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Maternal Mortality Rate in GhanaIn September 2000, the United Nations launched the Millennium Development Goals (MDG): eight steps aimed at making the world a better place. These goals ranged from establishing universal primary education to slowing the spread of HIV/AIDS. The fifth goal in the MDG plan is to improve maternal health, with one of the specific targets being to reduce the maternal mortality rate by 75% between 1990 and 2015. The World Health Organization defines maternal death as “the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.” Unfortunately, the World Health Organization could only report a 44% decrease in global maternal mortality by the end of 2015. The African nation of Ghana was one of these countries that sat right at 44%. In comparison to the original goal, the overall statistics seem poor; however, a 44% decrease is still a notable feat. Here are three factors that have been especially influential in reducing the maternal mortality rate in Ghana.

3 Reasons Why the Maternal Mortality Rate in Ghana has Decreased

  1. Free maternal health services. Free services for those who could not afford to pay full price made a huge impact on pregnant women in Ghana. This assistance was especially helpful given that, at that time, the country used a “cash and carry” healthcare system that required upfront payments to receive attention from healthcare professionals. This requirement restricted low-income women from obtaining adequate maternal care. In 2003, affordable services were extended to all Ghanaian womenregardless of economic statusafter the country adopted universal healthcare. The combination of universal healthcare and maternal health services provided by the United Nations enabled more women to schedule maternal care visits within their first trimester: in 2017, 98% of pregnant women received antenatal care by a professional, and 84% received postnatal care. With this improved accessibility, women could now monitor their babies’ health, prepare for any special cases and get the help they needed during pregnancy and following childbirth.

  2. Midwives. About 79% of women giving birth in Ghana were assisted by a nurse or midwife, a trained professional who helps during pregnancy and labor. Due to lower education requirements relative to medical professionals, midwives are often more accessible than doctors. Despite less schooling, these individuals are still able to provide physical and emotional support throughout pregnancy, write prescriptions and advise mothers on safely preparing for labor. Two training schools have recently opened in Ghana, accompanied by a 13% increase in national enrollment.

  3. High Impact Rapid Delivery Program (HIRD). The High Impact Rapid Delivery program was established by the Ministry of Health. This program addresses the need for quick and effective change in health policies to increase safety and maximize health within a given nation. Examples of high-priority items include promoting the use of iron tablets during pregnancy, guaranteeing skilled attendance during deliveries and regular de-worming. Of note, Project Fives Alive!, a group assisting HIRD from 2008-2015, advocated for stronger “coverage, quality, reliability and patient-centeredness” in the health industry. The initiative engaged future health professionals in a 12- to 18-month training program designed to quickly teach effective ways to improve their skills in caring for pregnant women and children under the age of 5. Project Fives Alive! made significant progress: the organization helped foster an 11% increase in skilled delivery, a neonatal care institution that boasted a coverage rate seven times higher than its baseline and representation in 33 of Northern Ghana’s 38 districts.

There has indeed been considerable progress in lowering the maternal mortality rate in Ghana over the past 25 years. However, there is still much progress left to make: the country still experiences an alarming rate of 308 deaths per 100,000 (2017), whereas the global rate stands at 211 deaths per 100,000. With continued help from the aforementioned initiatives, the development of new drugs and technology and a commitment to improving maternal health, there is hope that these numbers will further decline.

– Rebecca Blanke
Photo: Flickr

Healthcare in New Zealand
New Zealand is a small island country situated just southeast of Australia. Its healthcare system is known as one of the best in the world. While there are still improvements to be made, the government of New Zealand has worked to make healthcare affordable and accessible. Here are ten facts about healthcare in New Zealand.

