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How the Pandemic Affect the Social Problem in the Local Context

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How the Pandemic Affect the Social Problem in the Local Context

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Philippine Hospitals already feeling the Rise of the Delta Variant Cases.

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Sofia Tomacruz covers foreign affairs and is the lead reporter on the coronavirus pandemic. She also writes stories on the treatment of women and children. Follow her on Twitter via @sofiatomacruz. Email her at sofia.tomacruz@rappler.com.

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Philippine hospitals already feeling the rise of the Delta variant cases

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Sofia Tomacruz covers foreign affairs and is the lead reporter on the coronavirus pandemic. She also writes stories on the treatment of women and children. Follow her on Twitter via @sofiatomacruz. Email her at sofia.tomacruz@rappler.com.

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Sustainable Development Goal 10: Reduced Inequalities

This aims at reducing inequality within and among countries. It calls for reducing inequalities in income as well as those based on age, sex, disability, race, ethnicity, origin, religion or economic or other status within a country.

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Limited Access to Healthcare Services

We live in a modern age with incredible medical advances that hit our headlines on a daily basis. As the years go by, we find quicker and more efficient ways to operate, diagnose and treat patients. Diseases are becoming more manageable and people are living longer than ever before. Despite this, there are countries with serious pharmaceutical market access issues, which we should really address.

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Here, Maria Yasko, PR manager at phamax, lists five countries with limited access to healthcare, going into detail about how these countries are suffering from healthcare sector problems and how these are getting in the way of patient access.
We live in a modern age with incredible medical advances that hit our headlines on a daily basis. ¹ As the years go by, we find quicker and more efficient ways to operate, diagnose and treat patients. Diseases are becoming more manageable and people are living longer than ever before. ² Despite this, there are countries with serious pharmaceutical market access issues, ³ which we should really address.

No two countries are alike and each country with limited access to healthcare will be experiencing unique and pressing issues. Below are five countries which suffer from healthcare sector problems. I'll cover what these problems are and how they are getting in the way of patient access.
1. Liberia's struggles with civil war, malaria and Ebola
One of the world's poorest nations, Liberia is a country that is struggling to achieve better access to healthcare after years of civil war and prolonged regional instability. ⁴ A great deal of clinics, hospitals and equipment were destroyed during Liberia's 14-year civil conflict, ⁵ and attempting to rectify the situation is wrought with financial roadblocks. On top of this, Liberia is suffering from a lack of qualified doctors. Figures suggest that there are only 14 physicians per million people in Liberia. ⁶

Liberians are suffering in the face of malaria, the second leading cause of death in the country, ⁷ which kills thousands of pregnant women and children each year. unfortunately, hospitals don't always have access to antimalarials. ⁸ The Ebola outbreak in 2014 also hit the country hard. But since this time, thanks to the government working on strategies to improve patient care and international aid, healthcare services have started to improve.

The healthcare system is now more decentralised, there are more medical supplies for health workers and extra training is being provided in infection prevention control. Healthcare in Liberia is also free, ⁸ which helps struggling patients who would otherwise have no means of obtaining treatment.

There are also other exciting technological advances that could facilitate access to healthcare. Increasingly, mobile devices are being used for this purpose, and Julius SM Gilayeneh, a Liberian medical doctor, has said that he hopes investments in modern mobile technology could change the lives of those who live in rural areas. ⁹ Where medical access is concerned, travelling is always an issue, but Gilayeneh believes that long trips to the hospital could be eliminated if individuals were able to call or text doctors for advice.
2. Malawi has to cope with regular 'stock-outs'
Healthcare in Malawi faces a lot of problems, notably that of infant mortality, tuberculosis, HIV/AIDS and malaria. As with Liberia, Malawi has a dearth of physicians; there are only 19 doctors per million people and the World Health Organisation's (WHO) report ranks Malawi's health system as number 185 out of 190 due to lack of manpower, lack of skills and scarcity of appropriate equipment and technology. ⁶

Only 46% of Malawi citizens live within 5 km of a health facility and, although most public health services are free, patients can rarely afford the associated costs that are involved when it comes to travelling to and from a facility. ¹⁰ This means that despite how much they might need care, some patients refuse to, or are unable to, get the attention they deserve.

