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Maternal Mortality in South SudanOne of the happiest moments in a mother’s life is taken away from her in South Sudan. With 789 deaths amongst 100,000 births, South Sudan’s maternal mortality rate ranks as one of the highest in the world. The probability of death when giving birth is higher when a woman is in poverty. Also, with little access to professional assistance and resources, death becomes far more likely. 

In turn, when maternal mortality occurs, the risk for child mortality increases. Orphaned children are more likely to become subject to child labor. They also tend to have limited access to high-quality education and encounter more obstacles that prevent them from reaching their highest potential. Maternal mortality in South Sudan is an urgent issue not only because mothers die, but also because maternal mortality leads to the ongoing suffering of the children left without moms.

Causes of Maternal Mortality in South Sudan

First, studies have shown that many women do not receive professional assistance when giving birth. In Juba, the capital of South Sudan, only a quarter of the women go to a hospital during the time of labor. That low figure partially stems from a lack of South Sudanese trained in maternal, newborn and child health (MNCH). With only one physician per 65,574 people and one midwife per 39,088 people, the country has a severe lack of professionals at hand. For this reason, mothers are forced to request assistance from non-certified individuals.

Poverty is a significant cause of maternal mortality risk factors. According to the World Health Organization (WHO), 4.8 million people in South Sudan, mothers included, suffer from food insecurity. Additionally, only 7% of the population has access to sanitation resources, which further prevents safe births. Poverty also influences South Sudan’s high illiteracy rate of 88% among women. In turn, that high illiteracy rate limits awareness of healthy birth practices.

Finally, communicable and chronic non-communicable diseases contribute to maternal and child mortality. Tuberculosis, a risk factor of maternal mortality, is high at 146 cases per 100,000 people in South Sudan.  Second, HIV/AIDS is at epidemic levels in South Sudan. Finally, diabetes and cardiovascular diseases are on the rise and elevate maternal mortality risk factors.

 A Focus on Increasing Trained Labor and Delivery Staff

Several initiatives have been launched to reduce maternal mortality rates in South Sudan. One significant example is the Global Health Innovation Laboratory’s Maternal, Newborn, and Child Survival (MNCS) program. Launched in 2010, MNCS has worked to increase training for MNCH professionals throughout South Sudan. Importantly, MNCS trainees learn how to identify and prevent major threats that women face during labor. In its first two years, MCNS trained 732 healthcare workers who are now providing assistance in labor and delivery patients in South Sudan.

Also, in 2012, the Ministry of Health in South Sudan, the United Nations Population Fund (UNPFA) and local nonprofits collaboratively launched the Strengthening Midwifery Service to train midwives and nurses. Additionally, three years later, the Ministry of Health also began partnering with the Canadian Association of Midwives and UNPFA to foster professional mentorships between midwives in Canada and South Sudan so they can exchange expertise with each other.

On the Path to Save South Sudanese Women and Children

Maternal mortality in South Sudan has been an urgent issue since the beginning of the South Sudanese Civil War. It puts both the mother and child at risk of death and may permanently jeopardize the future of a baby. Fortunately, the South Sudanese government and international organizations are working to improve that dire situation. With more professional help available to mothers, slowly, South Sudan is saving its women and children.

– Mariam Kazmi
Photo: Flickr

Telemedicine Clinics in GuatemalaNew telemedicine clinics in Guatemala are providing vital resources to women and children living in remote areas with limited access to healthcare specialists. This advancement in healthcare technology increases Guatemala’s healthcare accessibility and follows a trend of a worldwide increase in telemedicine services.

Guatemala’s New Telemedicine Clinics

Guatemala’s Ministry of Public Health and Social Assistance (MSPAS), in conjunction with the Pan American Health Organization (PAHO) and the World Health Organization, launched four new telemedicine clinics in Guatemala in December 2020.

