The periods of labor and childbirth are critical moments when a joyful event can suddenly turn into crisis- consequently; there is need for medical attentiveness and preparedness.  The lack of proper medical attention in these periods leads to high burden of maternal deaths as well as large numbers of stillbirths and early newborn deaths.

Globally, about 3.2 million stillbirths, 4 million neonatal deaths and more than half a million maternal deaths occur annually. Up to 17% of maternal deaths occur during childbirth while 70% occur postpartum. Approximately 98% of these deaths occur in low- and middle-income countries, mostly due to obstetric complications in labor. Majority of these deaths are preventable.

Safe motherhood is a phrase that encompasses the series of initiatives, practices, protocols and service delivery guidelines designed to ensure that women receive high-quality care in order to achieve optimal health for the mother, fetus and infant during pregnancy, childbirth and postpartum. Maternal mortality can be prevented through safe motherhood and family planning- which reduces 25-40% of maternal deaths. Safe motherhood also decreases maternal and infant mortality or morbidity because most maternal and infant deaths can be prevented through safe motherhood practices. Identified health risks for maternal and child illness or death are poor nutrition, illiteracy, lack of income and employment opportunities, inadequate health and family planning services, and low social status. Several countries have been able to improve maternal and new-born health and well-being in the last few decades. However, developing countries- with the highest burden of maternal and infant mortality and morbidity have made the least progress. As a result, there is an increased inequality between countries and within countries.

Breast milk is the right food for babies; strong evidence exists that babies do best if they consume only breast milk for the first six months of life. Breast milk confers both short and long term protection from infections on babies. Exclusive breastfeeding- defined as continuous uninterrupted breastfeeding for a period of six months, provides more protection and is more likely to reduce the risks and severity of allergies. However, protection can still be achieved when breast milk is combined with some formula. Women who breastfeed their babies have lower risk of pre-menopausal breast cancer, ovarian cancer and osteoporosis later in life.

Major challenges for prevention include how to deliver services and scale up interventions, particularly to vulnerable, inaccessible, marginalized and excluded mothers and babies. Political will is essential at all levels, especially at national and district levels. Policy-makers and program managers need to shift their focus from the development of new interventions to the development of practical strategies that ensure the availability of care and account for every birth and death. Medical policies and practices that can reduce maternal deaths and improve women’s health are also capable and crucial for ensuring newborns’ survival and health. A major limitation in the overall progress of preventing maternal and infant mortality or morbidity is the gap between what is needed and what is available in terms of skills and resources at local, national and international levels. Other challenges include:

• Lack of emergency preparedness
• How to maintain stocks of drugs, supplies and equipment in the face of increased demand
• Inaccessibility or lack of transportation for people who live far away from care centers
• Ineffective referral
• Unavailability of round-the-clock quality services ,particularly emergency obstetric care

Ethics is defined as the systematic examination of the way humans treat and relate with each other as well as their surrounding natural environment… it is the study of the values and beliefs that guide people’s attitudes and behaviors. Irrespective of differences in social, cultural, economic or professional backgrounds, ethics is practiced by everyone on a daily basis.

Advancements in medical knowledge and technology come with significant moral challenges. Health ethics is the field of ethics that deals with health-related ethical and moral issues in health care, medicine and science. It involves discussions concerning choices of treatment and options of care that are faced by individuals, families and health care workers. It requires a critical evaluation of the programs, systems, and structures developed to improve the health of a population. Health care ethics is concerned with series of moral decisions- and most moral issues in healthcare are due to innovations and developments in reproductive and genetic knowledge and genetic technologies. Other areas of moral and ethical interest include:

• Relationship between health care professionals and their patients
• Biomedical and behavioral human subject research
• Harvest and transplant of human organ
• Abortion
• Allocation of health care services; deciding between clinical care or health promotion
• Making decisions about end-of-life care
• Equity in distributing healthcare goods and services
• Ethical conduct in health research
• Implications of genetic cloning and similar technologies