As we mentioned above, scarcity of equipment and drugs are an issue in Malawi - so much so that a phrase has been coined (stock-outs) to describe empty hospital and pharmacy shelves, ¹¹ so even if patients manage to travel to the appropriate facility, they might not be able to receive the necessary drugs. The government acknowledges these problems and is making efforts to resolve the issues, but as it stands, the people of Malawi, especially in rural areas, are having to deal with long periods of drug shortages.
3. Somalia's healthcare concerns are linked with political and environmental complications
Access to basic and essential healthcare services remains a challenge in Somalia. WHO argues that the reasons behind Somalia's struggles with access to healthcare are numerous and complex, including environmental stress, ongoing armed conflict, political instability, recurring drought conditions, overcrowding and forced evictions. ¹²

The lack of access to clean drinking water and malnutrition cause disease outbreaks, but with such limited healthcare and with only 35 doctors per million citizens, ⁶ patients struggle and very often die without medical care. It is likely that with added investment in healthcare, along with improved water and hygiene practices, disease outbreaks will lessen and more patients will get appropriate care.
4. Nigeria has issues with health insurance
Despite the fact that Nigeria has ' one of the largest stocks of human resources for health', ¹³ this African country still struggles with a deficit of midwives, nurses and doctors, meaning that delivering appropriate patient care is a challenge. On top of this, the healthcare providers tend to be concentrated in urban areas, causing rural areas to suffer. The country also deals with medical supply shortages. ¹⁴

One of the biggest worries for Nigeria, however, is the issue of health insurance. According to one source, only approximately 3% of Nigerians have access to healthcare coverage under the National Health Insurance Scheme (NHIS). ¹⁵ Professor Usman Yusef, executive secretary of NHIS, has expressed his sadness at this statistic and has said that they are determined to do better, with the aim of improving access to quality health care for all Nigerians.
5. India has great healthcare, but only some individuals can benefit
In many ways, Indian healthcare is globally acclaimed and provides a wide quality of care. ¹⁶ In other areas, however, Indian hospitals and healthcare research are suffering, particularly due to the lack of reliable data with relation to certain diseases. On top of this, access to healthcare tends to depend very much on where you live. For example, it has been shown that 80% of doctors in India only serve 28% of the nation's population. ¹⁷ This could be explained by the fact that 70% of the Indian population lives rurally, in areas that have no or limited access to hospitals.

Research into healthcare issues in India shows that the country spends only 4.2% of its national GDP on healthcare goods and services, ¹⁷ which can be compared to the USA, which spends 18% of its GDP on this area.

One area that is rarely discussed, but which causes a problem for Indian citizens, is the question of haemophilia. There are approximately 16,000 registered haemophiliacs in India, ¹⁸ according to the Hemophilia Federation of India, but the actual estimated haemophiliac population is actually 54,000. This shows that not all Indians who suffer symptoms of haemophilia are seeking help, which might be because The Insurance Act in India doesn't accommodate individuals with pre-existing genetic disorders. So, these sufferers never seek treatment.

This is a serious market access concern, as the only way we, as a modern society, will adequately address and treat rare bleeding disorders is if we get a full and accurate picture of how many sufferers there are in the world while collecting data on their symptoms and bleeds. Some sources suggest that the Indian government should implement an ' Orphan disease' policy to create drugs for diseases that don't receive a lot of attention. ¹⁹
No simple solution
All the countries above have their own unique sets of problems with relation to healthcare and, as such, the answer to improving access to healthcare will be different in each case. There is no simple way to resolve such complex issues, but with governmental support, technological evolution and a dedication to medical advancements, it's likely that all the countries above will thrive long-term and provide patients with the support and care they need.
References:

1. http://www.huffingtonpost.com/entry/7-amazing-medical-breakthroughs-that-will-wow-the-world-in-2017_us_5852c870e4b012849c05d133

2. http://www.bbc.co.uk/news/health-35550407

3. http://phamax.ch/blog/?p=800?utm_source=enoutreach&utm_medium=article

4. http://allafrica.com/stories/20170524096html

5. http://who.int/hac/donorinfo/cap/Liberia_compendium_Jan06.pdf

6. http://www.worldatlas.com/articles/the-countries-with-the-fewest-doctors-in-the-world.html

7. http://www.healthdata.org/liberia

8. https://kristof.blogs.nytimes.com/2017/06/23/in-liberia-more-drugs-in-my-suitcase-than-in-the-hospital/

9. http://ghi.wisc.edu/ghi-in-action/mobile-technology-improves-health-in-rural-africa/

10. http://joshuainmalawi.org.uk/what-we-do/health/

11. http://policy-practice.oxfam.org.uk/blog/2012/06/access-to-medicines-in-malawi

12. http://www.who.int/emergencies/response-plans/2017/somalia/en/

13. http://www.who.int/workforcealliance/countries/nga/en/

14. https://www.internations.org/nigeria-expats/guide/moving-to-nigeria-15540/healthcare-in-nigeria-3

