Children in sub-Saharan Africa who suffer from diarrhea are receiving lifesaving treatment at a lower rate when visiting private hospitals as compared to public ones. Closing that gap would save an estimated 20,000 lives each year.
When a child present signs of diarrhea, hospitals are supposed to instruct parents to give the child oral rehydration salts (ORS). The basic mixture of water with a little bit of sugar and salt prevents the child from dying from dehydration. It’s wide use over the past few decades has saved millions of lives. However, it is not always available nor is it recommended in every case.
“Clearly the private sector is not following public health guidelines in the way that the public health sector is doing,” said Zachary Wagner, co-author and doctoral student in public health at the University of California, to Humanosphere.
The findings from his research, with Neeraj Sood, PhD, the study’s senior author and director of research at the Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, were published yesterday in the American Journal of Tropical Medicine and Hygiene.
A funny thing happened at the World Bank the other day.
The international financial institution devoted to fighting poverty and advancing economic growth in the poorest parts of the world held an event last week, Toward Universal Health Coverage by 2030.
That wasn’t the funny part. What was funny (or, well, funny-strange maybe) was watching the Bill & Melinda Gates Foundation work so hard to avoid taking a position on this goal of ensuring all people have access to affordable, basic health care.
As Humanosphere has noted, there’s a lot of enthusiasm around the world today for universal health coverage. Even many of the hard-pressed health and finance ministries of poor and middle-income countries are enthusiastic, largely because a number of analyses and expert studies have shown that getting everyone reliable access to basic health services contributes to long-term economic development, social stability and poverty reduction.
“There’s a consensus out there that universal health coverage is a critical development goal,” said Robert Marten, a global health policy expert for the Rockefeller Foundation. Continue reading
A US appeals court determined on Monday that a US Securities and Exchange Commission rule compelling public companies to disclose whether or not their products contain “conflict minerals” is a violation of their free speech rights.
The rule, Section 1502 of the Dodd-Frank financial regulation bill, has been controversial from its inception. It’s intent is to track where minerals that appear in everyday electronics, such as cell phones, are fueling conflict and supporting armed groups. The corporations that extract the minerals say the new rules place an undue burden on their work and violate their rights.
The court partially agreed. The Securities and Exchange Commission (SEC) rules were not entirely struck down by the ruling. It does represent a minor set-back for the advocates who have campaigned for transparency in the mining sector in conflict-affected countries. The real losers are the corporate lobby groups that brought forward the lawsuit.
“At the end of the day this is a huge loss for the National Association of Manufacturers,” said Laura Seay, assistant professor of Government at Colby College, to Humanosphere. ”They still have to file through the SEC whether their supply chains were audited and free of conflict minerals. What has changed is that these companies do not have to disclose to their investors whether or not they are using conflict free minerals. ”
The Enough Project, a Washington DC-based advocacy group who took an active role in crafting and campaigning for 1502, called the ruling a ‘step backward for atrocity prevention.”
Much of the world took note last week of the 20th anniversary of the Rwandan genocide, with most of the news reports focusing on Rwanda’s stunning improvements made over the past few years – and on how the West failed to stop the slaughter of perhaps a million Rwandans.
What Humanosphere took note of is the rising awareness of the need for a more accurate narrative of modern day Rwanda – as a place making great gains on health and welfare, but at the expense of political and democratic freedoms. Some allege the government of Rwanda’s President Paul Kagame even engages in assassinations of political opponents.
Now, Kizito Mihigo, a musician who specializes in Catholic liturgical music has been arrested and charged with terrorism. Some say the arrest is for writing a song that contends some of the atrocities of the 1994 genocide were commited by Kagame’s forces as well (a contention supported by many independent studies and reports). As Rwanda’s New Times reports, Mihigo, a radio journalist and another man have been arrested and charged with subversive activities.
Here’s a video of Kizito performing one of his liturgical songs:
Mihigo and others are accused by the Rwandan police of carrying out grenade attacks and planning terrorist acts. Others, on social media today, suggest Mihigo’s arrest was prompted by the lyrics in his songs – and his faith-based compulsion to work for peace and stability in Rwanda by encouraging all sides to acknowledge wrong-doing.
“I sing peace and forgiveness, I launch a permanent call for reconciliation,” Mihigo says.
