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VillageReach is Improving Healthcare
The history behind VillageReach is very similar to The Borgen Project’s history. Blaise Judja-Sato, a native Cameroonian, founded VillageReach in 2000 after returning to Africa to aid in the relief efforts of a devastating flood in Mozambique. While he was in Mozambique, Judja-Sato saw a problem with the healthcare system. Since many citizens live in rural areas, the government could not provide them with the medical supplies they needed, which led to their frustration. Thus, she coined the phrase “starting at the last mile” and established VillageReach. Here is some information about how VillageReach is improving healthcare in low and middle-income countries.

Healthcare That Reaches Everyone

VillageReach’s mission is simple. It aims to reach “the last mile” in LMICs (low and middle-income countries) where people do not always have access to healthcare or any at all. Even with VillageReach, 1 billion people do not have access to healthcare. However, VR is working to improve the already existing health systems in different areas. It focuses on four pillars including healthcare accessibility, information availability, human resource constraints and lack of infrastructure. VillageReach is improving healthcare in these countries so that the people in and out of rural areas thrive.

Big Partners

Additionally, VR has over 30 partners that keep its organization running strong. From the Bill and Melinda Gates Foundation to UNICEF, VR has quite an array of influential partners. The President of the organization is Emily Bancroft. She stated that VR “could not have made an impact the last 20 years without the collaborative power of partnership.” The team is spread out over 13 countries. It has headquarters in Seattle, Washington and offices in Mozambique, Malawi and the Democratic Republic of the Congo (DRC).

Drones

Furthermore, in 2019, VR collaborated with the Ministry of Health, Swoop Aero and Gavi, the Vaccine Alliance, to launch the Drone Project in the Équateur Province of the DRC. The partners decided to pick this place in the DRC because of its many geographical challenges. More than half of the health systems in place are only accessible by river. The goal of the Drone Project is to increase vaccine availability in areas that are hard to reach. The drones, provided by Swoop Aero, can take off with the push of a button and land without guidance. It can also carry around six pounds. After the Drone Project’s first flights were successful, the partners are already thinking bigger, brainstorming on how to send other medical supplies and equipment.

COVID-19 Response

Also, VR is a supporter of the COVID-19 Action Fund for Africa. The initiative works to supply PPEs (personal protective equipment) to community health workers in Africa. PPEs are practically inaccessible in most African countries and the consequences are horrible. Health workers stay home or work without PPEs. With health workers not working, there is no way that Africa will be able to stop the spread of COVID-19. VR plays a crucial part in the initiative’s seven-approach plan, which focuses on the last mile and working with similar in-country organizations to accomplish its goals.

Recognition

As a 20-year-old organization, VR received recognition numerous times for its fantastic work in Sub-Saharan Africa. Recently, the Washington Global Health Alliance honored VR with the Pioneers Outstanding Organization Award. The WGHA awards winners that work hard to improve health equity all over the world. The judges select winners, and in 2020, WGHA board member Erin McCarthy led it. VR received an award for its innovative approach, collaborations with local governments in the places it works and its international emphasis on equity.

Overall, from COVID-19 response to innovating delivering vaccines by drones, VillageReach has covered it all in its 20 years of service to the world. VR is improving healthcare, one small rural village at a time.

– Bailey Sparks
Photo: Flickr

healthcare in Belarus
Belarus is a landlocked country in Eastern Europe with a population of approximately 9.5 million people. Before gaining independence in 1991, Belarus was a constituent republic of the Soviet Union. The country had maintained strong economic and political relations with Russia for much of its post-independence history. Aleksandr Lukashenko, elected president in 1994, remains in power today. Despite sharp economic fluctuations in recent decades, Belarus is considered an upper-middle-income economy by the World Bank, and its GDP per capita was an estimated $18,900 in 2017. Belarus spent around 5.9% of the total size of its economy in the health sector in 2017 — slightly more than the 5.5% the nation invested from 2010 to 2014. To learn more about this important topic, here are five facts about healthcare in Belarus.

