Posts

Mental Health in the Philippines
Mental health in the Philippines is worsening during the COVID-19 pandemic. The number of calls for mental health assistance has increased along with higher reports of depression and suicidal thoughts. UNICEF, the Philippine Red Cross and the World Health Organization (WHO) have come together to contribute invaluable resources, such as infographics and a hotline. These two key implementations have been instrumental in reducing the negative mental health effects of these trying times and in unifying isolated Filipinos.

Infographics for Frontline Workers and Filipino Citizens

The WHO updated its Philippines website in September 2020 to include mental health infographics. The graphics portray encouraging messages and quick facts and are all available for download. It tailored the various infographics to specific audiences — among the selections are the elderly, family of COVID-infected patients and frontline workers.

Some images directed toward Filipino citizens include reminders to nurses, doctors and other healthcare professionals to self-care. With the high amount of Filipinos in the healthcare field, a high volume of nurses and doctors are bound to have very particular needs relating to the emotional exhaustion of caring for extremely sick people.

A Mental Health Hotline

The Philippine Red Cross has instituted a special hotline to provide psychological first aid related to the effects of COVID-19. UNICEF is pairing with Red Cross to provide resources and mobilize support systems to improve mental health in the Philippines.

The hotline’s Red Cross workers consist of 14 trained volunteers hailing from mainly social work and mental health backgrounds. They receive training for three days in helping skills and mock calls. The trainees also attend four-hour sessions on self-care for the volunteers’ own mental health benefit. This vital self-care helps fend off emotional exhaustion.

Filipino citizens are able to use this national COVID-19 hotline to tackle their mental health situations. The hotline provides emotional care, such as talking about callers’ problems. Additionally, it functions as a source of information about COVID-19 to prevent misunderstandings surrounding the pandemic’s uncertainty and hysteria.

The Philippine Red Cross has also extended its services during the pandemic. It has utilized social media as a way to provide a more convenient avenue for people to talk about their hardships. On Facebook, a feature exists that allows Red Cross volunteers to chat through an avatar. The chat even allows avatar customizations, such as male, female, LGBTQ and young child settings according to the callers’ preferences. The Philippines’ hotline has helped over 9,000 callers since its creation and continues to support mental health in the Philippines.

Where Mental Health Currently Stands

The pandemic, social isolation and general fear and uncertainty have affected mental health in the Philippines. Both peoples’ stress and rates of depression continue to increase. The pandemic has resulted in distancing and isolation, which has deeply impacted the Philippines — a country where tight-knit families and community-mindedness abound. However, aid from nonprofit organizations has lessened the devastating effects of the pandemic. Support from UNICEF and the WHO has benefited mental health throughout the nation and fostered a much-needed sense of connection.

Alyssa Ranola
Photo: Flickr

Way to Support Albania
Since the beginning of COVID-19, the unemployment rate in Albania increased from 12.33% to 12.81%. As thousands of Albanian people have entered poverty, UNICEF Albania and other humanitarian organizations are leading the way to support Albania during these trying times.

United Nations Development Programme (UNDP)

The United Nations Development Programme (UNDP) Albania started its COVID-19 response on March 9, 2020, by helping the Regional Local Democracy Programme (ReLOaD). The ReLOaD program helps update projects that deliver hygiene packages to vulnerable households. It also supports Albanian farmers with seeds and Albanian children with online learning materials. Support has reached 11 areas from Tirana to Lezhë, Albania. The UNDP even created an International Romani Day campaign where approximately 1,150 Albanian households received food and hygiene packages in April 2020.

UNICEF Albania

The United Nations International Children’s Emergency Fund (UNICEF) Albania works to protect child rights with government and organization partners. Through programs supporting social and child protection, education and early childhood development, UNICEF Albania has three priorities: respecting child rights while implementing social inclusion through maintaining family access to the Albanian justice system, reforming the social care system and keeping children in school with NGO support.

In April 2020 and amid the COVID-19 pandemic, UNICEF Albania supported a child protection organization statement about how thousands of children can receive protection from violence. This can occur through phone helplines, temporary shelters and professional workforces in Albania. In response to the call to action, child protection helplines underwent initiation in June 2020 through UNICEF and The Alliance for Child Protection in Humanitarian Action (CPIHA) support.

Educational Support in Albania

World Vision Albania and Kosovo Education and Youth Technical Advisor Brisida Jahaj told The Borgen Project that, “There was a huge challenge with families in poorer households.” This is because the families do not have the IT equipment or the internet for children to continue their education in Albania. The Ministry of Education in Albania found that 10,000 children lost educational resources over COVID-19.

