Introduction
Colombia is the second-most populous nation in Latin America. It is positioned close to the Caribbean Sea in the northwestern part of South America. In spite of its strategic position in the continent, the country is plagued with a couple of challenges ranging from healthcare delivery to the poor socioeconomic status of its population. Political turmoil has also been a major destabilizing factor. For instance, the drug trade has instigated armed conflict since the 1960s. Although the situation is being rectified, Colombia has other emerging and chronic national challenges that will continue to affect it even in the future.
About 75 % of the Colombian population is made up of urban residents. The country has a total population of slightly over 46 million people. However, it has a marginal per capita income of 8,600 US dollars. The latter figure is far below the regional mean of 23,823 US dollars. Although the country’s economy has been performing dismally over the years, it is still among the largest economies in South America (ranked at number four).
17 percent of the entire population lives under abject poverty while 46 % is comprised of Colombians who live under the poverty line (Jacobsen, 2009). The last twenty years have witnessed a steady expenditure on healthcare even though regional spending has significantly gone up. According to the latest healthcare statistics, the eastern savannas, the Amazon forest, and the coastal region of the Pacific Ocean are among the worst-hit regions with malarial infestation. Close to 86 percent of the population is faced with the threat of malaria as a communicable disease (Bleakley, 2010). This paper offers a critical look at the burden of disease, socioeconomic determinants of health, access to healthcare and healthcare inequality, the status of child health, control of infectious diseases, non-communicable diseases, and the state of nutrition in Colombia. Healthcare recommendations have also been given at the end of the essay.
Burden of disease
In Colombia, 73 % of the land has been urbanized. As of 2003, 7 % of the population was living below the poverty line. By 2006, the mortality rate for children below the age of five years was 21 out of 1000 live births (Arroyave, Cardona, Burdorf & Avendano, 2013). During the same year, life expectancy was recorded at 74 years. In terms of the environmental disease burden, diarrhea is mainly caused by poor sanitation, low hygiene standards, and a lack of adequate and clean drinking water. A total of 2100 deaths are realized every year as a result of poor sanitation standards. Other similar environmental factors that have increased disease burden include malaria vector and contaminated indoor as well as outdoor air. The percentage of the total disease burden occasioned by the above factors stands at 16%.
In addition, the aspect of disease burden in Colombia has been immensely contributed by dominant infections such as cardiovascular diseases with a prevalence rate of 2.0, neuropsychiatric disorders (2.9), lung cancer (0.2), respiratory infections (1.2), and diarrhea (2.5).
In a national survey carried out in 2010, it was revealed that the number of obese Columbians had increased by a margin of 10 percent within a scale of five years. Children were also included in this empirical study. The body mass index of about a quarter of children aged between five and seventeen years was found to be excess. There were some regions within the country that recorded as high as 30 %.
Socioeconomic determinants of health
Poverty remains one of the key socioeconomic determinants of health in Colombia. The portion of the population that lives below the poverty line is quite high. The high rate of poverty has led to a poor state of health among the impoverished Colombians. Poverty has led to high infection rates for HIV/AIDS especially through commercial sex (Mosquera, Zapata, Lee, Arango & Varela, 2001). Healthcare inequality in Colombia has been worsened by the state of poverty since the low-income earning segment of the society can hardly afford to pay for healthcare services.
Second, armed conflict in Colombia is yet another contributing factor to socioeconomic determinants of health. Injury-related deaths are higher since victims cannot easily access healthcare services.
Poor hygiene and sanitation standards in rural areas are also major socioeconomic determinants of health in Colombia. The rising population has led to increased pollution. In addition, hazardous chemicals sprayed in farms and environmental degradation through deforestation have culminated in the emergence of several lifestyle diseases.
Access to healthcare and healthcare inequality
Healthcare inequality and access to healthcare services are major concerns in the Colombian healthcare sector. For example, 10,000 people are served by an average of 5.5 midwives and nurses as well as 14 doctors. This implies that Colombia is not doing very well in the region in terms of equitable healthcare delivery. In fact, the regional average is higher than that of Colombia. In order to revamp the healthcare sector, the Colombian government has instructed workers to inject additional funds into the healthcare kitty. This implies that the government is seeking additional funds through taxation. The growth of the healthcare sector in Colombia has been greatly hampered by inadequate funding. Nonetheless, the poor segment of the population has not benefitted from this plan bearing in mind that they cannot afford to contribute to the program. As a result, access to healthcare among the poor Colombians is still a dream to be achieved.
