Poverty and health

Meeting the health-related needs of the very poor
Eldis Dossier

There is a growing concern within the international development community that policies aimed at reducing the number of people living below the poverty line could leave the most disadvantaged groups behind. In line with these concerns, this Eldis dossier looks at different strategies for reaching the very poor within the health sector, and at the institutional challenges associated with scaling up health-related interventions to cover broader segments of the population.

Meeting the health-related needs of the very poor
Eldis

There is a growing concern within the international development community that policies aimed at reducing the number of people living below the poverty line could leave the most disadvantaged groups behind. In line with these concerns, this dossier looks at different strategies for reaching the very poor within the health sector, and at the institutional challenges associated with scaling up health-related interventions to cover broader segments of the population. It also highlights the fact that there are ways outside the health sector to improve health or reduce the impoverishing impact of disease, and that in some contexts these may benefit the poor most.

Member States focus on reducing poverty ahead of UN summit
United Nations: 15 September 2010

In the run-up to the United Nations’ (UN) three-day summit on the Millennium Development Goals (MDGs), held in New York from 20–24 September 2010, UN Member States underlined the vital role that democracy plays in reducing poverty. Democracy remains central to any development approach, Joseph Deiss, President of the General Assembly, told a meeting at UN Headquarters. He identified the pursuit of the MDGs – which include reducing poverty, fighting disease, halting environmental degradation and boosting health – along with UN reform and the promotion of environmentally sustainable development as key areas of focus for the Summit. In particular, he argued that stakeholders must bridge the gaps in the fight against hunger, child mortality and maternal health. He called for a sincere commitment from all world leaders taking part in the Summit and a genuine plan of action to ensure that the MDGs are reached. Member States are expected to come prepared to put forward concrete commitments on what they will do over the next five years to reach the MDGs.

Mental Health and Poverty in Africa
European Foundation Centre, 20 November 2006

World Health Organisation (WHO) together with other key partners have joined forces to develop a new Project "Mental Health and Poverty Project: Improving Mental Health, Reducing Poverty (MHaPP)". The project will undertake an analysis of existing mental health policies in poor countries, provide interventions to assist in the development and implementation of mental health policies in those countries, and evaluate the policy implementation in order to provide new knowledge regarding comprehensive multi-sectoral approaches to breaking the negative cycle of poverty and mental ill-health. The project will be conducted in four African countries: Ghana, South Africa, Uganda and Zambia.

Microfinance and poverty reduction in the SADC Region
SADC Secretariat, SADC International Conference on Poverty and Development, 18–20 April 2008, Pailles, Mauritius

Microfinance has been recognised, globally, as a viable and sustainable tool for poverty reduction and economic development through improving income generating activities and employment creation. Despite well documented evidence of the positive impact of promoting access to finance to under-served segments of the community, many poor people in the Africa, particularly in Southern African Development Community (SADC), still remain excluded from the mainstream financial system. Microfinance programmes are reported to stimulate the growth of the micro-enterprises and the SME sectors, assist in the formalization of the informal sector and integrate that sector into the mainstream economy, thus contributing to socio-economic development and to poverty reduction.

Millennium Villages: A new approach to fighting poverty
Earth Institute, Millennium Promise and UNDP: 2009

Five years ago, pregnant women in the village of Sauri, in western Kenya's Nyanza Province, had access to just one rundown and poorly staffed sub-district hospital. Few chose to use it, instead giving birth at home, risking complications during delivery and, for those living with HIV, passing it on to their child. Sauri is now part of the Millennium Villages Project, which, since December 2004, has established maternity wards in nine health facilities across Yala division. The village project, part of the United Nations (UN) Millennium Project, aims to lift communities out of extreme poverty through community-led initiatives to improve health, agriculture, education, gender equality and environmental sustainability. ‘With the improvement of these health facilities through the provision of free maternal services, 64% of expectant women in Sauri now come to deliver in health centres,’ said Patrick Mutuo, science coordinator and team leader of the Sauri cluster. ‘Right now those mothers still delivering at home are doing so not because of cost or distance. It could be due to cultural beliefs or other reasons. We have also initiated door-to-door voluntary testing and counselling services and health education,’ he added.

Millet porridge with Artemisia annua as first aid for African children with malaria?
Bonati M, Severino F, Bagnati R, Carrà A and Fanelli R: Journal of Alternative and Complementary Medicine 17(4): 371-373, 2011

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.

Millions Fed: Proven Successes in Agricultural Development
Spielman DJ and Pandya-Lorch R (eds): International Food Policy Research Institute, 2009

Humanity has made enormous progress in the past 50 years toward eliminating hunger and malnutrition. Some five billion people – more than 80% of the world's population – have enough food to live healthy, productive lives. Agricultural development has contributed significantly to these gains, while also fostering economic growth and poverty reduction in some of the world's poorest countries. This book examines how policies, programmes and investments in pro-poor agricultural development have helped to substantially reduce hunger across Africa, Asia and Latin America. The 20 success stories presented here provide both lessons and inspiration for continued efforts to eradicate hunger and malnutrition among the one billion people still facing this scourge.

Millions of Malawians hungry as food crisis deepens
Henderson P: Pambuzuka News, 16 June 2016

The author reports that Almost four million Malawians are battling severe famine due to poor or no harvests because of the effect of El Nino, which last year affected most of the country’s southern and northern regions, and that this could double by the end of the year. The number of hungry people is expected to rise to eight million by December 2016 and this is exactly half of the population. Torrential rains in the north aggravated the already dramatic situations, and in February a state of emergency was declared. In the meantime food prices continue to rise as Malawi’s Kwacha continues to lose value, forcing the poorest families to further reduce their already precarious daily meals, or to sell goods in order to make ends meet. According to a report by World Food Program (WFP) of May, 2016, in most parts in Southern Africa harvesting was underway, temporarily alleviating some market pressure and allowing for food price improvements in pockets of the region as people consume their own production. The report, however, states that, crop expectations remain poor following one of the driest seasons in 35 years with seasonal rainfall deficits experienced throughout the region, particularly in central and southern Malawi.

Mind the Gap: House Structure and the Risk of Malaria in Uganda
Wanzirah H; Tusting LS; Arinaitwe E; Katureebe A; Maxwell K; Rek J; Bottomley C; Staedke SG; Kamya M; Dorsey G; Lindsay SW: PLOS One, January 2015, doi: 10.1371/journal.pone.0117396

Good house construction may reduce the risk of malaria by limiting the entry of mosquito vectors. The authors assessed how house design may affect mosquito house entry and malaria risk in Uganda. 100 households were enrolled in each of three sub-counties: Walukuba, Jinja district; Kihihi, Kanungu district; and Nagongera, Tororo district. CDC light trap collections of mosquitoes were done monthly in all homes. All children aged six months to ten years (n = 878) were followed prospectively for a total of 24 months to measure parasite prevalence every three months and malaria incidence. Homes were classified as modern (cement, wood or metal walls; and tiled or metal roof; and closed eaves) or traditional (all other homes). The human biting rate was lower in modern homes than in traditional homes. The odds of malaria infection were lower in modern homes across all the sub-counties, while malaria incidence was lower in modern homes in Kihihi but not in Walukuba or Nagongera. The authors concluded that house design is likely to explain some of the heterogeneity of malaria transmission in Uganda and represents a promising target for future interventions, even in highly endemic areas.

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