The clinics were designed to improve accessibility to doctors and specialists for citizens living in rural areas, where unstable or lengthy travel can deter patients from getting the care they need. Lack of staff is another barrier telemedicine hopes to overcome. Special attention will be given to issues of child malnutrition and maternal health.

The funding of the program was made possible through financial assistance from the Government of Sweden and the European Union. aimed at increasing healthcare access in rural areas across the world.

Guatemala’s State of Healthcare

Roughly 80% of Guatemala’s doctors are located within metropolitan areas, leaving scarce availability for those living in rural areas. Issues of nutrition and maternal healthcare are special targets for the new program due to the high rates of child malnutrition and maternal mortality in Guatemala.

Guatemala’s child malnutrition rates are some of the highest in all of Central America and disproportionately affect its indigenous communities. Throughout the country, 46.5% of children under 5 are stunted due to malnutrition.

Maternal death rates are high among women in Guatemala but the country has seen a slow and steady decline in maternal mortality over the last two decades. The most recently reported maternal death rate is 95 per 100,000 births.

Guatemala does have a promising antenatal care rate, with 86% of women receiving at least four antenatal care visits during their pregnancies. By increasing the access to doctors through telemedicine clinics, doctors can better diagnose issues arising during pregnancy and prepare for possible birth difficulties that could result in maternal death.

Guatemala’s COVID-19 rates have also impacted the ability of patients to seek healthcare. The threat of the virus makes it difficult for those traveling to seek medical treatment due to the risk of contracting COVID-19.

Trends in Worldwide Telemedicine

The world has seen a rise of telemedicine clinics as the pandemic creates safety concerns regarding in-person visits with doctors. Doctors are now reaching rural communities that previously had little opportunity to access specialized medicine. Telemedicine is an important advancement toward accessible healthcare in rural areas. While the telemedicine clinics in Guatemala are limited in numbers, they set an important example of how technology can be utilized to adapt during a health crisis and reach patients in inaccessible areas.

June Noyes
Photo: Flickr

Maternal Mortality LaosIt is hard to imagine how giving birth can be fatal to so many women around the world. However, even in 2021, maternal mortality remains a significant issue, especially in developing countries where modern medicine is scarce and medical facilities are not easily accessible. Fortunately, these maternal mortality rates have been dropping all over the world, especially in Laos.

Birth Complications in Laos

Laos, or Lao People’s Democratic Republic, is a landlocked nation between Thailand and Vietnam. With a population of 7.2 million, the country suffers from a declining fertility rate. In 2020, women in Laos had an average of 2.7 children, yet this rate was more than doubled just 30 years ago. In addition to infertility, women in Laos are at a greater risk for birth complications. According to the U.N., a mother’s risk of dying in Laos due to delivery and post-delivery complications is one in 150. This number is especially alarming when compared to statistics in Europe, where a woman’s risk of death is one in 3,400.

Declining Maternal Mortality Rates

Since the turn of the millennium, maternal mortality rates have dropped significantly all over the world due to the spread of modern medicine. According to the World Health Organization (WHO), the maternal mortality ratio dropped by approximately 38% worldwide in less than 20 years. Similar encouraging statistics are emerging from Laos. Eksavang Vongvichit, the nation’s former health minister, discusses Laos’s progress in tackling this issue: “We’re in third place worldwide in terms of bringing down the maternal mortality rate… We’ve brought down the number of maternal deaths from 450 out of 100,000 live births down to 220.”

The Ongoing Fight Against Maternal Mortality in Laos

Maternal mortality is a more frequent reality in developing countries. On average, women in low-to-middle-income countries more likely to die during or immediately after pregnancy than women in developed nations. This is largely because many birth-related deaths result from easily preventable causes, including severe bleeding, infections, high blood pressure, complications from delivery and unsafe abortions.

To prevent such avoidable deaths, numerous charities and NGOs are working on better educating reproductive healthcare workers in developing nations. The United Nations Population Fund (UNFPA) is a prime example of this work, being stationed in Laos and other developing nations all over the globe. In Laos, the program helped the Ministry of Health create better training programs for volunteers and midwives in reproductive care. This education includes bringing awareness to mothers about proper family planning, which covers how long to space out pregnancies and prevent undesired pregnancies. Not only will such education prevent unnecessary fatalities, but it will also aid families in properly planning for the future to break the cycle of poverty.