Regarding education, UNICEF Albania has partnered and supported the Akademi.al online learning platform since 2019. Plans intend to implement it online and on television for all students by 2021. Funding from UNICEF and support from the Ministry of Education in Albania gave Akademi.al the opportunity to put approximately 1,100 lessons online for students taking Matura exams in Albania. Jahaj describes the platform as a “backup plan that if we go into the third level scenario,” wherein Albanian schools shut down in 2021.

In August 2020, UNICEF Albania worked to combat poverty due to COVID-19 by initiating its first Albanian cash transfer program to approximately 1,700 vulnerable families in Shkodër, Korçë and Durrës, Albania.

UNICEF Albania and the World Health Organization (WHO) also established an online training program to teach professionals about Mental Health and Psychosocial Support (MHPSS) and how to implement support to vulnerable populations during emergencies from May to July 2020. The eight module training course helps professionals master how to support mental health and psychosocial issues during emergencies. Approximately 230 frontline professionals obtained certification by September 2020.

Red Cross and World Vision

Albania experienced a series of earthquakes on November 26, 2019, which impacted approximately 200,000 Albanians. The Albania Red Cross responded to the earthquakes by sending 160 volunteers and providing 4,500 shelter relief packages to families who lost homes. The Albanian Red Cross received a 2020 Coca-Cola Company $100,000 grant in the wake of the pandemic to give community food aid and medical equipment to Albanian hospitals.

The Qatar Red Crescent Society partnered with the Albanian Red Cross to provide food package relief to 700 vulnerable families as a way to support Albania. Following the initial response, the Albanian Red Cross collaborated with Better Shelter. A total of 52 Better Shelters underwent construction in Durrës, Krujë, Laç, Shijak and Tirana, Albania, while home reconstruction continues through 2021.

World Vision Albania also helped with the earthquake response in Durrës, Lezhë, Kamëz and Kurbin, Albania by giving food and hygiene aid to 1,019 families and materials to help 27 families with home reconstruction. Jahaj told The Borgen Project that food and hygiene aid will continue in 2021 as World Vision and other humanitarian organizations including Save the Children and UNICEF provide “a lot of the masks and hand sanitizers for the schools” in Albania.

Where is Albania Now?

As of 2021, several humanitarian organizations are working to protect children and vulnerable individuals from the impact of the Albanian earthquakes and COVID-19 on the ground and online. Jahaj explained how World Vision Albania utilizes the Building Secure Livelihoods economic development program to help alleviate poverty while helping parents provide for their children from 2019 until 2023.

On all fronts, UNICEF, World Vision, Save the Children and the Albanian Red Cross responded to Albanian communities. By providing everything from medical care, earthquake shelter, child protection and online learning directly to families, these organizations have found a way to support Albania. As of January 2021, humanitarian organizations continue to work on home reconstruction, mental health support and flood response. Furthermore, Albania acquired 500,000 COVID-19 vaccines to distribute in 2021.

– Evan Winslow
Photo: Flickr

Female Genital Mutilation in Iraq
In 2008, Gola told her story of female genital mutilation in Iraq to reporters with The Human Rights Watch. It was a story of silent pain. “My family took me and told me nothing, I never went to the doctors, my family was never concerned.”

About Female Genital Mutilation

Female genital mutilation or FGM has been going on for centuries. The World Health Organization (WHO) defines FGM as “all procedures involving partial or total removal of the external female genitalia or injury to the female genital organs for non-medical reasons.”

Iraq’s older generations believe that cutting a woman’s clitoris will ensure the preservation of her virginity and push the prevalent practice of female genital mutilation in Iraq. Additionally, the women do not receive any anesthesia beforehand. FGM consists of three types including type one which is the removal of the labia minora and the labia major, the protective layers surrounding the vaginal orifice. Meanwhile, type two is the removal of the clitoris and the labia minora and type three is the narrowing of the vaginal orifice. However, all reproductive parts of a woman are important to her maintaining physical and mental health, and expulsion of one or more of these parts puts women’s lives at risk.

FGM is a silent practice that has been going on for decades. Female genital mutilation in Iraq occurs across Iraq without religious, lawful or ethical reasoning. Mutilation begins on girls as young as 3 although grown women may also experience it.

