Updates on SDG Goal 1 in AfghanistanThough Afghanistan is a relatively poor country, it is on the road to betterment. The U.N.’s Sustainable Development Goals (SDGs) adopted by world leaders in 2015, are helping to create this reality and below are some updates on SDG Goal 1 in Afghanistan.

What are the SDGs?

The Sustainable Development Goals (SDGs) are an agenda for global change, put together by the leaders of 193 nations and slated to span 15 years, from 2015 to 2030. A broad look at the SDGs can be broken down into three primary goals:
1. End Extreme Poverty
2. Fight Inequality and Injustice
3. Protect Our Planet

What the SDGs Mean For Afghanistan

The Millennium Development Goals — a similar set of precursor goals, intended for the years 2000 to 2015 — set the previous stage for success within Afghanistan. Despite the country’s continuous challenge in creating better lives for its citizens, Afghanistan made much progress during these years. For example, the first 15 years of the millennia saw a change in the mortality rate of Afghan children; in 2001, 25% of Afghans would die before age five, while today that number is down to 10%. Although this statistic is still alarming when compared to those of the developed world, it constitutes a significant improvement. Fast-forwarding to 2015, the compiling of the SDGs took place at the United Nations General Assembly. There, Chief Executive Abdullah Adulla — GoIRA, represented Afghanistan and committed to pursuing the SDGs within his nation.

Since October 2015, upon the approval of the Afghan Minister’s cabinet, the Ministry of Economy has taken the responsibility of keeping track of Afghanistan’s progress and reports regarding the SDGs. The cabinet is currently working on nationalizing the agenda and extending consultations to those with an international stake in Afghanistan reaching its SDG targets.

Progress So Far

Specific updates on SDG Goal 1 in Afghanistan or updates in ending extreme poverty mostly concern planning, rather than actual action. Extreme poverty describes those living on less than $1.25 per day. While 42% of Afghans are below the poverty line (meaning they live on less than $1.90 per day), it is unclear what portion of this statistic is made up of those suffering in “extreme” poverty. Regardless, a great deal of preparation has been made in efforts to achieve SDG Goal 1 in Afghanistan; e.g., 111 national targets and 178 indicators are set for the country.

Recommendations and reports concerning the SDGs are on the minds of Afghan leaders. Aligning Afghanistan’s National Priority Programs with the United Nations SDGs is complete and communications and advocacy strategies are drawn up and approved by the SDGs Executive Committee. In addition, the Targets Prioritization Guideline has been finalized and shared with the relevant authorities.

A Final Outlook: Positive Trends

On a more humanitarian level, the Sustainable Development Report shows updates on SDG Goal 1 in Afghanistan as somewhat bleak. “Major challenges remain” still characterizes most of the assessment of the nation’s progress. However, this does not mean that a great deal of improvement has not already taken place. In terms of hunger issues, the prevalence of starving children in Afghanistan has dropped, as has the prevalence of obesity. The general health and wellness trajectory also seems promising — with maternal mortality rates and new HIV rates in particular, dropping significantly.

Overall, while updates on SDG Goal 1 in Afghanistan may on the surface be merely organizationally based — the nation is making a great deal of important progress towards the end goal. By 2030, the country’s outlook might well be much more promising.

Ava Roberts
Photo: Flickr

E-Mental Health in Chile
As mobile technologies and the internet spreads throughout the developing world, health care has become a new field for emerging technologies to treat patients from a distance. While the number of online programs and mobile apps has increased exponentially in the past decade, the science to verify their effectiveness has lagged. For this reason, Swiss researchers with Frontiers, a peer-reviewed health journal, studied a series of Chilean intervention technologies to test their effectiveness in treating and monitoring different mental health symptoms in adults and adolescents. The results show that while case studies are lacking in scope and resources to date, initial findings are that e-mental health in Chile is addressing inequalities in mental health access and affordability.

Mental Health Problems in the Developing World

A common misconception of the developing world since the 1990s was that depression and anxiety were conditions unique to the developed world. The Millenium Goals of the United Nations (U.N.) in 2015 made no mention of mental health as a global issue. The U.N. Millenium Development Goals for 2030 now include low-cost mental health as a pillar of development. The belief that poor countries were relatively immune to mental disorders due to their communal living and family-centered life has often inflated this misconception. Experts believed that these strong ties safeguarded poor communities in developing countries from developing mental health disorders. Health professionals, including doctors, psychiatrists and the World Health Organization (WHO) held this belief for most of the 20th century.

