United Nations' International Universal Health Coverage Day, December 12
Progress on universal health care coverage has been made but inequitable access to affordable and quality health care, health promotion, and illness/injury prevention services persist in many countries, including Canada.
INTERNATIONAL RURAL WOMEN'S DAY, OCTOBER 15
On International #RuralWomen Day I am remembering the strength, resilience, wisdom, courage, and determination of rural women in #lowincomecountries who have shared their powerful stories with me. Stories of childbirth, of income-earning initiatives to pay school fees, of elders and ancestors, of hope and determination for a better future for their families, of leadership roles, and of pride in their communities. This infographic summarizes facts about the lives of rural women and girls: https://lnkd.in/eDBaDsqA
World Literacy Day (UNESCO), September 8
September 8th marks UNESCO’s World Literacy Day. Literacy is a fundamental determinant of health and a human right. Being literate enhances human dignity and fosters life-long learning. In the aftermath of the pandemic, UNESCO challenges us to create equitable and learner-centric literacy spaces for youth and adults. UNESCO estimates that 24 million children will not return to the formal school system post-pandemic.
In 2021, Sierra Leone began implementation of a robust and ambitious "National Policy on Radical Inclusion in Schools".
https://mbsse.gov.sl/wp-content/uploads/2021/04/Radical-Inclusion-Policy.pdf. This policy will help address low literacy rates in this West African country, especially among youth and young adults.
UNESCO’s concept note for international literacy day can be accessed here: https://en.unesco.org/sites/default/files/ild-2022-cn-en.pdf
In 2021, Sierra Leone began implementation of a robust and ambitious "National Policy on Radical Inclusion in Schools".
https://mbsse.gov.sl/wp-content/uploads/2021/04/Radical-Inclusion-Policy.pdf. This policy will help address low literacy rates in this West African country, especially among youth and young adults.
UNESCO’s concept note for international literacy day can be accessed here: https://en.unesco.org/sites/default/files/ild-2022-cn-en.pdf
world environment day, JunE 5
Those who live on the edge of sustainable development have much to teach us. Master farmers in rural Sierra Leone had a deep understanding of sustainable farming practices. Women held critical knowledge about vegetable farming that kept families fed during the long dry season. It was my impression that neither of these groups were adequately consulted when international development agencies introduced cash crops such as palm oil plantations. On World Environment Day, let’s acknowledge the expertise and seek the wisdom of knowledge keepers in our communities.
INTERNATIONAL DAY TO END OBSTETRIC FISTULA, MAY 23
I had never encountered the condition of obstetric fistula until I worked in Sierra Leone. An obstetric fistula is a devastating childbirth injury. It is estimated that 500,000 women and girls live with this stigmatizing and debilitating condition, the majority in countries with inadequate maternity care. The condition is preventable and treatable.
Obstetric fistula is a public health, development, gender, and human rights issue. The UNFPA is working in 55 countries to end this condition. https://www.unfpa.org/events/international-day-end-obstetric-fistula
In December 2018, UN Member States adopted a resolution to end obstetric fistula by 2030.
https://www.unfpa.org/sites/default/files/resource-pdf/UNGA_PUB_2018_EN_RESOLUTION_73.pdf
Obstetric fistula is a public health, development, gender, and human rights issue. The UNFPA is working in 55 countries to end this condition. https://www.unfpa.org/events/international-day-end-obstetric-fistula
In December 2018, UN Member States adopted a resolution to end obstetric fistula by 2030.
https://www.unfpa.org/sites/default/files/resource-pdf/UNGA_PUB_2018_EN_RESOLUTION_73.pdf
INTERNATIONAL HEALTH HUMAN RESOURCES DAY, MAy 20
Health human resources are an essential pillar for well-functioning health care systems. Major disparities exist in the distribution of health care professionals both within and between countries. A 2022 report by AMREF highlights health human resource challenges on the African continent. "Despite having 25% of the world’s illness burden, WHO estimates that Sub-Saharan Africa has only 1.3 per cent of the world’s trained health personnel. Africa had an average of 1.30 health workers per 1000 people in 2015, significantly less than the 4.5 needed to meet the Sustainable Development Goals (SDGs). Though gains have been made, Africa has the most severe health personnel shortfall, predicted to reach 6.1 million by 2030, out of the anticipated global health staff need of 14.5 million required for universal health care and SDGs.” A position statement on re-engineering the health workforce in Sub Saharan Africa was released by AMREF in 2022 (https://amref.org/wp-content/uploads/2022/03/Re-engineering-the-Health-Workforce-in-Sub-Saharan-Africa_Position-Statement.pdf).
Health human resources are not simply about the number and distribution of health workers. Rather, each group of professional and trained health workers needs to be supported and deployed to their full capacity. As one example, see the WHO Global Strategic Directions for Nursing and Midwifery Report (2021-2025) (https://www.who.int/publications/i/item/9789240033863). This report points to significant gender disparities in health care organizations' leadership roles. "Women comprise almost 70% of the global health workforce, 89% of the nursing workforce, and 93% of the midwifery workforce, but hold only 25% of senior roles in health organizations" (p. 15).
