Brief Country Profile
Madagascar is an island nation located off the South East Coast of the African content which has a population of roughly 18.5 million people and specializes in the export of agricultural products and textiles. Unfortunately the country has one of the highest infant mortality rates in the world wherein 75 out of every 1000 births results in the death of the infant (Madagascar, 2005). This particular fact is compounded by demographic data that indicates that the life expectancy of most individuals within the island nation is said to be around 57 to 59 years of age (Madagascar, 2005).
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The reason behind this is the prevalence of disease, unsanitary practices and an overburdened healthcare system that does not possess sufficient resources or personnel to adequately care for the growing population (Domarle et al., 2008). Domarle et al. (2008) states that the country itself is not economically rich and has few industries as such its citizens are not even able to afford the bare minimum of healthcare (Domarle, 2008). As such this has exacerbated the problem leading to the present social system where early death and infant moralities are considered a daily aspect of living within the country (Primary health Care, 2008).
Mortality Rates and Disease
As mentioned earlier, Madagascar has one of the highest mortality rates in the world with the average of death within the country currently standing at 58 years of age (Madagascar risk summary, 2008). When examining the causes of death within the country such as the prevalence of certain types of diseases, data collected from the Africa Watch reveals that on average people in country die more from respiratory related infections, malaria, diarrhoeal disease as well as measles and various perinatal conditions as compared to all other forms of infectious disease (Madagascar risk summary, 2008).
It must be noted though that when examining the various conditions and diseases that are the main cause of death within the country it can be seen that all of them are actually quite preventable if proper national healthcare procedures and facilities were employed. In fact nearly all of the listed diseases are easily treatable in most industrialized countries and as such their prevalence within a country as the main causes of death indicates a deeply rooted problem with the country’s healthcare system.
An examination of risk factors within the country reveals that the prevalence of being stunted and underweight for children belonging to both sexes stands at an average of 45% for the entire child population under 5. Howes (1998) states that the reason behind could be attributed to the fact that with the prevalence of disease as well as the fact that a majority of the country’s population impoverished this results in the children not being able to get the nutrients they need when they need it resulting in their current undernourished and stunted state (Howes, 1998).
Health Service Coverage
Evidence of the country’s deficient health care services sector can be seen in data collected by the World Health Organization examining the prevalence of proper health care procedures within the country. For example, in 2004 alone only 59% of one year old children were given vaccinations as compared to the 75 that die out of every thousand births due to infections attributed to the surrounding environment (Madagascar, 2005). In fact an examination of children that were actually taken to health care facilities for cases related to either diarrhea, ARI, fevers and other maladies barely reaches 50% per individual case (Madagascar, 2005).
When taking into consideration the fact that on average the population of children in Madagascar has been estimated to be roughly 2.2 million this indicates that roughly half of the children are actually receiving proper medical assistance as compared to the rest who apparently do not even visit healthcare facilities (Madagascar, 2005). It must also be noted that only 51% births from 2003 to 2004 were attended by skilled health personal. With an average of 1000 births per day this indicates another contributing factor to the infant mortality rate in the country since not only are mother’s not giving birth with the assistance of skilled medical personnel but it can also be assumed that they are doing so within unhygienic locations as well (Madagascar, 2005).
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One of the inherent problems with the country is the amount expended on healthcare itself. Africa Monitor, a nonprofit organizations states that based on the data from 2004 only $2.9 million dollars was expended on healthcare, when taking into consideration the fact that the population of Madagascar is comprised of 20 million people this translates into a barely a fraction of a dollar per person on healthcare costs (Madagascar risk summary, 2008).
Further examination reveals that the country apparently has an inadequately staffed health care system with registered physicians and nurses averaging around 5 per 1000 cases (Madagascar, 2005). Based on the data provided it can be seen that the combined cases of low healthcare expenditure and an equally low rate of professional medical personnel makes the country’s healthcare system once of the worse in the world which explains the country’s infant mortality rate and the low age of death.
Examination of the State of Health Care in Madagascar
An examination of the current economic status of the Madagascar shows that it has a primarily agricultural based economy with various peripheral industries in the tourism and textiles (Primary health care, 2008). Despite its status as the world’s largest supplier of vanilla with half the vanilla in the world originating from Madagascar the fact remains that rampant overpopulation and a lack of significant industrialization has kept the country from developing any more than it already has (Primary health care, 2008).
As a result of the lack of significant industrial development this in effect has caused the local health care system in Madagascar to stagnate over time resulting in high mortality rates and low physician to patient ratios. A cursory reading of the latest data examining the state of healthcare in the country reveals that there are only 29 physicians available per 100,000 people and that the infant mortality rate was a staggering 74 per 1,000 live births (Madagascar, 2005).
Contributing to this problem is the fact that the life expectancy of most individuals within Madagascar only reaches 58 years shows that there is a distinct problem with the country’s health care system (Madagascar, 2005). Keane (2007) states that an examination of the infant mortality rate as well as the average life expectancy shows that such high death rates are actually the result of various diseases and ailments nearly eliminated in various industrialized countries such as the U.S. (Keane, 2007). When examining the healthcare system of the U.S. and examining it with that of Madagascar a common trend appears wherein methods of disease prevention and administering of vaccines and common hygiene practices followed in the U.S. are not done so in the Madagascar health care system which explains the rather high mortality rate (Cebul et al., 2008).
It must be noted though that in comparison to the U.S. economy, Madagascar has a relatively low economic threshold with the average annual amount spent on healthcare within Madagascar amounting to $27 per person while in America it averages to about $800 or more (Cebul et al, 2008). The reason behind this is due to the fact that Americans and the U.S. healthcare system simply has more money to spend thus enabling it to better control disease epidemics and establish proper healthcare practices which unfortunately Madagascar cannot implement due cost prohibitiveness.
Cebul, R., Rebitzer, J., Taylor, L., & Votruba, M. (2008). Organizational Fragmentation and Care Quality in the U.S. Healthcare System. Journal of Economic Perspectives, 22(4), 93-113.
Domarle, O., Randrianarivelojosia, M., Duchemin, J., Robert, V., & Ariey, F. (2008).
Atelier paludisme: an international malaria training course held in Madagascar. Malaria Journal, 71-5.
Howes, O. (1998). Environmentally friendly health care begins in Madagascar. Lancet, 351(9102), 577.
Keane, T. (2007). Power of effective communication. Nursing Standard, 21(45), 78-79.
MADAGASCAR RISK SUMMARY. (2008). Africa Monitor: Southern Africa, 13(6), 9.
Madagascar (2005).Results from the Demographic and Health Survey 2003 – 2004.
Studies in Family Planning, 36(4), 321-325.
Primary health Care. (2008). Back to basics in Madagascar.Bulletin of the World Health Organization, 86(6), 421-426.
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