Guinea-Bissau as a High Mortality Country
World symposiums and scientific research nowadays are devoted to global health systems and the ways to improve health care delivery. The worst probable outcome of a deficient healthcare system is high mortality rate. This parameter is closely related to the socio-economic development of a country that faces the problem. This paper will analyze global health systems and ways to improve healthcare delivery as well as decrease high mortality rate on the example of Guinea-Bissau.
In order to determine the reasons of high mortality rate in Guinea-Bissau, it is important to comprehend how the national health system of the country works as an element of a global health system. People’s health has been recently recognized as a key element of socio-economic development of any country. Therefore, the funding of this sphere has recently increased. However, besides financial resources, more important factors should be taken into consideration. Frenk (2010) states that it is essential not to misinterpret the understating of a global health system as “three common misconceptions are particularly prevalent, which see the health system as a black box, as a black hole, or as a laundry list” (para. 4). The first metaphor means seeing a health system as a too complicated set of components which are impossible to manage normally. The second name implies that nobody will ever determine the amount of money needed to improve healthcare. The laundry list is interpreted as a view on health systems as lists of separate disintegrated components. Frenk (2010) states that the three erroneous views on health systems do not give the nations a chance for steady improvements. Certain determining factors such as the implementation of technological innovations, high-quality-management of all resources, including HR, construction of numerous institutions that will be responsible for separate sectors and cooperate, and opening job opportunities for real leaders capable of analyzing and offering innovative solutions influence the global health systems (Frenk, 2010). Thus, financial, technological and human factors promote global health.
In case of implementing Frenk’s plan of health improvement, global health systems will most likely benefit. However, health disparities still exist, and modern state of global health systems cannot eliminate them. Barr (2014) considers socio-economic factors as the main reasons of health disparities. The author states that no matter how hard the governments seek to improve health care, “some of the best-kept secrets of longevity and good health are to be found in one’s social, economic and cultural circumstances” (Barr, 2014, p.1). Barr’s viewpoint can be supported by the statistical data of Guinea-Bissau correlated with the aforementioned factors. Thus, neonatal mortality rate per 1000 live births makes 45.7. There were approximately 2750 neonatal deaths in 2012. The rating of infant deaths is twice as high (World Health Organization, 2013). Undernutrition is the reason of one third of child deaths. Children and pregnant women dramatically need vitamin A as its lack results in the fact that 47% of children are stunted. Being weak of hunger, newborns and infants suffer from serious diseases such as malaria, pneumonia and diarrheal diseases. Even those passing a complicated period of hungry childhood do not live long as the average life expectancy in Guinea-Bissau is 48 years. The maternal mortality level is also high. The lifetime risk of death is 1 in 13 (360 maternal deaths in 2013). The crude death rate is 12, 7 per 1,000 people. The main risk factors for adult mortality are HIV/AIDS, malaria, tuberculosis, and other infectious diseases neglected by the patients (The World Bank, n.d.). These values prove that the scale of the high mortality rate problem in the country is great.
The main factor that influences undernutrition in Guinea-Bissau is the economic one. In order to eliminate the main causes of the wrong child diet, “annually Guinea-Bissau loses over US$6 million in GDP to vitamin and mineral deficiencies” (The World Bank, n.d., p. 1). Guinea-Bissau is very close to meet the peak of extreme poverty in 2015 (The World Bank, n.d.). Regarding the healthcare of the country, it is important to mention that the considered statistical data does not give any values for the number of hospital beds per 10 000 population, and the number of physicians per 10 000 people is only 0.7 (World Health Organization, 2013). However, according to WHO, wrong nutrition is not the only reason of high infant mortality in the country. Thus, the number of deaths is 160 in Leste and 101 in Norte regions which is higher than the levels for Sul and SAB per 1000 live births (World Health Organization, 2013). Therefore, the geographical area with certain living conditions also affects the mortality rate. Moreover, mother’s education is a crucial aspect in the context of the considered issue (The World Bank, n.d.). Worse educated mothers do not give sufficient attention to the diet of their children. The diseases enumerated above have infectious character conditioned by the bad sanitary situation in Guinea-Bissau when the breast milk quality may damage the immunity system of children. The cultural background of indigenous tribes of Guinea-Bissau do not give them a chance to accept the latest medical and technological innovations in order to improve their living and healthcare access. Therefore, it is possible to conclude that health disparities of Guinea-Bissau are conditioned by a set of economic, social, geographic, educational, and cultural factors that result in a high child mortality rate and low life expectancy in general.
