by Felicia Krausert
“Healthcare is like business- we need to find a way to increase both supply and demand”
This was a theme I took away from attending the 2019 Canadian Conference on Global Health (CCGH) in Ottawa. It was a privilege to be there- thanks in part to a grant from the CCGHR SYPN- a place where global health advocates gathered to share research and ideas on the challenges and successes of health systems in some of the poorest parts of the world.
I have often found that interventions aimed at helping vulnerable and marginalized populations are strong only on the “supply” side of this equation- they create and deliver interventions like mosquito bed nets, vaccines, and nutritional supplements. But without looking at the “demand” for these services, their efforts are often misguided, short-lived, and unsustainable.
Even in my own experiences in Tanzania during a medical elective, efforts had been made to improve “supply” of maternal healthcare through increased training for doctors, nurses, and midwives. Yet in talking to local medical students, I heard that “demand” was low- many women still preferred to deliver in the comfort of their own home, even with a less skilled birth attendant.
It seemed one of the reasons for this was that many women felt they were poorly treated in hospitals. Unfortunately I witnessed it for myself- understaffed, overworked midwives yelling at delivering women to push harder, slapping and pinching their thighs, all in an effort to hurry the process and get to the next waiting woman.
With this environment awaiting them during their labour and delivery, it should come as no surprise that improving the “supply” was not enough to entice these women. Luckily, there were some solutions to this very problem delivered at CCGH in a presentation from the SHOW Project- a group aiming to reduce child and maternal mortality.
Some of their ideas to improve supply included capacity building with new skills and local participation, and increasing shared decision-making. But I was especially interested in their ideas for improving demand- by increasing education and awareness of services provided, increasing the agency and decision making power of local women, and improving their social capital to access such services independently.
As long as we keep considering both the supply and demand for interventions, I am hopeful that groups around the world can create lasting, meaningful changes in Global Health.
Felicia Krausert is a medical student at the University of Calgary, where she serves as the Vice President of Global and Community Health for her class, and as the Global Health Liaison to the Canadian Federation of Medical Students (CFMS). She first fell in love with Global Health during a four-month practicum in Uganda as part of her Masters of Management of Applied Sciences (MMASc) specializing in Global Health Systems at the University of Western Ontario. In her spare time, Felicia loves to read, ski, bake, and eat new food from all over the world.