With the continued implementation of modern medicine and reproductive education in developing countries, there is great hope that the rate of maternal deaths will continue to decline in Laos.

– Amanda J. Godfrey
Photo: Unsplash

Maternal Mortality
Maternal mortality is a devastating cause of death for women around the world, especially those who live in low-resource communities or developing countries. Many conditions that cause maternal mortality are preventable. However, progress is occurring to save the lives of mothers and babies all over the globe.

Maternal Health Issues

The World Health Organization (WHO) has a commitment to reaching maternal health goals and improving healthcare systems. It is reaching towards this by working with partners to address inequality of access to healthcare, researching all possible causes of maternal deaths and providing clinical and programmatic guidance and more.

 The U.S. Agency for International Development (USAID) is a global leader in solving maternal health issues. It has a commitment to improving maternal, newborn and child healthcare services. In fact, it has partnered with governments to help meet the needs of mothers and babies with country-specific plans. USAID has saved the lives of over 340,000 mothers. It also protects the life of the mothers’ babies after delivery with immunization and sanitation resources available.

Merck for Mothers, or MOMs, is a global initiative that focuses on creating a world where no woman dies while giving birth. MOMs boasts helping over 13 million mothers deliver their babies safely. In addition, it also supports over 100 strategic investments aimed at programs that help the cause. Its focus countries are India, Nigeria, Kenya and the United States. It also has a global corporate grants program supporting nongovernmental organizations worldwide.

MOMs in India

India has a high maternal mortality rate of 145 deaths for every 100,000 births (56 highest of 182 countries in January 2020). MOMs focuses on supporting programs that help struggling mothers in India use technology. One such partnership is with USAID, the Bill & Melinda Gates Foundation and other organizations that work with the Alliance for Savings Mothers and Newborns (ASMAN) to digitally monitor the health of mothers during labor and delivery.

ASMAN provides links to healthcare providers for a Safe Delivery App – a smartphone application that shows “up-to-date clinical guidelines on obstetric care and can be used as an immediate life-saving reference during complicated deliveries.”

Solving delivery complications requires quick thinking and action on the spot, which is a MOMs specialty. The initiative utilizes MOMs’ resources to enhance already existing solutions. It creates a “failing fast” learning method to quickly get hands-on experience that can save lives.

An Indian digital health company, Avegen, has also partnered with MOMs to help release a web-based platform to educate women about quality maternal care. It gives them the ability to rate the services they receive on a public platform for others to read. This gives women the power to educate themselves and choose an accessible healthcare provider that meets their needs. It also gives healthcare providers the feedback they need to improve the quality of care.

MOMs in Africa

Developing nations such as Nigeria are more susceptible to maternal mortality and other delivery complications because of poor healthcare systems. Nigerian women are around 500 times more likely to die during childbirth compared to the most advanced nations. Nigeria’s high level of maternal mortality comes from a multitude of factors such as poverty, food insecurity and low healthcare resources.

Nigeria had the fourth highest maternal mortality rate in the world of 182 countries ranked in January 2020. In 2021, Merck reported it as the highest.

In Nigeria, health conditions like diabetes and hypertension are on the rise. These health risks can be precursors to eclampsia/preeclampsia, a high cause of maternal death. MOMs has a dedication to locating indirect causes of maternal mortality such as malaria and cardiovascular disease by partnering with Nigerian healthcare initiatives to identify how to manage these risks.

MOMs is bringing unidentified maternal death statistics to light by collaborating with Africare and Nigeria Health Watch to support an advocacy program, “Giving Birth in Nigeria.” The program lets communities report otherwise unreported maternal deaths online. Many maternal deaths do not get reported because they do not happen in hospitals or do not receive confirmation. However, communities need to understand why women in certain areas are at risk and how their deaths can undergo prevention.