5 Facts about Healthcare in Belarus

  1. Experts estimate Life expectancy at birth in Belarus for women and men at 79.2 years and 69.3 years, respectively. This ranking grants the country a ranking of 139th in the world. Additionally, physician density, the number of physicians per 1,000 persons stands at 0.00519 as of 2015. Hospital bed density is similarly modest, amounting to 10.8 beds per 1,000 persons as of 2014.
  2. The Ministry of Health directs the Belarusian healthcare system. The Ministry of Health centralizes, stratifies and operates the country’s healthcare system. Also, the Ministry of Health is solely involved in all matters related to creating and implementing healthcare policies and programs — as well as playing a significant role in pharmaceutical regulation. Individual regions fund primary and secondary care, while the Ministry of Health funds tertiary services. Notably, general taxation funds healthcare in Belarus.
  3. Belarus utilizes universal healthcare. Healthcare in Belarus is mostly provided through government-owned facilities, allowing citizens to receive free services. Moreover, the percentage of out-of-pocket expenses relative to total health expenditures has traditionally been low. For instance, in 2017, this figure reached approximately 27.5%. The breadth of access to primary care providers and inpatient care services depends on citizens’ geographical location, except for emergency services.
  4. Preventable habits and diseases represent major health concerns. Alcohol, tobacco, tuberculosis and HIV/AIDS are all lifestyle-induced conditions posing major health risks to the citizens of Belarus. With an average of 17.5 liters per person, Belarus ranks among the top 10 countries with the highest rates of annual alcohol consumption. Tobacco use is similarly prevalent. For example, in 2011, 50.4% of men and 10.2% of women reported smoking, daily. Tuberculosis (TB) is another disease that has imposed a significant threat in terms of public health in Belarus. More than 9,000 diagnoses occurred in 2011; approximately 25% of those patients had multi-drug-resistant (MDR) TB. This represents a strain of TB that is highly resistant to drugs and may cause death. The country also ranks 75th for the number of people living with HIV/AIDS, estimated at 27,000.
  5. Efficiency in delivering healthcare services is problematic. Not only is there a shortage of professionals at primary care facilities, but the overuse of healthcare facilities is also a key concern. Moreover, many areas rely on healthcare professionals who are either still in training or preparing for retirement. This means that their capacity to serve is limited. Also, the industry in Belarus pays Healthcare workers noticeably less, compared with neighboring countries.

Room for Improvement

These facts indicate that the healthcare system in Belarus is generally effective in terms of coverage and guaranteeing medical services to all. However, there remain significant areas where healthcare in Belarus needs improvement. For example, some suggestions include implementing better management, tackling the health risks associated with heavy alcohol and tobacco consumption and providing better pay for healthcare workers. With these improvements, healthcare in Belarus can better the lives of thousands of citizens, nationwide.

– Oumaima Jaayfer
Photo: Pixbay

COVID-19COVID-19 has decimated the people of Brazil as 15,000 to 30,000 new cases are reported daily. As of July 31, 2020, the country had 2,625,612 confirmed cases and 91,607 deaths. The pandemic can be traced back to the wealthy but has now trickled down into the country’s most at-risk communities. These communities are the indigenous and homeless populations and those living in favelas and slums. Furthermore, Brazil’s medical system is at capacity as nearly 100 nurses succumb to COVID-19 per day. With such dire circumstances, residents of favelas have mobilized to combat the virus themselves.

Brazil’s Viral Epicenter

Favelas became epicenters for COVID-19. The number of infected individuals is 17% of the inhabits in favelas are infected in relation to 7.5% in the entire city. Data shows that the most at risk are those of ethnic minority groups. Sao Paulo’s municipal government data states that 62% of black Brazilians are at a higher risk of dying from COVID-19 than white Brazilians. According to the Ministry of Health, one out of three deceased has been from a population of color.

Gang-Enforced Curfews

Rampant gang warfare is well-known in favelas. However, favela residents initially stuck to social distancing guidelines due to local drug gangs imposed curfews in some settlements as well. In Rocinha, residents feared death threats as a result of violating curfew. In another favela, gangs enforced a strict 8 a.m. to 8 p.m. curfew for nearly a month.

Also, gangs have used a variety of methods to spread the news of these lockdowns. Large posters, social media and public announcements made through megaphones atop moving cars have been their delivery method. They even boldly proclaimed that if the government does not have the capacity to fix it, organized crime will solve it. Favela gangs are the first to know about what happens inside these settlements and often make decisions regarding any actions taken.