If you build it, he will come. In the case of Cambodian schools it is more like: if you provide safe drinking water, kids will go to school.
When schools provided treated water in containers, the rate of absence for students dropped. That is what research published in the health journal PLOS One last month finds.
What makes the study notable is that it shows that the water itself, not necessarily the health gains, are what get kids come to school.
The association between safe drinking water and school attendance is strongest during the dry season. Why students in Cambodia are not going to school during the rainy season is not entirely known.
Paul Hunter, professor of health protection at the University of East Anglia, the study’s lead other and his co-authors surmise that it is due to the farming season.
“There were also strong seasonal effects as absenteeism in several of the schools increased dramatically during the wet season, irrespective of water delivery. We were informed that this increase in absenteeism during the early wet season was partly because children were frequently kept off school to help in the fields,” they write in the study.
What is almost entirely certain is that providing safe drinking water gets kids to go to school during the dry season. They know this because of a delivery problem at one of the schools.
The design of the program was for every class to have one 20 liter bottle of safe drinking water each day. School children then had the opportunity to take water as they wanted, each day. Roughly each student had a half liter of water available each day, costing less than half of a penny per day for each student ($1.40/yr).
The school where deliveries of water were inconsistent saw student attendance react to whether or not the water was at the school. The researchers determined that there was a 2.9% reduction in absenteeism for every container of water delivered at the school. Students were more likely to go to school because of the safe drinking water, not necessarily because of how the water may make them healthier.
The water provided may also have mattered. The 1001F water distributed at the schools was filtered and disinfected by UV light. The use of chlorine is one of the cheapest and most effective ways to treat water, but some people complain that the water does not taste good. The researchers posit that the choice of water may have contributed as an additional incentive for kids to attend school.
“Any scheme to increase drinking water provision in the classroom that does not ensure that that water is safe to drink is likely to put the children at risk of waterborne disease. However, providing safe water in the school environment does not necessarily mean children will drink it,” conclude the authors.
“Indeed taste appears to be a major determinant affecting whether or not people continue to use safe drinking water sources.”
Like most other research, the study concludes that more research is needed. There is a recommendation for a randomized control trial to get a better sense of what is happening and how much credit safe drinking water deserves for keeping kids in school.
Whoa, it’s already Friday! Time for another podcast!
This week, East Coast correspondent Tom Murphy and I ramble and argue but mostly agree with each other about lots of things happening in the humanitarian sphere – you might even call it the Humanosphere. We cover USAID’s “fake Twitter” fiasco,” new developments in World Vision’s gay marriage “flip flop” fiasco, as well how much money there is in global health (spoiler: not enough!) and what it’s actually being used for (spoiler redux: it should bolster the public sector, not get funneled into one-off gadgets and gizmos). I’m sure there are other fiascos out there we didn’t have time for.
All of that may sound like bad news, but here’s the good news: Tom and I bring our humano-nerd powers to bear on sorting through it all, so you don’t have to! And you get to observe the interplay between my tendency to paint people of different political persuasions (World Vision donors who don’t believe in gay marriage, for example) with a broad, unflattering brush, and Tom’s level-headed attempts to contextualize and rationalize their beliefs.
Don’t worry, nerdliness isn’t contagious through headphones or speakers.
Earlier this week, Humanosphere reported on the overall trends in funding for global health – fairly steady, mostly flat the last few years, and perhaps in need of a re-focus.
But which countries need help the most on the health front?
That critical question came up at the April 8 launch event for this report from the Institute for Health Metrics and Evaluation’s (IHME), Financing Global Health 2013: Transition in an Age of Austerity at the Center for Strategic and International Studies (CSIS) in Washington, D.C.
The question about which countries deserve the most aid is a complex question. IHME director Chris Murray pointed to key regional funding gaps identified in the study.
“If you are thinking ahead, then who do we need to help the most?” asked Murray. “Central and Western Africa and a few other fragile states have the worst health outcomes. We might need to strategically rethink what we’re doing to address problems in countries who are most at risk.”
A related paper was also published the same day in the journal Health Affairs. J. Stephen Morrison, Senior Vice President and Director of the Global Health Policy Center at CSIS, chaired the launch event. The panel featured Murray and USAID Assistant Administrator for Global Health Ariel Pablos-Méndez. Continue reading