MOMs began partnering with LifeBank, a technological healthcare supply distribution system based in Nigeria. LifeBank aims to bring much-needed medical supplies to patients quickly with a multi-modal transportation network. It has saved the lives of over 10,000 people and served 676 hospitals, with a focus on providing blood and other medical supplies to mothers during childbirth.

Continuing Maternal Health Success

MOMs provides service around the world to help mothers before, during and after pregnancy survive and live a healthy life with their babies. Measures can sometimes prevent the loss of a woman to maternal mortality, especially in impoverished countries. MOMs and its partners have been working to ensure that healthcare systems are more efficient, that women are empowered to share their experiences and to ensure that healthcare workers are up-to-date on childbirth procedures.

– Julia Ditmar
Photo: Flickr

Maternal healthcare in Algeria
Algeria, a large country in North Africa, bordering the Mediterranean Sea. The country is known for its rich history and culture, as well as its scorching temperatures. Like many nations in Africa, Algeria struggles to combat maternal mortality – a long-standing, persistent issue for many women in the country. However, in the last several years, Algeria has taken numerous steps to expand maternal healthcare and reduce pregnancy and labor complications. Here are four facts about maternal healthcare in Algeria.

4 Facts About Maternal Healthcare in Algeria

  1. According to recent updates on the maternal mortality ratio in Algeria — it has gradually dropped from 179 deaths per 100,000 live births in 1998 to 112 deaths per 100,000 live births in 2017. Much of the success in lowering the number of deaths is attributed to a multitude of factors such as increased medical training, investments in healthcare and specific government initiatives aimed at reducing maternal deaths. During the years 2009–2017, Algeria trained about 900 professionals from university hospitals such as, Benni Messous, Kouba, Oran and Bab El Oued on multidisciplinary management of pregnancy.
  2. Within the last couple of years, Algeria has managed to make major investments in healthcare. Algeria managed to increase expenditures in healthcare as a share of GDP from 3.6 % in 2003 to 6.4 % in 2017 — growing at an average annual rate of 4.57%. This is an impressive number when compared with Algeria’s neighboring countries. Moreover, these investments have also helped to establish successful disease detection programs and allowed for improved medical facilities.
  3. In 2015, the Ministry of Health in Algeria began to work in collaboration with UNICEF in an attempt to implement a neonatal and maternal mortality reduction plan. This plan was implemented with the intention of reducing as many preventable, maternal deaths as possible, with a target of 50 deaths per 100,000 live births by 2019. Additionally, in 2016 the Ministry of Health put forward an emergency maternal mortality rate (MMR) reduction plan. “The goals set by the plan relate to strengthening family planning, improving the quality of healthcare during pregnancy, birth and postpartum.”
  4. In order to continue the reduction of the maternal mortality rate, the Health Ministry of Algeria held a survey to consolidate the maternal death rate with the technical and financial collaboration of the three U.N. agencies: (UNFPA, UNICEF and the WHO). The objectives of this survey were to reach a consensus on connections between frequent causes of maternal death, update the maternal death rate and cultivate reliable data “for the readjustment of national programs on maternal health and the reduction of preventable maternal deaths for the implementation of Algeria’s ICPD commitments.”

A Leader in Maternal Healthcare

Much work remains in order for Algeria to be able to effectively put an end to preventable, maternal deaths. However, the measures put into practice within the last several years have already proven to be a success. Thanks to these policies, Algeria has become known as a leader in maternal healthcare in North Africa and the country continues to build a strong momentum and infrastructure to fight this problem.

Shreeya Sharma
Photo: Flickr

Health Care in Sudan
Sudan is rich in natural and human resources; however, it is poverty and conflict-stricken. Agriculture is an income provider for 70 percent of the populace. Due to a lack of resources and training availability, the health care sector of the country remains underfunded and understaffed. Here are ten facts about health care in Sudan.