Health human resources are not simply about the number and distribution of health workers. Rather, each group of professional and trained health workers needs to be supported and deployed to their full capacity. As one example, see the WHO Global Strategic Directions for Nursing and Midwifery Report (2021-2025) (https://www.who.int/publications/i/item/9789240033863). This report points to significant gender disparities in health care organizations' leadership roles. "Women comprise almost 70% of the global health workforce, 89% of the nursing workforce, and 93% of the midwifery workforce, but hold only 25% of senior roles in health organizations" (p. 15).
world immunization week, April 24
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Immunizations are considered one of the top ten public health achievements of the last century. The Expanded Program on Immunization was established in 1974. In Sierra Leone, program roll-out began in 1978. It was a game-changer. Photo (left) is Serabu Hospital's public health team heading out for an immunization clinic in a non-motorable village (circa 1980).
A thorough retrospective of the Expanded Program on Immunization in 204 countries was published in The Lancet in 2020. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00984-3/fulltext. As Piot et al. (2020) explained, unmet vaccination needs remain; the immunization agenda is unfinished https://www.nature.com/articles/s41586-019-1656-7. Great progress has been made, but it’s too early to rest on our public health immunization laurels. |
WORLD HEALTH DAY, APRIL 7
The Alma-Ata Declaration on Primary Health Care was signed by 134 countries in September, 1978. “Health for All by the Year 2000” was the clarion call. Access to universal health care was an important component of the Declaration. I began working as a CUSO volunteer in Sierra Leone the same year the Alma-Ata Declaration was signed. West Africa is where I first experienced how principles of primary health care could be successfully implemented. I have drawn on those experiences throughout my career.
Recently, the Canadian Public Health Association hosted a webinar to celebrate Ottawa’s Charter for Health Promotion (now 35-years young and an articulation of principles for the primary health care movement). The webinar speakers remind us of not only how far we’ve come but also how far we still have to go to achieve universal health care and health equity.
https://www.youtube.com/watch?v=wljV5VNaHoU
Recently, the Canadian Public Health Association hosted a webinar to celebrate Ottawa’s Charter for Health Promotion (now 35-years young and an articulation of principles for the primary health care movement). The webinar speakers remind us of not only how far we’ve come but also how far we still have to go to achieve universal health care and health equity.
https://www.youtube.com/watch?v=wljV5VNaHoU
World TB day, March 24
The international community has committed to ending the tuberculosis (TB) epidemic by 2030. Ending the global TB epidemic is a Sustainable Development Goal and the aim of the World Health Organizations End TB Strategy. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039935/).
"Sierra Leone is among the 30 countries most impacted by TB . . . Approximately 170 centres in Sierra Leone offer treatment for TB". https://borgenproject.org/tuberculosis-in-sierra-leone/ Multi-drug resistance is a concern although some recent efforts to address this problem are yielding promising results https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(22)00045-6/fulltext?rss=yes.
"Sierra Leone is among the 30 countries most impacted by TB . . . Approximately 170 centres in Sierra Leone offer treatment for TB". https://borgenproject.org/tuberculosis-in-sierra-leone/ Multi-drug resistance is a concern although some recent efforts to address this problem are yielding promising results https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(22)00045-6/fulltext?rss=yes.
world water day, march 22
Too many women in lower-income countries are still dependent on rivers, streams, swamps, ponds, and unprotected springs as water sources for their households.
(Photo: Child sitting by a water hole where women retrieved "drinking" water, Southern Province, Sierra Leone, circa 1980).
Goal 6 of the United Nations’ Sustainable Development Goals is clean water and sanitation. The Lancet article by the WASH collaboration (2020) provides a sobering look at inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries. https://doi.org/10.1016/S2214-109X(20)30278-3.
In their report of national WASH indicators in Sierra Leone, UNICEF states that “only 16 percent of the population have access to basic sanitation services and 23 per cent have no access to basic water services”. https://www.unicef.org/sierraleone/water-sanitation-and-hygiene
(Photo: Child sitting by a water hole where women retrieved "drinking" water, Southern Province, Sierra Leone, circa 1980).
Goal 6 of the United Nations’ Sustainable Development Goals is clean water and sanitation. The Lancet article by the WASH collaboration (2020) provides a sobering look at inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries. https://doi.org/10.1016/S2214-109X(20)30278-3.
In their report of national WASH indicators in Sierra Leone, UNICEF states that “only 16 percent of the population have access to basic sanitation services and 23 per cent have no access to basic water services”. https://www.unicef.org/sierraleone/water-sanitation-and-hygiene
International women's day, March 8
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On International Women’s Day, I think of the many Traditional Birth Attendants (TBAS) I met in Sierra Leone. They were such strong women, passionate about their work, committed to the health of their communities, and eager for training. They worked under the most difficult circumstances.
In some lower-income countries, TBAs are no longer allowed to perform deliveries. Yet, TBAs often hold the trust of women in rural communities. When crises and civil conflict arise, TBAs may provide the only semblance of accessible maternal health care. Educational opportunities for TBAs remain relevant and important. (Photo: Community health nursing students interviewing a Sowei (head TBA) in Serabu village, circa 1981). See resources' page for reference documents. |
