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Health in Mali

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Title: Health in Mali  
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Health in Mali

Health in Mali, one of the world’s poorest nations, is greatly affected by poverty, malnutrition, and inadequate hygiene and sanitation. Mali's health and development indicators rank among the worst in the world, with little substantial development over the last 20 years [1] High mortality rates and concerns for children's health places Mali in one of the countries with the most need for attention and improvement regarding health.[2] The lack of physicians in Mali, however, restrict proper improvement to occur and poses a huge health issue for the country.[3]

Health infrastructure

Mali is dependent upon international development organizations and foreign missionary groups for much of its health care. In 2001 general government expenditures on health constituted 6.8 percent of total general government expenditures and 4.3 percent of gross domestic product (GDP), totaling about US $4 per capita at an average exchange rate.[4]

Medical facilities in Mali are very limited, especially outside of Bamako, and medicines are in short supply. There were 5 physicians per 100,000 inhabitants in the 1990s and 24 hospital beds per 100,000 in 1998. In 1999, 36 percent of Malians were estimated to have access to health services within a five-kilometer radius.[4] There are three major public hospitals in the greater Bamako region.

In 2009 the government of Mali aided by the Chinese government began construction of a fourth in Missabougou quarter, Bamako, to be named "Hôpital du Mali".[5]

Sanitation

In 2000, 62–65 percent of the population was estimated to have access to safe drinking water.[4] 69 percent of the population had access to sanitation facilities of some kind. 8 percent were estimated to have access to modern sanitation facilities. 20 percent of the nation’s villages and livestock watering holes had modern water facilities.[4] In urban areas, it was revealed that almost 90% of all citizens had access to clean water.[6]

Health status

Malaria and other arthropod-borne diseases are prevalent in Mali, as are a number of infectious diseases such as cholera, hepatitis, meningitis, and tuberculosis. Mali’s population also suffers from a high rate of child malnutrition and a low rate of immunization for childhood diseases such as measles and polio.[7]

There were an estimated 100,000 cases of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) in 2007, and an estimated 1.5 percent of the adult population was afflicted with HIV/AIDS that year, among the lowest rates in Sub-Saharan Africa (see also HIV/AIDS in Africa).[8]

The 2010 maternal mortality rate per 100,000 births was 830. This compares with 880 in 2005 and 1200 in 1990. The under 5 mortality rate, per 1,000 births was 194 and the neonatal mortality as a percentage of under 5's mortality was 26. In Mali there were 3 midwives per 1,000 live births and the lifetime risk of maternal death was 1 in 22.[9]

Life Expectancies

Infant and juvenile mortality rates:[10]
up to 1 year: 80 deaths/1,000 live births. This has decreased significantly over the years, by a percentage of around 50% over the last 20 years.[6]
up to 5 years:115 deaths/1,000 children in 2015 (11.5% percent experience death in their first 5 years).[11] This places Mali at the 8th place in terms of most mortality rates for children under 5.[6] This number has been decreasing steadily, from 132 in 2011, 127 in 2012, 123 in 2013,and 118 in 2014, then 115 currently.[11]

Life expectancy at birth:[8]
total population: 54.55 years
male: 52.75 years
female: 56.41 years (2013 est.)

Prevalent Diseases

HIV/AIDS - adult prevalence rate: 0.9% (2012.)[6]

HIV/AIDS - people living with HIV/AIDS: 100,000 (2012.)[6]

HIV/AIDS - deaths: 5,800 (2007 est.)[8]

Vaccines: Over 89% of Mali's citizens have had immunization coverage.

Nutrition

Because Mali's economy is one of the poorest in the world (regarded as one of the 48 least developed countries by the UN), over half of the country's population survives on less than a dollar every day.[12] Thus, the malnutrition if Mali is severe, especially for children.[13] The malnutrition levels exceed the critical level in the national scope.[13] 18 percent of all children born are born in a underweight or malnourished state.[6] 18.9 percent of all citizens are underweight in a moderate or severe way.[6]

Children's Health

Malaria, a preventable and curable disease that is heavily prevalent in Africa and is detrimental to African children,[14] is prevalent in Mali. Mali's children especially are susceptible not only to malaria but also other diseases and parasites, which prompts their immune systems to generate an unusually high number of responses and mechanisms for defense.[15]

Children in Mali also face severe skin diseases, among which pyoderma tinea capitis, pediculosis capitis, scabies, and molluscum contagiosum are the most prevalent. Many of these skin diseases are associated with poor hygiene. Even though skin diseases cause a severe problem for children in Mali, the public health service does not take care of skin diseases, making skin disease a huge problem in the health of Mali.[2]

Children may be more prone to diseases due to the high rate of child labor, capping at 21.4% of all children in Mali.

