The paper examines the relationships between income inequality, social inequalities and individual health. The role of social cohesion is analysed vis-à-vis the status and provision of public goods as they foster the integration and formation of social capital. In such paradigms, equality and equity constitute fundamental dynamics to understand or comprehend well-being, and the needs for equitable income redistribution as mediums for growth and social developments.
Poverty and health
Health, Inequality, and Economic Development
Hidden and exposed: Urban refugees in Nairobi, Kenya
Pavanello S, Elhawary S and Pantuliano S: Humanitarian Policy Group Working Paper, March 2010
This report examines the daily challenges urban refugees face, including police harassment, discrimination and limited livelihood opportunities. The report presents the challenges that affect refugees and explores the policies and current assistance government is giving to them, to identify ways of attending to their long-term and immediate needs. The authors suggest a gap in clear policy on the issue. They point to issues for policy attention: Many refugees have not registered with authorities and lack required identification documents. In addition, they experience difficulties in accessing formal employment and face problems of poor access to adequate health and education services and precarious living conditions.
High malnutrition rates a silent emergency in DRC
World Food Programme: 6 April 2010
Nutrition surveys carried out by the government of Democratic Republic of Congo (DRC), with the support of the United Nations (UN) Children’s Fund and the UN World Food Programme, have found unusually high levels of malnutrition in children living in five provinces of the Democratic Republic of Congo (DRC). Experts believe the basic structural causes of malnutrition have been aggravated by conflict, high food prices and the global financial crisis, which has shaken the mining industry in the west and south-east of the country. Some 530,000 children under five and more than one million pregnant women need urgent nutrition interventions, according to the DRC Ministry of Health. In several areas surveyed, global acute malnutrition rates are above the 10% threshold for intervention and also in some cases above the emergency threshold of 15%. The causes behind such high malnutrition rates vary from one territory to another and are identified in the survey as lack of access to healthcare and to safe drinking water, poor access to good quality food, non-optimal feeding practices of infants, young children and women, and lack of tools and seeds for agriculture.
History of rotavirus research in children in Malawi: The pursuit of a killer
Cunliffe N, Witte D and Ngwira B: Malawi Medical Journal; 21(3):113–115, September 2009
Rotavirus gastroenteritis is a major health problem among Malawian children. Studies spanning 20 years have described the importance, epidemiology and viral characteristics of rotavirus infections in the country. Despite a wide diversity of circulating rotavirus strains causing severe disease in young infants, a clinical trial of a human rotavirus vaccine clearly demonstrated the potential for rotavirus vaccination to greatly reduce the morbidity and mortality due to rotavirus diarrhoea in Malawi. This new enteric vaccine initiative represents a major opportunity to improve the health and survival of Malawian children.
HIV/AIDS, growth and poverty in KwaZulu-Natal and South Africa: An integrated survey, demographic and economywide analysis
Thurlow J, Gow J and George G: Journal of the International AIDS Society, 16 September 2009
This paper estimates the economic impact of HIV and AIDS on the KwaZulu-Natal province and the rest of South Africa. It extended previous studies by employing: an integrated analytical framework that combined firm surveys of workers' HIV prevalence by sector and occupation; a demographic model that produced both population and workforce projections; and a regionalised economy-wide model linked to a survey-based micro-simulation module. Results indicate that HIV and AIDS greatly reduces annual economic growth, mainly by lowering the long-run rate of technical change. However, impacts on income poverty are small, and inequality is reduced by HIV and AIDS because high unemployment among low-income households minimises the economic costs of increased mortality. By contrast, slower economic growth hurts higher income households despite lower HIV prevalence. The increase in economic growth that results from addressing HIV and AIDS is sufficient to offset the population pressure placed on income poverty. Moreover, incentives to mitigate HIV and AIDS lie not only with poorer infected households, but also with uninfected higher income households. The findings confirm the need for policies to curb the economic costs of the pandemic.
Home is best: Why women in rural Zimbabwe deliver in the community
Dodzo M; Mhloyi M: PLOS One 12(8) e0181771, doi: 10.1371/journal.pone.0181771, 2017
Maternal mortality in Zimbabwe has unprecedentedly risen over the last two and half decades although a decline has been noted recently. Many reasons have been advanced for the rising trend, including deliveries without skilled care, in places without appropriate or adequate facilities to handle complications. The recent decline has been attributed to health systems strengthening. On the other hand, the proportion of community deliveries has also been growing steadily over the years and in this study the authors investigate why. Twelve focus group discussions with child-bearing women and eight key informant interviews (KIIs) were conducted. Four were traditional birth attendants and four were spiritual birth attendants. The study shows that women prefer community deliveries due to perceived low economic, social and opportunity costs involved; pliant and flexible services offered; and diminishing quality and appeal of institutional maternity services. The authors conclude that rural women are very economic, logical and rational in making choices on place of delivery. Delivering in the community offers financial, social and opportunity advantages to disenfranchised women, particularly in remote rural areas. The authors recommend increased awareness of the dangers of community deliveries; establishment of basic obstetric care facilities in the community and more efficient emergency referral systems. In the long-term, they argue that there should be a sustainable improvement of the public health delivery system to make it accessible, affordable and usable by the public.