Health ethics involves reflecting on ways to allocate limited resources as well as the best decisions regarding complex moral options that result from continuous health care advancement. It also entails a critical, political, and ethical analysis of the definition and health determinants. Public health ethics on the other hand, involves a systematic process to clarify, prioritize and justify possible outcomes of public health actions based on ethical principles, values and beliefs of stakeholders or based on scientific information. It seeks to understand and elucidate the principles and values that guide public health actions and provide the framework for making and justifying decisions. Since public health actions are mostly taken by governments and are directed at the population level, the guiding principles and values differ significantly from those of biological and clinical medicine (bioethics and medical ethics) which are more patient or individual-centered. As a field of practice, public health ethics involves the application of appropriate principles and values to public health decision making. Using an ethics framework, public health ethics inquiry carries out three core functions:

• Identify and clarify ethical dilemma
• Analyze and compare alternative courses of action and their consequences
• Problem resolution by making a decision that best incorporates and balances the guiding principles and values.

One goal of public health ethics is to integrate the tools of ethical analysis into day-to-day operations. To achieve this, the basic principles of health care ethics are used, they’re highlighted below as guiding principles- Typically, for a medical practice to be considered “ethical”, it must respect these principles:

• Non-maleficence- The principle of non-maleficence- do no harm, emphasizes that health care professionals must act in ways that do not harm patients, even at their request

• Beneficence- This is the obligation to create or produce benefit for individual patients or clients. Every act by health workers must be performed with good intentions

• Health maximization- In public health, the principal outcome is the health of the public and improvements to this are the key outcome used to measure success

• Efficiency- There will always be more health need than available resources to deal with those needs. Hence, there is a moral duty to use scarce health resources efficiently.

• Respect for autonomy- The principle of respect for autonomy means that patients’ rights should be respected; however, it is not at the detriment of maximizing the health of the broader public.

• Justice- Justice and health equity demand equal opportunities which includes a fair distribution of health outcomes in societies

• Proportionality- It demands that in weighing and balancing individual freedom against wider social goods, considerations will be made in a proportionate way.

It is important to understand the leading causes of death because by measuring how many people die each year, the corresponding causes of their death and gauging how diseases and injuries are affecting people, the effectiveness and efficiency of the country’s healthcare system can be assessed. Additionally, the number and cause-of-death statistics help health authorities to determine their focus for public health actions; for instance, a country which experiences a sudden increase in the number of deaths from heart disease and diabetes in a few years, would strongly consider the initiation of vigorous programs to encourage lifestyles that help prevent these illnesses. Similarly, if a country realizes through cause-of-death research and statistics that many children die of malaria, the health budget can be adjusted to accommodate and increase spending in that area.

High-income countries have effective surveillance systems for collecting data on causes of death in the population but most low- and middle-income countries lack such systems, hence, deaths from specific causes are often estimated from incomplete data. Improvements in producing high quality cause-of-death data are crucial for improving health and reducing preventable deaths in these countries.

Leading causes of death differ across the world based on various factors including country, economy and developmental status, age group and income group. In low income countries for instance, over 70% of deaths are attributed to preventable causes such as communicable diseases (CD), pregnancy or childbirth complications and poor nutrition while in high income countries, only less than 10% of deaths are due to these causes. On the other hand, non-communicable diseases (NCD) cause about 88% of deaths in high-income countries and about 37% of deaths in low-income countries.

Considering only the absolute number of deaths, 78% of global NCD deaths occur in low and middle-income countries while some diseases such as lower respiratory infections occur across all income groups. Given the lack of development, infrastructures and basic amenities in low income and developing countries, injuries- especially due to road traffic accidents, claim nearly 5 million lives annually. Road injuries are also among the leading causes of death in the world. The global rate of road traffic accidents was 18.3% but low-income countries have the highest mortality rate with about 28.5% deaths per 100,000.