10 Facts About Health Care in Sudan

  1. Approximately 14 percent of Sudanese do not have access to health care. This is largely due to the fact that Sudan has a critical shortage of health care workers. According to the World Health Organization, there are 23 qualified health care workers per 10,000 members of the population.
  2. Sudan’s maternal mortality rate has improved, but it varies by region. In 2015, the maternal mortality rate was 311 per 100,000 live births. This was a significant improvement from 744 per 100,000 live births in 1990. Unfortunately, these rates are not consistent across the country. While more recent data is not available, in 2006, the maternal mortality rate in Southern Kordofan was 503 per 100,000 live births. In the Northern state, however, the rate was only 91 per 100,000 live births.
  3. Approximately 32 percent of Sudan’s population is drinking contaminated water from untreated water sources. This is a result of chemical and bacterial contamination from industrial, domestic and commercial waste that degrades the water quality. There are acts at the state and national levels to help prevent this washing and injection; however, these acts need activation. UNICEF is working with the Sudanese government to increase access to basic treated water supplies for the people of Sudan, with a focus on women and children.
  4. Sudan suffers from outbreaks of cholera, dengue fever, Rift Valley fever (RVF), chikungunya and malaria. Increased outbreaks in 2019 were, in part, a result of heavy rainfall during the rainy season. Consequently, this rainfall left behind stagnant pools which were breeding grounds for mosquitos, contributing to the spread of infection. Government authorities and their humanitarian partners worked to respond to outbreaks across the country. The Kassala and North Darfur Ministries of Health launched weekly response task force meetings and developed state-level plans to mitigate the outbreak.
  5. Sudan has widespread micronutrient deficiencies. This is partially due to insufficient levels of crop growth. Only 14 percent of 208 cultivable acres are being cultivated. Drought, pests and environmental degradation also contribute to widespread malnourishment. However, vitamin A deficiency decreased due to repeated vitamin A supplementation given during National Immunization Day campaigns.
  6. Many Sudanese women and girls lack adequate health care and resources. Women and girls living in the rebel-held areas of Southern Kordofan or the Nuba Mountains of Sudan have very limited or no access to contraception. Human Rights Watch found most of the women interviewed did not know what a condom was and was unfamiliar with other common contraceptive practices. This lack of education and the low availability of condoms are why there are high percentages of women testing positive for hepatitis B. Consequently, gonorrhea and syphilis are on the rise in Sudan.
  7. The National Expanded Program on Immunization in Sudan supports an increase in routine immunization coverage. In addition, the government’s financial investment to EPI and polio eradication program is 15 million USD. Challenges the program faces include poor service delivery and a lack of resources and skilled staff.
  8. Sudan spends 6.5 percent of its gross domestic product and 8.3 percent of government spending on health care. Before the 1990s, receiving care at public health care facilities was mostly free. However, the structural reforms of 1992 introduced user fees. Now, out-of-pocket expenses for patients hover in the 70 percent range.
  9. There are 75 degrees and diploma-granting health institutions in Sudan. About 28 of these institutions offer diplomas and 47 of these schools offer degrees. There are 14 private institutions, while the others belong to agencies such as the Federal Ministry of Health and other government agencies. In 2001, the Federal Ministers of Health and Higher Education signed a Sudan Declaration and Nursing and Allied Health Workers in 2001. The goal of the declaration was to improve nursing and other health care education. The Academy of Health Sciences was established in 2005 to help implement this goal.
  10. The Sudanese government is working to rebuild and reform the health care system. A 25-year plan spanning from 2003 to 2027 was created in the early 2000s. This plan focuses on ensuring health care services are accessible and high quality, particularly for impoverished and vulnerable populations.

These ten facts about health care in Sudan illuminate some of the struggles the nation has faced, as well as improvement efforts by the Sudanese government and other humanitarian organizations. It is imperative that these efforts continue in order for health care to continue to progress in Sudan.