Solutions

Wadi, an NGO, finds solutions for women in crisis. In early 2004, Wadi began visiting villages after learning of the high number of women that FGM affects. After interviewing several women in the area, it found that 907 out of the 1,544 women it questioned were victims of FGM. Wadi has launched a campaign to educate women about the harmful consequences of FGM. In 2011, the parliament of the Kurdish region passed a bill banning domestic violence against women thus banning FGM. However, even though the Kurdish region has banned this practice, women’s voices are continuing to cry out against it to prevent future injustices.

A Light at the End of the Tunnel

In July 2012, Wadi launched an FGM hotline to provide social, mental, medical and reproductive advice to FGM-affected women throughout the region. By mainstreaming gender rights and working on educational programs, Iraq should be able to make headway to eradicate FGM. To fully eliminate this practice, the Wadi team began to visit local villages and midwives to educate them that these mutilations do not preserve a woman’s virginity, the wounds are not self-healing and the practice causes harm that is often permanent. Hadiya, who experienced FGM at the age of 5-years-old, spoke of pain 20 years after the mutilation occurred. FGM can cause infertility, incontinence, complications in labor and even death.

 

With all endings come new beginnings. Iraq has been the home to unlawful practices and prevalent mistreatment of women, but women are steadily pushing back to reclaim their freedom and honor. Some who have undergone FGM are now refusing to let their daughters experience the same fate, disallowing their clerics from approving practices of FGM. They band together in face of an ancient ritual that tears the body apart. Gola told her story so that women born after her will not have to tell theirs.

– Nancy Taguiam
Photo: Flickr

Côte d’Ivoire Health Care
Côte d’Ivoire health care has faced challenges in recent years and even more so during the COVID-19 pandemic. According to a 2020 Helen Keller International report, Moriame Sidibé, a mom and homemaker from northern Côte d’Ivoire was a “Vitamin A Hero” because every six months for the past three years she spent three full days walking door to door and village to village to give young children Vitamin A and deworming pills. Sidibé faced challenges because sometimes she needed to convince mothers of the importance and safety of the pills, coax the children to swallow the pills and mark the children’s fingers with black ink so she would not accidentally give them a second pill.

Sidibé left her own four young children to do this, but it was worth it to her because she has training as a community health volunteer who is part of a collaboration between the Ivorian government, Helen Keller International, the United Nations International Children’s Fund (UNICEF) and Nutritional International fighting the extreme form of malnutrition in children called micronutrient deficiency or “hidden hunger.”

The Situation

Twenty-five percent of Ivorian children get enough calories, but not foods with sufficient Vitamin A, zinc, iodine or iron.  That “hidden hunger” puts one in four Ivorian children at risk of blindness, impaired brain development and some fatal infections. Deworming pills kill the parasites that prevent children from absorbing micronutrients including Vitamin A, and together the deworming pills and the Vitamin A can save children’s lives. In December 2019, the campaign reached 5 million children or 98% of all Ivorian children, an incredible accomplishment of a ministry of health working with international non-governmental organizations (NGOs) and trained community health volunteers.

Côte d’Ivoire, the West African nation of 25 million, enjoyed a strong 8% average GDP growth between 2011 and 2018. According to the World Bank, the country had one of the strongest economies in sub-Saharan Africa due to an expanded middle class that supported demand in industry, agriculture and services. The Côte d’Ivoire health care indicators, however, lagged behind other less-developed nations, and in 2018, Côte d’Ivoire ranked 165 of 189 countries on the U.N. Human Development Index.

As noted in a 2020 Oxford Business Group report, planned increases in health care spending should improve these indicators. Côte d’Ivoire spent $1.8 billion on health care in 2016, $2 billion in 2019 and intends to spend $2.3 billion in 2021. The country invested in access to services, renovation and building of medical facilities, and development of technical platforms aligned with international health standards. The Ivorian government worked with a number of programs like the Helen Keller International Vitamin A Heroes; however, then the COVID-19 pandemic hit.

Despite COVID, Côte d’Ivoire Health Care Initiatives Regroup to Persevere

Based on the World Health Organization COVID-19 transmission guidance, the Vitamin A Heroes collaboration discontinued its door-to-door campaign. Nevertheless, during the pandemic, the campaign has resolutely distributed Vitamin A and deworming pills at local health clinics when children come with their families for other reasons. Once the pandemic subsides, it will renew its crucial Vitamin A Heroes campaign.

Predicted to Rebound Post COVID and Target Health Care

Côte d’Ivoire’s pre-COVID targeted investment in health care services, facilities and technical innovation gives Côte d’Ivoire health care a positive outlook according to the Oxford Business Group report. The International Monetary Fund predicts that Côte d’Ivoire’s GDP growth will climb back up to 8.7% in 2021 as the new investment in Côte d’Ivoire health care parallels the successful investment in other sectors.