Poor access to healthcare has also been witnessed among the rural population or individuals living in remote locations. For example, a lot of physical injuries occasioned by armed conflicts cannot be treated promptly due to the sparsely located healthcare facilities. Accessing healthcare facilities that offer treatment for war injuries is a nightmare for victims.
Status of child health-control of infectious diseases
Infant mortality in Colombia is roughly average to that of entire Latin America. However, most children still die before birth due to the high mortality rate of pregnant mothers which stands at thirty percent. Besides, stunted growth has been a healthcare concern for a long time even though the trend is gradually going down. One of the main causes of stunted growth is inadequate healthcare for children and poor nutrition. Birth complications have also contributed significantly towards infant mortality. Currently, the figure stands high at about 52%. The income of individuals is a major determinant of the quality of healthcare received. Some of the common infectious infant diseases in Colombia include measles, chickenpox, and TB. However, most children are immunized against these infectious diseases (Nigro, Larocca, Celesia, Montineri, Sjoberg, Caltabiano & Fatuzzo, 2006).
Non-communicable diseases and Nutrition
The dominant non-communicable diseases include diabetes, cardiovascular diseases, chronic respiratory diseases, and different forms of Cancer. Children below the age of five years have recorded a positive dietary intake. Malnutrition has declined by a margin of 4%.
Conclusion and recommendations
From the above discussion, it can be concluded that the state of healthcare in Colombia is still wanting. The efforts by several intra-government agencies to boost healthcare delivery in the country have not generated desired outcomes. Worse still, the disease burden and the socioeconomic determinants of health are yet to be streamlined in order to increase access to healthcare and minimize healthcare inequality. Nonetheless, it is vital to mention that the status of child health has significantly improved over the years. Fewer children are dying as a result of communicable and non-communicable diseases.
While nutrition is a vital parameter in the overall health standard of an individual, it is crucial to mention that Colombians are still not on the right course in regards to dietary intake. There are instances of either obesity or lack of adequate and balanced food intake. It is against this backdrop that the following recommendations have been proposed in order to improve the state of healthcare in Colombia.
First, cholesterol levels should be reduced in food substances (McPake, Yepes, Lake & Sanchez, 2003). Cardiovascular diseases can be controlled by taking the latter measure. A culture of maintaining a healthy diet should be encouraged across the board. Second, new programs should be established with the aim of reducing instances of obesity. In addition, communicable diseases such as malaria and HIV/AIDS can be controlled by enacting preventive rather than curative measures (Bleakley, 2010). It is also necessary to train additional doctors, nurses, and midwives so that access to healthcare can be improved. The Colombian government should also seek ways of establishing a medical program for the majority of poor people. For instance, a universal healthcare plan can be enacted.
References
Arroyave, I., Cardona, D., Burdorf, A. & Avendano, M. (2013). The Impact of Increasing Health Insurance Coverage on Disparities In Mortality: Health Care Reform In Colombia, 1998-2007. American Journal of Public Health, 103(3), E100-E106.
Bleakley, H. (2010). Malaria Eradication in the Americas: A Retrospective Analysis of Childhood Exposure. American Economic Journal. Applied Economics, 2(2), 1-45.
Jacobsen, K.H. (2009). Introduction to Global Health. London: Jones and Bartlett Publishers.
McPake, B., Yepes, F. J., Lake, S., & Sanchez, L. H. (2003). Is the Colombian Health System Reform Improving The Performance of Public Hospitals In Bogota? Health Policy and Planning, 18(2), 182.
Mosquera, M., Zapata, Y., Lee, K., Arango, C., & Varela, A. (2001). Strengthening User Participation Through Health Sector Reform In Colombia: A Study Of Institutional Change And Social Representation. Health Policy and Planning, 16(2), 52.
Nigro, L., Larocca, L., Celesia, B. M., Montineri, A., Sjoberg, J., Caltabiano, E., & Fatuzzo, F. (2006). Prevalence of HIV and Other Sexually Transmitted Diseases among Colombian and Dominican Female Sex Workers Living In Catania, Eastern Sicily. Journal of Immigrant and Minority Health, 8(4), 319- 323.