Robert Forsyth
Photo: Flickr

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

10 Facts About Healthcare in Nepal

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

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

Robert Forsyth
Photo: U.N. Multimedia

10 Facts About Life Expectancy in Kyrgyzstan
Kyrgyzstan is a landlocked country in Central Asia with a population of 6.4 million. Since its independence from Russia in 1991, Kyrgyzstan has had unstable political conditions, leading to poor health conditions. Here are 10 facts about life expectancy in Kyrgyzstan.

10 Facts About Life Expectancy in Kyrgyzstan

  1. The average life expectancy in Kyrgyzstan is 71 years. For men, life expectancy is around 68 years, while women generally live 75 years. This represents a significant increase over the last 10 years, rising from an average of 67.7 years in 2010. However, the life expectancy in Kyrgyzstan still remains below the average in Asia, which is 79 years. It also falls behind other Central Asian countries, as the average life expectancy in Central Asia is 70 years for men and 76 years for women.
  2. The mortality rate for children under 5 in Kyrgyzstan is 20 per 1,000 live births. Comparatively, the average mortality rate for children under 5 in developing countries in Europe and Central Asia is 11 per 1,000 live births. Still, Kyrgyzstan has made much progress on reducing the mortality rate for young children over the past 20 years; in 1990, the mortality rate for children under 5 was 65 per 1,000 live births.
  3. Ischemic heart disease is the leading cause of death and disability in Kyrgyzstan. The rate of ischemic heart disease in Kyrgyzstan is significantly higher than the rates in other low-and-middle-income countries. In fact, 4,628.7 per 100,000 deaths in Kyrgyzstan are caused by ischemic heart disease, while the average rate for other low-and-middle-income countries is 3,036.7 per 100,000 deaths. The second most common cause of death in Kyrgyzstan is stroke.
  4. Kyrgyzstan’s sanitation and drinking water services have a significant impact on the health of its population. Around 93 percent of the population has access to basic sanitation services and piped water services reach 58 percent of the nation. Additionally, the practice of open defecation is not found in the country, contributing to more sanitary conditions.
  5. As of 2015, the maternal mortality rate in Kyrgyzstan is 76 per 100,000 live births. Maternal mortality has remained high in the nation for the past two decades, barely decreasing from 1990 when the maternal mortality rate was 80 per 100,000 live births. This is in spite of the fact that 99 percent of all births in Kyrgyzstan are attended by a skilled professional.
  6. In Kyrgyzstan, there are approximately 1.9 doctors and 6.4 nurses per 1,000 people, according to World Bank data from 2014. This is lower than the average for low-and-middle-income countries in Europe and Central Asia, which is approximately three physicians per 1,000 people. Kyrgyzstan has made improvements, however, as the rate was approximately 2.5 doctors per 1,000 people in 2008.
  7. Kyrgyzstan has made reforms to its health care system three times since 2001, with the goal of improving the availability and quality of medical services. A mandatory health insurance fund has been in place since the 1990s and on average people in Kyrgyzstan pay 39 percent of the total cost of their health services. However, a lack of pharmacy price regulation and the devaluation of the national currency led to a 20 percent increase in co-payments for reimbursed medicine in outpatient care increased between 2013 and 2015, driving up out-of-pocket costs.
  8. Kyrgyzstan’s Ministry of Health and Mandatory Health Insurance Fund will implement a new Primary Health Care Quality Improvement Program between 2019 and 2024. This program is largely funded by the World Bank, which is contributing nearly $20 million. Alongside this program is the country’s new health strategy for 2019-2030: “Healthy Person – Prosperous Country.” The government of Kyrgyzstan recognizes that strengthening the primary health care system is essential to improving lives, particularly for the impoverished.
  9. The impoverished — which account for 25.6 percent of the population — and those living remotely in the mountains are most likely to experience malnutrition in Kyrgyzstan. UNICEF estimates that 22 percent of all child deaths occur due to malnutrition and almost 18 percent of all Kyrgyz children are malnourished. Malnutrition causes stunting, low birth weight and vitamin and mineral deficiencies that can have a life-long effect on one’s health and wellbeing.
  10. Education is also an important factor contributing to health and life expectancy. In Kyrgyzstan, education is mandatory for nine years between the ages of 7 and 15. UNICEF notes that many children drop out after grade nine when this mandatory education ends, as only 59 percent for boys and 56 percent for girls attend upper secondary school. Quality of education is another challenge for the nation, with more than 50 percent of children not meeting the basic level of achievement in reading, math and science.