15. https://www.dailytrust.com.ng/news/health/only-3-percent-of-nigerians-have-healthcare-coverage-nhis/172812.html

16. http://content.healthaffairs.org/content/35/10/1753.full

17. http://www.hindustantimes.com/health-and-fitness/80-of-doctors-in-india-serve-only-28-of-the-nation-s-population-report/story-hxfxTu1jiYoplroBrD0vyL.html

18. http://phamax.ch/blog/?p=772?utm_source=enoutreach&utm_medium=article

19. http://www.thehindubusinessline.com/companies/hemophilia-patients-concerned-over-medicine-prices-short-supply-as-customs-waiver-goes/article8214172.ece

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Limited access: What healthcare problems affect five countries and how these impact patient access

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Here, Maria Yasko, PR manager at phamax, lists five countries with limited access to healthcare, going into detail about how these countries are suffering from healthcare sector problems and how these are getting in the way of patient access. We live in a modern age with incredible medical advances that hit our headlines on a daily basis.

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How the Pandemic affect the Social Problem in the Global Context

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How the Pandemic affect the Social Problem in the Global Context

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The impact of drought and COVID-19 on families' livelihoods has been catastrophic for children's health.

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Why should there be awareness and action for the social issue/problem?

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Why should there be awareness and action for the social issue/problem?

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Awareness raising means making people conscious about a problem or issue. You want to make a certain topic or issue more visible within a community. The goal is to make people understand the importance of a certain issue and find support to address it.

Awareness raising is very powerful, because it educates people about topics which are new to them and encourages them to participate in bringing change.

Healthcare access is something we all need, especially during a pandemic. But there are places where this is limited due to lack of funds, lack of physicians, etc. Therefore, healthcare is only accessible to those who can afford it. We want to spread awareness about this issue because our goal is to reduce inequalities. We must realize that the privileged are served, but the poor are still waiting. As fellow citizens, we owe it to them to be their voice.

Source: https://www.youthdoit.org/themes/awareness-raising/

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How it works

1. Read the articles

2. Check out the stories, quizzes and reflections

3. Train yourself with the accompanying skills

4. Take action!

Awareness raising means making people conscious about a problem or issue. You want to make a certain topic or issue more visible within a community. The goal is to make people understand the importance of a certain issue and find support to address it.

The difference with advocacy, is that awareness raising doesn't have the goal to change a policy directly. It is purely about informing people and giving them new bits of information. However, awareness raising can also be a tool for advocacy, to convince policy makers of the urgency of a certain issue, backed up by a whole segment of the community!

Awareness raising is very powerful, because it educates people about topics which are new to them and encourages them to participate in bringing change.

In this course, you will find more information on:

You practice!

Choose one of the awareness raising activities below, and prepare it with the information you will get in this course!

Organize a (social) media campaign to involve your community and put pressure on decision makers

Go into the community to tell people in your own environment about an issue you find important

Hold a debate about a certain issue in school, community, hospital, youth center...

Start a petition to get people's support. This can then be presented to a decision maker

Organize a rally, demonstration or peaceful march.

Hand out brochures and leaflets with information

Do a theatre performance, sing a song or create a piece of art about an issue

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Want to know how to raise awareness? | Youth Do It " Youth Do It

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Read the articles Check out the stories, quizzes and reflections Train yourself with the accompanying skills Take action! The difference with advocacy, is that awareness raising doesn't have the goal to change a policy directly. It is purely about informing people and giving them new bits of information.

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Davao City focuses on access to comprehensive, quality health services for all.

The city government prioritized access to various levels of care in well-defined and functional networks of health facilities. “Everyone, particularly those living in remote areas and Indigenous Peoples, should be able to access different levels of care in any barangay health station or primary health care facility,” Villafuerte stated.