10 Facts About Healthcare in New Zealand

  1. The national government runs New Zealand’s universal healthcare system. This means the government handles the public healthcare system from its budget to the agency that oversees it. This allows healthcare to be free to access, as it is funded publicly through taxes and by the national government. However, the government does not handle the responsibilities for providing health services, leaving this up to regional and private healthcare centers in the system.
  2. New Zealand’s average life expectancy is about 82 years. The nation ranks 15th in the world for highest life expectancy rates. New Zealand’s healthcare system has contributed to the high life expectancy and the country is striving to increase life expectancy even further.
  3. Healthcare in New Zealand is not completely centralized. Instead, it is a mixture of both public and private. However, universal healthcare still exists in the form of public funding. The government provides a universal healthcare package for all residents. If a New Zealander wishes for more benefits or wishes to have non-essential services such as cosmetic surgery, then they must pay for these services themselves.
  4. Compared to most developed countries, healthcare in New Zealand receives more government funding than private funding. Most of the funding comes from taxation. This ensures that the taxes New Zealanders pay is put towards their healthcare services.
  5. The government also provides financial compensation for injuries. The Accidental Compensation Corporation (ACC) is a government agency that works with the national government to provide financial compensation for injuries during work and other events. Because of this, health services for injuries are often free of cost.
  6. Drugs and medicine are not provided by the state under the healthcare system. Instead, private pharmacies and pharmaceutical companies provide medicine to individuals via prescription or over the counter.
  7. Private health insurance is still available in New Zealand. However it only compensates for 5% of health insurance. Nonprofit and for profit non-government organizations offer private health insurance, which is mainly used for elective surgery or to cover cost sharing requirements.
  8. Mental health, cardiovascular diseases and diabetes are the main health concerns in New Zealand. However, the number of physicians, nurses, specialists and dentists are steadily increasing in the country. Moving forward, this could help the nation more effectively tackle these persistent health concerns.
  9. One problem New Zealand faces is a decrease in hospital bed availability. Although New Zealand’s healthcare system is seen as very effective, there are some problems. One of these is the decreasing number of available hospital beds in the country. Although the reason for this is that many elderly patients are shifting to nursing homes and senior centers, this could be a problem in the future especially if the COVID-19 pandemic continues to be a significant concern.
  10. Inequality is also an issue in New Zealand’s healthcare system. Although the healthcare system is effective overall, the indigenous Maori do not have the same access to healthcare as the other residents of New Zealand. This inequality often prevents the Maori from receiving the same care and treatment.

New Zealand has a very effective healthcare system that is able to treat many diseases. However healthcare in New Zealand can still be improved, the most pressing issue to address being inequality. Moving forward, it is imperative that the government of New Zealand continue to support universal healthcare and expand its availability to everyone living in the country.

– Sadat Tashin
Photo: Flickr

Healthcare in JapanHealthcare in Japan is both universal and low-cost. The country provides healthcare to every Japanese citizen and non-Japanese citizen who stays in Japan for more than one year. Japan’s healthcare system is uniform and equitable, providing equal medical services regardless of a person’s income. Here are five facts about healthcare in Japan.