Moving Forward, Côte d’Ivoire to Roll Out Planned Health Care Initiatives

One example of a Côte d’Ivoire health care collaboration of governmental, NGO and local organizations that launched during the COVID-19 pandemic in 2020 is Harness the Power of Partnerships. Harness the Power of Partnerships is a Côte d’Ivoire health care initiative to use faith-based organizations in the HIV response. Faith-based leadership is working with the President’s Emergency Plan for AIDS Relief (PEPFAR) and the Joint United Nations Programme on HIV and AIDS (UNAIDS) on long-term strategies to reduce the stigma of HIV/AIDS and to keep Ivorians on their antiretroviral therapies. This PEPFAR/UNAIDS program exemplifies how the Ivorian government continues to partner with non-government groups, including local groups, in order to improve Côte d’Ivoire health care indicators.

Improving Côte d’Ivoire health care will not be an easy task, but creating collaborations with international powerhouses like PEPFAR, UNAIDS, Helen Keller International and local nonprofits and community leaders is definitely a strategy worth watching as COVID-19  subsides and the Ivorian economy rebounds.

– Shelly Saltzman
Photo: Wikipedia Commons

Healthcare in Germany
Only months before the World Health Organization (WHO) declared the COVID-19 outbreak a global pandemic, Germany motioned to reconstruct its national healthcare system, starting with the Digital Healthcare Act. Passed in Sep. 2019, tasks that once required an in-person visit to a physician’s office can now occur online. Options available to patients and doctors through telehealth include:

  1. Manage prescriptions through smartphone apps.
  2. Report and monitor conditions remotely, such as blood sugar.
  3. Arrange consultations and appointments online, as well as attend over video calls.
  4. Collect data electronically, increasing accessibility for healthcare professionals and researchers.
  5. Provide medics specialized in emergency telemedicine to reduce mortality rates in areas that lack access to medical resources.

Maintaining a Digital Healthcare System

Through government support, healthcare in Germany has successfully transitioned to a digital format. The government dedicates €200 million per year for the development of medical technology. Additionally, healthcare providers have received encouragement to comply with the national system, the Telematics Infrastructure. Physicians who do not offer virtual options receive a charge of a 2.5% fee. The charge ensures that providers are staying up-to-date with emerging technology and meeting the national standards for healthcare. Despite the complications which accompany telemedicine, to guarantee care is available for everyone, the Digital Healthcare act covers all fees incurred virtually under insurance.

How Telehealth Benefits Impoverished Populations

The benefits of digital healthcare in Germany differ depending on the unique needs of each individual. Groups who benefit the most from digital healthcare include but are not limited to:

  1. Individuals over the age of 60.
  2. Low-income individuals.
  3. Families affected by catastrophic spending.
  4. Individuals lacking health insurance.

Catastrophic spending occurs when families must pay out of pocket for emergency medical services, often leaving them in debt. Low-income individuals as well as those without insurance are most likely to experience negative effects from catastrophic spending. Although it only affects a small percentage of the population, catastrophic spending to cover medical expenditures is very much a marginalized issue, as two out of three households who catastrophic spending effects are already in poverty.

Telehealth benefits impoverished families because virtual healthcare comes with a smaller price tag than many in-person services. Insurance plans place a cap on the number of inpatient services a patient may receive before an increase in pricing. However, there is currently no cap on outpatient visits, such as telehealth calls, which still provide a medical service but do not require a hospital visit.

Healthcare in Germany, specifically telehealth, is also more affordable for lower-income patients due to the Hospital Care Structure Reform Act of 2016. The legislation aims to cut back on unnecessary charges for medical services for patients. For example, a low-income family would be more likely to afford a telehealth appointment than a different service that requires lab testing or an in-person visit to a physician’s office.

Influences on COVID-19

Telehealth serves as a model for countries seeking solutions for healthcare in a time that requires less direct contact. The influence of German telehealth allows countries that did not previously utilize a virtual system to continue to safely provide care throughout the pandemic. Ways in which digital healthcare protects both doctors and patients include:

  1. Virtual appointments decrease the amount of direct contact between healthcare professionals and patients, simultaneously decreasing the chances of transmission.
  2. Treating patients with less severe concerns via telehealth enhances flexibility so medical professionals may attend to patients who require immediate care.
  3. The capability of healthcare specialists to partner remotely offers patients extended hours to receive virtual care.
  4. Online resources, such as self-evaluation tools, advise individuals on how to remain cautious throughout the pandemic.

