What 860 million people that live in this

 What challenges face sub Saharan Africa – health
care

Sub Saharan Africa has many dubious highs when it comes to health care –
it has the world’s highest HIV rate, the greatest number of deaths from malaria
and the highest infant mortality rate. 
In this pod we will look at the reasons for this and what is being done
to try and improve the lives of the 860 million people that live in this
region.

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Infant mortality in sub Saharan Africa accounts for over one third of
all neo natal deaths in the world – in terms of new born death and deaths in
children under 5 it is the highest in any region. 1.1 million babies die in the
first month of their life and 1 in 9 never see their fifth birthday.

Why are these figures so high? 
Many  new borns die due to
infections they catch when they are delivered in poor, unhygienic conditions
with a lack of trained professionals to help. 
About a tenth die due to diarrhoea 
caused by drinking contaminated water and about half a million will die
due to malaria.

ActionAid is a charity that
works across the globe but it supports a number of projects in Africa.  One example of a bottom up approach taken by
ActionAid is the building of the Aduwan Health Centre for the people of the
Aduwna II community in Kaduna State, central Nigeria.  Prior to this, the community just had 1 shop
that doubled up as a clinic.  There were
just few health workers and they lacked the right equipment to treat people – treatment
was so ineffective people did not bother to go there.  Pregnant women preferred to visit local
village women to give them advice about their pregnancy and deliver their
babies.  The incidence of HIV/AIDS in the
area was increasing, with no testing for the disease, no drugs to control the symptoms
and no education to control its spread.  
In short, the people of Aduwna were very unhealthy and unhealthy people
are not economically active.

ActionAid, working with the
local community was to change all of that. 
They managed to empower people and raise awareness in the village and
people who had come to accept poor health care as a way of life,  began to realise they were entitled to
better. They demanded a health centre from the local government. After a great
number of meetings with various levels of officials and some very strong
arguments they made contact with the State Ministry of Health.  They were told that the World Bank supported
programmes in their area.

They managed to secure a loan
from the World Bank for a modern health clinic which was opened in 2010.  Thanks to testing,  people are now aware of their HIV status and
can adapt their lifestyle accordingly. Pregnant women are getting the right
help during their pregnancy, at  the
birth of their baby and in its early years. Thanks to an education programme,
mothers are having their babies immunised against crippling diseases such as
polio. People of the community are now healthier and as a result, more
productive. 

Other small charities such as Nets
for Life  and Nothing but Nets are working
in Sub Saharan Africa to provide  insecticide treated mosquito nets to stop the
spread of malaria.  They also educate
people about malaria prevention.  Malaria
is a debilitating disease and 90% of the world’s deaths from malaria are in Sub
Saharan Africa,   but  it
is preventable and if people are malaria free and they can work and make an
income.  

Since 2000, through charities,
one billion nets have been given to families. 
In 2015 it was estimated that 68% of under fives were sleeping under
insecticide treated nets  – in 2000 the
figure was just 2% – as a result of net provision the under 5’s death rate has
fallen by 65%. Rapid diagnostic testing has also helped as it means people can
be treated more quickly – for example a non malarial fever and a malarial fever
can be distinguished from one another – and new drugs are proving effective
against the most common and deadly strains of malaria.  

 We have seen how village clinics can help the HIV crisis in
Sub Saharan Africa but what else is being done? It’s a big problem with 70% of
the world’s HIV cases in this region alone. 
There have been many strategies to address this including encouraging
people to be tested so they are aware of their HIV status, encouraging condom
use and trying to get people to change their sexual behaviour.  There has been a programme of condom
distribution but men are reluctant to use them and women do not feel able to
insist.  Antiretroviral drugs have helped
in reducing the number of HIV deaths in Sub Sharan Africa by nearly 40%  but not the number of cases.  Part of the problem is that people are unware
they have HIV and therefore do not seek help early enough.  Current projects are working on community
based testing programmes and self testing kits.   As a result of this some countries have stabilised
the number of HIV cases but in other countries such as Lesotho and Rwanda, it continues
to rise.