According to the latest statistics in 2016, there were about 56.9 million deaths worldwide. Over half of these deaths were attributed to ten top causes – with Ischemic heart disease and stroke as the biggest killers- accounting for a combined 15.2 million deaths in the same year. These diseases have remained the leading causes of death globally for 15 years. Chronic obstructive pulmonary disease claimed 3 million lives while lung cancer (including trachea and bronchus cancers) caused 1.7 million deaths. Diabetes killed 1.6 million people while deaths due to dementia more than doubled between 2000 and 2016, making it the 5^th leading cause of global deaths. Lower respiratory infections remained the most deadly communicable disease, causing 3 million deaths worldwide. Diarrheal diseases caused 1.4 million deaths while tuberculosis had a death toll of 1.3 million, coming in as the 8^th and 9^th leading cause of global deaths respectively. The 10^th cause of death was road injuries which killed 1.4 million people in 2016.

In the United States specifically, about 75% of all deaths are attributed to just ten causes, with the top three accounting for over 50% of all deaths. These ten leading causes of death are similar to the above named causes of death in the world and have remained fairly consistent. They include:

• Heart disease
• Cancer
• Chronic lower respiratory disease
• Accidents
• Stroke
• Alzheimer’s disease
• Diabetes
• Influenza and pneumonia
• Kidney disease
• Suicide

As the overall population ages and the Patient Protection and Affordable Care Act (PPACA) continues to expand health insurance coverage, policy makers must focus on the growing shortage of primary care workforce especially doctors. The shortage of doctors in the United States is a major concern facing and affecting hospitals, and patients in particular. This shortage subjects Doctors to a draining work environment and hectic lifestyle leading to constant burnout and an increased turnover rate which hospitals cannot afford. Consequently, it is essential to improve the quality of the work environment as well as reduce the workload of these doctors in order to retain them, sustain the quality of care received by patients as well as improve patient access to healthcare.

In recent years, physician shortage in the US has overwhelmed the healthcare industry and is expected to continue growing exponentially. Some reasons for this shortage include, but is not limited to population growth, increase in the number of aging Americans, and retirement of practicing doctors. A 2017 study by the Association of American Medical Colleges (AAMC) showed that the US could face an impending crisis of physician shortage to a maximum of 104,900 physicians by 2030. A crisis of physician shortage will be detrimental to patients and doctors; patients will experience longer wait times, barriers in accessing healthcare, dissatisfaction, distrust in the health system, and difficulties in getting beds or being admitted for extended hospital stays. Doctors on the other hand will be unable to treat patients efficiently due to fatigue from extended work hours and patient influx. More so, the shortage of physicians does not only affect hospital patients but also people who visit their primary care physicians and family doctors. Ultimately, the shortage of doctors will erode and negatively impact the overall quality of healthcare across the US if not averted.

In general, recent years have recorded significant decrease in patient care access due to a number of factors; however, some people propose that this decrease may not be as a result of physician shortage. A 2014 study by the Institute of Medicine claimed there was no statistical shortage of physicians or doctors in the US. As a consequence, there is need for further research to ascertain if there is indeed shortage, to what degree it exists and the possible impacts it could have on hospitals, doctors and patients.

To improve the quality of health and meet global health standards, many countries around the world continue to seek better ways of organizing, financing and delivering health care and services. Major components and concerns of health to be improved include equity, quality, accessibility, cost, efficiency and effectiveness. Consequently, privatization, globalization and liberalization have become important political agenda in these countries. Privatization may be achieved by a change in ownership, either by decentralization or dis-investment as well as by contracting public services to private agencies or by allowing the private sector to manage public health facilities. Liberalization or deregulation means the activities organized by the State would be provided by the private sector, an example is allowing government doctors to do private practice after office hours or allowing private doctors to use public facilities.