5 Facts About Healthcare in Japan

  1. Everyone has health coverage. Established in 1961, Japan’s universal health insurance sought to provide people with equal access to “necessary and adequate” medical care at low costs. Two key characteristics of Japan’s healthcare are that medical care is affordable and equally accessible to everyone. Citizens can either receive coverage through social insurance if they work for a corporation or through national medical insurance if they are self-employed. Patients and physicians have great freedom in their choices. Patients can choose their own physicians, and physicians are able to freely choose the best procedures, tests and medications they see fit for their patients.
  2. Insurance plans vary for individuals. Japan has three main forms of health insurance. The first insurance system covers employees who work at companies. Companies deduct insurance premiums for healthcare from employees’ paychecks. The second insurance system covers citizens who are self-employed. Factors such as the individual’s income, the number of people living in the household and any assets determine premiums. The third system is a pooling fund, with premiums coming from the previous two plans for medical costs of people 70 years or older. The three medical plans cover citizens from all backgrounds, ensuring that everyone has access to healthcare. Because everyone has coverage, there are seldom issues of people in low-income households or poverty lacking medical care.
  3. Payment is through a fee schedule. Patients pay for their medical care through a national fee-for-service schedule. The government sets the schedule, which includes both primary and specialist care fees. Since the fee schedule is uniform and applies to everyone, all providers “share the same prices for medicines, devices and services.” The poor and the elderly also receive government subsidies to pay for their health insurance. This ensures that the poor do not have any disadvantages in receiving medical care.
  4. Japan’s healthcare plans provide various medical services. The insurance plans include primary and specialty care, visits to hospitals, mental health care and most dental care. Plans also cover prescription drugs that physicians and hospice care approve for the elderly. For pregnant women, the local governments often subsidize check-ups, making it easier for women to access adequate medical care. People with disabilities also get aid from the government. They receive government subsidies to pay for any equipment such as wheelchairs or hearing aids. By making medical care both comprehensive and accessible to disadvantaged groups, healthcare in Japan looks out for the poor.
  5. Japan’s healthcare is extremely equitable. An individual’s income makes less of an impact in influencing the quality of care in Japan in comparison with many other countries. Because the fee schedule for medical care is uniform across the nation, everyone pays the same prices. Furthermore, physicians receive the same fee from patients with or without government assistance due to government subsidies for low-income people. Therefore, Japan’s healthcare system provides no incentives for physicians to treat patients differently. Everyone receives equal treatment and equal access to medical resources, regardless of their social class. This allows the disadvantaged and people living in poverty in Japan to receive the “necessary and adequate” care that the country’s universal health insurance pledges.

Japan’s healthcare system operates on a national fee schedule and is universal in nature. The fee schedule allows healthcare in Japan to be equitable as well as cost-efficient, ensuring that medical care is available to everyone. It also keeps total health expenditures at a minimum due to its set, uniform fees. Healthcare in Japan demonstrates how people in poverty do not experience exclusion from or have difficulties finding medical care, but rather enjoy equal access to healthcare like everyone else.

– Silvia Huang
Photo: Flickr

healthcare in South Korea
South Korea is one of the many countries in the world that provides universal health care for its citizens. This universal health care is both a source of relief and national pride for many South Koreans. This pride is further amplified by the fact that modern health care in South Korea rose out of the devastation of the Korean War. With the recent COVID-19 global pandemic, South Koreans rely, now more than ever, on their health care system.

History of the South Korean Health Care System

South Korea’s health care system was developed at the end of the Korean War in 1953. One of the first projects that aimed to help South Korea was the Minnesota Project, launched in September 1954. Under the Minnesota Project, Seoul National University agreed to receive medical education and equipment from the University of Minnesota. The U.S. Department of State also contracted the University of Minnesota to assist Seoul University with staff improvement and equipment aid.

This project allowed the health care system to grow and flourish over tte next couple of decades. In 1977, the Korean government mandated all companies with more than 500 employees to provide health insurance programs for employees.

How South Korean Health Care Works

Established in 2000, the National Health Insurance Corporation (NHIC) is still in charge of national insurance enrollment, collecting contributions and setting medical fee schedules. To provide coverage for all Korean citizens, the NHIC gathers contribution payment from all citizens as part of their taxes. In addition to the contribution payment, the NHIC gather their funds through government subsidies, outside contributions and tobacco surcharges. This wide range of funding sources allows South Korea to provide clinics that are both modern and efficient.

Prevailing Issues

The South Korean health care system does have some issues, however. While the overall quality of health care in South Korea is excellent, access to high-quality medical care can still be difficult for rural residents. According to a WHO case study of South Korea, 88.8% of physicians in South Korea were employed by non-governmental clinics. These non-governmental clinics are usually located in urban areas. About 25% of all elderly over the age of 65 years reside in rural areas, where they are at high risk of falling and other physical injuries. With physicians mainly located in urban areas, the South Korean government recognizes the need to improve health care in rural areas.

