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Leukemia in Children-Canada

Leukemia is the most commonly diagnosed cancer in children in Canada.
It can take several years to collect and confirm cancer data, so the number of new cancer cases and deaths from recent years may not be available for some time. The most recent data available are provided.
The most recent incidence and mortality statistics for leukemia in children aged 0 to 14 years are from 2009 to 2013.
  • 1,445 Canadian children were diagnosed with leukemia.
  • 145 Canadian children died from leukemia.
  • 1,130 Canadian children were diagnosed with acute lymphoblastic leukemia and 59 died from it.
  • 180 Canadian children were diagnosed with acute myelogenous leukemia and 57 died from it.


Children with leukemia and their parents may have questions about prognosis and survival. Prognosis and survival depend on many factors. Only a doctor familiar with a child’s medical history, type of cancer, characteristics of the cancer, treatments chosen and response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
A prognosis is the doctor’s best estimate of how cancer will affect the child, and how it will respond to treatment. A prognostic factor is an aspect of the cancer or a characteristic of the child that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together and they both play a part in deciding on a treatment plan and a prognosis.
Prognostic factors can vary depending on whether the child has acute lymphoblastic leukemia (ALL) or acute myelogenous leukemia (AML)

Canadian Healthcare Funding

The Canadian healthcare system is predominately public, with 70% of healthcare funding coming from the public-sector and the remaining 30% from the private-sector (Canadian Institute for Health Information, 2016). It is estimated that health spending in Canada will be $228.1 billion in 2016, or approximately 11.1% of GDP, the majority of which goes to hospitals (29.5%), drugs (16%) and physicians (15.3%) (Canadian Institute for Health Information, 2016). Since 2005, physician compensation as a portion of total health spending has increased but since 2014, the share has slowed and is now maintaining levels comparable to those of the late 1980s (Canadian Institute for Health Information, 2016).
Spending on healthcare varies across Canada, but on average provinces spend approximately 38% of their total budgets on healthcare (Canadian Institute for Health Information, 2016). Per capita spending in 2016 for all of Canada is projected to be $6,299, but spending by province ranges from $5,822 in Québec to a high of $7,256 in Newfoundland and Labrador (Canadian Institute for Health Information, 2016).
Global Budget is the most common healthcare funding in Canada, where a fixed amount of payment is allocated to a provider (such as the health authority or hospital), which covers the operating expenses for a period of time, usually a year. Most Canadian provinces have their healthcare regionalized-the local or regional health authorities are responsible for the delivery of primary health services. In most province, the government allocates funding to health authorities through a global budget and many health authorities, in turn, use global budgets to fund specific groups of services. In Canada, most hospitals, long-term care facilities, publicly-funded rehabilitation facilities and mental and public health programs are funded under global budgets (Sutherland et al., 2013). Funding amounts are typically based on factors such as historical budgets, inflation and politics, and are provided irrespective of the number of patients or levels of demands on resources (Sutherland & Repin, 2012).
Global budget is an effective means of controlling healthcare expenditure growth by the use of spending "caps". It provides financial predictability for administrators and policy makers (Wolfe & Moran, 1993Antioch & Walsh, 2004). Its only weakness is the impetus to meet the budget target. Providers may restrict the access to services or limit the number of hospital admissions. Global budgets covers little incentive for innovation or improve the healthcare efficiency (Sutherland & Crump, 2011), since global budgets do not provide opportunities for increased revenue of patient, healthcare providers have no incentive to shorten patient lengths of stay or to discharge patients to lower cost healthcare settings (Sutherland et al., 2013). Global budgets do not promote coordination across service providers in acute and post-acute settings, creating a fragmented healthcare system that is often associated with inefficiencies and reduced quality of care (Sutherland & Crump, 2011Sutherland & Repin, 2012).

Child Mortality Rate in Nigeria

About 10% of new born deaths in the world occurred in Nigeria in the year of 2017, a new report of the United Nations Children Fund, according to UNICEF.  

The report states that five countries are accounted for half of all new-born deaths within the year, inclusive with Nigeria as the third country in the list. India had 24%, Pakistan 10%, Nigeria 9%, the Democratic Republic of Congo 4% and Ethiopia 3%. Most new-born deaths occurred in Southern Asia of 39 per cent and Sub-Saharan Africa 38%.  The report indicated that 15000 children died globally at the age of 5 in the year of 2016, with at least 46% of deaths within the first 28 days of life.  

WHO issued a press conference in 2017 stating that there is a new study “Levels and Trends in Child Mortality”, revealing, although the number of children dying before the age of 5 is at a new low-5.6 million in 2016, compare to that of 9.9 million in 200. The proportion of under-five deaths in new-born increased from 41 to 46 per cent during the same period.  

The UNICEF Chief of Health, Stefan Peterson, said “though the lives of 50 million children under-five have been saved since 2000 through increased level of commitment by governments and development partners to tackle preventable child deaths, more still needs to be done to stop babies from dying the day they are born, or days after their birth. “We have the knowledge and technologies that are required – we just need to take them where they are most needed.” 


According to the report released by UNICEF, the World Health Organization, the World Bank and the Population Division of UNDESA, which make up the Inter-agency Group for Child Mortality Estimation (IGME), at current trends, 60 million children will die before their fifth birthday between 2017 and 2030, half of them new-born. 

The Nigerian Minister of Health, Isaac Adewole, had earlier this year described the high mortality rate of under-five in the country as unacceptable. “He said the government has however made significant progress in reducing the rate of new-born deaths in the country as it has declined from 201/1000 live births to 128/1000 live births in 2013”. 
Nigeria loses a total of 2,300 under-five year olds and 145 women of child bearing age per day, making the country the second largest contributor to under-five and maternal mortality rate in the World. Latest reports states that many lives would be save on the circumstances of decrease in global inequalities.  