In recent years, private investments in healthcare have become essential for public health systems to meet present and future health challenges. The growing engagement of private sector investments has raised several concerns about equity, quality, accessibility, cost, efficiency and effectiveness. Thus, it is important to compare the aims and objectives of both as well as evaluate their relevance. Comparing the private and public health sectors is tough and involves several multidimensional factors given that their goals are significantly different. Private health sectors are exclusively individually-owned and profit oriented while the public sectors are government-run and social-service oriented. Since the aim of private sector is primarily profit, its focus is on the curative services, whereas, public sector provide preventive and highly specialized medical care services. The private sector is easier to manage and can be more efficient once the financial responsibilities of patients are met, they also such as in India, the private sector tends to focus on services which are easy to make quick profit and the public sector may have to carry the unprofitable activities. Public sector, on the other hand, aims to provide health care services for all citizens using a universal health system where contributions are made by citizens based on their income. This equity-based system enables the public sector to provide services irrespective of age, social class, income and geographical location.

Given the relevance of each sector, a mixed public and private system is obtainable in most countries- in India for example; the private sector plays significant roles in the health care delivery system- accounting for about 57% of the total number of hospitals and 32% of hospital beds. In this case, health care delivery is jointly provided by the public and private sector which requires a public-private partnership. The government must make efforts to use the private health sectors to achieve their aims through collaborations, support, subsidies and partnerships. Major policy concerns about private sectors include the existence of suitable regulations to monitor and control resource allocation, equal distribution of services in geographic locations, quality of services and funding. To address these issues, private healthcare facilities including hospitals, nursing homes and clinics must be registered by the appropriate authority so as to be properly monitored. In Addition, there is need to have regulations for equal distribution of services in different geographical regions as well as poor and underprivileged populations- this can be achieved by tax rebates on income or profit in these locations and licensing of private institutions. To ensure quality care, measures such as accreditation, laws that protect the rights of patients, periodic monitoring of facilities and services and continuing training of healthcare workers. Government should support private health systems dedicated to the improving public health by offering incentives that may include provision of logistics and supplies such as free or subsidized drugs, equipment, vaccines, IEC materials and maintenance of equipment related to national health programs. These will empower private health systems and enable them put patients, and not financial gains, at the forefront of their services.

It is no longer news that Cannabis or Marijuana is now legal in Canada. This new law comes with several implications including health, social, political and economic. We will attempt to discuss some of the political and economic implications here in.

First off, let us clarify the two most common political terms used around this new law- decriminalization and legalization. Decriminalization is the removal of the criminal penalties associated with or imposed for personal marijuana use even though the manufacturing and sale of the substance is illegal. On the other hand, legalization is the termination or abolishment of laws banning the possession and personal use of marijuana for adults and includes decriminalization.

The recent legalization and undeniable public acceptance of using recreational cannabis has raised considerable public concern and has been very controversial due to moral, ethical, public health, legislative and logistic issues associated with it. Results from past public opinion polls showed that majority of Canadians will be happy if marijuana is decriminalized or legalized. Specifically, a poll conducted in 2015 by the Forum Research revealed that 68% of Canadians favor decriminalization and legalization of marijuana.

Legalization will enable the Canadian government to regulate the production, sale and use of marijuana just like tobacco and alcohol.

The proponents of the legalization argue that the use of marijuana is not associated with income generating crime because it is an insignificant constituent of budgets and presents less danger in terms of possibility of overdose, risk of tragic intoxicated behavior and risk of addiction. Contrarily, the opponents of legalization argue that it will increase use, abuse and accessibility to minors.

Economically, one of the major economic effects of legalizing cannabis is a possibility of increased government revenue through the taxation imposed on cannabis and its products. The current legalization is creating a completely new industry- probably a whole new economy, and will likely generate new companies, jobs and stock market earnings, in both businesses and the society as a whole.