Luiz Henrique Mandetta, the former health minister, even recommended that authorities have an open discourse with gangs to quell the outbreak within the various favelas. However, removing Mandetta from his position led to his recommendation never coming into effect.

Favelas Unite to Fight COVID-19

In Brazil, 13 million people inhabit favelas across the country. They are unable to handle self-isolation or maintain proper sanitary standards needed to halt the spread of COVID-19. However, residents throughout the various favelas have made notable efforts to fight back.

Paraisopolis is the second biggest favela in Sao Paolo. It has taken on a local production of face masks, the distribution of food rations and hygiene supplies to aid residents. Two makeshift sick wards have opened for those who might be a carrier. For two weeks, 300 residents used the facilities for isolation.

Furthermore, favelas have even organized ambulances to respond to emergencies with doctors, and three have been hired in Paraisopolis. When the municipal government failed to help, proceeds came from donations and crowdsourcing efforts.

Additionally, around 100,000 people live within Rocinha, yet 1 out of 4 tested positive for COVID-19. Rocinha is the largest favela in the country and it is located in Rio de Janeiro. Further outreach efforts via campaigns to inform the denizens of risks associated with COVID-19 continue.

 

From daycares to financial aid for children to study, the favelas are reacting in solidarity to the outbreak. These initiatives taken by Brazil’s most impoverished population are a stark contrast to the official response from municipal governments across the country. A bold, yet critical, move to combat the pandemic.

 

Michael Santiago
Photo: Flickr

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

Facts About Life Expectancy in BarbadosLife expectancy is affected by many different factors including, but not limited to, health care, access to food, disease control and sanitation. In Barbados, the high life expectancy rate is a result of the high quality of life that many citizens experience. Below are eight facts about life expectancy in Barbados.

8 Facts About Life Expectancy in Barbados

  1. The average life expectancy in Barbados is approximately 79 years. Life expectancy is higher than for women at 80.1 years compared to 77.6 years for men. Barbados has the highest-ranking life expectancy in the Caribbean.

  2. Dengue fever is a potentially fatal mosquite-borne disease that is endemic in Barbados. Barbados has fought dengue fever for decades, with its most recent outbreak in 2016. In addition to awareness campaigns, the Ministry of Health prioritizes fogging exercises and house-to-house inspections to contain the spread of dengue.

  3. The leading cause of death in Barbados is heart disease. Noncommunicable diseases accounted for 83 percent of all deaths in Barbados in 2016. Diabetes and cancer are the other main causes of death. Health care in Barbados is held to a high standard and easily available to most. The Queen Elizabeth Hospital is the main provider of secondary care for the population.

  4. The infant mortality rate is 11.3 deaths per 1,000 live births as of 2018. While this is a sharp decline since 1960 when the infant mortality rate stood at 69.6, the rate is higher than the average of 4 deaths per 1,000 live births for high-income countries globally.

  5. Barbados experienced its biggest increase in life expectancy in 1951. In response to The Great Depression, Barbados entered a time of political change that fundamentally transformed the island. The spike in life expectancy continued to increase in pace, as the country developed into an independent nation.

  6. Barbados participated in the U.N. project, “Piloting Climate Change: Adaptation to Protect Human Health.” The Global Environment Facility funded the project. Environmental challenges that affect health include air quality, vector-borne diseases, waste disposal and water scarcity. The objective of the project was to deal with climate-sensitive health risks. Some of the achievements in Barbados were disease prevention, a quick and reliable response system and better storage for rainwater. Only six other countries participated: Bhutan, China, Fiji, Kenya, Jordan and Uzbekistan.

  7. In 2019 there were 100 AIDS-related deaths. Ninety-two percent of the population living with AIDS know their status. According to the Ministry of Health, there have been no babies born with HIV in the past six decades, which is a significant accomplishment.

  8. In 2017, the homicide rate was 10.5 cases per 100,000 population. The most common crimes are drug-related and residential burglaries.

These eight facts about life expectancy in Barbados show that the country is well on its way to being a prospering nation. While there are some challenges, the quality of life in Barbados is on the higher side of the spectrum compared to other Caribbean countries. With a focus on disease control and prevention, as well as continued better access to health care, the life expectancy rate could increase over the next 10 years.

