There are many challenges for low resource health systems. This is a subject which has been studied extensively, and many have ideas about how to better balance the equation. The first problem is often a lack of scientific evidence, but a lack of funding to study a particular intervention. For this reason, a lot of the work is still being done by research teams with generous support of WHO, USAID and other international organizations.
The life expectancy for those without access to health care is only fifty-five years old. Those with access live an average of seventy-five years old. That is a difference of twenty years and that is only one life.
The need for healthcare interventions in low income countries
This post explores the need for health care interventions in low income countries. There are issues that are common to low income countries that need to be addressed before any interventions can take place. These are things like ensuring that basic and essential drugs including vaccines are available and being monitored for quality improvement, that there are enough medical professionals, that the drugs are used rationally, that the food is properly stored and protected, and that there are enough medical supplies to treat patients at the time of need or to prevent the spread of a disease. It’s only by addressing these issues first that interventions will be able to be implemented properly or with maximum effectiveness. Many of these interventions being implemented are done so with the intention of reducing the spread of infectious diseases, but there are social and behavioural interventions needed to keep these diseases from spreading in the first place. Healthcare professionals including pharmacists and nurses spend more time interacting with the patient. Their knowledge and skills can dramatically reduce the burden on healthcare costs, prevent spread of a disease, promote rational drug use, help improve drug quality and control drug expiration.
Challenges for low resource health systems
The most common healthcare interventions in low resource settings are largely basic in nature, with the number of staff members and their training rarely exceeding that of basic first responders. Providing for all public health needs of low-income communities in this way is often unmanageable, so the healthcare professionals most often concentrate on acute care, with most chronic care left unmet. Health professionals in these settings prioritize preventing and limiting the spread of communicable diseases, with most preventative services not available or easily accessible. Of course, many of the populations in these regions are without access to health care whatsoever, leading to an increase in the rate of complications, especially in childbirth –one of the major cause of increased mortality rate among Low- and Middle-income Countries (LMICs).
The first thing one must realize is that, more often than not, all healthcare interventions in low resource settings are implementing public health interventions. Of course, some programs will be more focused on clinical care, but these are typically reserved for those who can afford expensive healthcare. Healthcare professionals shift their attention to work in private clinics leaving limited capacity in the public sector.
Advancement of public health in low resource countries requires an understanding of the healthcare system and how it can be improved.
Systems for improving healthcare in low income countries
Three key priority features that need attention and awareness among low resource communities:
1. Almost two-thirds of the world’s population lives on less than $2.50 per day with around 1 billion people in the world who live with less than $1 per day. This means that more than 3.8 billion people are at risk for developing, or are currently living with, chronic disease.
2. Poverty and a lack of quality healthcare greatly limits a population’s ability to survive chronic illness, which leads to a slow death for many individuals.
3. Disease leads to decreased socioeconomic status and poor health outcomes, requiring even more resources to be spent on maintaining the individual’s health instead of focusing on reducing poverty. In order to combat the negative cycle of poverty and disease, it is important to focus on interventions that improve healthcare in low resource countries.
There are many different aspects of healthcare interventions in low-resource settings. One of the more critical aspects of healthcare interventions in low-resource settings is that of providing adequate infrastructure. This can be a challenge because to improve healthcare, other aspects of the country should be simultaneously invested in, e.g. education, employment, communication.
Many people live in countries with poor infrastructure, which can lead to many adverse effects on the community. One of the most significant things about infrastructure is the lack of ability for water and sewage systems to provide clean water. For example, lack of infrastructure has resulted in contaminated water sources that lead to poor maternal and child health. This has led to 1 in 3 babies dying before their first birthday. Many patients’ parents are too busy trying to find food to take time to keep their children sanitized or to bring home clean water.
Of the many issues any country faces, one of the most pressing is the issue of access to medicine. WHO model list is based on the highest level of evidence available from clinical trials to support their use. These drugs are designed to treat malaria, tuberculosis, and several other diseases that affect the poorest people on the planet. Read more!
Improving access with generic drugs
The use of generic drugs is a simple and effective way to improve access to medication in low-resource settings. Generic drugs are less expensive than other forms of medication, and can be just as effective. Recent studies have shown that the use of generics may be one way to lower the treatment cost for diseases such as HIV, malaria, and tuberculosis.
How to build a healthy healthcare system in Low resource countries
The lack of resources and infrastructure in low-income settings can affect treatment and prevention activity. The World Health Organization (WHO) and other organizations have identified key gaps in health care practices in low and middle-income countries. To address these gaps, the plans have been developed that focus on the following four key areas:
(1) Making it possible to see a doctor or nurse
(2) Getting (improved quality) medicines to those who need them
(3) Improving the quality of care through education & training, and
(4) Helping pay for health care costs, where possible.
Building a health system is a large and complex undertaking. However, it is essential if we are to improve health and reduce poverty worldwide.
