The unfinished agenda of maternal and child health in Africa and Asia: Promising directions to address maternal mortality challenges

Latest News from the Center, Policy Blog, Stories from Africa Seminar Series
Blog by Ekene Osakwe, Ipchita Bharali, and Dr. Megan HuchkoThis blog summarizes the discussion and key takeaways from the webinar that was hosted on April 22, 2022 as part of the Asia-Africa Health Initiative Seminar series. Click here to view the live recording of the seminar. BackgroundNo woman should die from childbirth. Although global trends in maternal mortality from 2000 to 2017 show a 38% reduction in the maternal mortality ratio (MMR), the agenda to eliminate preventable deaths in mothers and children on the African and Asian continents is still unfinished. Low- and middle-income countries contribute 99% of global maternal deaths for women aged 15-49 years. Maternal mortality has remained unacceptably high with 297 000 deaths occurring in 2017 alone. Sub-Saharan Africa and Southern Asia contributed 86% of the global maternal…
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Reducing Kenya’s health system dependence on donors

Policy Blog
This blog was first published in Brookings Future Development Blog, March 2, 2021. The authors are Kaci Kennedy McDade, Kenneth Munge, Gilbert Kokwaro, and Osondu Ogbuoji. Health systems in most low- and middle-income countries face two major obstacles: insufficient domestic funding and inefficient use of available resources. While the problem of insufficient domestic funding has partly been mitigated by foreign aid, these arrangements are changing quickly: As countries move from low- to middle-income status, they are perceived as capable of financing their health systems. Some donors have begun to transition out of such middle-income countries. While graduation from foreign aid is a positive milestone for any country, this transition, if poorly managed, may lead to a reversal of health gains. The suspicion is that this is happening in many countries. To…
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How health aid can reach the world’s poorest people

Policy Blog
This blog was first published in Brookings Future Development Blog, February 2, 2021. The authors are Cordelia Kenney, Kaci Kennedy McDade, Wenhui Mao, and Osondu Ogbuoji. Disruptions caused by the COVID-19 pandemic could reverse progress in global poverty reduction and in global health improvements among poor people. The links between health and poverty are clear: Poverty limits people’s ability to access medical care, safe living environments, and sufficient nutrition, the absence of which can have disastrous consequences. Conversely, good health enables employment and income generation. The pandemic will make it harder to achieve the Sustainable Development Goals (SDGs). While 70 percent of the world’s poor already reside in middle-income countries (MICs), the World Bank projects that more than 100 million more people, most of them in MICs, might have fallen below…
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Myanmar’s response to the COVID-19 pandemic

Policy Blog
This blog was first published in Brookings Future Development Blog, December 1, 2020. The authors are Ashwini Deshpande, Khaing Thandar Hnin, and  Tom Traill. During the first wave of the coronavirus pandemic, from late March to early August, Myanmar recorded just 360 cases and 6 deaths. Early in the crisis, the government rapidly implemented measures to contain the virus. Just as it started easing them though, the country was hit by a major second wave in mid-August. Daily cases increased from less than 10 per day in early August to over 1,000 per day in mid-October. This wave has overwhelmed Myanmar’s inadequate and understaffed health infrastructure. By November 20, there were 76,414 confirmed cases and 1,695 deaths (Figure 1). Figure 1a. Cumulative active confirmed cases, discharged patients and deaths Figure 1b.…
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How well is Ghana—with one of the best testing capacities in Africa—responding to COVID-19?

Policy Blog
This blog was first published in Brookings Future Development Blog. The authors are Jiaqi Zhang, Justice Nonvignon, and Wenhui Mao. The first two COVID-19 cases in Ghana were confirmed on March 12, 2020. As of July 23, 2020, there have been 32,969 confirmed COVID-19 cases with 168 deaths. The virus has disproportionately affected southern Ghana—52 percent of cases are in Greater Accra (Table 1). With a population of about 30 million—the 10th largest in sub-Saharan Africa—Ghana now has the fourth highest number of cases in sub-Saharan Africa (after South Africa, Egypt, and Nigeria). The reason is that Ghana has one of the highest testing rates when compared to other African countries. Table 1. Half of Ghana’s COVID-19 cases are in and around the capital city Region Cases Greater Accra 17,152 Ashanti…
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How well is India responding to COVID-19?

