Prof.

Auxilia Chideme-Munodawafa,
PhD,RN
Poverty & health in Developing
countries and in USA
 Poverty Alleviation in Sub Sahara Africa

 Africa – they say is the poorest region in the world is it?

 Number of population earning less than 1$ rose from
42% to 47% in 2001
 Part of the Poverty closely related to HIV?AIDS in Sub
Sahara Africa
 Experience of HIV and AIDS leads to intensified
poverty ( loss of income, medical expenses, funeral
expenses, etc.) ( on a personal level)
 Also Wars & political unrest, natural disasters e.g.
drought
world.
 Africa loses each year?????
 The money that Africa loses each year is over
one and half times the amount of additional
money needed to deliver affordable health care
to everyone in the world. 
 If the rest of the world continues to raid Africa
at the same rate, over the next 10 years $580
billion will be lost by the African people.
 Africa loses each year??? Cont.
 Many of Africa’s loses directly benefit rich
countries.
 They are a result of policies and practices that
drain Africa and keep its people in poverty.
 These include dodging, unfair trade policies,
 and the practices of multinational companies,
and the brain draine of skilled workers.
https://www.globalpolicy.org/component/c
ontent/article/211-development/52662-dev
elopment-aid-to-africa-negligible-in-comp
arison-to-illicit-outflows-.html
( accessed 3-24-18
 Multi-dimensions of poverty in Africa

 Poorest households usually female headed

 Intergenerational aspects of poverty (becomes a
culture of poverty)
 Capabilities & contributions are influenced by the
epidemic
 HIV and AIDS also alters the complex relationships
between the poor and the rich through changes in
income and asset distributions
 Through an intensification of social exclusion
 Poverty & HIV infection

 Poverty associated with weak human & financial

resources such as low levels of literacy and limited
marketable skills
 Also associated with poor health status & low labor
productivity
 Poor people have limited household assets
 Usually politically marginalized
 Due to economic challenges, delay in seeking health
care , - live with undiagnosed sexually transmitted
diseases that increase chances of HIV transmission
Impact of hunger
Health, Education, Productivity in Relation to
poverty
 Health and education of parents influences health &
education of children
 Malnutrition and disease affect the cognition
development and school performance of children
 Education contributes to prevention of illness
 For example ; HIV/AIDS results in poor health of one
generation and affects the next generation
Health, Education, Productivity in Relation to
poverty cont.
 If parents die of AIDS – children orphaned – poorly
fed – malnourished – resulting in ill health
 Malnutrition limits schooling and school
performance
 Delay in school enrollment due to ill health
 Reduction of attendance of malnourished children
 Children constrained from learning
 Reduction of school years
 Reduction in future earnings leading to POVERTY
CULTURE
 Why it is important to educate mothers

 A mother is a predictor of a child’s health

 The more educated the mother, the likelihood of
children being immunized
 If mother is Educated, better family health seeking
behaviors
 Study findings show ; 10% increase in mother’s
education directly related to the reduction in infant
motality by 41% ( Glewe, 2001).
 Health, the cost of Illness and Poverty in
Developing countries
 When health costs are high, there is loss of assets
resulting in poverty
 Poor people will seek for health care but at the last
minute & usually in the emergency room
 Costs of hospitalization very high
 Cost of transport, relocation from rural areas to the
city and strain on extended family in the city for
accommodation Cost of funerals high from HIV
related deaths
 What are the Major Challenges facing
Africa?
 The world produces enough food for its inhabitants.
 Need to eradicate extreme poverty- key to eradicating
hunger by ensuring that ordinary people in the
developing world can get access to food
 Achieve universal primary education ( 23 million
girls are out of school in Africa)
 Promote Gender equality and empowering women

Source; World Bank/UNICEF, Africa 2015

 What is currently in place in Africa?