Evolution of Healthcare

German contributions to telehealth reflect the way in which the U.S., as well as many other countries, are handling the COVID-19 pandemic. The German Digital Healthcare Act paves the way for the future of medical treatment and offers new options for healthcare that are not only efficient but also introduce a new aspect of convenience for patients. Although some individuals may be reluctant to adopt a digital healthcare system due to the unique challenges it poses, Germany has proven that transitioning to virtual medicine is not only possible but beneficial, as well as it continues to deliver flexible options for healthcare during the pandemic.

Calla Howard
Photo: Flickr

Environmental Impacts on DiseaseHuman health and environmental concerns are commonly thought of and treated as unrelated issues. However, environmental degradation has an unquestionable impact on a community’s health. The United Nations Environment Program (UNEP) recently released a report underscoring this point. The UNEP finds environmental impacts on disease are especially apparent in Africa, where large numbers of people are directly reliant on natural resources. According to the World Health Organization (WHO), an estimated 35% of the total burden of disease in sub-Saharan Africa is caused by environmental hazards. For example, contaminated water and air pollution commonly cause diarrhea and respiratory issues.

Indoor Air Pollution

Indoor air pollution is one of the leading environmental impacts on disease and death in Sub-Saharan Africa. People living in extreme poverty primarily depend directly on solid fuels (i.e. biomass fuels) for their heating and cooking needs. The harmful biomass fuels such as crop waste, coal and wood cause significant air pollution, especially when burned by inefficient and poorly ventilated stoves. Biomass smoke contains thousands of health-damaging substances. These pollutants penetrate deep into the lungs and initiate the development of acute lower respiratory disease, cancer and multiple other diseases, including chronic obstructive pulmonary disease. Women and young children are at the highest exposure to the fumes and have the highest rates of mortality resulting from indoor air pollution. WHO estimates that Sub-Saharan Africa has the highest rate of indoor air pollution deaths in the world, along with parts of Southeast Asia.

Improving the Environment and Fighting Disease

Shifting from solid fuels to cleaner energy technologies can have a major impact on indoor air pollution levels. For instance, liquid petroleum gas (LPG), biogas and solar power generation all produce less indoor air pollution. Governments and NGOs alike should plan to help communities make this transition. However, air pollution is just one environmental concern that needs addressing.

Simple solutions to environmental concerns include safer storage of water and dangerous chemicals; these relatively cheap improvements can be highly effective in reducing disease. Ultimately, providing low-cost storage containers to urban and rural communities will result in prominent and lasting gains in health and economic development. Additionally, improving common household appliances can reduce indoor air pollution in poor communities; for example, stoves and ventilation systems often contribute to or fail to reduce indoor air pollution. Lastly, increasing education and public awareness about the environmental impacts on disease is critical; many environment-related health issues are preventable. For instance, educations can encourage mothers to keep small children away from constant contact with fires while cooking.

In Conclusion

It is imperative to address the upstream determinants of Sub-Saharan Africa’s high morbidity and mortality rates. Clean water and air are powerful preventative medicines. Implementing simple, yet effective solutions and sustainable management of natural resources is crucial to ending poverty. By helping people to treat the environment well, governments and NGOs can reduce diseases and child mortality; additionally, their work will improve maternal health and education across sub-Saharan Africa.

Samantha Johnson
Photo: Flickr

The State of Malaria in South-East AsiaAlthough Malaria remains at the forefront of global health issues, malaria in South-East Asia represents a success story in terms of mobilizing aid in the fight against the disease. In 2018, the World Health Organization (WHO) reported eight million malaria cases, a decline of 69% since 2010, marking the largest decline of all WHO regions.

Direct Aid Strategies

South-East Asia has been the target of hefty aid strategies from a variety of non-profits. The aid primarily comes from the WHO and the Global Fund to Fight AIDS, Tuberculosis and malaria. As the Global Fund puts it, “The fight against malaria is one of the biggest public health successes of the 21st century.” The multi-pronged strategies used by these non-profits begin with a tactic known as surveillance.

Surveillance involves testing, record-keeping and reporting malaria cases. Surveillance systems have become more efficient. As a result, health care systems maintain a much more refined picture of malaria cases in any given region. This eventually gains “near real-time individual case data in small areas.”

Vector control is limiting contact between people and the mosquitos that transmit the disease. It has also helped eliminate malaria in South-East Asia. One of the most effective means to achieve this has been the wide-scale distribution of insecticidal mosquito nets. So far, the Global Fund has donated 142 million nets, providing a simple means for those in rural and urban areas alike to keep themselves protected.

