The State Health & Development

1. The State Health & Development Nnadozie, chapter 9

2. 1.Introduction: Defining Health • The UN defines Health as “state of complete mental, physical, and social well-being, and not merely the absence of disease or infirmity” • Epidemiologists include “the existence of conditions that promote fulfilling and satisfying human lives”

3. 2.Ecology and Epidemiological Factors • 80% of Africa is in the tropics where the risks of endemic and epidemic diseases is high, but preventable. • The major killers include Malaria and other infectious disease caused by parasites. Of some 300 million infected with Malaria, 90% are in Africa. • Other diseases such as schistosomasis, diarrhea, billaharzia, are water born environmental diseases. • Tuberculosis is another huge killer. • Recently, HIV/AIDs has emerged as a major killer affecting many African states. • According to one estimate 25% of Africans are infected by HIV/AIDS. Perhaps 70%, of those affected in the world are in Africa. • Prenatal, infectious, and parasitic diseases are responsible for 75% of infant deaths in Africa

4. Measuring Health • Life expectancy is one measure. It is low in Africa and ranges between 48 and 62 for males and 51 to 68 for females, and this is decreasing. • Gains in life expectancy has been reversed by incidence of HIV/AIDS in Southern Africa (Zambia, Zimbabwe, Botswana and South Africa) • Maternal deaths are 500 times higher in an average woman relative women in industrial nations. • See Disease Incidences by Gender (1990) table 9.2

5. III. Africa’s Commitment to Health Care • Primary Health Care is the key to improve health of Africans. These are inexpensive. • Unfortunately, governments have not made the necessary commitments. • The Colonial health care system remained intact a few years after independence.This was highly unequal. • Malnutrition is another problem primarily from not having enough calorie intake, including other nutrients such as protein. • Combination of malnutrition and disease in Africa is estimated to account for 210/1000 deaths among children in W.Africa, 169/1000 in Central Africa, 171/1000 in East Africa and 129/1000 in Southern Africa

6. III. Africa’s Commitment to Health Care • Annual budget allocations for healthcare increased from 0.7% of GNP to an average 2.4% by 1990. • There is also improved access to health care. • The increases are as follows: • 1985-91 health access increase in 64% • Safe water 56%, sanitation 41%. But, there is disparity between rural and urban.

7. The effect of Lack of Clean Water on Health • Lac of access to clean water and clean indoor latrines is a major problem. • Disease exposure routes are as follows: • -Water-born diseases (typhoid, cholera, etc) • -Water-contact diseases such as Guinea worm and schistosomaisis, • -Water-wash diseases that occur due to water scarcity such as trachoma, Insects and rodents • -Household infections from airborne diseases, such as tuberculosis, whooping cough, and various respiratory elements

8. Health and Economic Security • Health indicators are related to the level of income (see table 9.3). • These indicators which include: Mortality rate, crude birth rate, maternal mortality, total fertility rate, adolescent fertility rate, infant mortality rate, etc.. are correlated with level of income. • Africa is mostly hot and humid with dry and wet seasons. African mountains and highland regions are safer from malaria mosquito bites. • African highlands are in Ethiopia, Kenya, Mozambique, Malawi, South Africa, and Zimbabwe are more conducive to health

9. Conclusion • Primary health care based on prevention should be the major focus due to its cost-effectiveness and the nature of the diseases. • Immunization, safe water, and sanitation will go a long way to improve health in Africa. • African governments must spend less on arms and more on people’s health and education

10. Test #1 Scores • Last 4 digits of Your Win # Score out of 50 • 8146 39 • 6054 50 • 0881 45 • 9362 22 • 8205 41 • 4869 40 • 9808 44 • 8678 40 • 5345 43 • 9758 50 • 5136 46 • 4416 42 • 5151 40 • 4976 35 • 3591 47 • 3976 47 • 6698 44 • 9225 42 • 9800 49 • 8416 45 • 1693 34 • 0556 40 • 9914 38 • 8248 36 • 2606 38 • 1531 38 • 4329 36 • 5359 31 • 0053 46 • 8947 29 • 4576 47 • 1160 43 • 1318 30 • 7230 32 • 5602 43 • 1583 43 • 2356 37 • 2388 30 • 6676 48 • 7709 44 • 4810 37 • 3456 37 • 9705 48 • 0494 35 • 2956 39 • 6854 40 • 8138 41 • 7451 45 • 4630 37 • 7869 48 • 1527 36 • 0449 41 • 3135 45 • 6734 34 • 8131 48 • 3138 47 • 3142 35 • 7065 32 • 4116 34 • 8544 37 • 7396 32 • 5723 46 • 8922 35 • 9890 34 • 5249 39 • 4646 39 • 1593 38 • Average 40(80%)