However, WHO reported a stark lack of access to mental health services in Afghanistan, Rwanda, Chad, Eritrea and Liberia in a 2005 report. Each country at the time had only one or two psychiatrists nation-wide. Poorer countries spend almost no money on treating mental health in comparison to general medicine. Many still consider access to mental health a luxury in these countries, exposing the socioeconomic inequalities. Prior to this, the World Bank (WB) in 1993 had found that mental disorders were the greatest cause of disability worldwide, including both in developed and developing countries.

According to Tina Rosenberg of The Guardian, the data from the WB in 1993 did not fully capture the influence that depression has on general health in poor countries. The data neglected to take into account how depression and other mental health issues can interact with other illnesses such as its effect on the immune system, remembering to take HIV and other essential medicines or maltreatment of newborns from a depressed parent, for example. Although the debate over mental health has changed since the turn of the century, poor countries still spend very little money on mental health programs or access to treatment.

Affordable Solutions

Psychiatrist Vikram Patel, a Pershing Square professor of global health at Harvard Medical school, stated that the majority of people with mental health disorders require very little counseling to guide them in what he describes as “hope interventions.” In his research in Zimbabwe, he found that there are inexpensive solutions to providing mental health help to those experiencing depression or anxiety. An example he points to is a program that elder community members in Zimbabwe runs. This program sets up benches outside of clinics to engage the public in talking through issues with lay mental health workers. He concluded from his research that mental health coverage in poor countries depends on implementing solutions that were affordable and scalable.

Technology is becoming one of these affordable solutions to address the lack of mental health care. Recent data from WHO shows that 85 percent of developing countries are not getting the mental health treatment they need. The spread of mobile phones in developing countries is a novel solution to bringing a therapist to low-income and rural areas to help bridge the accessibility gap. WHO is now promoting the use of electronic health technologies in its Mental Health Action Plan 2013-2020. Technology also offers a confidentiality element that gets around the mental health stigma in some places so patients can seek help in privacy if desired. Smartphones can also be proactive in monitoring their owners, offering routine check-ins, noticing a drop in sociability, reacting to phone usage and vital signs. Above all, e-mental health has the potential to cut costs as there is no need to travel to see a trained professional.

E-Mental Health in Chile

Although technology seems to be a viable and affordable solution to the gap in mental health services in the developing world, it has so far outpaced the science to back up the claim that it is an effective solution. In an effort to catch up with the science, Swiss Researchers with Frontiers Public Health conducted several mini studies on the effectiveness of different mental health intervention technologies in both adults and adolescents in Chile which the Millennium Science Initiative of the Ministry of Economy funded in its Dec. 2019 publication.

Researchers also wanted to know how to address the inequalities in treatment that are observable between socioeconomic groups. They found that only 38.5 percent of people diagnosed with a mental health disorder received treatment in Chile. This comes in spite of 25 years of progressive policies by the government to support the expansion of health services in the country. Those who received treatment tended to come from wealthier and urban communities, such as the capital city.

Nevertheless, the researchers concluded that internet-based digital technologies that individuals used as interventions could reduce the gap in access to mental health care in Chile. For example, the researchers evaluated remote collaborative depression care programs that can monitor patients who live in rural areas with little support. The results show that the program received a higher user satisfaction ratio at six months of care when compared to traditional care. The program utilized internet and telecommunication training for interventions, while making it clear to participants that a trained profession was available in an emergency situation.

Another case study the Swiss researchers examined was from the University of Chile Faculty of Medicine that conducted a feasibility and acceptability study for depression management among adolescent females with mild to moderate depressive symptoms. The psychotherapeutic tool used was an online adventure video game to score and recognize negative cognitive bias, interpersonal skills, healthy lifestyle skills and behavioral health. Most patients, as well as their therapists, rated the game favorably, indicating that they believed their mental health benefited from playing it. In a similar project, called The Mascayano, mental health providers created a suicide prevention program through an online intervention for adolescents. The format for the technology was both an online platform and a mobile application with a virtual community. The intention was for the program to be informative and interactive for participants as well as identify those most at risk.

Another program, called Ascenso, aimed to monitor patients post-discharge from treatment. It used an online assessment to monitor symptoms on a biweekly basis and provided automatic feedback. Most patients accepted the program favorably and said that the program was easy to use, educating them on depression, teaching them self-monitoring skills and being a generally beneficial source of support.

The Implications of E-Mental Health in Chile

The heterogeneous studies that researchers conducted regarding e-mental health in Chile show that digital technologies have the potential to bridge the gap in coverage for low-income and rural areas through a patchwork of different programs that aim to improve mental health for those experiencing depression and other mental health disorders. Those who participated in the different programs reported a good level of acceptability on par with traditional care, if not better in some instances. This is particularly hopeful for those who live in remote locations of Chile and have limited access to health care but experience mental health issues at higher levels than their wealthier counterparts due to economic inequality or location.