Strengthening Local Healthcare Systems

Besides direct aid, many non-profits also turn to bolster already-existing local healthcare systems in the fight against malaria in South-East Asia.

Malaria Consortium is a non-profit organization specializing in the disease. It began working in Myanmar in 2016 to train locals in rural areas to administer essential health services. Malaria Consortium also taught local health workers to treat malaria, working to close the gap in rural healthcare.

In one village, 13 healthcare workers were trained in the treatment of malaria and other diseases common to the area. These workers went on to teach local mothers and adolescents, expanding the web of healthcare knowledge even further. By the end of the program, 90% of trainees were able to diagnose malaria cases correctly. Trainees were also able to run malaria diagnostic tests and administer Artemisinin. Artemisinin is the most widely used drug to treat the disease.

Concerns with Treating Malaria

Aid has been successful in treating malaria in South-East Asia. However, a new drug-resistant strain on the rise reignites concerns around the disease. Artemisinin-resistant malaria has the potential to undermine malaria prevention and was first recorded in the Mekong River region of Vietnam, Thailand and Cambodia. In 2014 and 2015, studies conducted by Vietnam’s National Malaria Control Program found treatment failure rates ranging from 26% to 46%.

From the perspectives of non-profits and medical experts, the rise of this new Artemisinin-resistant malaria in South-East Asia means surveillance efforts must be bolstered to prevent global spread. Likewise, instead of merely treating already-present cases, the goal must be preventing transmission in the first place. According to Chris Plowe, the director of the Duke Global Health Institute, is using all the tools available to the institute to eliminate aggressive malaria in the Greater Mekong subregion.

Overall, direct aid, community mobilization and the bolstering of healthcare systems have transformed a region once fraught with malaria. As these efforts continue, malaria in South-East Asia moves closer toward its extinction.

Jane Dangel
Photo: Flickr 

Mental Health in ChinaThe World Health Organization (WHO) reports that about 54 million people in The People’s Republic of China have depression and about 41 million have anxiety disorders. The psychiatrist-population ratio is at 1.49 to 100,000. This article discusses the obstacles and the plans to improving mental health in China.

COVID-19’s Impact

During the COVID-19 outbreak, China’s National Health Commission mobilized mental health workers and increased the volume of services. The Commission produced guidelines on mental healthcare protocols to curb psychosocial effects arising from the pandemic. The interventions included outreach programs by psychiatrists and other professionals. Additionally, hotline services offer psychological support to patients, survivors, as well as affected families, and healthcare workers alike. The most commonly reported psychiatric conditions associated with the outbreak were depression, PTSD, and anxiety disorders.

A nationwide survey of people, most of whom on lockdown, found that 16.5% had depressive symptoms, 28.8% had anxiety symptoms, and 8.1% had stress symptoms. Nevertheless, 71.5% of them were satisfied with the health information provided during the outbreak. The highest psychological impact was felt by women, students, and those who reported poor physical symptoms. During the lockdowns, psychiatric patients experienced more intense symptoms such as anger outbursts, insomnia, and suicidal ideation.

Alcohol and Tobacco Use Disorders

In China, alcohol is traditionally consumed during social functions and holidays. Over time, however, the WHO noted a rise in regular alcohol consumption and a subsequent impact on mental health, including alcohol dependence and alcohol use disorders (AUDs). A Beijing study showed that 2.4% of people with alcohol dependence were treated overall with only 1.4% receiving treatment from mental health professionals. Further research in China pointed to the need for early intervention in treating alcohol disorders. The WHO recommended educating both the public and healthcare workers on the importance of seeking mental health treatment for such issues.

Tobacco smoking has also negatively impacted mental health in China. With over 300 million cigarette smokers, China has the highest number of tobacco users in the world. The WHO partnered with the Chinese Government to control tobacco consumption and thereby reduce diseases and premature deaths arising from exposure to the harmful chemicals in cigarettes. The WHO also launched an initiative to curb tobacco dependence, training healthcare workers, and providing informational guidelines to tobacco users.

Promoting Mental Health in China

China needs reformations in its healthcare delivery system. The 2016 Policy on Building High-Quality and Value-Based Service Delivery details such reformations, aiming to move from a hospital-centered approach to a people-centered one that canvases both rural and urban areas. These changes call for a multi-tiered health care delivery system that strengthens primary care. China’s new delivery system aims to better monitor such quality of care, specifically by improving integrative management practices, building a strong healthcare workforce, and investing in community health. Additionally, the nation has made progress in attaining universal health coverage according to the UN 2030 Agenda for Sustainable Development.