A more recent issue that the South Korea health care system is facing is the treatment of foreign nationals. In the past, there were some foreigners who forewent payment after their medical treatment in South Korea. Termed “health care dine and dash,” the Korean government now requires all foreign nationals to sign up for the National Health Insurance scheme within their first six months of living in the country. Once a foreign national receives their Alien Registration Card, they can benefit from Korea’s National Health Insurance Scheme and private insurance.

A Model of Universal Health Care For the World

Developing out of the devastation of the Korean War, the excellent quality of health care in South Korea is a prime example of how a country can implement and sustain universal health care. Despite needs for improvement, the South Korean health care system remains an international model for universal health care. With the recent COVID-19 pandemic, South Koreans recognize the importance of their continuous support for the universal health care system.

 – YongJin Yi 
Photo: Pixabay

Living Conditions in Poland
Situated in Central Europe, Poland neighbors Slovakia, Ukraine and the Czech Republic to the North, Russia, Lithuania and the Baltic Sea to the South, Belarus to the East and Germany to the West. Home to the eighth largest economy in the European Union, 30 percent of the nation’s landscape is covered with forests partially due to the national reforestation program. While the nation has begun to gradually reduce poverty, nearly 15 percent of the Polish population face poverty. Listed below are the top 10 facts about the living conditions in Poland.

Top 10 Facts About Living Conditions in Poland

  1. Poland boasts one of Europe’s best education systems with a 96.8 percent primary school enrollment rate leading to a 99.7 percent adult literacy rate. The nation has taken part in education reforms stemming from the 1990s which have led to positive improvements on students’ educational performance. Twelve Poles have won the Nobel Prize, causing Poland to be ranked 17th for the number of wins in the world.
  2. Young people in Poland face high unemployment and when employed, often take temporary jobs. Temporary positions employ 66 percent of young Poles leading to layoffs in the 2009 economic downturn. To combat the rising rates of youth unemployment, the Tripartite Commission, a labor relations forum in Poland, introduced an anti-crisis package that focused on increasing minimum wage and co-financing training. Polish trade unions highlighted the importance of equal treatment of different contracts and implementing the same tax rates.
  3. The average earnings of high earners (earning greater than 90 percent of workers) is 4.7 times greater than a low earner (earning less than 90 percent of workers) in Poland. This high-to-low ratio is among the highest in the European Union. Three primary factors impacting wage dispersion include the disparity in pay due to levels of education, low levels of compensation (often below minimum wage) and low density of trade unions in the nation. Polish people have seen a decrease in social inequality due to a focus on reforms regarding the tax-benefit system and family allowance system as well as a fall in wage dispersion.
  4. Poland is one of 58 countries worldwide to offer its citizens universal health care. Treatment of sudden illnesses and emergencies is typically free. Costs in the private medical sector are higher than in the public medical sector.
  5. One in four Polish children faces poverty, one of the highest childhood poverty rates in Europe. This particularly affects large families and single-parent families. In 2016, the Polish government introduced the Family 500+ program which provides a monthly payment of 500 Zlotys ($130.00) for every child after the first until the age of 18. The first child in families whose income is below a defined threshold receives this benefit. The program predicts that it will initiate a significant decrease in childhood poverty.
  6. Poland’s national minimum wage increased from 2,100 Zlotys ($548.66) in 2018 to 2,250 Zlotys ($587.85) in 2019. The nation’s annual variation rate of the Consumer Price Index increased 1.2 percent, granting Poles buying power in the economy. The cost of living in Poland is 44.9 percent lower than the United States.
  7. Ranked 189 out of 200, Poland’s fertility rate is among the lowest in the world. The nation is in the first stages of initiating a family policy.
  8. The Organisation for Economic Co-operation and Development suggests that Poles are less than satisfied with their lives as they rank their life satisfaction an average of six which is less than the average of a six and a half. Particular noteworthy factors within Polish lives include strong personal security and education, and below average health status and income.
  9. According to the World Health Organization in 2016, Poland’s life expectancy stood at 78 years old. Women have a life expectancy of 82 years while men have a life expectancy of 74 years. Looking over the past several years, Poland’s life expectancy has seen a minimal decrease. Researchers from the Medical University of Lodz divided the major causes of death into three groups. The first group was comprised of infectious diseases, diseases related to childbirth/pregnancy and malnutrition which are the least common causes of death. Chronic noninfectious diseases such as cancer or heart disease made up group two which are the most common causes of death in Poland. External causes of death such as accidents and suicide contribute to 15.7 percent of male lives lost and 5.3 percent of females. External causes of death have seen a decrease.
  10. World Bank Data shows that Poland’s GDP growth has reached 5.1 percent in 2018, improving the Polish economy. Challenges still face the Poles in “shortage of labor in the economy, procyclical government policies encourage by the political calendar, and adverse global factors.” These issues could weigh on the continuance of Poland’s GDP growth.