 Despite challenges – there is a light at the end of the

tunnel
 Programs are in place led by African Union (UN).
 AU is developing structures and institutions to allow
Africa to better prevent, manage, and resolve conflict
in the region
 Development of programs mostly Africa led
 Improvement of partnerships with Donor agencies
resulting in better usage of aid flows
 The New Partnership for Africa’s
Development (NEPAD) & AU aims to;

 Tackle HIV?AIDS
 Reduce poverty
 Sustain long-term economic growth
 Good governance
 Promoting peace and security
 The New Partnership for Africa’s
Development (NEPAD) & AU aims cont.
 Reduce child mortality
 Improve maternal mortality
 Combat HIV and AIDS, Malaria and other diseases
 Ensure environmental sustainability
 Develop a global partnership for development
Success stories of AU & NEPAD collaboration

 Mozambique has reduced poverty from 70% to 55%

in 5 years & doubled the number of children in school
 Kenya introduced free primary education resulting
in1.2 million children back in school
 Zimbabwe introduced Free primary education since
independence in 1980
 Zimbabwe also mounted adult literacy campaign and
achieved 70% literacy level in the country
Success stories of AU & NEPAD collaboration

 Tanzania build 1000 new schools and 18,000 teachers

recruited
 Uganda reduced HIV from 20% in 1991 to around 6.5
% in 2001, including
 Other countries with success stories are Ghana &
Rwanda,
 Poverty in USA
 USA as a nation has been continuously pulling apart
economically in the past 25 years - the rich are richer,
the poor are poorer
 Over 13 million American families with children
have income under 200% of the Federal poverty level
 Despite more than a decade of strong economic
growth, many America’s communities are falling
behind median national measures of economic growth
 Americans lack spare cash because of the difficulty
of making ends meet on minimum wage.
 Americans are deeply in debt
Inequality in the distribution of wealth in the
U.S
 The lowest earning 23,303,064 Americans combined make
36% less than the highest earning 2,915 Americans do.
 According to the Pew Research Center, the top 7 percent of
all U.S. households own 63% of all the wealth in the country.
 According to numbers that were just released this week, 49.7
million Americans are living in poverty.  That is a brand new
all-time record high.
 In the United States today, the wealthiest one percent of all
Americans have a greater net worth than the bottom 90%
combined
 Other Reasons of Poverty in USA
 Recession
 Jobless
 Housing problems
 Americans are deeply in debt, Credit cards VS cash purchases
 Work still pays for some of the rich
 Women are working men are increasingly not working
 Sobering news for “American Dream” seems elusive
 Many families living on the edge
 Inequality of wealth distribution in USA
 Chasing jobs in the new economy; a timeless Pre-occupation
 Hunger among American
children
 More than 1 in 5 children are at risk of hunger. Among
African-Americans and Latinos, it’s 1 in 3.

 40% of food is thrown out in the US every year, or about

$165 billion worth.

 These 8 states have statistically higher food insecurity rates

than the US national average (14.6%): Arkansas (21.2%),
Mississippi (21.1%), Texas (18.0%), Tennessee (17.4%),
North Carolina (17.3%), Missouri (16.9%), Georgia (16.6%),
Ohio (16.0%).
 Hunger among American
children cont.
 Over 20 million children receive free or reduced-price
lunch each school day. Less than half of them get
breakfast, and only 10% have access to summer meal sites.
 For every 100 school lunch programs, there are only 87
breakfast sites and just 36 summer food programs
 40 percent of all American workers (36.6 % to be precise)
make less than $20,000 a year.
 According to the Pew Research Center, the top 7 percent of
all U.S. households own 63% of all the wealth in the
country.
Hungry American Children
 Conclusion

 Poverty reduction efforts are in progress in both Sub

Sahara Africa through the Africa Union & New
Partnership for Africa’s Development (NEPAD) and
in USA
 The main causes of child poverty in USA are low
levels of parental work and high numbers of single-
parent families.
 Need to encourage marital unities as well as increase
work opportunities.
 References
 Fritzell, J. (2003). "Income Inequality Trends in the 1980s: A Five-Country
Comparison," ACTA SOCIOLOGICA Vol. 36

 Wolff, E.N. (2005). TOP HEAVY; A STUDY OF THE INCREASING INEQUALITY

OF WEALTH IN AMERICA (New York: Twentieth Century Fund,
 Smith, G.D., (2006). "Income inequality and mortality: why are they related?" BRITISH
MEDICAL JOURNAL Vol. 312 (April 20, 1996), pgs. 987-988.
 Kaplan, G.A. ( 2006), "Inequality in income and mortality in the United States: analysis
of mortality and potential pathways," BRITISH MEDICAL JOURNAL Vol. 312.
 Chideme-Munodawafa. (2009) Family Functioning in Childhood Cancer Among
Zimbabwean Families, VDM publishers
 https://boingboing.net/2013/11/08/rich-america-versus-poor-ameri.html ( accessed
16/3/18
 Munodawafa, A. (2009). Family Functioning Among Families Living with Childhood
Cancer
