Health

“Health” Please respond to the following: DUE THUR 5-21-15

No plagiarism Please answer in at least 2 to 3 paragraphs

Based on the Webtext materials and article below, address the following:

1. What are several of the major health problems confronting developing counties?

2. Secondly, aside from building more rural clinics, what specific steps can governments take to improve their health care systems?

Mortality and Morbidity: what are the major health problems in the developing world?
On one hand, people in low-income countries are much worse off, and much more likely to die prematurely, than people in wealthier parts of the world. On the other hand, it’s important to note that those who live past age five have strong chances of living to the age of 60; saving a life from even a single cause of death means saving a person who is likely to live significantly longer.

Children under five in low-income countries primarily die of preventable and treatable diseases such as malaria, respiratory infections, diarrhea, perinatal conditions, measles, and HIV/AIDS. Between the ages of 5 and 60, the major causes of death in low-income countries (relative to higher-income countries) are HIV/AIDS, tuberculosis, and maternal mortality (i.e., deaths in childbirth). After the age of 60, there are large differences in the mortality rates for many of the same causes of death that affect those under 5, as well as for many conditions that require advanced medical attention (heart disease, cancer, diabetes).

The table below shows the differences between low-income and high-income countries, in terms of deaths per 1,000, by age range and cause of death. It is color-coded: yellow squares represent causes of death for which mortality rates are greater in low-income countries by at least 0.5 deaths per 1,000 people, orange squares represent causes of death for which mortality rates are greater in low-income countries by at least 1 deaths per 1,000 people), and red squares represent causes of death for which mortality rates are greater in low-income countries by at least 2.5 deaths per 1,000 people.

Note that conditions vary within the developing world. Mortality rates for many causes are higher in Sub-Saharan Africa than in the group of low-income countries (which includes some highly populous Asian countries, such as India, Pakistan, and Bangladesh).

Non-fatal health problems

Household surveys of those living on under $1 or $2 per day show that the poor are often sick. In the surveys cited by Banerjee and Duflo (2006), in every country for which data was available an average of over 10% of households reported at least one member needed to see a doctor in the month prior to the survey. In many areas the average exceeded 25%; parts of India, Mexico, and Nicaragua had averages above 35%. Here we do not discuss all health problems in detail, but we present three prevalent conditions (malnutrition, parasitic worms, and malaria) which are both direct causes of symptoms and risk factors for other conditions. In addition, we present data on the prevalence of a selection of health problems that are common in low- income countries and compare prevalence rates in these countries to rates in high-income countries.

Malnutrition is a widespread problem in the developing world. It is estimated that in 2000-02, over 800 million people in the developing world were undernourished (insufficient energy intake), and 2 billion are micronutrient deficient. In 2005, approximately 32% of children under five in developing countries were stunted (had a height-for age that was more than two standard deviations below the global average), which likely reflects chronic malnutrition throughout life. Malnourishment may be both caused by disease (such as parasitic worms) and increase susceptibility to disease. Lacking certain nutrients has been associated with a wide range of health problems including low energy, diarrhea, anemia, hypothyroidism, poor vision, and pneumonia. We do not know how common or severe these symptoms generally are among malnourished people. Malnutrition is sometimes associated with infection with parasitic worms. It is estimated that there are more than 1.2 billion roundworm infections globally, 700- 800 million infections with each hookworm and whipworm, and 250 million infections with schistosomiasis. While most infections do not cause symptoms, heavy worm infection can cause anemia, dysentery, and growth retardation. In the long run, worm infection “impairs physical and mental growth in childhood, thwarts educational advancement, and hinders economic development.”

Death from worm infection can occur, but is fairly rare. Another major cause of disability and suffering is malaria. The Disease Control Priorities Project estimates that there were 213 million cases of malaria in 2000, resulting in over 1.1 million deaths. This means that while malaria is a leading cause of death, the vast majority of cases are not fatal, but do cause suffering and disability. Like many other diseases, risk of malaria infection and complications are increased by malnutrition. As can be seen in the chart above, children under five average over 4 days of sickness with malaria per year, and older children fall sick every 2-3 years for an average of 2.3 days. Uncomplicated malaria is characterized by fever, headaches and nausea. Severe malaria can cause cognitive impairment, seizures, coma, respiratory distress, and heart problems.

What problems do people in the developing world believe are most pressing?

In 2006, the Gallup World Poll asked a representative sample from 26 Sub-Saharan Africa countries to rank the Millennium Development Goals (MDGs) in order of importance to them. The MDGs are a set of targets established by the United Nations in 2000 on a range of human development goals including poverty, education, health, gender equality, and the environment. Respondents consistently ranked reducing poverty and reducing hunger as the two most important goals. Health goals followed the top two, with reducing the spread of HIV’ ranking third and reducing under five mortality, maternal mortality and reducing the spread of malaria and TB coming in at 5, 6, and 8, respectively, out of a total of 12 goals. One argument for why health goals are not ranked higher than they are, argued by Deaton (2008), is that Africans report being more satisfied with their health than we might expect because they are more used to being sick. The youth-focused goals of ‘Providing more jobs for youths’ and ‘Achieving primary education for all’ were also considered important by many respondents and were ranked 4 and 7, respectively. The goals of improving access to clean water and sanitation, achieving gender equality, and increasing access to new technology were least important to those surveyed. Each respondent was asked to rank order six of the twelve goals. A value of 1 was assigned to the top-ranked goal, through 6 for the lowest-ranked goal. Thus the averages below fall in the range of 1 to 6.

Millennium Development Goal Weighted

There were few differences in how men and women, urban and rural dwellers, employed and unemployed adults, or different age and education cohorts ranked the goals. Rankings did vary across countries and regions, but reducing hunger and poverty were the top two goals for all but 6 of the 26 countries polled. Of these six, four were Southern African countries where HIV prevalence is very high; all four ranked ‘Reducing the spread of HIV’ as their top priority.