Taylor Pittman
Photo: Flickr

Health care system in Zambia
Zambia’s healthcare system is decentralized, therefore it is broken up into three different levels: hospitals, health centers and health posts. Hospitals are separated into primary (district), secondary (provincial) and tertiary (central). It offers universal healthcare for its citizens, yet the health care system in Zambia remains one of the most inadequate in the world.

Universal Health Care

Zambia is working on implementing universal health care coverage for its citizens to diminish the burden of accessing life-saving treatments. At the moment, Zambia’s government-run health facilities offer basic healthcare packages at the primary (district)level free-of-charge. Their services are under the National Health Care Package (NHCP). With this being said, due to “capacity constraints” and limited funding, the services sometimes do not reach those who need it most. Luckily, the Ministry of Health (MoH) of Zambia and Japan International Cooperation Agency (JICA) have come together in order to help restore the health care system in Zambia. They are investigating ways to effectively set priorities so that processes in health facilities can run faster and smoother.

Private vs Public Healthcare

Even though there are a good number of public and private health facilities, a lot of the public hospitals are chronically underfunded. Another major problem in the public healthcare sector is that there is inequality in the order that doctors meet with patients. As mentioned above, the public sector is divided into three divisions, level one hospitals are in charge of provision of services and level two and three hospitals are referral or specialized hospitals.

District Health Offices (DHOs) are staffed by community health assistants (CHAs). Over the course of their one-year training, they are prepared to improve the management of malaria, child and maternal health and common preventable health conditions. DHOs spend 80 percent of their time on disease prevention and health promotion and another 20 percent “at the health post.”

There are good private hospitals in Zambia’s big cities, for example, Lusaka. They offer their services to everyone with the majority of people that participate in the private sector being foreigners or affluent Zambians. Over 50 percent of formal health services in rural Zambia are private clinics or hospitals. They also account for 30 percent of all health care in the nation. Even though they offer higher quality services at a faster rate, when a serious medical emergency presents itself, the majority of the time people will be evacuated to South Africa since they are able to provide better medical services.

Pharmacies

Pharmacies are not always stocked with the medications or drugs that most people need when they are sick. Even though they are available in most major cities and towns in Zambia, they do not operate on a 24/7 schedule. Their typical work week is Monday to Saturday. When people are in need of a pharmacy, it is recommended to go to one that is attached to a hospital or a clinic for immediate assistance.

Diseases

Zambia’s top five killer diseases are HIV/AIDS, neonatal disorders, lower respiratory infections, tuberculosis and diarrheal diseases. Zambia also sits in the malaria belt, so it is recommended to have a mosquito net to prevent mosquito bites. Other diseases like cholera and dysentery are common during rainy seasons. The Centers for Disease Control and Prevention (CDC) has been helping Zambia since 2000 after establishing an office in the nation. The CDC “funds and assists international and local organizations” like the Ministry of Health to “provide health services at the national and community level.” In addition, the CDC has performed more than 173,000 medical male circumcisions and has prevented 98 percent of HIV exposed infants from getting HIV in 2018.

– Isabella Gonzalez
Photo: Flickr

10 Facts About Life Expectancy in Guadeloupe
Life expectancy is an assessment of not only the projected lifetimes of individuals within a population but also a measure of the quality of life. Life expectancies of various countries range from 50 to nearly 85 years, but life expectancy statistics are consistently higher for women than they are for men regardless of what region a person is analyzing. Guadeloupe, one of three island regions of France that exist overseas in the Caribbean, is showing that it is exceeding the minimum standards in terms of human longevity. Guadeloupe continues to improve relative to the place with the highest life expectancy. Here are 10 facts about life expectancy in Guadeloupe.

10 Facts About Life Expectancy in Guadeloupe

  1. The standard for living for the islanders of Guadeloupe is near the highest in the Caribbean. Coincidingly, life expectancy numbers are also relatively high for this region. Various factors (not just the GDP per capita) measure the standard of living of a country that determines the quality of life, such as personal consumption of goods as well as factors that are outside of individual control, like environmental conditions and public services.

  2. Since Guadeloupe is a French territory, the social legislation in place is synonymous with that of metropolitan France. The largest general hospital is at Pointe-à-Pitre, but multiple smaller independent clinics exist throughout the area. As of 2016, France implemented a universal health care system for Guadeloupe citizens in an attempt to reduce poverty and prevent further revolts.