Working with the government
The process of working with the government in low resource settings is not always easy. There is often a lot of red tape and bureaucracy to contend with. Getting the government to make a decision and produce any kind of result takes a lot of time, commitment, and energy.
So, what can you do when faced with these challenges?
1) Communicate clearly – The key is to communicate clearly and be precise with your needs and requirements. Make sure they understand that the process is important and that there is a specific end goal.
2) Give them time – It can be hard when they don’t react to your request quickly, but it’s important to know that they need time to process information, review results of small interventions, understand the severity of the problem that need attention and must be prioritized.
Childbirth is also a defining moment of life for the baby. Yet, for many mothers in low-resource settings, childbirth is an event marked by fear of the unknown, pain, and grief of previous losses. Focusing on the needs of mothers during childbirth offers the potential of improving the health of both mothers and their children.
Improving healthcare for mothers
Childbirth is the single most important moment in a woman’s life. It is a time of anticipation, joy, and intense physical and emotional challenges. Childbirth is also a defining moment of life for the baby. Yet, for many mothers in low-resource settings, childbirth is an event marked by fear of the unknown, pain, and grief of previous losses. Focusing on the needs of mothers during childbirth offers the potential of improving the health of both mothers and their children. While complications that arise during childbirth may be unavoidable, interventions focused on the health of mothers that happen before, during, and after birth can improve outcomes. This can reduce costs on healthcare system as well.
Gender inequity in healthcare is a pervasive problem in low-resource settings around the world. One major contributor to this inequity is the lack of maternal healthcare providers, with low resource nations seeing an estimated close to 2,000 or more maternal deaths per day. This shortage of providers is deeply rooted in several communities. It is important for mothers to receive the proper care during pregnancy and childbirth to make sure that they, their child, and future generations are well taken care of.
Healthcare interventions in low resource settings are key to providing the necessary care for mother and child. Providing healthcare for mothers in low resource settings can be difficult due to minimal resources. When natural disasters occur, healthcare can be even more difficult to access. Here are some interventions that have been shown to work well.
- Trained midwives
- Portable, easy-to-transport medical equipment
- Availability of birth kits
Trained midwives are often not available in low resource countries due to lack of training or because they are practicing illegally. Training these individuals could be a contributing factor to overcome serious issues, maintaining good hygiene and improve maternal and child health.
Improving healthcare for children
50% of the world’s population live in countries with high to severe levels of poverty. Healthcare interventions are necessary to improve healthcare for children in these low resource settings. Routine primary care is a primary intervention that can help to increase “life expectancy at birth” in low-income countries. Maternal, neonatal, and child under-nutrition are primary problems that need to be addressed in order to provide quality healthcare for children. There is a developing link between HIV and other chronic illnesses, such as diabetes and asthma. Continuing to provide care for these and other chronic illnesses will allow for a healthier lifestyle and improve the quality of life for a child. Diarrhea is another common illness in children that is preventable with less expense but with impactful training of all involved.
Could a simple salt water solution lessen symptoms of COVID-19 and help people get better faster? Read more!
Closing the economic gap
In a society where the gap between the economically advantaged and disadvantaged is growing, a large gap in healthcare access is something to be anticipated. In low-resource countries, the gap is even more prevalent. Healthcare interventions in low-resource settings for mother and children are needed, but what are the best methods for addressing the gap? Firstly, it’s important to address the gap in access to quality health care. The gap in access to services requires intervention in order to effectively uplift the disadvantaged in society. Research has shown that health care interventions in low-resource settings for children can be achieved in the following ways: the provision of in-service training in pediatrics, and in-service training in performing minor procedures in community settings, etc.
There are many health issues that children face in low resource settings, and there are some simple interventions that can be done to help. The first intervention is to educate mothers on the hygiene practices that are important for their families. One simple hygiene practice is hand washing.
Focusing on low cost interventions, COVID-19, Nasal Wash Study Pakistan is another way to experiment low-cost intervention and to lessen the burden on healthcare costs.
Another simple intervention that can be done to help is to use household resources such as soap and boiled water. The problem is that many people in low resources settings do not have access to clean and running water and soap and thus cannot wash their hands and clean their water supply.
When discussing medical interventions in low resource settings, it is vitally important to consider the health care systems that are in place in low income countries in order to glean the best understanding of what is in store for healthcare in these regions. In order for the health care systems of low income countries to reduce the burden of infectious diseases, they must make substantial strides in three key areas. They must, in order of importance, improve the availability of quality medicines, improve the availability of qualified medical staff, and increase community preparedness for tropical diseases.
Disclaimer: The views and opinions expressed on PharmaRead are those of the authors and do not necessarily reflect the official policy or position of any agency or organization. PharmaRead articles are provided for information only with focus on global health, pharmacy practice, and healthcare systems in Low- and Middle-income Countries (LMICs). Readers should seek expert opinion for use, implementation or application of this knowledge based on their individual circumstances.