Development and Health

What is development?

Kolkata street scene

A street in Kolkata, West Bengal

What is development and how is it measured?

Development is any improvement in the standard of living of the people living in a country. It is measured using development indicators.

It’s important to give development indicators both their full title and unit of measurement. For example, infant mortality is about the number of babies who die before they are one year old. It’s correctly given as: number of babies/1000 live births.

Economic indicators measure the wealth and industrialisation of a country. An example of a common economic indicator is GNP/capita ($).

Social indicators show how a country uses its wealth to try and improve the quality of life of its people. Social indicators can measure different things like health (doctors /100,000), diet (calories/person/day) and education (% adult literacy).

The problem with any development indicator is that it is an average figure for the whole country, and often hides huge differences in the standard of living within a country.

Models of development

Different countries in the developing world are at very different stages of development. Countries are often grouped together as if they were steps on a development ‘ladder’, such as in Rostow’s model. As their development improves, they move up the ladder.

Another model of development considers all countries on a hill slope, with the richest developed countries like Japan at the top, and the poorest developing countries like Burkina Faso at the foot of the hill. The best-off developing countries are the Newly Industrialised Countries (NICs), like South Korea, who would be halfway up the hill beside the poorest of the developed countries, such as Hungary.

Comparison between South Korea and Burkina Faso

Development Indicator South Korea Burkina Faso
GNP/capita (US$) 7970 240
Doctors/100,000 people 127 5
Adult literacy (%) 98 22
Birth rate per 1000 15 45
Life expectancy (years) 72 44
Number of universities 39 1

The table above compares a number of development indicators for South Korea and Burkina Faso. Look closely at the values for each development indicator. What does it tell you about life in that country? What explains the huge differences between these two countries?

Reasons for differences in levels of development relate to both positive and negative factors, and to both physical and human factors.

Positive factors

Positive factors include accessibility for good trade, a pleasant climate or attractive scenery to encourage tourism, natural resources like oil or other minerals, stable government and an increasingly educated workforce.

Negative factors

Negative factors include remoteness, a very cold or very dry climate, disease, lack of natural resources, corrupt government, civil war, natural disasters like drought, cyclones, floods or earthquakes, fast growing population and crippling debt.

You can deduce some information of this kind from the development indicators, but some you’ll have to provide from your own knowledge.

Primary health care

A doctor treating patients in Peshawar Hospital, Pakistan

Medical care in Peshawar Hospital, Pakistan

In order to address the human geography aspects of development and health, you will need to be able to explain:

  • how a lack of fresh water and adequate sanitation leads to disease and how these problems can be tackled (revise your water related diseases)
  • why child mortality rates are so high, how this can be reduced and how effectively
  • how primary health care can improve standards of health and why these are effective strategies
  • how disease prevention will benefit quality of life in developing world countries

All of the information needed to explain these points should be covered by case studies. You need to learn real examples from around the developing world.

China and the ‘barefoot doctors’

This is one of the earliest examples of primary health care, from the 1960’s. Local people were trained in basic medical care, so that only the more serious cases were referred to central hospitals. This allowed hospitals to concentrate on the very sick. The ‘barefoot doctors’ lived and worked part-time in the community who paid for their services; they were understood and trusted by their neighbours. Because local medicines were used in addition to western drugs, the cost of drugs was reduced.

Effectiveness

  • very successful in early years at reducing disease/illness/deaths in rural areas

But

  • too few health workers trained to supply all the rural communities
  • lack of funding in the local community to pay for the training
  • lack of volunteers who are willing to do community work rather than work in private practice in wealthier urban areas

Nicaragua

A government run programme in the 1980’s built 500 new health centres in rural areas. As in case study 1, basic medical care and health education were practised in the heart of the community.

Effectiveness

  • infant mortality rates reduced from 30% to 9%
  • polio was eradicated by a vaccination programme
  • malaria was reduced from 40% to 3% of rural population

But

  • more recently war, economic depression and natural disasters have reduced the effectiveness of the scheme

The Bamako initiative

With UNICEF support, 34 countries (Benin, Burkina Faso, Chad, Guinea, Niger and Sudan being examples) are developing their primary health care systems. Links are established between hospitals, rural social services, schools, religious groups, women’s and youth groups to encourage, develop and strengthen any health care and health education initiatives.

In Benin, in West Africa, for example:

  • 200 health centres, covering 58% of the population, spread their costs among the local communities
  • a vaccination programme for BCG, polio and DPT (diphtheria, polio and tetanus) was introduced in 1993
  • infant mortality rates were tackled by a programme of pre- and post-natal health education

Effectiveness (Benin 1993)

  • 86% of the population received a BCG immunisation
  • 71% of the population received a Polio/DPT immunisation
  • 75% of pregnant women obtained medical consultations
  • 63% of births were attended by skilled medical staff
  • costs to the community were kept down to $0.50 per visit
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