The Eastern European country finds itself prospering economically amidst below average life satisfaction, high unemployment in young adults and low fertility rates. The good fortune of the Polish people is a central interest of the government. These 10 facts about living conditions in Poland indicate that contributions to the sustainment of the country are helping as literacy rates are on the rise, the minimum wage has increased and poverty has waned in recent years.

– Gwendolin Schemm
Photo: Flickr

China's Health PlanChina has a population of nearly 1.4 billion people. About 5% of those people are living below the poverty line in China, with the majority unable to afford health care services.

Although China provides universal coverage for basic health insurance, out-of-pocket expenses could easily lead to bankruptcy for low-income individuals. However, China’s health plan aims to tackle this issue.

On June 21, 2016, 15 central government departments released a guideline stating that all people living below the poverty line in China will have access to basic medical care and other health services by 2020. The government will organize various resources and take more measures to support the development of health and medical services in poor areas.

Several ministries, including the National Health and Family Planning Commission and the Ministry of Human Resources and Social Security, are working together to tackle health-related poverty.

They have organized a nationwide investigation into the major health conditions responsible for the poverty in rural China. The investigation will cover every household that fell into poverty from health expenses. A report of the investigation will be completed in July and help authorities provide assistance to different groups based on medical needs.

Hospitals, doctors and other medical resources are very scarce with a major gap between supply and demand. The government will increase insurance aid to help regions living in poverty gain access to more health resources. The government is also encouraging nongovernmental organizations and private sectors to invest in poor regions.

Additionally, the Chinese Red Cross Foundation is partnering with an IT company to launch an online crowd funding website, which will give poor patients direct access to donations for medical resources and healthcare.

The guideline for China’s health plan is part of a national strategy being put in place to guarantee that all people living below the poverty line in China are no longer impoverished by 2020 and have access to universal health and medical care.

Jackie Venuti

Photo: The Telegraph

Universal Health Care Can End Extreme Poverty
Universal health care in all countries could help bring an end to extreme poverty by 2030, says World Bank President Jim Yong Kim. He explains that “every country in the world can improve the performance of its health system in the three dimensions of universal coverage: access, quality and affordability.” Last month Kim set the goal of ending extreme global poverty around the world, which means that nobody will be living on $1.25 or less each day by the year 2030. He claims that universal health coverage is essential to be able to reach this goal because it is costly to receive medical care, and many of the poorest families cannot afford these costs.

Health issues are a major reason people are in extreme poverty, putting 100 million people into extreme poverty as well as creating severe financial stress for an additional 150 million people around the world each year. Kim states that to create a valuable and helpful system, those in the public sector should take tips from private sector companies to be more efficient and provide “value-for-money health care.” He further explains that to create the best universal health care in poor, developing countries, point-of-service and out-of-pocket costs must be eliminated, because they hinder people’s ability to obtain the services they need but cannot afford.

Kim knows that for the poorest people around the world, even what would seem like small costs to visit a doctor or receive a vaccine can be detrimental to a family’s financial stability, and could push some people back into poverty or extreme poverty. With universal health care, these individuals and families can receive these necessary health benefits without sacrificing other areas of life or worrying about being forced back into poverty.

Katie Brockman
Source: Businessweek
Photo: World Health Coverage