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As aforementioned, health as a leading factor for steady socio-economic development became a focus of attention for the international community. All countries, even the most developed ones, have significant healthcare problems and inequities. The Third Global Symposium on Health Systems Research in Cape Town in 2014 defined people-centered health care as the main theme of its sessions. The fact that health care approach needs change was mentioned by Barr (2014) in his work who stated that modern healthcare delivery is focused on private interests more than on the feedbacks of usual people. The first key objective to achieve determined by the Symposium is to “share cutting-edge research addressing the development of people-centered health systems <[….>]” (“Symposium theme,” 2014, para. 3). The other aims are as follows: strengthening the implacability of medical investigations, building the capacities for researches and policy-makers to conduct health systems investigations, and “strengthen learning communities and knowledge-translation platforms working, to support people-centered health systems across disciplines, sectors and countries and, particularly, bridging practitioner, activist and researcher communities” (“Symposium theme,” 2014, para. 3). The topic of people-centered healthcare was chosen as the leading one since it covers many health aspects. It excludes healthcare inequities, makes individual interests a ruling mechanism of healthcare services integration, and gives more benefits to medical professionals (“Symposium theme,” 2014, para. 5). Thus, the main solution for improving healthcare quality stipulated by the global community is to center all possible health resources on the interests of people making medicine less expensive and more accessible.
There is no single reason to argue that people’s interests in healthcare should be the central priority. However, it is easier for developed and rich countries to reorganize their healthcare systems following this unique standard. Concerning Guinea-Bissau that cannot provide even normal nutrition for the children, the country should reach the aim of people-centered healthcare step by step solving its current issues. Thus, the actions to be taken to tackle the problem of malnutrition include incising nutrition capacity through the Ministers of Health and Agriculture, improving infant and child feeding through effective education and counseling, as well as promoting dietary diversity making mothers aware of a healthy diet for their children. In order to ensure healthy breast feeding of children and prevent spreading of infectious diseases with milk, mothers should have lectures on the importance of regular breast-feeding for babies and normal nutrition for mothers (The World Bank, n.d.). It is important to “involve multiple sectors including agriculture, education, social protection, transport, gender, the food industry, health and other sectors, to ensure that diverse, nutritious diets are available and accessible to all household members” (The World Bank, n.d., p. 2). The enumerated solutions seem effective for the discussed problem in the future. Currently, the World Bank takes part in the National Health Development Plan and contributes to the improvement of service delivery to Guinea-Bissau. It is performed by facilitating access to essential drugs, improving the quality and management of HR, and administering financial resources. The Emergency Food Security Support Project, in which the Bank also takes part, will reduce the negative impact of rising food prices in Guinea-Bissau in the general situation with malnutrition (The World Bank, n.d.). Thus, Guinea-Bissau does not fight its malnutrition and high child mortality rate alone, and international organizations such as the World Bank assist the country.
To conclude, it is worth mentioning that the problem of high mortality rate, especially among children, in Guinea-Bissau is caused not only by superficial healthcare disparities but also by a complex of social, economic, cultural and other issues. In order to solve this problem, the government of the country should closely cooperate with the world community and seek for concrete solutions. It is worth starting with education of indigenous mothers concerning their babies’ nutrition and ending with the regulation of food prices to promote a healthy diet full of vitamins for the entire population.
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