International World Population Day 2018

Tuesday, July 17, 2018

Global

In 1989, the Governing Council of the United Nations Development Programmed recommended that 11 July be observed by the international community as World Population Day, a day to focus attention on the urgency and importance of population issues. This year, on World Population Day, UNFPA will celebrate the theme “Family Planning is a Human Right.”

This year marks the 50th anniversary of the 1968 International Conference on Human Rights, where family planning was, for the first time, globally affirmed to be a human right. The Teheran Proclamation states, “Parents have a basic human right to determine freely and responsibly the number and spacing of their children.”

Tragically, reliable family planning methods are out of reach for hundreds of millions of people around. Many resort to unsafe, unreliable methods, some of which can be dangerous.

UNFPA has collected dozens of examples of harmful and ineffective strategies people employ while trying to prevent pregnancy. Together, these examples highlight the urgent need to improve access to, and information about, modern, reliable family planning.

Here are 10 facts about the world’s population:

Reproductive Rights

- An estimated 214 million women in developing countries have an unmet need for modern contraception, with women in the poorest 20 per cent of the population having the least access to sexual and reproductive health services.

- Nearly half of the estimated 56 million abortions carried out worldwide each year are unsafe, leading to the deaths of at least 22,800 women every year, due to a combination of lack of access to contraception, strict laws on abortion and stigma around terminations.

- 95 percent of the world’s births among adolescent’s girls occur in developing countries.

Growth of Cities

- The world’s population totals 7.6 billion people and is expected to grow to nearly 10 billion by the middle of this century before levelling off at around 11.2 billion by the end.

- More people live in urban than rural areas, with 55 percent residing in urban areas in 2018, compared to 30 percent in 1950. By 2050 this proportion is expected to reach approximately 70 percent.

- The most urbanized regions are North America (with 82 percent of people living in urban areas), Latin America and the Caribbean (81 percent), Europe (74 percent) and Oceania (68 percent).

- Asia is about 50 percent urbanized, while Africa is still predominantly rural (43 percent).

- Africa and Asia are home to nearly 90 percent of the world’s rural population, with India having the largest number of people living in rural areas (893 million), followed by China (578 million).

- Tokyo is the world’s largest city with 37 million inhabitants, followed by Delhi with 29 million and Shanghai with 26 million people.

- The world is ageing rapidly. People aged 60 and older make up 12.3 per cent of the global population, and by 2050, that number will rise to almost 22 percent.

World over population disability and health

Overpopulation refers to a population which exceeds its sustainable size within a particular environment or habitat. Overpopulation results from an increased birth rate, decreased death rate, the immigration to a new ecological niche with fewer predators, or the sudden decline in available resources. Therefore, overpopulation describes a situation in which a population in a given ecosystem limit the resources available for survival.

Overpopulation Effects

Overpopulation can have several effects on the environment, as well as other species within an ecological system. Indeed, human overpopulation has resulted in technological advances which have increased human lifespan and fertility, and consequently placed pressure on global resources. Such effects are such that the planet is currently in a novel geological epoch called the Anthropocene. In general, overpopulation results in an ecological disruption as resources are depleted. This disruption can lead to the decline of other populations which compete for the same resources. Typically, such effects result in the cycling between periods of population growth and periods of population decline until it can reach homeostasis within a particular ecological niche. Some examples of naturally regulated population growth are rodents, rabbits, and various insect populations (e.g., army worms and locusts).

In situations of overpopulation caused by the introduction of a foreign species for which they have no natural predators, they can become an invasive species. An example is the inadvertent introduction of zebra mussels to the North American water systems. Since zebra mussels are natively from the Black Sea and Caspian Sea, they have no natural predators in the foreign ecosystems of North America and parts of Europe.

Disability is extremely diverse. While some health conditions associated with disability result in poor health and extensive health care needs, others do not. However all people with disabilities have the same general health care needs as everyone else, and therefore need access to mainstream health care services.

Article 25 of the UN Convention on the Rights of Persons with Disabilities (CRPD) reinforces the right of persons with disabilities to attain the highest standard of health care, without discrimination.

Key facts

• Over a billion people, about 15% of the world’s population have some form of disability, 110 million and 190 million people have significant difficulties in functioning.

• Rates of disability are increasing due to population ageing and increases in chronic health conditions, among other causes.

• People with disabilities have less access to health care services and therefore experience unmet health care needs.

 In our today’s Health Matters edition, we continue with Dr Hassan Azadeh, our health adviser who is also a senior lecturer at the University of The Gambia focusing on people with impairment (weaken in strength), disabilities and handicap living in a society  in a poor health, hopelessness and with little chance of survival and long life.

What is definition of disability

The most commonly cited definition is that of the World Health Organisation in 1976, which draws a three-fold distinction between impairment, disability and handicap, defined as follows. ‘

Impairment is any loss or abnormality of psychological, physiological or anatomical structure or function; Disability is any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being; Handicap is a disadvantage for a given individual, resulting from an impairment or a disability, that prevents the fulfilment of a role that is considered normal (depending on age, sex and social and cultural factors) for that individual.

People with a disability may include:

• People who are blind or partially sighted

• People with learning or intellectual disabilities

• people who are deaf or hearing impaired

• People with a physical disability

• People with long term illnesses

• People with mental health or psychological difficulties

• People with an acquired brain injury

According to the World Health Organisation, a disability is “Any restriction or lack (resulting from any impairment) of ability to perform an activity in the manner or within the range considered normal for a human being”

A disability includes those that:

• are present, or

• Once existed but don’t any more, for example, a person who has had a back injury, a heart attack or an episode of mental illness, or

• may exist in the future, for example, a person with a genetic predisposition to a disease, such as Huntington’s disease or heart disease or a person who is HIV positive, or

• Someone thinks or assumes a person has.