  3. Guadeloupe has seen a rise in the cost of living and increased disparity among commodities in comparison to metropolitan France. In 2009, islanders began revolting for a relative wage increase. Still, poverty and unemployment rates in Guadeloupe run more than double what exists in France.

  4. The efforts that the Ministry of Health and the Ministry of Overseas Territories put forth served priorities including improving the overall status of health and reducing disparities of health status, improving crisis management, assessing and addressing the needs of senior citizens and persons with disabilities and lowering inequality with regard to access to health services. This health insurance covers pregnant women and means that they no longer have to pay upfront for their medical appointments as part of their maternity coverage. Patients suffering from long-term illnesses also do not have upfront copays, which takes a lot of financial stress off of those with medical needs living in poverty. This type of access to health care should only improve these 10 facts about life expectancy in Guadeloupe.

  5. The leading causes of death during maternity and birth are maternal hypertension and hemorrhaging during delivery. Mosquitoes spread the Zika virus and it can be a source of illness for pregnant women, causing microcephaly in the fetus of an infected mother who does not receive treatment. The Caribbean has announced that Zika is no longer prevalent, however, scientific analysis reveals that due to changes in the classification system, the ability to track the Zika virus is what has actually changed, not the disease itself. In other words, the status of the Zika virus has merely shifted from epidemic to something that one needs to manage long-term.

  6. Guadeloupe has a low population growth rate relative to the other West Indian Islands. This makes sense, considering both the birth and death rates are below the Caribbean average. Perhaps less turnover is indicative of a relatively high life expectancy, as demonstrated by the population of Guadeloupe.

  7. The life expectancy for both sexes in Guadeloupe was 81.84 as of July 2019, whereas the life expectancy of women is 85.24 next to 78.13 for men. In comparison, statistics for France show a projected life expectancy of 85.36 for women and 79.44 for men, with a figure of 82.46 for both sexes. The life expectancy is lower in Guadeloupe in all classifications of sex, even though both countries are French territory.

  8. Some causes of death go unclassified in Guadeloupe. In 2013, there was documentation of 6,600 deaths between the three departments of the French West Indies. These deaths were due to cardiovascular diseases, parasitic or infectious diseases and unclassified diseases. In fact, 13.4 percent of deaths in Guadeloupe were unclassifiable.

  9. In 2013, reports determined there were 240 new cases of HIV in Guadeloupe. Mortality rates from AIDS remain relatively and consistently low due to the fact that population growth rates are fairly low along with the availability of antiretroviral drugs. However, it is still notable that while AIDS might not be a common direct cause of death, mortality from AIDS-related infections is still the leading cause of death in Guadeloupe. In metropolitan France, the leading cause of death is cancer.

  10. Survival rates of and trends of patients with HIV/AIDS in Guadeloupe resemble patterns to Europe as opposed to those in the Caribbean. However, reports still confirm that HIV infections do not typically receive a diagnosis until they have progressed to the stage of AIDS. Although therapy treatments are slightly more developed in Guadeloupe than in neighboring Caribbean countries, medical advancements remain necessary to increase survival rates and aid in the prevention and diagnosis of HIV/AIDS.

When considering life expectancy on an international scope, Guadeloupe is surpassing the minimum standards. Currently, the benefits of the 2009 uprisings are evident only in the health care system; poverty and unemployment continue to be rampant among the islanders of Guadeloupe. At the very least, a high percentage of the population has this universal insurance coverage and the populations most in need even receive supplementary health insurance coverage which provides augmented health care at no additional cost. These 10 facts about life expectancy in Guadeloupe show that things are moving in the right direction in terms of decreasing disparity between Guadeloupe and metropolitan France. The supplemental assistance available to individuals (regardless of employment status) is just the type of progressive accessibility to resources that should be implemented in so many countries facing extreme poverty.

 – Helen Schwie
Photo: Flickr

Hunger and Malnutrition in Timor-Leste
Hunger and malnutrition in Timor-Leste are largely impacted by 41.8 percent of its population living on less than $1.54 a day, making it one of the poorest nations. Timor-Leste, also known as East Timor, is an island nation in Southeast Asia, between Indonesia and Australia. Additionally, only gaining its independence in 2002, it is one of the youngest nations. Among factors impacting hunger and malnutrition in Timor-Leste also include climate variability.

