Poverty is the state of having little or no money and few or no material possessions. Poverty can be caused by unemployment, low education, deprivation and homelessness. This study assessed the relationship between poverty and patient abandonment (PA) in hospitals, and the attitude of health care professionals (HCPs) towards the patient. The study targeted all patients who were abandoned at MNH and who voluntarily accepted to participate in this study under informed consent and strict confidentiality. This is the first study to be conducted in Dar es Salaam with respect to PA in hospital. Results revealed unnecessary overcrowding in wards and overwhelmingly heavy burden of patient care on the HCPs. The study also observed a correlation between poverty and PA, which was to a great extent related to the patient's level of education. The respondents strongly condemned PA immoral. The authors propose that government re-introduce subsidies on services to alleviate the burden of medical expenses incurred by the low income citizens, particularly the unemployed and farmers. The study also recommends that the government should improve services in regional hospitals to reduce travel and patients care expenses.
Poverty and health
Adequate infant and young child nutrition demands high rates of breastfeeding and good access to nutrient rich complementary foods, requiring public sector action to promote breastfeeding and home based complementary feeding, and private sector action to refrain from undermining breastfeeding and to provide affordable, nutrient rich complementary foods. The authors argue, however, that public and private sectors do not work well together in improving infant and young child nutrition. The authors argue that there are lessons to learn in managing public and private interactions on nutrition from the actions taken around sweatshops. One example is the Ethical Trading Initiative, in which companies, trade unions, and civil society organisations work together to enhance implementation of labour standards and address alleged allegations of abuse.
The number of people requiring humanitarian assistance in the Horn of Africa could increase sharply in coming months due to below-average rainfall and high food and fuel prices, say aid workers. According to the World Food Programme, the Horn of Africa drought, which began with the failure of the short rains in December 2010, is the first since a two-year regional drought in 2007-2009 that saw the number of people needing humanitarian assistance in the region rise to more than 20 million. Conflict over rising food prices could further increase the number of people requiring help. While governments of the affected countries have already started interventions, short- and long-term international assistance is needed to help address critical needs but also underlying structural causes and chronic vulnerabilities. What is needed, according to this article, is a set of interventions which strengthens people's own resilience capacity and coping mechanisms to survive such severe conditions while at the same time responding to their current humanitarian needs and protecting their livelihoods. It is crucial that people can feed themselves through their own means instead of being dependent on food distributions.
The thirteen case studies contained in this publication – including studies from Tanzania and South Africa - were commissioned by the research node of the Knowledge Network on Priority Public Health Conditions (PPHC-KN), a WHO-based interdepartmental working group associated with the WHO Commission on Social Determinants of Health. The publication is a joint product of the Department of Ethics, Equity, Trade and Human Rights (ETH), Special Programme for Research and Training in Tropical Diseases (TDR), Special Programme of Research, Development and Research Training in Human Reproduction (HRP), and Alliance for Health Policy and Systems Research (AHPSR). The case studies describe a wealth of experiences with implementing public health programmes that intend to address social determinants and to have a great impact on health equity. They also document the real-life challenges in implementing such programmes, including the challenges in scaling up, managing policy changes, managing intersectoral processes, adjusting design and ensuring sustainability.
The objectives of this study were to measure inequalities in child mortality, HIV transmission and vaccination coverage within a cohort of infants in South Africa. The researchers observed disparities in the availability of infrastructure between least poor and most poor families, and inequalities in all measured child health outcomes. Overall, 75 (8.5%) infants died between birth and 36 weeks. Infant mortality and HIV transmission was higher among the poorest families within the sample. Immunisation coverage was higher among the least poor. The inequalities were mainly due to the area of residence and socio-economic position. This study provides evidence that socio-economic inequalities are highly prevalent within the relatively poor black population. Poor socio-economic position exposes infants to ill health. In addition, the use of immunisation services was lower in the poor households. These inequalities need to be explicitly addressed in future programme planning to improve child health for all South Africans.
