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The State Health & Development Nnadozie, chapter 9 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” 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 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 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 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. 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 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 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 Test #1 Scores • • • • • • • • • • • • • • • • • • • • • • • • • • • • Last 4 digits of Your Win # 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 Score out of 50