Psychiatric hospital Skopje, Macedonia
Healthcare in Macedonia utilizes a mixture of a public and private healthcare system. All residents are eligible to receive free state-funded healthcare and have the option of receiving private healthcare for treatments that the public system does not cover. Public healthcare in Macedonia often comes with long wait times and although public hospitals have basic medical supplies, they do not have specialized treatments. For these specialized treatments, residents typically seek private treatment where they must pay out of pocket or buy private insurance on top of their free healthcare.

Improvements in Overall Health

North Macedonia did not become a part of NATO until 2019, and still has not received admission into the E.U. As a result, its healthcare system has developed slower than member countries. Despite this, North Macedonia has shown growth in overall health. The introduction of private healthcare allowed residents to seek a wider range of treatments and cut down wait times. Life expectancy has grown from 71.7 years in 1991 to 75.1 years in 2010. However, this is still lower than the E.U.’s average life expectancy which is 80.2.  Although life expectancy has grown, North Macedonia’s infant mortality rate is still above average.

North Macedonia reached a European record of 14.3 deaths per 1,000 live births in 2015. To compare, the average mortality rate in Europe for 2015 was 5.2 deaths per 1,000 live births. The high infant mortality rate is likely the result of outdated equipment at public health facilities and a shortage of qualified health workers. Only 6.5% of North Macedonia’s GDP goes towards healthcare, and therefore healthcare in Macedonia is often reliant on outside donations. These conditions have caused health workers to leave the Macedonian healthcare system in search of better working conditions. The health ministry has worked to purchase new equipment as well as increase the amount of qualified staff in public hospitals by hiring more workers. Today, the infant mortality rate in North Macedonia is 10.102 deaths per 1,000 births. This is an improvement, and hopefully, with continued programs, the numbers will continue to decrease. Organizations such as Project HOPE and WHO have already made a direct impact on Macedonia’s healthcare system.

Organizations Combating Infant Mortality

Project HOPE has donated over $80 million worth of medicines, medical supplies and medical equipment to hospitals throughout North Macedonia since 2007. Starting in 2017, most of these donations went to hospitals specializing in infant care. Project HOPE also provides training for healthcare workers so they can adapt to the updated equipment. The current drop in the infant mortality rate is due to these donations that allow hospitals to buy updated equipment and retain healthcare workers through training. There is only one hospital in North Macedonia that accepts low birth-rate and premature babies, University Clinical Center at Mother Theresa. Therefore, Project HOPE’s donation has greatly lessened the burden on this hospital to care for infants. Since Project HOPE implemented this program, the number of deliveries at Mother Theresa has increased by 40%.

WHO has also assisted North Macedonia in developing a new 2020 healthcare plan for infants and mothers. This plan would link healthcare facilities in the country and classify them by level of service to ensure everyone is receiving the appropriate care. It should also improve transportation between hospitals to increase the continuity of care between locations. This shared communication and learning between healthcare facilities is imperative since there are only nine hospitals in Macedonia for 2.08 million people and seven of those hospitals are in the country’s capital, Skopje. Increasing transportation and communication will ensure that those living outside of the capital are receiving quality healthcare. Slowly but surely with these new policies in place, North Macedonia’s infant mortality rate will continue to drop.

– Rae Brozovich
Photo: Flickr

The post Improving Healthcare in Macedonia appeared first on The Borgen Project.

Original Source: borgenproject.org

Healthcare in Zambia
Zambia, a landlocked country in Southern-Central Africa, faces several ongoing health challenges. In 2017, Zambia’s public health expenditure was 4.47% of the GDP, one of the lowest rates in southern Africa. Two ministries that provide information about health and deliver health services, administer public healthcare in Zambia. These are the Ministry of Health and the Ministry of Community Development, Mother and Child.

Problems in the Healthcare System

As public healthcare in Zambia remains incredibly underfunded, pharmacies in Zambia are not always well-stocked, and many deem emergency services inadequate. Additionally, inequities in public health care service access and utilization exist in the country. While 99% of households in urban areas are within five kilometers of a health facility, this close access occurs in only 50% of rural areas.

As a result of these deficiencies within the system, UNICEF reports that Zambia’s under-5 mortality rate is 57.8 deaths per 1,000 live births. In 2009, 980,000 people lived with HIV/AIDS in Zambia, and 45,000 of those people died the same year due to the disease.

Lack of clean water has resulted in water- and food-borne diseases and epidemics that have been devastating Zambia for decades, including dysentery and cholera. These issues mainly affect impoverished areas, as overcrowding leads to sanitation issues. In the Kanyama slum in Lusaka, 15 households share one latrine when the weather is good. During the rainy season, Kanyama’s high water table causes the filling of 10,000 latrines with water. Areas like Kanyama require long-term infrastructure measures, such as sanitation, sewage lines and piped water.

The Path to Development

Centers for Disease Control and Prevention (CDC) established an office in Zambia in 2000 to address HIV, tuberculosis, malaria and other diseases. CDC support in Zambia includes expanding academic and clinical training programs with advanced technology at the University of Zambia and the University Teaching Hospital, and the development of a National Public Health Institute to strengthen public health surveillance. Moreover, CDC instituted a Field Epidemiology Training Program (FETP) to train a workforce of field epidemiologists to identify and contain disease outbreaks before they become epidemics. Exactly 42 epidemiologists have graduated from the program since December 2018.

In 2018, Zambia presented to the World Health Assembly in Geneva regarding the cholera outbreak by citing its efforts regarding vaccination, water safety and waste management. Additionally, Gavi, the Vaccine Alliance, worked with Zambia to fund and deliver 667,100 oral cholera vaccine doses to Lusaka slums after an outbreak that affected more than 5,700 people.

Looking Ahead

Most recently, Zambia embarked on the first round of its annual Child Health Week campaign from June 22- 26, 2020 to deliver child survival interventions to protect children and adolescents from deadly diseases. Furthermore, to promote fairness and equality, the campaign aims to improve children’s health by ensuring essential services reach children who do not benefit from routine health services. This campaign accelerates the country’s progress toward attaining the U.N. Sustainable Development Goals (SDGs) for reducing child deaths by two-thirds by 2030, improving healthcare in Zambia overall.

The infrastructure for healthcare in Zambia is overall poor due to a lack of funding, poorly maintained facilities and supply shortages of medications and medical equipment. However, one step to a better healthcare system is to ensure equitable access to health services, especially for those who live in rural areas or slums. To reduce inequities, Zambia must strengthen primary facilities that serve the people who live in these regions and dismantle the existing barriers.

– Isabella Thorpe
Photo: Flickr

The post Improving Healthcare in Zambia appeared first on The Borgen Project.

Original Source: borgenproject.org

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