In the Global Conference on Health in 2016, stakeholders emphasized the need for healthy cities to improve mental health in China and the world. Since the majority of Chinese people live in urban areas, many would benefit from interventions such as people-centered urban design, “greening”, and recreational spaces. To further promote mental health, China also targets to treat 80% of people with depression by 2030 and 30% by 2022.

To prevent AUDs, the WHO has recommended China strengthen policies that regulate alcohol commerce and increase education about safe alcohol consumption. In line with the WHO’s Framework Convention on Tobacco Control, China enacted a law that banned tobacco smoking in indoor public spaces and the mass media advertising of cigarettes. In a social media campaign dubbed #RUFREE, China supported smoke-free spaces while altogether decreasing tobacco use and curbing associated disorders.  Hopefully, China will continue to take steps to improve the mental and physical health of its citizens.

– Beth Warūgūrū Hinga
Photo: Pixabay

Universal Healthcare in Mali
In early 2019, the Malinese government made an announcement that shocked the global health world: it would make healthcare free at the point-of-service to pregnant women and children under 5 years of age. The country had achieved universal healthcare in Mali.

The Situation

In a country where poverty and healthcare outcomes were in dire straits, the move to provide universal care for the most vulnerable demographic in Mali was welcome and necessary. Previous to the 2019 decree, Mali had disastrous health outcomes.

About 106 children out of 1,000 live births would not survive delivery. Adding to the issue was the fact that 587 per 100,000 mothers would not survive delivery either, one of the highest rates of maternal mortality in the world. Only malaria and digestive diseases claim more lives in Mali.

In order to diagnose the problems with Malinese healthcare, a historical context is necessary. With that understanding, the new approach reveals itself to be necessary, positive and inclusive.

Post-Colonialism

After Mali’s liberation from France in the 1960s, the nascent country fell back on the healthcare system that was already in place. That system emerged 50 years prior and had not evolved with the needs of the populace. It would not change until the 1980s.

The Bamako Initiative

Launched in 1987, the initiative came under recommendation from both UNICEF and the World Health Organization (WHO). Named after the capital city of Mali, the initiative proved problematic, pushing the Malinese into poor health outcomes.

The initiative called for patients to pay for things like health services and drugs to offset costs and insufficient funds. The system requirements led the impoverished to avoid seeking care.

Post-Implementation

The free to pregnant mothers and under 5-year-old children policy has already yielded benefits. The new model re-centers care away from costly hospital services to community-based care.

Nurses can now travel door-to-door to service mothers and children under 5-years-old without fees. The results have been stunningly effective, with infant mortality dropping by 95% in the Bamako district.

Dr. Ari Johnson, a professor of global health sciences at the University of California, San Francisco heralded the approach: “The ministry of health [in Mali] has taken a very brave and bold political move to make real, evidence-based healthcare change.”

The approach serves as a model example; One that Mali hopes will become the standard across Africa. Johnson continues with optimism, stating that he hopes the new approach will: “make Mali a leader in health sector reform on the African continent.” Universal healthcare in Mali was no longer a dream.

The COVID-19 Pandemic

Although Mali has experienced strain due to the pandemic, U.N. Secretary-General Antonio Gutierrez has noticed Mali’s new model of healthcare. He called on nations to implement Universal Health Care for all nations in order to beat COVID-19. He stated that “The pandemic has revealed utterly inadequate health systems, yawning gaps in social protection, and major structural inequalities within and between countries.”

Gutierrez continued on to make the connection between robust systems and access, stating that “ . . . we cannot wait 10 years. We need Universal Health Coverage, including mental health coverage, now, to strengthen efforts against the pandemic and prepare for future crises.”

Foreign Aid

A number of Western nations have come to Mali’s aid. The impoverished nation, just starting on its new policy, has found itself hobbled by the current crisis. Experts see support for the nation, and its new health policy, as crucial.

The Netherlands

The Project to Accelerate Progress Towards Universal Health Coverage (PACSU) is a joint effort between the Dutch Embassy and the Global Financing Facility, the World Bank and the Ministry of Health in Mali. Learning from the impact of previous health crises in the region, the Netherlands’ support will focus on pregnant mothers and newborns.

When the Ebola crisis hit the region in 2014, a startling trend of infant and maternal mortality gripped Mali. Resources were scant and pregnant women were unable to secure the necessary health services to ensure a successful birth. PACSU will provide facilities, professionals, equipment and any other resources necessary to the ailing system during COVID-19.

