Why Public Health?

Why Public Health?
Prepared by THRI member Nellie Garlow '14

The HIV/AIDS epidemic is the main public health concern in South Africa today due to its exponential growth and devastating effects on the country’s population, economy, and overall stability. Even though this disease is the dominant health crisis, the country faces additional challenges such as Measles, widespread rape, and diarrheal infections among children.
Still, South Africa has the ability to improve public health conditions and has already made improvements in the past decade in terms of maternal health and high primary school enrollment.

International Reports:
    •    8.5% of the total GDP was spent on health services (WHO 2009)
    •    11.6% of the population reported having Measles. 62% of 1-year olds received a Measles immunization (WHO 2009)
    •    5.9% of the population had Rubella (WHO 2009)
    •    Third highest death rate internationally (CIA World Fact Book)
    •    Tuberculosis caused 14% of deaths (26,000 deaths excluding HIV and 400 thousand including HIV) (WHO 2003)
    •    In 2009 49% of people infected with TB had HIV (WHO 2009)

HIV/AIDS:
    •    5.6 million people living with HIV/AIDS (CIA World Factbook 2009)
    •    310,000 people died of AIDS (CIA World Factbook 2009)
    •    If AIDS rates continue at their current level, by 2050, the country’s total population will decrease by 5 million people from its present level (Lamptey, Peter, et al.)
    •    HIV/AIDS caused 57% of deaths under the age of 5 (WHO 2003)
    •    Only 21% of the infected population received antiretroviral therapy (WHO 2005)

Dehydration, Diarrhea, and Nutrition:
    •    South Africa is constantly at risk of facing major droughts and lacks governmental restrictions on water usage and waste (CIA World Factbook)
    •    Diarrhea: 3rd most common reason for children under the age of 5 to die (WHO)
    •    8.7% of children were underweight, 23.9% did not receive enough nutrients and had stunted growth, and 4% were wasting (WHO 2008)
    •    Only 8.3% of children were exclusively breastfed under 6 months* (WHO 2003-4)
*Exclusive breastfeeding is vital for babies up until the first 6 months of life because it gives them the proper nutrients to resist disease and grow to a healthy weight
    •    Diabetes mellitus accounted for 12% of deaths (WHO 2002)

Maternal and Women’s Health:
    •    89.5% of births are attended by a skilled health personnel (WHO 2003)
    •    Perinatal Mortality Rate: 3.8% (WHO 2007)
    •    8% of babies were born underweight (WHO 2003)
    •    Fertility rate: 2.8 (WHO 2004)
    •    #1 country for rapes per capita (United Nations 2000)
    •    1 in 3 women have been raped in the past year (“South Africa,” Britannica)
    •    42.8% of women were obese (WHO 2008)

Drugs and Alcohol:
    •    Currently, South Africa is one of the largest producers of marijuana and one of the largest consumers of heroin and cocaine (CIA World Factbook)
    •    Alcoholism: 48.1% of males and 41.2% of females were considered heavy episodic drinkers (WHO 2004)
    •    On a 1 to 5 scale of how burdensome alcohol is to a country, South Africa was rated a 4 (WHO 2004)
    •    29.5% of male adults smoke tobacco, 9.4% of females smoke (WHO)

Hope in the Future:
    •    89% of South African children enrolled in primary school (WHO 2006)
    •    In 2006 there were no reported cases of polio (WHO)
    •    There is currently a stable, decentralized government
    •    There are many nongovernmental organizations involved in improving South Africa’s public health

How Education Can Help:
    •    Knowledge about good nutrition and clean water is the best way to prevent diarrheal death. Learn How to Treat and Prevent Diarrhea
    •    Talking about HIV/AIDS prevention in primary and secondary schools can curb the infection in youths and the future. Health officials also need to teach HIV-positive pregnant women about stopping the spread to their baby. Learn About Stopping Mother-to-Child Spread of HIV

Recommended Books:
    •    Community Health Needs in South Africa
Author: Ntombenhle Protasia Khotie Torkington
    •    Financing South Africa's National Health System Through National Health Insurance: Possibilities and Challenges
Authors: Claire Botha and Michael Hendricks
    •    Alcohol Policy and Public Health in South Africa
    Authors: Charles David Heber Parry and Anna L. Bennetts
    •    HIV/AIDS in South Africa
    Authors: Salim Abdool Karim and Quarraisha Abdool Karim
    •    The Impact of HIV-AIDS on African Economies
    Authors: Fred Ahwireng-Obeng and George Akussah

Essential Articles and Online Resources:
    •    CIA World Factbook: South Africa
    •    WHO: South Africa
    •    HIV/AIDS: U.S. Global Health Policy
    •    LoveLife: South Africa’s largest national HIV prevention, education, and behavior change initiative for young people
    •    Addressing Domestic Violence in South Africa
    •    Farmers Set Up Mobile Clinics for HIV Workers
    •    Breaking with Past, Zuma Broadens South Africa’s AIDS Policy