Women's Health

Pregnancy

Women are generally expected to take care of infants and kids for most of their lives.[16] Also, even during pregnancy and times nearing childbirth, women in Mali are culturally pushed to work their normal routines, managing household jobs and taking care of the other kids.[16] Furthermore, breastfeeding is deemed to be the most acceptable way of raising infants, increasing the pressure on women.[16]

Women in Mali have especially high rates of pregnancy at a young age (younger than 18 years of age), even compared to other African countries.[17] 9.8% of girls who are not yet 18 in Mali are mothers, a percentage that is almost 5 times that of Nigeria and Togo. Mali has one of the highest infant mortality rates as well, reaching a peak of 28%, which could be attributed to a lack of ultrasound examinations and tocolysis.[18] Children in Mali also marry very early, which may attribute to the early marriage: 55% of all children marry before the age of 18.[6]

Health in Urban Mali

Despite the very low number of physicians in Mali (8 physicians per 100,000 people [3]), study has shown that most women in Mali seek medical treatment when giving birth.[17] This was especially prevalent in the urban regions of Mali. Also, a woman's social indicators, including her status and type of marriage (widowed, married, or engaged in a male polygyny), her social power regarding other members of the community, and her connections throughout different regions and a variety of people were the defining characteristics of her status of health as well.[19] There is a strong correlation between a woman's social status and health status, as women of more esteemed social status sought more medical treatment and care than those of lesser status who tried to fight through illnesses themselves.[19] Two of the most affected groups in terms of social instability (and therefore health insecurity) were those pregnant with polygamous men and those who have lost their husbands, directing many researchers to target those women in terms of aid.[19]

Because of the nature of Mali's cultural context among women, their relations with other women (including social networks, conflicts among co-wives, standings in women's associations) heavily influences their use of contraceptives, number of children, and child survival.[19] While many women in Mali suffer from sexually transmitted infections, this area is quite understudied and is lacking in data.[19]

Health in Rural Mali

There is a severe dearth of health services in rural Mali, since even urban regions do not have adequate numbers of physicians. Unlike women living in urban Mali, women in rural regions tended to depend more on other around them for their health needs, being influenced by their community and the number of people with at least secondary education. Delivery (of infants, from pregnancy) remains a huge issue for those living in rural areas. Poverty and personal problems related to rural areas also negatively affect the health status of women in these areas.[20]

Female Genital Cutting Practices

Female genital mutilation is an act that intentionally harms or damages the female organs in a nonmedical setting.[21] Because it has a nonmedical setting, there has been no reports of health benefits gained through female genital cutting.[21] More than 125 million young girls from birth to age 15 undergo this process, of which most are from Africa and Middle East.[21] Although the U.N. and World Health Organization has implemented policies to stop the inhumane act of removing genital parts, the cutting is often culturally and religiously rooted in societies, making it hard to eliminate.[21]

Mali, like many other African countries, engage in female genital cutting practices, which negatively impact women's health.[22] Female genital cutting often occurs between the ages of 4 to 8, and results in hemorrhage, shock, pain, damage to organs, urinary infections, and other serious diseases.[22] Because the equipment used may not be cleaned completely, HIV and Hepatitis B is also spread with the procedure. In Mali, around 94 percent of women undergo female genital cutting practices. Apart from physical health, this is also commonly seen as having a severe psychological effect on women as well.

The objective of the female genital cutting practice is to decrease promiscuity for the husband once the woman gets married. It is often seen as a religious and cultural tradition, even thought the government in Mali has made several attempts to alleviate the practices.[22]

See also

References

  1. ^
  2. ^ a b Mahe, Antoine, Prual, Alain, Konate, Madina, Bobin, Pierre. “Skin diseases of children in Mali: A public health problem.” Tropical Medicine & Hygiene 89.5 (1995) 467-470. Print.
  3. ^ a b
  4. ^ a b c d Mali country profile. Library of Congress Federal Research Division (January 2005). This article incorporates text from this source, which is in the public domain.
  5. ^ Malian leader lays foundation stone for 150-bed hospital. PANA Press. 2009-04-11.
  6. ^ a b c d e f g h
  7. ^
  8. ^ a b c
  9. ^ .
  10. ^ .
  11. ^ a b
  12. ^
  13. ^ a b
  14. ^
  15. ^ Thomas, Bolaji N. et al. “Circulating Immune Complex Levels Are Associated with Disease Severity and Seasonality in Children with Malaria from Mali.”Biomarker Insights 7 (2012): 81–86. PMC. Web. 25 Sept. 2015.
  16. ^ a b c
  17. ^ a b
  18. ^
  19. ^ a b c d e
  20. ^
  21. ^ a b c d
  22. ^ a b c
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