Silvi is eight months old. She lives in a remote village in one of the poorest regions of Bangladesh.
Her mother Maya often reflects on her pregnancy and worries about her daughter’s wellbeing as she recalls her morning sickness, the uncertain and painful birth, and the long nights at Silvi’s side as the baby lay wide awake wailing, fighting one illness after the other.
She remembers, too, the thrills of hearing Silvi giggle at the sound of her rattle, and when she began to crawl.
Despite the little joys that her baby brings to Maya, Silvi’s early childhood was marked with apprehension: Shouldn’t she be a little heavier? When will she learn to walk? Will she be healthy and intelligent enough to earn a decent living when she grows up? Or would she be handed down her parents’ poverty and get married like Maya had to, at only sixteen?
But with the right kind of support, Silvi can have a chance at a better life and bring her family out of poverty.
Growing evidence has shown that .
Thus, —or too short for their age--, low birth weight is prevalent, and maternal nutrition remains poor.
Sadly, poor families like Maya’s are not utilizing services available to them.
It requires people to be active participants in development, demanding services and products that add value to their lives and engaging in behaviors that are conducive to increasing their own welfare. Health prevention is a case in point.
At our HIV Impact Evaluation Workshop in Cape Town, South Africa in 2009, I listened to Nancy Padian, a medical researcher at the Women’s Global Health Imperative, presenting a systematic review of random control trials testing the effectiveness of HIV prevention campaigns.
The study she presented explained how three dozen HIV prevention campaigns had failed to change sexual behavior and reduce HIV incidence.
The presentation gave us pause. The review dismissed the communication campaigns as an ineffective means to change behavior and slow down the HIV epidemic.
A closer look revealed that the campaigns lacked inspiring narratives, and were communicated through outdated and uninteresting outlets such as billboards and leaflets.
The question we asked ourselves was: Can we do this differently?
Even before the protractive conflict, implementing development projects in some of the most remote and disadvantaged districts in a number of Yemeni governorates faced significant challenges. To address these challenges, and overcome some of the problems related to access to these remote areas, Yemen’s Social Fund for Development (SFD) devised a program in 2004 to attract youth interested in volunteering to promote development. In its first phase, this program — known as “Rural Advocates Working for Development (RAWFD)” — targeted a number of male and female students from these remote areas and provided them with a development-related program while they are attending universities in major cities. After graduation, these young graduates made a big difference in facilitating SFD operations and activities of other national and international organizations in their home areas.
Five billion people—two thirds of world population—lack access to safe and affordable surgical, anesthesia and obstetric (SAO) care while a third of the global burden of disease requires surgical and/or anesthesia decision-making or treatment. Treating the sick very often requires surgery and anesthesia. Despite such huge burden of disease, safe and affordable SAO care is often overlooked.
Why? It may be because surgery and anesthesia are not disease entities. They are treatment modalities that address the breadth of human disease — infections, non-communicable, maternal, child, geriatric and trauma-related disease and injuries, and international development agencies have been focusing on vertical disease-based programs.
Prior to 2015, global data on surgery, anesthesia and obstetric care was virtually nonexistent. With the idea that “We can’t manage what we don’t measure”, the Lancet Commission on Global Surgery developed six Surgical, Obstetric and Anesthesia (SAO) indicators (discussed here) and collected data for them. The analysis of these data show large gaps in SAO care across countries by income groups.
The SAO or “surgical” workforce is extremely small in low-income countries (1 SAOs per 100,000 population) and lower middle-income countries (10 SAOs per 100,000 population) whereas there are 69 SAOs per 100,000 population in high-income countries. The discrepancy between high-income countries and low- and middle-income countries is even greater for surgical workforce density than that of physician density.
Five billion people—two thirds of world population—lack access to safe and affordable surgical, obstetric and anesthesia care with low and middle income countries (LMICs) taking a lead.1-3 Surgical care is a crucial component of building strong health systems and one that is often overlooked (Dr. Jim Kim UHC 2017 video). All people are entitled to quality essential health services, no matter who they are, where they live, or how much money they have. This simple but powerful belief underpins the growing movement towards universal health coverage (UHC), a global commitment under the Sustainable Development Goals (SDGs). Inherent in the framework of UHC is access to safe surgical, obstetric and anesthesia (SOA) care.
An estimated 33 million undergo financial hardship every year from the direct costs of surgical care. And those are the individuals fortunate enough to have access to care.4 Moreover, about 11% of the world’s disability-adjusted life years are attributable to diseases that are often treated with surgery such as heart and cerebrovascular diseases, cancer, and injuries from road traffic accidents.2,5 Other surgically treatable disorders such as obstructed labour, obstetric fistulas, and congenital birth defects are major causes of morbidity and mortality in the developing world.5,7 The delivery of safe and quality SOA care is critical for the realization of many of the Sustainable Development Goals, including: Good health and well-being (Goal 3); No poverty (Goal 1); Gender equality (Goal 5), and Reducing inequalities (Goal 10).
Like many, we were relieved to hear from the Government of Madagascar and WHO in November last year that the pulmonary plague outbreak in Madagascar had been contained. Plague is a disease caused by bacteria called Yersinia pestis that are typically transmitted by rodents through their fleas but can also be transmitted from human to human. Since the onset of the outbreak in early August 2017, there had been 2,300 human cases of plague reported, leading to 207 deaths (WHO update). WHO called for continued vigilance until the end of the plague season at the end of April, as more cases of bubonic plague should be expected and could lead to a resurgence of pulmonary plague. The President of Madagascar also committed to establishing a permanent “plague unit” at the level of the Prime Minister’s office to work on the eradication of plague―rightly so, as experience tells us that addressing risks at the interface of human, animal and environmental health is challenging.
Sarah Ruteri*, aged 14 months, is a survivor. A few months ago, I saw her admitted to the pediatric ward of Lodwar hospital in northern Kenya’s drought-affected Turkana district. Suffering from severe pneumonia, Sarah was gasping for breath – and fighting for her life. Her tiny ribcage was convulsed by a losing struggle to get air into her lungs. Doctors told her mother to expect the worst. But with a combination of oxygen therapy and intravenous antibiotics, Sarah pulled through.
Rising obesity rates are in the headlines – with increasing recognition of the major role that agriculture and food systems play in the epidemic. As agriculture economists interested in human nutrition, we wanted to take a look at what it all means, to look at how agriculture and food systems are part of the problem and how they are part of the solution. While conducting research for a recent report, a few things stood out to us.
As we mark the International Day of Zero Tolerance for Female Genital Mutilation, on Feb. 6, we are supporting #EndFGM, a survivor-led movement gaining momentum and power around the world.
; girls who experience it are more likely to be forced into child marriage, more likely to be poor and stay poor, and less likely to be educated. Beyond the data and the statistics, researchers have shown that FGM deprives women of sexual health and psychophysical well-being.
The attention given to female genital mutilation (FGM) as a harmful practice has grown in recent years. Yet, while ending the practice is a target under the Sustainable Development Goals, it remains common in many countries.