Rate of Hunger and Malnutrition

In the past decade, Timor-Leste has made substantial progress reducing it’s Global Hunger Index (GHI) from 46.9 percent in 2008 to 34.3 percent in 2017; however, hunger remains classified as a “serious” concern. Timor-Leste’s high levels of food insecurity, poor agricultural yields and low levels of disposable income directly contribute to this serious-level GHI.

Malnutrition and stunting levels in Timor-Leste are one of the highest in the world and have been persistent problems. Malnutrition in Timor-Leste is the leading cause of premature death and disability. Quality nutrition is especially crucial for pregnant women and children, up to the age of 2, ensuring proper growth.

That being said, anemia affects over 40 percent of children and 23 percent of women ages 15 to 49, inclusive of childbearing years. The percent of Timorese children under 5 years old with stunted growth in 2013 was 50.2 percent. This is a slight decrease from 55.7 percent in 2002. This shows some progression, but malnourishment and stunting are still at an alarming rate in Timor-Leste.

Timor-Leste’s National Nutrition Strategy

Timor-Leste’s Ministry of Health established its first National Nutrition Strategy in 2004. It introduces basic nutrition interventions and nation-wide goals. To increase the government’s effectiveness in addressing nutrition, UNICEF is providing technical support to the Ministry of Health, which has created the Timor-Leste National Nutrition Strategy of 2014-2019.

It is Timor-Leste’s largest nutrition policy, and its overall objective is to reduce malnutrition and micronutrient deficiency among children and women. Additionally, Timor-Leste became the first Asian Pacific country to join the U.N.’s Zero Hunger Challenge in 2014 reaffirming their commitment to reach hunger and nutrition goals.

Intervention of USAID

USAID efforts are also working to combat hunger and malnutrition in Timor-Leste with 2 large programs. USAID’s Avansa Agrikultura Project works to increase agricultural productivity especially for vegetables, fruits and legumes. It also focuses on strengthening agricultural markets, food accessibility and sustainability in the midst of climate change.

Their other program, Reinforce Basic Health Services Activity, currently works to support Timor-Leste’s government in strengthening the skills of health workers to provide effective maternal and newborn healthcare.

Additional Interventions in Timor-Leste

Mother support groups are another common method to reduce malnutrition in Timor-Leste. A partnership between the European Union, UNICEF and Timor-Leste’s Ministry of Health established these support groups to empower mothers and families by supporting them to seek care for their children and themselves.

Similarly, the World Food Programme (WFP) has nutrition programs aiming to improve mothers’ health and, in turn, their children’s health. One of their programs, Moderate Acute Malnutrition (MAM) provides malnourished pregnant and nursing women with fortified meals and treatment. The WFP also has informational sessions on nutrition and cooking demonstrations. This aids in families learning more about the importance of and access to nutrition.

With the combination and collaboration of Timor-Leste’s government, national government organization’s (NGO’s), intergovernmental organizations and international aid, hunger and malnutrition in Timor-Leste are being broken down and addressed. These continued and intensified efforts provide hope for zero hunger Timor-Leste in the future.

– Camryn Lemke
Photo: Flickr

Healthcare Improvements Indonesia
Healthcare improvements in Indonesia have been increasingly prevalent and apparent due to the government’s focus on improving the sector. Indonesia has set a goal of establishing universal healthcare by 2019, a move commended by the United Nations as part of the 2030 Sustainable Development Goals.

Addressing Non-Communicable Diseases

Non-communicable diseases (NCDs), which are mostly related to unhealthy lifestyle choices are a problem in Indonesia, accounted for 71 percent of all deaths in the country om 2014.

In addition to such sobering statistics, the poor continue to suffer disproportionately from Indonesia’s major health problems and are thus less likely to be immunized. In fact, children from the most impoverished families are nearly four times more likely to die before their fifth birthday than children from the richest families.

Local governments have become the focal point for healthcare provision. To demonstrate such prioritization, this group’s share in total public health spending increased from 10 percent (prior to decentralization) to 50 percent in 2001. This shift could make public spending more responsive, relative to local conditions and variations in disease patterns.