If all countries achieved the average mortality of high-income countries, 87 per cent of under-five deaths could have been averted and almost 5 million lives could have been saved in 2016. 
Tim Evans, Senior Director of Health Nutrition and Population at the World Bank Group said “it is unconscionable that in 2017, pregnancy and child birth are still life-threatening conditions for women, and that 7,000 new-borns die daily”. 

“The best measure of success for Universal Health Coverage is that every mother should not only be able to access health care easily, but that it should be quality, affordable care that will ensure a healthy and productive life for her children and family". 

“We are committed to scaling up our financing to support country demand in this area, including through innovative mechanisms like the Global Financing Facility (GFF)”, he said. “Pneumonia and diarrhoea top the list of infectious diseases which claim the lives of millions of children under-five globally, accounting for 16 per cent and eight per cent of deaths, respectively”.

Health Crisis in Syria

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According to WHO, attack rate on the health sector in Syria has continued to increase over the past years. There has been 67 verfied attacks on the health facilities, workers and infrastructure within the first two of 2018, and about 50% of verified attacks in the year of 2017.  

Dr. Tedros Adhanm Ghebreyesus General Director of WHO, stated that “this health tragedy must come to an end”. “Every attack shatter communities and ripples through health systems, damaging infrastructure and reducing access to health for vulnerable people. WHO calls on all parties to the conflict in Syria to immediately halt attacks on health workers, their means of transport and equipment, hospitals and other medical facilities.” 

The attacks on the health system occurs in the most needed places for medical attention. An estimate of 2.9 million Syrians is living in the UN-declared hard-to-reach and besieged locations, with the collaboration of the World Health Organization providing health services to the areas that lacks access to healthcare.  

About 400,000 individuals are living under siege for half a decade in East Ghouta, running out of the most basic health supplies in the area, with at least 1000 people in urgent need of medical evacuation. “It is unacceptable that children, women, and men are dying from injuries and illnesses that are easily treatable and preventable,” said Dr Tedros. 

70% of health supplies provided by the WHO aimed to reach East Ghouta were restrained by the authorities and sent back to the warehouse of the World Health Organization. The confiscated items were desperately needed to save the lives of the population, as well as decrease the suffering rate. The medical supplies are also routinely removed from the inter-agency convoys to the hard-to-reach and besieged locations.  

Seven years of conflict has affected the healthcare system in Syria. At least half of the country’s public hospitals and healthcare centres are shot down or in bad conditions to function. More than 11.3 million people are seeking for the immediate health assistance possible, with 3 million injured and disabled people.  

WHO ensures that the people in Syria have access to the essential supplies, life-saving healthcare and has delivered more than 14 million treatments and medications in the country, which includes cross-border and cross-line services.  

“The suffering of the people of Syria must stop. We urge all parties to the conflict to end attacks on health, to provide access to all those in Syria who need health assistance, and, above all, to end this devastating conflict,” said Dr Tedros. 

The Next Step In Improving The Nigerian Health Care Services: Co-Financing With Multi Stakeholders

Some of the Nigerian health indicators have been proven to be the worst in Africa. Nigeria has the most population growth around the world with a range of 5.5 live births per woman and an annual growth rate of 3.2. It has been estimated that by 2050, Nigeria will reach a peak of 440 million individuals. Its increase in population and its developing challenges, the country will drag the socioeconomic indicators down in the whole of Africa.  

The government of Nigeria and the Global Financing Facility (GFF) made an announcement on the 15th of August, 2018, of a multi-stakeholder partnership, investing $20 million to improve and the strengthen the primary health care of Nigeria, beginning with three states, with the aim of targeting the less privilege and the most underserved individuals within the entire country. The Nigerian Government is linking the financing investment to a sum of $150 million, which is equivalent its yearly budget. This is implemented as a part of the Basic Healthcare Provision Fund (BHCPF) of the National Health Act. The provided resources and prioritization of the services will contribute the financing of the health and nutritional needs of women, children and adolescents.

“The Government of Nigeria is committed to ensuring that all Nigerians—particularly the women, children and adolescents facing some of the most challenging circumstances, in the most challenging places—have access to the basic health and nutrition services that they need, without becoming poorer by paying for them,” said Professor Isaac F. Adewole, Minister of Health of Nigeria. “The Global Financing Facility has created a new sense of awareness that we must put our money on the table for these essential investments in our people, and use them in even smarter ways—and that is something that hasn’t been done before.” 

The challenges Nigeria undergoes has outpaced the government spending on health and nutrition, in particular within the recent years, yet, unable to offer medical coverage to those who seeks it most, doing little decline the high and Impoverishing-out-of-pocket spending on the health by the poor Nigerians. With the recent advocacy and support of the GFF, the World Bank, the Bill & Melinda Gates Foundation, Global Affairs Canada, Norwegian Ministry of Foreign Affairs, the U.S. Agency for International Development, the UK Department for International Development and other partners, the Government of Nigeria has begun implementing the National Health Act, which was enacted in 2014 and established the BHCPF for the first time in 2018. Through the BHCPF the Nigerian Government is expanding its fiscal space for health to the tune of US$150million or NGN 55.1 billion for primary health care strengthening and service delivery. 

The grant from the GFF co-finances with the early implementation of the BHCPF with the mobilized funds from the government and other contributors, starting from Abia, Niger and Osun state. 

“The Government of Nigeria will make an enormous difference in the lives of millions of Nigerians by making a lasting investment in the health and nutrition of women, children and adolescents, the foundation of society and the economy,” said Mariam Claeson, Director of the Global Financing Facility“Nigeria’s commitment to sustainably financing health and nutrition is a beacon for other countries, as they work closely with the Global Financing Facility to make sure that the investments they make today last for years to come.”