According to a report by the Canadian Imperial Bank of Commerce (CIBC), the legalization of cannabis could create an industry with an annual profit of $10 billion, of which the government will collect at least 50% – depending on the tax rate for such potential industries.

Despite possible drawbacks and many uncertainties surrounding the fledgling legalization, it would substantially reduce the Government’s spending on the enforcement of the federal cannabis laws and allow saving the tax money which was previously spent on prohibition, arrests, criminalization and law enforcement. Statistics Canada reported that there were 73,000 marijuana-related criminal offences (67% of all police-reported drug offences) in 2013.

The decriminalization of cannabis will also reduce the size of Canada’s black market and all its consequences for the society. However, it may concurrently result in public health problems such as increased uptake of the drug, more road accidents and injuries as a result of driving under the influence. These problems all have economic consequences.

To ensure that the government actually saves money by reducing cannabis-related arrests, legalization should be accompanied by comprehensive strategies to keep the drug away from minors as well as increase public awareness and knowledge sharing about the harmful effects of the drug.

The term work-life balance refers to the balance needed by individuals to maintain stability and equilibrium between work and other aspects of life. Work-life balance does not mean an equal balance because it’s impossible and impractical to spend the same number of hours for work and social or personal activities. However, it means attaining a daily fulfillment in each quadrant of life: Work, Family, Friends and Self. Balance is important to maintain efficiency, effectiveness and a positive mental health; consequently, there is need to manage the times allocated for work and other aspects of life. Important aspects of life besides work include personal matters, family affairs, social events and leisure activities.

The difficulty in striking a balance between work and life is a challenge faced by a good number of people. In Canada, 58% of workers report being overloaded by their multiple roles- work, school, family, friends, physical health, volunteer and community service. In 2010, the National Health Interview Survey Occupational Health Supplement data showed that 16% of American workers had difficulty balancing work and family. These findings were more prevalent among workers in certain age groups, races, educational levels, careers and marital status. For instance, middle aged workers (30–44 years) had the highest number of individuals reporting imbalance in work and life. Additionally, non-Hispanic black workers at 19% reflected the highest rate of people who reported imbalance in work and life, compared to 16% of non-Hispanic white workers and 15% of Hispanic workers. Workers who possess a bachelor’s or advanced degree also faced greater challenges attaining a work-life balance compared to workers who possess lower educational qualifications. Based on marital status, divorced and separated workers faced higher challenges attaining work-life balance compared to married workers widowed workers, and never married workers. Workers in certain careers and industries such as agriculture, forestry, fishing, and hunting reported lower prevalence of work-life imbalance compared to workers in other areas. More so, professional and highly skilled workers such as legal and medical professionals reported a higher rate of work-life imbalance. On the other hand, a lower rate was observed for workers in office and administrative support fields.

The major determinants of work-life imbalance include gender, hours of work, career ambition and family composition. Differences resulting from gender are based on the fact that in most cases, men prioritize work in order to gain the financial competence to provide for their families as well as maintain their social status, whereas women in most cases prioritize their families rather than work. Long hours at work leads to an imbalance because work takes the time needed to be spent doing other important things such as attending to family needs and resting. Family composition, structure and responsibilities also influence work-life balance because families with demanding needs require members to spend less time at work in order to maintain work-life balance while families with less demanding needs allow members the flexibility to spend more time at work and still achieve some balance. For instance, parents of growing children may need to spend less time at work as they have to cater for their kids. Symptoms of work-life imbalance are loss of control, guilt about neglecting other duties, difficulty concentrating and fatigue.

Irrespective of the many challenges of achieving work-life balance, it is essential to our mental health. Therefore, it remains our individual responsibility to take control and understand our lives enough in order to maintain a healthy balance in every aspect. According to Canadian Mental Health Association (CMHA), tips for maintaining balance include taking breaks, setting priorities and goals, exercising, budgeting, delegating and saying no to some activities.