Policy Blog
This blog was first published in Brookings Future Development Blog. The authors are Ipchita Bharali, Preeti Kumar, and Sakthivel Selvaraj. The first COVID-19 case in India was detected on January 30, the same day that WHO declared it a public health emergency of international concern. India went into lockdown almost two months later. On June 8, after 10 weeks of lockdown, India started a phased reopening of its economy. With Unlock 1.0, the country is trying to balance attempts to revive the economy while dealing with increasing caseloads and new hotspots. On June 30, official COVID-19 cases stood at over 585,000, and more than 17,500 deaths (Figure 1). While recovery rates have improved to 60 percent and the death rate is relatively low considering that India is the fourth most-impacted country…
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How well has Nigeria responded to COVID-19?

Policy Blog
This blog was first published in Brookings Future Development Blog. The authors are Siddharth Dixit, Yewande Kofoworola Ogundeji, and Obinna Onwujekwe. On January 23, 2020, the World Health Organization’s International Health Regulations (IHR) Emergency Committee advised that “all countries should be prepared for containment, including active surveillance, early detection, isolation and case management, contact tracing and prevention of onward spread of 2019-nCoV infection, and to share full data with WHO.” On January 30, 2020, the WHO declared COVID-19 to be a public health emergency of international concern. Is Nigeria prepared to respond effectively to pandemics? In 2017, during the WHO’s Joint External Evaluation (JEE) of IHR core capacities (an independent, collaborative multi-sectoral effort to assess a country’s capacity to prevent, detect, and respond to public health risks), Nigeria scored poorly both…
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Coronavirus: The new normal

Policy Blog
This blog is the text of a YouTube live talk given by our Center’s Director, Gavin Yamey, on June 12, 2020. Hello and thank you so much for joining this YouTube live conversation today on Coronavirus: The new normal. My name is Gavin Yamey, I’m a Professor of Global Health and Public Policy at Duke. I direct the Center for Policy Impact in Global Health in the Duke Global Health Institute. To give you a little bit of my background: I’ve had a rather eclectic career—I’m a physician who then became a health journalist who then became a public health researcher—and today I try and wear all three hats at the same time in my work on global health policy. Global health policy essentially means trying to achieve large scale…
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Crossing the quality chasm: Nigeria’s long walk to universal health coverage

Policy Blog
In a recently published blog, my friend Dr Abiodun Awosusi narrated this very touching story: “I walked into the paediatric unit of a teaching hospital in Nigeria a few years ago to review a patient. On the first bed was a lifeless child. He was brought in dead a few minutes earlier by his parents. His mother, “Bisi”, wept uncontrollably. While in tears, she recounted how difficult it was for them to borrow money to get to the hospital. Although they got some money from a chief in the community, the two-year-old baby died before they got to the hospital”. Many households such as this one have been pushed into poverty, debt, and financial hardship as a result of seeking health care. In Nigeria, data from the 2017 National Health…
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Ghana: Healthcare for a Country in Transition

Policy Blog
This blog was first published in Duke Global Health Institute News. The author Mary-Russell Roberson. Among sub-Saharan African countries, Ghana stands out for its high rate of health insurance coverage: About 40 percent of the population has policies available through the National Health Insurance Scheme (NHIS). But the NHIS is costing the government more than expected. A proposed cost-saving policy, called capitation, would pay providers per patient rather than for each service provided. The policy looked good on paper, but failed in a pilot program. Gilbert Abiiro wanted to know why. He’s a lecturer/researcher at the University for Development Studies in Ghana, who recently spent eight weeks at Duke as a fellow of the Center for Policy Impact in Global Health. In Ghana, Abiiro interviewed providers, policymakers, politicians, and people who…
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