1. The State Health & Development Nnadozie, chapter 9

2. 1.Introduction: Defining Health The UN defines Health as “state of complete mental, physical, and social well-being, and not merely the absence of disease or infirmity” Epidemiologists include “the existence of conditions that promote fulfilling and satisfying human lives”

3. 2.Ecology and Epidemiological Factors 80% of Africa is in the tropics where the risks of endemic and epidemic diseases is high, but preventable. The major killers include Malaria and other infectious disease caused by parasites. Of some 300 million infected with Malaria, 90% are in Africa. Other diseases such as schistosomasis, diarrhea, billaharzia, are water born environmental diseases. Tuberculosis is another huge killer. Recently, HIV/AIDs has emerged as a major killer affecting many African states. According to one estimate 25% of Africans are infected by HIV/AIDS. Perhaps 70%, of those affected in the world are in Africa. Prenatal, infectious, and parasitic diseases are responsible for 75% of infant deaths in Africa

4. Measuring Health Life expectancy is one measure. It is low in Africa and ranges between 48 and 62 for males and 51 to 68 for females, and this is decreasing. Gains in life expectancy has been reversed by incidence of HIV/AIDS in Southern Africa (Zambia, Zimbabwe, Botswana and South Africa) Maternal deaths are 500 times higher in an average woman relative women in industrial nations. See Disease Incidences by Gender (1990) table 9.2

5. III. Africa’s Commitment to Health Care Primary Health Care is the key to improve health of Africans. These are inexpensive. Unfortunately, governments have not made the necessary commitments. The Colonial health care system remained intact a few years after independence.This was highly unequal. Malnutrition is another problem primarily from not having enough calorie intake, including other nutrients such as protein. Combination of malnutrition and disease in Africa is estimated to account for 210/1000 deaths among children in W.Africa, 169/1000 in Central Africa, 171/1000 in East Africa and 129/1000 in Southern Africa

6. III. Africa’s Commitment to Health Care Annual budget allocations for healthcare increased from 0.7% of GNP to an average 2.4% by 1990. There is also improved access to health care. The increases are as follows: 1985-91 health access increase in 64% Safe water 56%, sanitation 41%. But, there is disparity between rural and urban.

7. The effect of Lack of Clean Water on Health Lac of access to clean water and clean indoor latrines is a major problem. Disease exposure routes are as follows: -Water-born diseases (typhoid, cholera, etc) -Water-contact diseases such as Guinea worm and schistosomaisis, -Water-wash diseases that occur due to water scarcity such as trachoma, Insects and rodents -Household infections from airborne diseases, such as tuberculosis, whooping cough, and various respiratory elements

8. Health and Economic Security Health indicators are related to the level of income (see table 9.3). These indicators which include: Mortality rate, crude birth rate, maternal mortality, total fertility rate, adolescent fertility rate, infant mortality rate, etc.. are correlated with level of income. Africa is mostly hot and humid with dry and wet seasons. African mountains and highland regions are safer from malaria mosquito bites. African highlands are in Ethiopia, Kenya, Mozambique, Malawi, South Africa, and Zimbabwe are more conducive to health

9. Conclusion Primary health care based on prevention should be the major focus due to its cost-effectiveness and the nature of the diseases. Immunization, safe water, and sanitation will go a long way to improve health in Africa. African governments must spend less on arms and more on people’s health and education

10. Test #1 Scores Last 4 digits of Your Win #Score out of 50 814639 605450 088145 936222 820541 486940 980844 867840 534543 975850 513646 441642 515140 497635 359147 397647 669844 922542 980049 841645 169334 055640 991438 824836 260638 153138 432936 535931 005346 894729 457647 116043 131830 723032 560243 158343 235637 238830 667648 770944 481037 345637 970548 049435 295639 685440 813841 745145 463037 786948 152736 044941 313545 673434 813148 313847 314235 706532 411634 854437 739632 572346 892235 989034 524939 464639 159338 Average 40(80%)