Mohammad, a three-year-old boy, lives in Yirimadjo, a community in Mali. A few weeks ago he woke up feeling ill with a high fever. That same morning, Kumba, a community health worker with the nongovernmental organization Muso, visited his family’s home during her daily door-to-door active case-finding visits. On discovering that the child had a fever, she administered a rapid diagnostic test for malaria, and he tested positive.
For the first time in history, more than half the human population lives in cities, and the vast majority of these people are poor. In Africa and Asia, the urban population is expected to increase between 30-50% between 2000 and 2020. This shift has led to a range of new public health problems, among them road traffic safety. Road crashes are the number 1 killer among those aged 15-29, and the 8th leading cause of death worldwide. The deadly impact from accidents is aggravated by pollution from vehicles, which now contributes to six of the top 10 causes of death globally.
People want dignity, people want rights
In the global survey World We Want 2015, health was the first priority of people living in poor countries. This was not surprising. Every year in Africa, nearly a quarter of a million children under five die because their parents cannot afford to pay for treatment. According to the World Health Organization, 150 million people face catastrophic health care costs every year, while 100 million are pushed into poverty because of direct payments. Increasingly, poor people are protesting the denial of their basic right to access health care when they need it.
The ongoing global initiative to expand universal health coverage (UHC), especially in low- and middle-income countries, is heartening, as is positioning UHC as a focus of the post-2015 development agenda. Most of us hope that UHC will make a real improvement in health status, in addition to expanding population coverage of health services.
In recent days, the media in Ghana have been abuzz with news about the government’s decision to scale up the capitation system as another method for paying health care providers under the National Health Insurance Scheme (NHIS). The Upper West, East and Volta regions of the country are included in the second phase of the capitation scale-up, which was piloted in the Ashanti Region, where the majority of affiliates and providers are reported to have expressed satisfaction with this system.
Two days before the world observes International School Meals Day, I’m here sitting in the U.K. Houses of Parliament thinking about the unexpected evolution of school meals programs in recent years.
Photo courtesty Creative Commons
For those of us who have been impacted by the death of loved ones due to the negative health consequences of smoking, the recent announcement by Larry Merlo, the CEO of the U.S. pharmacy chain CVS, to stop selling tobacco products in the chain’s 7,600 stores, was a ray of hope and a step toward a future when public health concerns trump short-term profit motives.
Countries working to provide quality health care often face bottlenecks in keeping remote health clinics stocked with essential medicines. This isn’t necessarily because they can’t afford sufficient drugs and supplies. Delivery may be stymied by bad roads and poor communications systems. Or the distribution process may have been established for a centralized system and can no longer keep pace with the growth in clinics in faraway settlements.