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Davao City is one of the country's most progressive cities, thanks to its strong and forward-looking local government. The city's dynamic approach to governance extends to the provision of a comprehensive range of high-quality health services.
"The first step we took was set the health agenda," said Dr. Josephine Villafuerte, City Health Officer of Davao City, who spoke on behalf of Mayor Sara Duterte during the 2018 Health for Juan and Juana Forum. She explained that the Local Health Board consolidated the health programs and projects of the national government, private sector partners, civil society organizations and other stakeholders. It then looked at local concerns and issues relating to the health care system. "Based on these data, we developed a road map of interventions at the LGU [local government unit] level," she added.
Dr. Villafuerte underscored the importance of appropriate health investments. "The Local Health Board drew up a health investment plan with significant consideration for capacity building of LGU health managers and localization of the Philippine Health Agenda," she said. The city government prioritized access to various levels of care in well-defined and functional networks of health facilities. "Everyone, particularly those living in remote areas and Indigenous Peoples, should be able to access different levels of care in any barangay health station or primary health care facility," Villafuerte stated.
One of the interventions is Byaheng DO30, which focuses on addressing 10 priorities through the implementation of 30 major programs and projects from 2016 to 2018. The 10 priorities are poverty alleviation; infrastructure development; solid waste management; health; education; agriculture; tourism; transportation planning and traffic management; peace and order; and disaster risk reduction and mitigation.
"Lingap para sa Mahirap provides indigent residents with financial assistance for hospitalization and dialysis, funeral and burial assistance, and medicines subsidies," Dr. Villafuerte said. Lingap para sa Mahirap help desks are located in the Davao City Hall and Southern Philippines Medical Center (SPMC).
Tara Na is a community-based drug rehabilitation program being implemented by the city government through its City Anti-Drug Abuse Council (CADAC). The program allows drug dependents to undergo rehabilitation in their own barangay instead of a drug rehabilitation facility. "Tara Na aims to provide a holistic recovery program and facilitate reintegration of recovering drug dependents as productive members of society," Dr. Villafuerte explained. The program also includes preventive education implemented through 11 partner academic institutions, faith-based groups, and NGOs. In partnership with the Department of Education, CADAC developed an anti-drug module for Grades 4 to 12 students enrolled in the DepEd's Alternative Learning System (ALS), she added.
According to Dr. Villafuerte, Davao City was the first LGU to implement the Integrated Management of Acute Malnutrition (IMAM), a set of updated and scientifically proven protocols that can be used by health care providers to manage acute malnutrition in children six to 59 months of age. "IMAM has helped us lower the incidence of acute malnutrition in Davao City."
Other health initiatives of the Davao City Government include a strict anti-smoking and liquor ban, a firecracker ban, a speed limit for all motor vehicles, a community-based teen center, a community-based HIV/AIDS rapid testing center, a child abuse hot line, Let's Go Organic (a local movement of organic farming practitioners and advocates in Davao City), and scholarship programs for deserving medical students, among others.

Teodoro B. Padilla is the executive director of Pharmaceutical and Healthcare Association of the Philippines (PHAP). Medicine Cabinet is a weekly PHAP column that aims to promote awareness on public health and health care-related issues. PHAP and its member companies represent the research-based pharmaceutical and health care industry.
medicinecabinet@phap.org.ph.

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Davao City focuses on access to comprehensive, quality health services for all

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Davao City is one of the country's most progressive cities, thanks to its strong and forward-looking local government. The city's dynamic approach to governance extends to the provision of a comprehensive range of high-quality health services.

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What can we (ordinary citizens) do about it?

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What can we (ordinary citizens) do about it?

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The Department of Health proposed solutions to this crisis, including partnering with universities that could recommend its students to understaffed hospitals. The government even went as far as to impose a  deployment ban for Filipino healthcare workers to force their participation in the local fight against COVID-19.

Additionally, we could lessen our burden to the community by following the safety protocols for the pandemic.

Source: https://www.who.int/images/default-source/wpro/countries/philippines/emergencies/covid-19/protective-measures/covid-19-rhymes-e.jpg?sfvrsn=dd2b30ff_2

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At least half of the world’s population cannot obtain essential health services, according to a new report from the World Bank and WHO. And each year, large numbers of households are being pushed into poverty because they must pay for health care out of their own pockets.

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At least half of the world's population cannot obtain essential health services, according to a new report from the World Bank and WHO. And each year, large numbers of households are being pushed into poverty because they must pay for health care out of their own pockets.

Currently, 800 million people spend at least 10 percent of their household budgets on health expenses for themselves, a sick child or other family member. For almost 100 million people these expenses are high enough to push them into extreme poverty, forcing them to survive on just $1.90 or less a day. The findings, released today in Tracking Universal Health Coverage: 2017 Global Monitoring Report, have been simultaneously published in Lancet Global Health.

"It is completely unacceptable that half the world still lacks coverage for the most essential health services," said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. "And it is unnecessary. A solution exists: universal health coverage (UHC) allows everyone to obtain the health services they need, when and where they need them, without facing financial hardship."

"The report makes clear that if we are serious - not just about better health outcomes, but also about ending poverty - we must urgently scale up our efforts on universal health coverage," said World Bank Group President Dr. Jim Yong Kim. "Investments in health, and more generally investments in people, are critical to build human capital and enable sustainable and inclusive economic growth. But the system is broken: we need a fundamental shift in the way we mobilize resources for health and human capital, especially at the country level. We are working on many fronts to help countries spend more and more effectively on people, and increase their progress towards universal health coverage."