Antibiotic resistance, also known as antimicrobial resistance or drug resistance is a situation where microorganisms resist the effects of antibiotics designed to kill them. When antibiotics lose their effectiveness, we lose the ability to treat infections and control public health threats. Many medical procedures such as joint replacements, organ transplants, cancer therapy and treatment of chronic diseases are dependent on the possibility to combat infections using antibiotics. Therefore, it is important that these antibiotics retain their effectiveness to ensure the success of these procedures and treatments.

The discovery of Antibiotics remains one of the wonders and breakthroughs of the 20th century. In 1928, Penicillin- the first ever commercial antibiotic was discovered by Alexander Fleming to combat micro-organisms. Subsequently, many other antibiotics have been discovered and used as drugs in the treatment, management and cure of several microbial infections and diseases. The effectiveness and importance of antibiotics cannot be overstressed; however, antimicrobial resistance has been a constant hindrance to their effectiveness.  The unique and unusual genetic capabilities and aptitude of microbes takes advantage of the abuse and overuse of antibiotics. These organisms use resistance genes and horizontal gene transmission to develop several mechanisms of resistance for antibiotics developed and used clinically, agriculturally and otherwise.

Antibiotic resistance occurs when microbes develop the capacity to survive drugs designed to kill them. Infections caused by antibiotic-resistant germs difficult and sometimes impossible, to treat. They often require longer hospital stays or visits, additional follow-ups and other expensive alternatives. Antibiotics have been abused in so many ways including using them when not necessary, overusing them in treating all types of infections, taking too much of them and imbuing them into different agricultural systems, animals, and food products. These various forms of abuse have unlocked the potential for bacteria to evolve into resistant strains that can survive antibiotic that previously could destroy them. Microbes- like most creatures will always find survival strategies and device innovative ways to resist new drugs. In fact, more organisms share their resistance with one another, making it harder to deal with them. To achieve a complete restoration of therapeutic use and effectiveness of antibiotics, there is a need to reduce and end antibiotic resistance. Specifically, one way to achieve this is through creative approaches in the discovery of new antibiotics and their controlled introduction to treatment.

Antibiotic resistance affects people at any stage of life; it also affects health and agriculture- making it one of the most critical public health problems in the world. In the US, about 2 million people are infected with antibiotic-resistant bacteria, and at least 23,000 people die as a result annually. People at greater risk of these infections are especially those already suffering chronic illnesses.

Health insurance is a significant concept in global health due to its relevance in every part of the world. It is broadly described as insurance that covers all or part of an individual’s expenses resulting from disability, ill health or injury. Health insurance considers and calculates each individual’s probability of incurring medical expenses; spreads it over the same probability for a group of individuals and then estimates the overall risk of health care and health system expenses in that group. Subsequently, a routine financing structure – usually a monthly premium, is developed by the insurer for the group to raise the funds needed to pay for the specified health care benefits in the insurance contract or agreement. Hence, health insurance is not really free health care; it is a system where individuals pay for healthcare as a society- by making different degrees of contributions thus reducing the overall cost and risk of being bankrupted by medical bills. Most of the time, these benefits are administered by a central organization such as the government, business agency or not-for-profit group.

The need for an effective and efficient health insurance plan cannot be overemphasized, and is crucial to maintaining a healthy world. One major advantage and aim of health insurance is to uphold the global health goal of promoting equity in health care- given that the right to health is a fundamental human right. This ensures that individuals and families who may be living in poverty can still get the health services and care they need, even though they would otherwise not be able to afford it. Other pros of health insurance include promoting affordable healthcare while balancing out-of-pocket costs, increasing safe and great quality healthcare options, encouraging innovation and competition in the health sector, improving access to healthcare, expanding service and choices of care options, encouraging individuals to seek medical care and strengthening the healthcare workforce to meet the diverse needs of patients.