Terminology

“Language is critical in shaping and reflecting our thoughts, beliefs, feelings and concepts. Some words by their very nature degrade and diminish people with a disability”

The term “disabled young person” tends to convey a message that the only thing worth mentioning about a person is their disability.  It is better to say “young person with a disability” as this emphasises the person first without denying the reality of the disability.

Terms such as cripple, spastic, handicapped, invalid are derogatory, offensive and you should avoid them.

Sometimes people with a disability are compared to normal people. This implies that the person with a disability is abnormal and ignores the fact that everyone has their own unique identity and abilities. For comparisons you could say other people instead.

Disability and health

The International Classification of Functioning, Disability and Health (ICF) defines disability as an umbrella term for impairments, activity limitations and participation restrictions. Disability is the interaction between individuals with a health condition (e.g. cerebral palsy, Down syndrome and depression) and personal and environmental factors (e.g. negative attitudes, inaccessible transportation and public buildings, and limited social supports).

Over a billion people are estimated to live with some form of disability. This corresponds to about 15% of the world’s population. Between 110 million (2.2%) and 190 million (3.8%) people 15 years and older have significant difficulties in functioning. Furthermore, the rates of disability are increasing in part due to ageing populations and an increase in chronic health conditions.

Unmet needs for health care

People with disabilities report seeking more health care than people without disabilities and have greater unmet needs. For example, a recent survey of people with serious mental disorders, showed that between 35% and 50% of people in developed countries, and between 76% and 85% in developing countries, received no treatment in the year prior to the study.

Health promotion and prevention activities seldom target people with disabilities. For example women with disabilities receive less screening for breast and cervical cancer than women without disabilities. People with intellectual impairments and diabetes are less likely to have their weight checked.

 

How are the lives of people with disabilities affected

 

People with disabilities are particularly vulnerable to deficiencies in health care services. Depending on the group and setting, persons with disabilities may experience greater vulnerability to secondary conditions, co-morbid conditions, age-related conditions, engaging in health risk behaviours and higher rates of premature death.

Secondary conditions occur in addition to (and are related to) a primary health condition, and are both predictable and therefore preventable. Examples include pressure ulcers, urinary tract infections, osteoporosis and pain.

Age-related conditions

The ageing process for some groups of people with disabilities begins earlier than usual. For example some people with developmental disabilities show signs of premature ageing in their 40s and 50s.

 

Engaging in health risk behaviours

Some studies have indicated that people with disabilities have higher rates of risky behaviours such as smoking, poor diet and physical inactivity.

Higher rates of premature death

Mortality (death) rates for people with disabilities vary depending on the health condition. However an investigation in the United Kingdom found that people with mental health disorders and intellectual impairments had a lower life expectancy.

Barriers to health care

People with disabilities encounter a range of barriers when they attempt to access health care including the following.

Affordability of health services and transportation are two main reasons why people with disabilities do not receive needed health care in low-income countries - 32-33% of non-disabled people are unable to afford health care compared to 51-53% of people with disabilities.

Limited availability of services

The lack of appropriate services for people with disabilities is a significant barrier to health care. For example, research in Uttar Pradesh and Tamil Nadu states of India found that after the cost, the lack of services in the area was the second most significant barrier to using health facilities.

Physical barriers

Uneven access to buildings (hospitals, health centres), inaccessible medical equipment, poor signage, narrow doorways, internal steps, inadequate bathroom facilities, and inaccessible parking areas create barriers to health care facilities. For example, women with mobility difficulties are often unable to access breast and cervical cancer screening.

Inadequate skills and knowledge of health workers

People with disabilities were more than twice as likely to report finding health care provider skills inadequate to meet their needs, four times more likely to report being treated badly and nearly three times more likely to report being denied care.

Addressing barriers to health care

Governments can improve health outcomes for people with disabilities by improving access to quality, affordable health care services, which make the best use of available resources. As several factors interact to inhibit access to health care, reforms in all the interacting components of the health care system are required.

Assess existing policies and services, identify priorities to reduce health inequalities and plan improvements for access and inclusion. Establish health care standards related to care of persons with disabilities with enforcement mechanisms.

Human resources

Integrate disability education into undergraduate and continuing education for all health-care professionals. Train community workers so that they can play a role in preventive health care services. Provide evidence-based guidelines for assessment and treatment.

Data and research

In order to improve access to health services for people with disabilities, WHO:

• guides and supports Member States to increase awareness of disability issues, and promotes the inclusion of disability as a component in national health policies and programmes;

• facilitates data collection and dissemination of disability-related data and information;

• develops normative tools, including guidelines to strengthen health care;

• builds capacity among health policy-makers and service providers;

• promotes scaling up of CBR;

Promotes strategies to ensure that people with disabilities are knowledgeable about their own health conditions and that health-care personnel support and protect the rights and dignity of persons with disabilities.

For further information seek advice from the Ministry of Health and Social welfare,  Also you can email Dr Azadeh azadehhassanmd10@gmail.com or text only Dr Azadeh on working days between3-6 pm only on 7774469/3774469

Author: DR AZADEH Senior Lecturer at the University of the Gambia, Senior Consultant in Obstetrics & Gynaecology, Clinical Director at Medicare Health Services.

Author: Dr Azadeh
Source: Picture: Dr Azadeh