Hospitalisation and mortality among primarily non-breastfed children during a large outbreak of diarrhoea and malnutrition in Botswana, 2006
Creek TL, Kim A, Lu L, Bowen A, Masunge J, Arvelo W, Smit M, Mach O, Legwaila K, Motswere C, Zaks L, Finkbeiner T, Povinelli L, Maruping M, Ngwaru G, Tebele G, Bopp C, Puhr N, Johnston SP, Dasilva AJ, Bern C, Beard RS, Davis MK: Journal of Acquired Immune
In 2006, a paediatric diarrhoea outbreak occurred in Botswana, coinciding with heavy rains. Surveillance recorded a three-times increase in cases and a 25-fold increase in deaths between January and March. Botswana has high HIV prevalence among pregnant women (33.4% in 2005), and an estimated 35% of all infants under the age of six months are not breastfed. This study followed all children <5 years old with diarrhoea in the country's second largest referral hospital at the peak of the outbreak by chart review, interviewed mothers and conducted laboratory testing for HIV and enteric pathogens. Of 153 hospitalised children with diarrhoea, 97% were <2 years old; 88% of these were not breastfeeding. HIV was diagnosed in 18% of children and 64% of mothers. Many children who died had been undersupplied with formula. Most of the severe morbidity and mortality in this outbreak occurred in children who were HIV negative and not breastfed. Feeding and nutritional factors were the most important determinants of severe illness and death. Breastfeeding is critical to infant survival in the developing world, and support for breastfeeding among HIV-negative women, and HIV-positive women who cannot formula feed safely, may prevent further high-mortality outbreaks.
Hostile Environment(s) – Designing Hostility, Building Refugia
Pezzani L: ar/ge kunst, Bolzano, unibz – Faculty of Design and Art in collaboration with Z33 – House of Contemporary Art, Design & Architecture, Hasselt, 2020
Hostile Environment(s) – Designing Hostility, Building Refugia is an expanded programme investigating the political ecology of migration and border violence. Through a series of lectures, workshops, screenings, commissioned texts and other materials delivered both online and in-person it provides an index and archive of materials that are regularly be updated with new content. The term “hostile environment” draws from legislation in UK, denying migrants from Africa and other countries deemed to be illegal access to work, housing, services and education. Far from being an exceptional condition, however, this process of making (urban) space unlivable for some resonates with the ways in which certain “natural” terrains (oceans, deserts, mountains) have been structured to deter and expel migrants. These materials seeks to capture these interconnected processes, investigating how certain forms of racialized violence have become as pervasive as the climate.
Household Air Pollution in Low- and Middle-Income Countries: Health Risks and Research Priorities
Martin WJ II, Glass RI, Araj H, Balbus J, Collins FS et al: PLoS Medicine 10(6): e1001455, 4 June 2013
Household air pollution (HAP) from solid fuel (biomass or coal) combustion is the leading environmental cause of death and disability in the world. The health effects of HAP and unsafe stoves are documented in this paper to be in seven areas (cancer; infections; cardiovascular disease; maternal, neonatal, and child health; respiratory disease; burns; and ocular disorders). Gaps in four cross-cutting areas were found that are relevant to research on HAP (exposure and biomarker assessment, women's empowerment, behavioural approaches, and programme evaluation). The authors argue that it is vital that researchers partner with implementing organisations and governments to evaluate the impacts of improved stove and fuel programmes to identify and share evidence regarding the outcomes of the many implementation programmes underway, including the socio-behavioural aspects of household energy use.
How do gender and disability influence the ability of the poor to benefit from pro-poor health financing policies in Kenya? An intersectional analysis
Kabia E; Mbau R; Muraya K; et al: International Journal for Equity in Health 17(149) 1-12, 2018
This study employed an intersectional approach to explore how gender disability and poverty interact to influence how poor women in Kenya benefit from pro-poor financing policies that target them. The authors applied a qualitative cross-sectional study approach in two purposively selected counties in Kenya. The authors collected data using in-depth interviews with women with disabilities living in poverty who were beneficiaries of the health insurance subsidy programme and those in the lowest wealth quintiles residing in the health and demographic surveillance system. Women with disabilities living in poverty often opted to forgo seeking free healthcare services because of their roles as the primary household providers and caregivers. Due to limited mobility, they needed someone to accompany them to health facilities, leading to greater transport costs. The absence of someone to accompany them and unaffordability of the high transport costs, for example, made some women forgo seeking antenatal and skilled delivery services despite the existence of a free maternity programme. The layout and equipment at health facilities offering care under pro-poor health financing policies were disability-unfriendly. The latter in addition to negative healthcare worker attitudes towards women with disabilities discouraged them from seeking care. Negative stereotypes against women with disabilities in the society led to their exclusion from public participation forums thereby limiting their awareness about health services. Intersections of gender, poverty, and disability influenced the experiences of women with disabilities living in poverty with pro-poor health financing policies in Kenya. Addressing the healthcare access barriers they face could entail ensuring availability of disability-friendly health facilities and public transport systems, building cultural competence in health service delivery, and empowering them to engage in public participation.