Despite the many benefits, one significant drawback of health insurance is that sometimes, it is not flexible and doesn’t cover all or part of the costs of very expensive medical services and care. This means that despite having an insurance plan, people can still go bankrupt if they suffer long-term ill-health that is quite expensive to manage and is not covered by their insurance agreement.

In Europe, nearly all the countries have universal health care (UHC), although there may be small variations across countries. Europe’s UHC is often referred to as “free health care” system due to its effectiveness and efficiency, even for foreigners. However- typical of health insurance, it is not exactly free. Europe’s health insurance system is delivered through a variety of national systems which are publicly funded through taxation.

In North America, health insurance is broad and diverse across the different countries. In the US for example, private and social insurance programs such as Medicare amasses resources and spreads the financial risk of medical expenses across the population. There are many health insurance plans in the US- including private and public plans which provide different levels of financial protection and scope of coverage. Irrespective of the various plans, over 40% of insured Americans reported that their health insurance plans did not sufficiently meet their needs. Canada’s universal health-care system is publicly provided and covers most health-care services as long as an individual possess a valid government-issued health card. This universal health-care system is funded by taxes, differs by province or territory and may vary in the medical costs and conditions covered.

In Africa, Nigeria has a National Health Insurance Scheme (NHIS) which operates under a prepayment system known as capitation. Registered members receive a monthly bill irrespective of whether or not that person used the NHIS’s services. The amount paid is dependent social factors such as income which promotes equity in the receipt of health services. The objective of NHIS in Nigeria is to reduce socioeconomic barriers to achieving universal access to health care and service. The downsides of NHIS include lack of organization, high financial cost, poor health care service and infrastructure, uneven distribution of hospitals and healthcare professionals.

Conflict can be described as a form of dissonance or disharmony arising within or among groups as a result of differences and disagreements regarding beliefs or actions. When conflict arises within a group, it is termed intragroup conflict while conflict among two or more groups is called intergroup conflict. Conflict usually involves violence, interpersonal discord, and often follows a particular course. In the face of conflicts, routine group interaction is interrupted due to differences of opinion or other types of disagreements between members. These threaten the unity of the group- and may cause separation, alliances or violence. The effects of conflict on human health can be broad and devastating- including:

• Direct physical impact or injury from fighting
• Indirect morbidity and mortality as a result of collapse or deterioration of public health
• Psychological and emotional effects of conflicts which have long-term effects on quality of life, disability, and survival.

Democratic Republic of Congo (DRC) is a case at hand, vividly illustrating how conflict cripples the healthcare system and consequently, the health of the populace. The country which was once known for its network of clinics and quality health care professionals has been experiencing political and economic downfall for the past three decades. Currently in DRC, hospitals and clinics have zero to limited qualified healthcare professionals as well as insufficient equipment, medicine and other medical supplies. Life expectancy is below average and government expenditure on health per capita remains one of the lowest in the world. Consequently, about 70% of the population lack or have limited access to health care. Malnutrition rate- both chronic and acute has remained over 43% for up to 2 decades and is reflected in the stunted growth and wasted look of many children. Additionally, approximately 39% of younger women anemic and about 14% are underweight. Needless to say, infectious diseases remain a major health problem with malaria resulting in an estimated 40% of outpatient visits, and causing nearly 1 in 5 deaths of children below 5 years of age. DRC has the 2^nd and 6^th highest global cases of malaria and Tuberculosis respectively, singlehandedly accounting for 11% of the global burden of malaria in 2013.

Improving the health care system is essential to improving the health of Congolese citizens. DRC has recently made significant progress following enhanced leadership and investments in priority health issues by the government and international partners. In general, the number of children between 12 and 23 months who received all recommended vaccines moved up from 31% in 2007 to 45% in 2013. From the year 2007 to 2013, the mortality for children below the age of 5 reduced from 148 to 104 deaths per 1,000 live births. The country has also been polio-free for over three years- a worthwhile progress given the conflict in the country.