There is some good news: The report shows that the 21st century has seen an increase in the number of people able to obtain some key health services, such as immunization and family planning, as well as antiretroviral treatment for HIV and insecticide-treated bed nets to prevent malaria. In addition, fewer people are now being tipped into extreme poverty than at the turn of the century.

Progress, however, is very uneven.

There are wide gaps in the availability of services in Sub-Saharan Africa and Southern Asia. In other regions, basic health care services such as family planning and infant immunization are becoming more available, but lack of financial protection means increasing financial distress for families as they pay for these services out of their own pockets. This is even a challenge in more affluent regions such as Eastern Asia, Latin America and Europe, where a growing number of people are spending at least 10 percent of their household budgets on out-of-pocket health expenses. Inequalities in health services are seen not just between, but also within countries: national averages can mask low levels of health service coverage in disadvantaged population groups. For example, only 17 percent of mothers and children in the poorest fifth of households in low- and lower-middle income countries received at least six of seven basic maternal and child health interventions, compared to 74 percent for the wealthiest fifth of households.

The report is a key point of discussion at the global Universal Health Coverage Forum 2017, currently taking place in Tokyo, Japan. Convened by the Government of Japan, a leading supporter of UHC domestically and globally, the Forum is cosponsored by the Japan International Cooperation Agency (JICA), UHC2030, the leading global movement advocating for UHC, UNICEF, the World Bank, and WHO. Japanese Prime Minister Shinzo Abe, UN Secretary-General Antonio Guterres, World Bank President Kim, WHO Director-General Tedros and UNICEF Executive Director Anthony Lake will all be in attendance, in addition to heads of state and ministers from over 30 countries.

"Past experiences taught us that designing a robust health financing mechanism that protects each individual vulnerable person from financial hardship, as well as developing health care facilities and a workforce including doctors to provide necessary health services wherever people live, are critically important in achieving 'Health for All,'" said Mr. Katsunobu Kato, Minister of Health, Labour and Welfare, Japan. "I firmly believe that these early-stage investments for UHC by the whole government were an important enabling factor in Japan's rapid economic development later on."

The Forum is the culmination of events in over 100 countries, which began on Dec. 12-Universal Health Coverage Day-to highlight the growing global momentum on UHC. It seeks to showcase the strong high-level political commitment to UHC at global and country levels, highlight the experiences of countries that have been pathfinders on UHC progress, and add to the knowledge base on how to strengthen health systems and effectively promote UHC.

The main high-level sessions of the Forum take place tomorrow, Dec. 14, and will also feature an all-day "innovation showcase," highlighting innovations driving progress in health systems around the world, and a celebratory public event in the evening. A commitment to action, called the Tokyo Declaration on Universal Health Coverage, will be released during the Forum's closing ceremony.

"Without health care, how can children reach their full potential? And without a healthy, productive population, how can societies realize their aspirations?" said UNICEF Executive Director Anthony Lake. "Universal health coverage can help level the playing field for children today, in turn helping them break intergenerational cycles of poverty and poor health tomorrow."

Building on the G7 Ise-Shima Summit and the TICAD VI in 2016, both of which stress the need for UHC, the Forum in Tokyo is seen as a milestone for accelerating progress towards the target of UHC by 2030, a key part of the Sustainable Development Goals. Countries will then gear up for the next global moment: a high-level meeting of the UN General Assembly on UHC in 2019.

Note to editors

The World Bank/WHO UHC Global Monitoring Report, issued regularly, measures the proportion of a population that can access essential quality health services, and the proportion of the population that spends a large amount of household income on health. It also evaluates the overall level and the extent to which UHC is equitable - offering service coverage and financial protection to all people within a population, such as the poor or those living in remote rural areas. The report uses 16 essential health services as indicators of the level and equity of coverage in countries.

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World Bank and WHO: Half the world lacks access to essential health services, 100 million still pushed into extreme poverty because of health expenses

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World Bank and WHO: Half the world lacks access to essential health services, 100 million still pushed into extreme poverty because of health expenses

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On Mindanao Island, more than 500,000 people were displaced in August 2008 after violent clashes erupted between the Moro Islamic Liberation Front and the army.

Rachma Usman is a midwife. On her own, she covers five different health centres. Azineth Guiapal is a displaced mother of three who regularly visits Rachma. They share their thoughts in the Libungan Toreta health centre.

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International Committee of the Red Cross (ICRC)

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Philippines: improving health care for residents and displaced people