Healthcare Improvements in Indonesia

Telemedicine and software development for healthcare has begun in Indonesia on a small-scale. Close collaboration between the government and private sector is needed to bring this technology to its full potential. However, one of the major challenges in accomplishing bringing telemedicine to Indonesia is the lack of solid regulations. Telemedicine weds medical devices with IT — a combination often not present in government regulations.

Infant mortality has dropped from 118 deaths per thousand births in 1970 to 35 in 2003, and life expectancy increased from 48 years to 66 years over the same period. Such positive developments can be attributed to the expansion of a public health provision in the 1970s and 1980s and increased development in programs for family planning.

Long-Terms Strategies to Create Healthcare Improvements in Indonesia

The government’s Ministry of Health strategy is built on four pillars:

  • Community empowerment
  • Health financing
  • Access to health services
  • Surveillance

Some of the key issues in the decentralized setting for the health sector in Indonesia include: an increase in allocation for health and the improvement of allocative efficiency, the prioritizations within reproductive health and the attempt to ensure the availability of reliable information to support decision-making processes.

Project Development Objective in Indonesia

The World Bank has a specific Project Development Objective in Indonesia known as the Health Professional Education Quality (HPEQ). The aim of the objective is to improve higher education in the health sector through a number of developments. These improvements include:

  • Strengthening policies and procedures for school accreditation
  • Developing a national competency-based examination at the school level for graduates
  • Improving school quality to meet accreditation standards
  • Leading schools to accelerate progress among less strong schools

Healthcare improvements in Indonesia occur because of increased support from the Indonesian government, as well as the help from local and national organizations. With such internal and external support and increased levels of impact, Indonesia continues to make steady improvement in its healthcare system and positively change the lives of its constituents. Other nations would do well to follow in Indonesia’s healthcare-focused footsteps.

Casey Geier
Photo: Flickr

Common Diseases in MacedoniaMacedonia, officially called The Former Yugoslav Republic of Macedonia by the U.N., has a population of 2.1 million. The life expectancy for men is 73 years and the life expectancy for women is 77 years. The “healthy life expectancy” in Macedonia, the number of years a person can expect to live in good health, is only 63 years. This significantly lower age is the result of common diseases in Macedonia.

The most common causes of death in Macedonia are circulatory diseases and cancer. Circulatory diseases, specifically cerebrovascular diseases and ischemic heart disease, are responsible for more than half the deaths in Macedonia, with a mortality rate of 57.2 percent. Cancer is the second most common cause of death, with a much lower mortality rate of 19.7 percent.

An important trend to notice regarding common diseases in Macedonia is that the deadliest diseases are noncommunicable. Injuries and communicable diseases also contribute to death rates, but not nearly as many deaths as noncommunicable diseases.

Public health officials in Macedonia have put emphasis on addressing circulatory diseases in Macedonia, as they have a high mortality and disability rate.

In 2007, the Ministry of Health in Macedonia adopted an extensive health strategy that outlined several plans for improving the healthcare system in Macedonia by 2020. Addressing noncommunicable diseases in Macedonia will require efforts on behalf of the government, non-governmental institutions, healthcare institutions and the citizens of Macedonia.

The strategy for reducing the morbidity, disability and premature mortality attributed to circulatory diseases will address primary, secondary and tertiary prevention. Primary prevention will include promoting healthy lifestyles that include regular exercise, proper nutrition and smoking reduction. Secondary prevention efforts include earlier detection for circulatory diseases. Tertiary prevention includes proper care and rehabilitation for patients facing these diseases.

On World Heart Day (September 29) 2013, Shaban Mehmeti, the Director of the Institute of Public Health of Macedonia, emphasized the importance of reducing the risk for cardiovascular diseases. Mehmeti pointed out that lifestyle changes can help prevent common risk factors for cardiovascular diseases such as high blood pressure, high cholesterol, high blood sugar, being overweight and physical inactivity. Reducing the incidence of cardiovascular diseases will reduce healthcare costs and improve the quality of life in Macedonia.

Macedonia’s cross-sectoral approach to addressing circulatory diseases along with the multiple levels of prevention will hopefully reduce the incidence of circulatory diseases and will also serve as a framework for addressing other common diseases in Macedonia.

Christiana Lano

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