Health aid advocates are gearing up to lobby for more, and better, aid at the Fourth High Level Forum on Aid Effectiveness in Busan, South Korea, in November 2011. And like many others, health aid advocates seem to be missing the bigger picture, according to this paper. While it is vital to improve aid procedures to get more aid flowing for health, this is not the only important issue: continuously overlooked are problems with the whole development model. Part of the problem is an epistemological one involving the discourse about "poverty reduction" that has seemingly supplanted earlier understandings of development. It seems, somehow, short-term "poverty reduction" has become a stand-in for actual long-term development. The author argues that, while aid advocates lobby external funders in one arena, the advocates' own representatives to the IMF executive board push a conservative monetary policy within another arena that exacerbates the ability of the aid recipients to develop. The same goes for the arena of trade policy, where the donor countries give aid with one hand while pushing for rapid and premature trade liberalisation in poor countries with the other.
In this study, researchers examined the use of contraception among women in 13 countries in sub-Saharan Africa with regard to wealth-related inequity. The analysis was conducted with Demographic and Health Survey data from 13 sub-Saharan African countries. The researchers found that the use of contraception has increased substantially between surveys in Ethiopia, Madagascar, Mozambique, Namibia and Zambia but has declined slightly in Kenya, Senegal and Uganda. Wealth-related inequalities in the met need for contraception have decreased in most countries and especially so in Mozambique, but they have increased in Kenya, Uganda and Zambia with regard to spacing births, and in Malawi, Senegal, Uganda, the United Republic of Tanzania and Zambia with regard to limiting childbearing. After adjustment for fertility intention, women in the richest wealth quintile were more likely than those in the poorest quintile to practice long-term contraception.
In a few malaria-endemic countries with high disease prevalence, especially in children, and local cultivation of Artemisia annua, the availability of recommended malaria medicines is scant. New sources of treatment could be used, drawing from traditional medicine, the autrhors of this paper argue. A popular African millet-porridge was prepared by adding dried, sieved leaves ofArtemisia annua. Artemisinin concentrations were detected by high-performance liquid chromatography–mass spectrometry. The artemisinin content of the porridge is stable and the concentration is maintained. The taste of the porridge is palatable. Authors conclude that further research is needed before proposing the millet-porridge artemisinin formulation, but such an affordable therapy could be an option in the near future (also) for children living in poor areas where access to effective antimalarial drugs is precluded.
This study involved 671 children aged 12-59 months living in the Agincourt sub-district, rural South Africa in 2007. Anthropometric measurements were taken and HIV testing with disclosure was done using two rapid tests. Z-scores were generated using WHO 2006 standards as indicators of nutritional status. Prevalence of malnutrition, particularly stunting (18%), was high in the overall sample of children. HIV prevalence in this age group was 4.4%. HIV positive children had significantly poorer nutritional outcomes than their HIV negative counterparts. Besides HIV status, other significant determinants of nutritional outcomes included age of the child, birth weight, maternal age, age of household head, and area of residence. HIV is an independent modifiable risk factor for poor nutritional outcomes and makes a significant contribution to nutritional outcomes at the individual level. Early paediatric HIV testing of exposed or at risk children, followed by appropriate health care for infected children, may improve their nutritional status and survival, the authors conclude.
This study uses updated global poverty estimates to infer that nearly half a billion people escaped extreme poverty in the five years from 2005 to 2010. However the gains have not been equally distributed, globally. Between 2005 and 2015, Asia’s share of global poverty is expected to fall from two-thirds to one-third, while Africa’s share will more than double from 28% to 60%. Although sub-Saharan Africa’s poverty rate had by 2010 fallen to below 50% for the first time and is projected to fall below 40% by 2015, at global level the authors argue that the share of the world’s poor people living in fragile states is rising sharply and will exceed 50% by 2014.