The US

The United States Agency for International Development (USAID) will join the fight as well supplying $45 million to Palladium, an international development firm. The organization will provide support to reinforce Mali’s health systems and financing, providing access to high-quality care. Two programs, the Human Resources for Health 2030 (HRH2030) and the Human Resources for Health Strengthening Activity (HRHSA), have not been successful and will undergo expansion.

These programs, in concert with Mali’s Ministry of Health, will focus on the decentralization of health services. Training, motivation and safety for new medical professionals, particularly in the prevention of illness among both patients and healthcare workers is crucial to the program’s success.

Universal healthcare in Mali is critical from many standpoints. Not only does it provide relief for the historically impoverished Sahelian country itself, but it serves as a model for the rest of Africa. The refocus on community health improves access and financing. Once again, Africa leads the way in methodology, access and care during the struggle against COVID-19.

– Christopher Millard
Photo: Flickr

Non-Communicable Diseases in the Caribbean RegionNon-Communicable Diseases (NCDs) are now causing more damage than communicable diseases, globally killing approximately 40 million persons annually, three-quarters of which occur in low and middle-income countries. Cardiovascular disease, cancer, diabetes, chronic respiratory disease and mental disorders have now been confirmed as the leading causes of death worldwide.

Unfortunately, this reality is no different in the Caribbean. According to the Pan American Journal of Public Health, every year 16,000 persons prematurely succumb to Non-Communicable Diseases in the Caribbean region. In fact, over 70% of all deaths in the region can be traced back to an NCD. Such a record has lasting effects, significantly stunting economic growth and productivity, and has been brought to the alarming attention of health authorities. While the exact reasons for such high mortality rates still remain an ongoing point of research and discussion, risk factors, including tobacco smoking, harmful use of alcohol, poor diet and physical instability, have been found to significantly contribute to the mortality of NCDs in the Caribbean Region. Furthermore, the lack of improvement in the quality of available health care has also been identified as one of the leading causes of the rise in NCD prevalence, case-fatality rate and mortality burden in the Caribbean region.

Investment in Prevention and Control of NCDs

For a long time, regional leaders wrote off deaths associated with NCD as unavoidable. However, the impacts of the NCD epidemic in the region have been found to be much more far-reaching than just health and well-being. Moreover, the existing NCD epidemic has served as a catalyst for negative ripple effects on the economies, productivity and quality of life in the region. Investing in the prevention and control of NCDs is therefore needed to keep other indicators of economic growth and development in check.

Existing Policy Action to Address the NCD Epidemic

Caribbean leaders have put forward outstanding effort and measurements to curb the growing costs associated with NCDs. While sticking with the timeline has proven to be quite a challenge, the regional health authorities have set the following paths and goals toward slowing the progression of its NCD epidemic:

  • The 2007 Mandates of the Port of Spain Declaration (POSD): This includes 27 commitments to action in the areas of reducing NCD risk factors, which include improving healthcare awareness and quality, increasing development of appropriate legislative frameworks and establishing NCD commissions to provide effective monitoring and evaluation of NCD prevention and control efforts.
  • The World Health Organization’s Best Buys/Investments: WHO has designed a set of affordable, cost-effective and evidence-based interventions termed the “WHO Best Buys” to achieve the Sustainable Development Target of 30% reduction of premature NCD related deaths by 2030. Made up of six policy target areas: tobacco use, harmful alcohol use, poor diet, low physical activity, management of cardiovascular diseases and diabetes and cancer management, the regional health authorities have set out to generate a $7 yield in health care costs for every $1 invested in Caribbean health care reform by 2030. Additionally, with 16 areas of targeted intervention to guide the policy decisions of each country in the region, countries can design their health policy to address their specific NCD related challenges.
  • Global WHO 25 x25 Strategy: After the 2007 mandate of the POSD in the Caribbean, the World Health Assembly set a global target of a 25% reduction in NCD related mortality by 2025. Set as a part of the WHO’s Global NCD Action Plan 2013-2020, the WHO detailed a total of nine voluntary national targets, with reduced mortality from NCDs and stopping the rise in diabetes and obesity being among the most urgent. This is set to be done through directed health and public policy, focusing on social, political and economic determinants of NCDs in the Caribbean Region.

With continued health policy effort and focus, both the Caribbean Region and the world at large will be able to successfully control this Non-Communicable Diseases epidemic.

Rebecca Harris
Photo: Flickr