Developing and developed countries :© Goodacre, Slattery, Upton 2007 Developing and developed countries Developed countries are those with low child and adult mortality, well developed industry, high GDP, established healthcare and education systems and longer life expectancy. Developing countries are those with high mortality and low life expectancy, low GDP, poor industry, limited trade, high rates of poverty and limited healthcare facilities. WHO regions Can you identify three countries for each region?


WHO stratum :© Goodacre, Slattery, Upton 2007 WHO stratum WHO has divided the member states into five mortality strata based on mortality A = Very low child mortality, very low adult mortality Australia, Japan, Germany, United States of America, United Kingdom B = Low child mortality, low adult mortality Mexico, Indonesia, Turkey, China C = Low child mortality, high adult mortality Estonia, Hungary, Latvia D = High child mortality, high adult mortality Ghana, Guatemala, Peru, Afghanistan E = High child mortality, very high adult mortality Botswana, Zimbabwe, Mozambique Countries that are classified as strata level A are developed, while those in strata D and E are considered developing. It is more difficult to label the countries in strata B and C as they have low mortality but still face a number of barriers to their health status and economic development.


Differences in health between Australia and developing countries :© Goodacre, Slattery, Upton 2007 There are several ways to measure differences in health status: Life expectancy Mortality data – causes of death, under-5 and infant mortality Burden of disease Differences in health between Australia and developing countries


Slide 4:© Goodacre, Slattery, Upton 2007 Source: UNICEF (2006) State of the World’s Children 2007


Causes of death :© Goodacre, Slattery, Upton 2007 Causes of death What are the leading causes of death in Australia? Non-communicable diseases, including cardiovascular disease. What are the leading causes of death in developing countries? Communicable disease – including AIDS. What changes are expected in relation to causes of mortality and disease burden over the next 30 years? The WHO has predicted that by 2030 developing countries will be further exposed to the double burden of disease. While HIV/AIDS is predicted to be the leading cause of global disease burden, diseases such as heart disease and depression are set to have an increasing impact due to changes in lifestyle behaviours, such as changes in diet, and an increase in the number of people smoking and consuming alcohol in developing countries.


Factors contributing to differences :© Goodacre, Slattery, Upton 2007 Factors contributing to differences Poverty Conflict Culture Access to water and sanitation Education and literacy


Poverty :© Goodacre, Slattery, Upton 2007 Poverty The World Bank identifies people living on less than US$1 a day as living in extreme poverty. Children who are born into poverty have less opportunity for education, and are less likely to have access to adequate food, shelter, water, sanitation and healthcare. Families experiencing poverty are more likely to experience violence and discrimination and poor health. They have fewer choices and find it difficult to break the cycle. Governments experiencing poverty are less able to provide resources such as safe water and sanitation, education, social security and healthcare.


Conflict :© Goodacre, Slattery, Upton 2007 Conflict Governments involved in conflict spend a large amount of GDP on military expenses, leaving little for healthcare and education. They will also experience loss of lives, injuries and disabilities from conflict and landmines, even after the conflict is over. This will place an increase burden on the healthcare system. Loss of infrastructure (such as hospitals and schools) will also reduce availability of services and rebuilding will be expensive. People may leave rural areas for safety, meaning they may no longer be able to grow crops. This leads to a loss of income for the family and may also contribute to food shortages. Many women may be left as widows and be unable to support their families, and many children may be orphaned, leading to an increase in child exploitation


Culture :© Goodacre, Slattery, Upton 2007 Culture In many developing countries women are treated very differently to men. They have fewer opportunities and less access to education, income, food and employment. Women often spend many hours a day doing labour intensive work for little or no pay. They may also spend many hours tending to crops, collecting water and preparing food for their family. Domestic violence against women in developing countries is common. Young women may be forced into marriage at an early age and have many children. Some cultures do not value education in the same way that it is valued in Australia. When combined with poverty, this leads to many young children being forced to start work from a young age. This robs them of an education and a childhood.


Access to water and sanitation :© Goodacre, Slattery, Upton 2007 Access to water and sanitation In some developing countries people do not have access to sufficient water. As a result, they may not be able to grow food and keep cattle alive. In other developing countries there may be enough water, but it is often unsafe to consume. Unsafe water can spread disease. Sanitation is also a concern. In many developing countries the environment is unsanitary due to poor access to amenities, overcrowding, inappropriate housing, poor drainage and a lack of knowledge of how to reduce the spread of disease.


Education and illiteracy :© Goodacre, Slattery, Upton 2007 Education and illiteracy Females in developing countries are less likely to be educated than males, and those in rural areas are less likely to be educated than those in urban areas. Poor literacy and a lack of education means many children are sent to work from a young age.


Globalisation :© Goodacre, Slattery, Upton 2007 Globalisation is the interconnectedness of the world through the transfer of goods, services, people and information. Globalisation has increased access to processed foods in developing countries and changed traditional dietary patterns, contributing to diets that are now higher in saturated fat, sugar, salt and refined carbohydrates. Globalisation has lead to an increase in alcohol consumption in some developing countries due to increased availability and changes in trade arrangements and marketing by multinationals. It has also lead to an increase in tobacco growing and consumption in developing countries. Multinationals are capturing a new market, run aggressive marketing campaigns and make their product more appealing to local markets. Globalisation


How does globalisation impact on health? :© Goodacre, Slattery, Upton 2007 Explain how increased consumption of tobacco, alcohol and processed foods can impact on health in developing countries. What are the advantages and disadvantages of globalisation? How does globalisation impact on health?


Primary healthcare :© Goodacre, Slattery, Upton 2007 Primary healthcare is ‘essential healthcare based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community can afford to maintain every stage of their development in the spirit of self reliance and self determination.’ (WHO) According to the WHO, the basic principles and values of primary healthcare as recognised during the Alma Ata conference include: Essential healthcare based on practical scientifically sound and socially acceptable methods and technology Universal access to and coverage of health services based on health needs Commitment, participation and individual and community self-reliance Intersectoral action for health Cost effectiveness and appropriate technology, as the available resources permit Health service provision and health promotion Can you list the eight core elements/activities of primary healthcare? Primary healthcare


:© Goodacre, Slattery, Upton 2007


Sustainable development :© Goodacre, Slattery, Upton 2007 Sustainable development means the community can keep the program going once aid is withdrawn. It involves the use of renewable resources and community involvement and should be based on education. Healthcare should be socially, economically and environmentally sustainable. Sustainable development


UN and WHO strategies :© Goodacre, Slattery, Upton 2007 The following primary healthcare strategies were developed by the UN and WHO to improve health: Immunisation Oral rehydration therapy Growth monitoring Breastfeeding Baby friendly hospitals Family planning Discuss how each can optimise health and development UN and WHO strategies


AusAID :© Goodacre, Slattery, Upton 2007 Manages Australia’s international aid program, which is funded by the Commonwealth Government. AusAID works with the UN and non-government agencies and directs most aid to neighbouring countries. AusAID