Question

(question)What three investments would you make a priority to reduce the deaths of under-five children in Skolnikland in the short run? Describe specifically what causes of death each priority investment would reduce

The Case:

Skolnikland is in Southeastern Africa. It has 30 million people. The country has a plains region, a hill region, and a region with high mountains. It has a number of ecosystems. The plains are dry for much of the year, there is some rainforest, and the rest of the country goes from hills to high mountains. There are two seasons of heavy rainfall, which mostly affect the plains.

The people come from many ethnic groups that tend to live in their own regions and each speaks their own language. The ethnic groups largely follow one of three different religions. The large cities are mixed ethnically. One ethnic group is economically and socially very dominant. The national language is the language of the ethnic group that is dominant.

Skolnikland is a very low-income country by World Bank criteria. The economy has been growing at about 4% per year on average over the last decade, but had very slow economic growth in the decades prior to that. About 70% of the people live in rural areas and 30% in urban areas. The number of people living in urban areas has been growing recently at an increasing pace. The richest 10% of the population controls 80% of total income.

The total fertility rate is about 4.5 but it has been declining at a moderate pace over the last decade, from over 6. There are an almost equal number of men and women in the population, although men play a dominant role in society. Infant mortality is 120 per 1,000 live births. Maternal mortality is about 600 per 100,000 live births. 25% of the children are underweight for age.

Most people earn their livelihood in agriculture, but there is an increasing garment manufacturing industry in the two largest cities. There are also a number of mining industries. Other export industries are beginning to grow in numbers, mostly focused on the export of commodities to China.

The adult literacy rate is about 35%. The educational enrollment rate, especially for girls at the primary and secondary levels, has been growing slowly but steadily and most recently at an increasing pace. Only about 25% of the people have access to safe water. Only about 20% have access to sanitary disposal of human waste.

HIV prevalence is 9% of the adult population. The number of new HIV cases annually is still increasing, although more slowly than before. Malaria is rampant in the plains. About 25% of the population is infected with TB.

Investments in the road system have been growing slowly, but the use of private automobiles has begun recently to increase more rapidly.

Skolnikland has a mixed health system that is made up of public institutions and publicly financed providers, licensed private providers, unlicensed medical practitioners, and traditional healers. There is no health insurance, except for some free services for the poor in the few publicly financed hospitals, to which the better off people do not go. The health system is not very effective or efficient and is largely of low quality. The HIV, TB and malaria programs are not effective or efficient and they are just beginning to adopt paradigms for services that follow best global practice.

Answer 1

The death of the childrens are mainly because of low income status, poor health conditions(maternal mortality,low birt weigh), vector borne disease(Malaria), communicable disease(TB),infectious disease (HIV)The investment which could be made are

• Antenatal care:This can screen the high risk mothers ,provide nutritional and health advice, antenatal checkups ,vitamin supplements,vaccination, etc., can be provided to pregnant women this can greatly reduce the maternal mortality and low birth weight babies
• Vector control or Malaria control program:The areas to be vector controlled by eradicating the breeding spots of mosquitoes, creating awareness, applying repellent creams and available options. This can prevent the malaria.
• Health camps:The general population can be screened for high risk disease like HIV in their home set up itself, which can create comfort , privacy and confidentiality in treatment
• Prevention of air borne,contact disease for preventing spread of communicable and infectious disease