These 10 facts about life expectancy in Kyrgyzstan shed light on health and living conditions in the nation. With new health initiatives being undertaken in the country, there is hope that life expectancy rates will continue to improve.

Navjot Buttar
Photo: UNICEF

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

Microlife CRADLE VSA Saves MothersRoughly 800 women die every day as a result of obstetric hemorrhaging, sepsis and pregnancy-related hypertension. The majority of these deaths occur in low-income areas that do not have the necessary tools to check a mother’s blood pressure and heart rate during or after childbirth.

In response, Professor Andrew Shennan and the CRADLE research team at King’s College London developed the CRADLE Microlife Vital Signs Alert (CRADLE VSA). The device features a “traffic light” early warning system that uses the traditional red, yellow and green colored lights. The user-friendly system indicates when a patient has pre-eclampsia or sepsis, even if the user has not undergone formal training.

CRADLE VSA relies on Shock Index, “the most reliable predictor of serious maternal adverse outcome. Appropriate thresholds for shock index were therefore incorporated into the traffic light algorithm, together with universally understood hypertensive thresholds, to trigger the coloured lights.” Several research studies have investigated the benefits of CRADLE VSA devices.

2013

A CRADLE research team found that over 90 percent of health clinics in a rural district of Tanzania lacked blood pressure devices. Often, the ones they did have were broken. The team provided 19 CRADLE VSA devices, containing tally counters to monitor use, to these clinics.

The CRADLE researchers conducted preintervention and postintervention studies over 12 months in three rural hospitals in Tanzania, Zimbabwe and Zambia. During the three-month preintervention phase, pregnant women who went to the hospital at twenty weeks gestation or more had their blood pressure measured twice with the validated CRADLE prototype device. The three-month intervention phase resulted in twenty rural and semirural peripheral antenatal clinics receiving one to two CRADLE prototype devices. They also received training sessions, instructions and a guide to referring based on blood pressure readings.

The researchers analyzed readings from 1,241 women (694 from the preintervention phase and 547 from postintervention). They discovered a link between the use of the device in these rural clinics and improved antenatal surveillance of blood pressure. They found a decrease in the proportion of women who never had their blood pressure measured in pregnancy from 25.1 percent to 16.9 percent.

April 2016

Researchers held a 20-month trial to determine the device’s efficiency. Over this time, new healthcare sites received the CRADLE VSA device every two months until 10 sites had the device. The goal of the trial was to determine the device’s ability to detect obstetric hemorrhaging, sepsis and hypertension and help providers reduce the number of deaths occurring during childbirth. In June 2016, researchers implemented the device in 10 low-income countries including Uganda, Sierra Leone, Ethiopia and Haiti.

June 2018

Studies showed that clinics in twelve countries across Africa, Asia and the Caribbean were using over 6,700 CRADLE VSA devices. A cluster randomized controlled trial in Mozambique, India and Pakistan used a prototype of the device in the intervention phase of pre-eclampsia. The trial enrolled a total of 75,532 pregnant women.

The CRADLE VSA saves lives by foreseeing the early diagnosis of pre-eclampsia. For many women, these health risks may have otherwise gone unnoticed. This innovation is contributing to the prevention of maternal deaths. This could help the world meet the United Nations Sustainable Development Goal 3, “to reduce the global maternal mortality ratio to less than 70,000 per 100,000 live births by 2030.”

– Sareen Mekhitarian
Photo: Upsplash