Furthermore, the conclusion of the mini studies suggests that the spread of internet-based technology and mobile devices to a younger, tech-savvy generation has proven to be a feasible method of reaching people living in low-resource areas. The authors of the study project that digital technologies such as these have a larger implication for the developing world as well. They represent an affordable delivery system to reach poor communities with mental health treatment, follow-up, education, monitoring and interventions that may inspire policymakers and stakeholders from other developing countries to invest in their own mental health infrastructure to resemble the early successes of e-mental health in Chile.

Caleb Cummings
Photo: Flickr

10 Facts About Life Expectancy in Ethiopia
Ethiopia, a country located in the Horn of Africa, is the continent’s second-most populous country. The government has made impressive strides toward eradicating poverty and improving Ethiopia’s life expectancy. Here are 10 facts about life expectancy in Ethiopia.

10 Facts About Life Expectancy in Ethiopia

  1. Ethiopia has a high life expectancy rate in comparison to similar countries. The average Ethiopian resident can expect to live 66.34 years while the average resident of the nearby Central African Republic can expect to live to about 53. In the United States, the average life expectancy is 79.
  2. Life expectancy rates took a hit in the 80s. During Ethiopia’s most recent famine, the average life expectancy began to decrease in 1979 and continued to drop until 1983, reducing 1.69 percent in total from 44.26 years to 43.52 years. The United Nations estimates that this famine was the cause of approximately 1 million deaths. 
  3. The life expectancy in Ethiopia has overall been on an upward trend. Its current average life expectancy has more than doubled since 1950 when it stood at 32.53 years.
  4. In recent years, the average lifespan for Ethiopians exceeded the projected life expectancy. In 2017, projections determined the life expectancy for women to be 61.3 years but observed to be 70.4, while projections stated that male life expectancy was 58.2 and observed to be 66.7. One could attribute this to the fast-paced growth of Ethiopia’s life expectancy. 
  5. Malnutrition rates are dropping. The number of Ethiopian citizens suffering from severe malnutrition dropped 32 percent from 2000 to 2010, and those dwindling numbers have aided in the improvement of the life expectancy in Ethiopia. UNICEF has had a significant hand in this reduction by providing health posts and training workers to aid in hygiene, sanitation and nutrition. 
  6. Communicable and noncommunicable illnesses are still a big problem in Ethiopia. The leading cause of deaths in Ethiopia is neonatal disorders. More than 60 percent of infant deaths are due to neonatal disorders as well as 40 percent of deaths among children under 5 years old.
  7. Infant mortality rates are decreasing. While neonatal disorders are the leading cause of death in Ethiopia, those numbers are improving. In 1990, the observed mortality rate for children under 5-years-old was 197.7 per 1,000 live births. As of 2017, that number had dropped to 56.1 deaths per 1,000 live births. This change is no doubt due to the government’s efforts to offer easier access to health clinics to expecting mothers.
  8. The government is working to improve health care. It has been taking steps to align its health care system with the Millennium Development Goals, and this has aided in improving the overall health of Ethiopian residents. UNICEF has led to a surge in the number of health posts from just a handful in 2004 to 9,000 in 2011. 
  9. Unemployment rates have decreased. Since 1999, unemployment rates in Ethiopia have been on a downward trend, dropping from 26.4 percent in 1999 to 19.1 percent in 2018. The number even hit a record low of 16.8 percent in 2015. The overall improvement of employment rates in Ethiopia, giving the poor the opportunity to provide for themselves, has also helped improve life expectancy.
  10. The fight against poverty in Ethiopia is making impressive progress. When one compares Ethiopia to other African countries, it has made the most progress against poverty second only to Uganda between 2000 and 2011. While Ethiopia’s poverty rate stood at 44 percent in 2000 and dropped to 30 percent in 2011, Uganda’s poverty rate went from 38.8 percent in 2002 to 19.7 percent in 2012. 

There is still much that people need to do in Ethiopia. Roughly a third of the population is without clean water and nearly a quarter of Ethiopians have no access to toilets. It has been a long journey recovering from the drought and consequent famine of the 80s, but the government is taking steps to better the daily lives of Ethiopians and lengthen Ethiopia’s life expectancy. These 10 facts about life expectancy in Ethiopia show that the country has a chance to continue its improvement.

– Amanda Gibson
Photo: Flickr