvements that will ensure longer, healthier lives for the Nepali people.

– Olivia Bendle
Photo: Pixabay

Urban and Rural Voucher Systems

Each year, millions of pregnant women give birth without access to proper health care services. Countries such as Ethiopia, Laos and Yemen are just a few parts of the world where this is a major problem. For example, in Ethiopia, 59 percent of women do not receive care by a medical professional during pregnancy. In Zimbabwe, however, access to prenatal care has drastically improved since the 2014 implementation of the Urban and Rural Voucher Systems (UVS and RVS, respectively). These systems allow for low-income pregnant women to receive the healthcare that they need. They have already had incredible benefits on thousands of pregnant women. Additionally, they set a great precedent for governments and NGOs to come together to find solutions to pressing maternal health issues.

Qualifications

The UVS and RVS service pregnant women whose incomes place them in the bottom 40 percent of households in Zimbabwe. Consequently, women who cannot afford the required $25 co-pay at many clinics can still receive care. Providing women with this essential health care helps to ensure that these women and their babies stay healthy and safe both during and after pregnancy.

Funding

The government of Zimbabwe, the World Bank and Codaid are the main sources of funding for the UVS and RVS. Cordaid is a local NGO that has assisted with much of the program’s implementation. Clinics are subsidized based on their performance. They measure performance on overall range and quality of coverage. This supply-side solution works to help promote jobs and economic growth in local communities, which contributes to the program’s long-term sustainability.

Impact on the Poor

Access to proper care during pregnancy is essential to ensure the health of expectant mothers and their child. In many countries around the world, women do not have access to this care. As a result, the consequences have been horrific.

For instance, there are roughly 3.3 million neonatal deaths recorded per year. Neonatal refers to the first four weeks of a baby’s life. Proper prenatal care can prevent these fatalities. A woman who receives such care is far less likely to give birth to a child with fatal health issues. Proper prenatal care can help identify and fix possible health issues before they become too serious. In addition, receiving prenatal care can offer educational resources. The care can educate a woman about the ways in which they should go about raising a healthy child.

Conclusion

Zimbabwe’s Urban and Rural Voucher Systems have had immense benefits since their implementation. The thousands of women that they have helped to serve reflect such benefits. The programs provide an affordable and accessible option for pregnant mothers to receive the care that they need to ensure both their health and the health of their babies. Also, the UVP and RVP supply-side design ensure that the programs are helping to stimulate local economies and bring communities together. All in all, while much progress must still be made towards increasing access to prenatal care for pregnant women around the world, Zimbabwe has taken an important first step with its Urban and Rural Voucher Systems.

– Kiran Matthias
Photo: Flickr

Top 10 Facts About Living Conditions in Nicaragua
Nicaragua faces mounting violence and instability as citizens go out to the streets to protest the corrupt rule of President Daniel Ortega. During times of chaos, it is important to understand what conditions for citizens have been like in previous years. The following 10 facts about living conditions in Nicaragua presented in the text below both describe the unsettling state of affairs in the country and provide evidence of hope for a brighter future.  

Top 10 Facts About Living Conditions in Nicaragua

  1. Nicaragua is the poorest country in Central America and the second poorest country in the Western Hemisphere, right after Haiti. Although the country’s economy has been growing in recent years, the fact about poverty still remains true and emphasizes the fact that there is a lot of work to be done.
  2. The unemployment rate for people between the ages of 15 and 24 is 8.5 percent. The country has the 110th highest unemployment rate out of 161 countries. Thus, Nicaragua does relatively well in terms of ensuring employment for its citizens.
  3. In 2015, 29.6 percent of the population was living below the poverty line. This number is quite high and suggests a dire need for economic growth.
  4. In 2016, 23.7 percent of the adult population was obese. This marked Nicaragua as the country with the 63rd highest adult obesity rate out of 192 countries. With development, it is important that the country initiate programs that provide its people with proper nutrition.
  5. In 2016, the life expectancy at birth for an average male was 72 years and for an average female, it was 78 years. Among the ten facts about living conditions in Nicaragua, this one is generally the most promising one as it indicates the relative general health of the population.
  6. In 2016, the infant mortality rate was 17 deaths for every 1,000 life births. In 2015, the United States faced just under 6 infant deaths for every 1,000 life births. This suggests that maternal and infant care in Nicaragua needs improvement.
  7. The labor force participation rate in 2017 was 66.6 percent. The rate of self-employment was 45.1 percent. This rate of participation is pretty much average for developing countries although low in comparison with developed countries.
  8. If literacy is defined as the ability to read and write, then 82.8 percent of people aged 15 years and older in 2015 were literate. Over 83 percent of women and 82.4 men were literate. This was the 106th highest literacy rate of 162 countries.
  9. In 2018, the approximate yearly minimum wage in Nicaragua was $2,218. This places the country in the top 37 percent of countries that are ranked by the minimum wage. There are 72 countries with higher minimum wage than Nicaragua.
  10. Between January and December of 2017, there were 55 reported cases of gender-based killing of women. In June 2017, an amendment to the Comprehensive Law on Violence against Women was approved. It reduced the definition of femicide to the private sphere suggesting that only crimes between spouses and partners would count as femicide.

These top 10 facts about living conditions in Nicaragua provide a mixed account of the status of the country. Nicaragua is developing and it cannot be, in any case, characterized as a stable country. Recent progress, however, indicates that the country could have the potential to develop and attain stability. Late violent outbursts linked to government corruption thwart such hopes for progress and the current priority for the Nicaraguan people should be finding peace and justice through dark times. It is important to remember the progress that Nicaragua has made, and can continue to make after such peace is settled.

– Julia Bloechl

Photo: Flickr