Develop a 1-page executive summary synthesizing your findings from your Module 1–3 SLP assignments (in order) on Key health indicators, Cholera in Africa, and South Africa’s health system (essays attached) and create a complementary 10-slide PowerPoint presentation to solicit funding for your proposed strategy to address Cholera in Africa with africans.

In your slide presentation, please include a budget, an implementation plan, monitoring and evaluation milestones to assess progress and success, and a communications/reporting plan for all stakeholders.

Length: 1-page executive summary paper and 10-slide presentation. cite your sources.

Running head: KEY HEALTH INDICATO                                  1

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KEY HEALTH INDICATORS

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KEY HEALTH INDICATORS

Key Health Indicators

Diamond DeWindt

November 19, 2019

Author Note

This paper was prepared for BHS380: Global Health and Health Policy, Session 2019NOV11FT- 1, Module 1, SLP 1 Assignment, taught by Dr. Michael Mucedola.

Key Health Indicators

Health indicators are generally characteristics of a population that allows researchers to have supporting evidence to help them describe the health of that particular population. (Wikipedia, 2019) To gather information about the health of a population, surveys have been conducted. A great example of a health indicator would be Life Expectancy. Systems can be used to collect data on ages at the time of death which is later used to support statements about the national life expectancy.

Infant Mortality Rate

Infant mortality rate is recorded as the death of an infant before their first birthday. This is rate is by number of infant deaths per every 1,000 live births. (CDC, 2019) Some of the causes of infant deaths before their birthday are birth defects, low birth weight, preterm birth, or Sudden Infant Death Syndrome or SIDS. The Center for Disease Control has been trying to improve these birth outcomes. The CDC has been working to understand Sudden Infant Deaths which is an unexpected death of an infant under 1 years old. States that are involved show data of trends to help the CDC develop strategies that they hope will reduce the chance of SIDS. (CDC, 2017)

Life Expectancy at Birth

Life expectancy at birth is the average of how long a newborn is expected to live at birth. (OECD Data, n.d.) This is actually one of the most used health status indicators by researchers. Having a high life expectancy at birth can show that the living standards of that area has improved lifestyle, education, and access to quality healthcare. If mortality is high in age groups that are young, the life expectancy at birth can be low, but if a person can live past their childhood mortality then they can expect to live longer. Different populations will have different life expectancies at birth because some countries are not as developed as others. A great example is comparing South Africa’s 59.5 years of age expectancy to the United States 81.2 years. (Population Pyramid, n.d.)

Maternity Mortality Ratio

The Maternity Mortality Ratio represents the risks that are associated with each pregnancy. (WHO, 2014) Some of the complications that arise during childbirth are the leading causes of death and disability among women in developing countries. Measuring this ratio can be quite difficult unless the death and cause of death is documented. Other estimates are formed from census, and surveys over maternal mortality. Maternal mortality ratio and maternal mortality rate should not be confused with each other. Maternal mortality rate is the number of maternal women who have died per women while maternal mortality ratio is the number of maternal deaths per live birth. (Morse, 2019)

Under 5 Mortality Rate

The Under 5 Mortality Rate is the probability of an individual from newborn to age 5 dying per 1,000 births. (WHO, 2019) Last year alone, it was reported that 5.3 million children under the age of 5 years old died. Currently, the African region has the highest risk of children dying under the age of 5 years old. It has 5 of 6 countries having the death rate at 100 deaths per 1,000 live births. The Sustainable Development Goals have come up with a target to end preventable deaths of children from birth to 5 years old. All countries are to try to reduce under 5 mortality to as low as 25 deaths per 1,000 live births. Currently, 21 countries are on track to reach this target by 2030.

Health Adjusted Life Expectancy

Health Adjusted Life Expectancy is a measure of a populations health that takes into report mortality and morbidity. (Health Knowledge, 2010) It tweaks overall life expectancy by the amount of time that is lived in less than perfect health. The formula is A + (f)B = life expectancy. A = years lived healthy, B = years lived with disability, and f = disability level. One of the concerns has been who gets to decide what level a disability is. The global health adjusted expectancy for both male and female together was 63.1 years old in 2015.

Disability Adjusted Life Years

Disability Adjusted Life Years or DALY measure the amount of life that is lost in a population as an outcome of either premature death or disability. (Health Knowledge, 2010) This helps researchers estimate the weight of a disease on a population. A single DALY can be thought of as a single year loss of healthy life. Measuring this across a population can help show the gap between current health status and the wanted health situation. DALY = Years of life lost + Years lost due to disability.

Life expectancy at birth is a health indicator that could be used to describe the overall health status of a developing country. Life expectancy can show the living standards of the developing country. The higher the life expectancy grows; it shows that the country is improving and vice versa if it is getting lower. Life expectancy will start to rise when the country is showing improvement in public health, nutrition, education, and medicine.

References

Wikipedia. (2019, October 14). Health indicator. Retrieved from

https://en.wikipedia.org/wiki/Health_indicator

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CDC. (2019, March 27). Infant Mortality. Retrieved from

https://www.cdc.gov/reproductivehealth/maternalinfanthealth/infantmortality.htm

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CDC. (2017, September 11). Infant Mortality: What Is CDC Doing? Retrieved from

https://www.cdc.gov/reproductivehealth/maternalinfanthealth/infantmortality-

cdcdoing.htm.

Health Knowledge. (2010, July 15). Health information: Life tables, HALEs, DALYs, and PYLLs. Retrieved from

https://www.healthknowledge.org.uk/e-learning/health-

information/population-health-specialists/lifetables-hales-dalys-pylls.

Morse, A. R. (2019, August 23). Definitions of Maternal Mortality. Retrieved from

Definitions of Maternal Mortality

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OECD Data. (n.d.). Health status – Life expectancy at birth – OECD Data. Retrieved from

https://data.oecd.org/healthstat/life-expectancy-at-birth.htm

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Population Pyramid . (n.d.). Life Expectancy At Birth, Female (Years) 2015. Retrieved from

https://www.populationpyramid.net/hnp/life-expectancy-at-birth-female-years/2015/

.

WHO. (2014, March 11). Maternal mortality ratio (per 100 000 live births). Retrieved from

https://www.who.int/healthinfo/statistics/indmaternalmortality/en/

.

WHO. (2019, October 24). Under-five mortality. Retrieved from

https://www.who.int/gho/child_health/mortality/mortality_under_five_text/en/

.

Running head:

CHOLERA IN AFRICA

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CHOLERA IN AFRICA

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CHOLERA IN AFRICA

Cholera In Africa

Diamond DeWindt

December 8, 2019

Author Note

This paper was prepared for BHS380: Global Health and Health Policy, Session 2019NOV11FT- 1, Module 2, SLP 2 Assignment, taught by Dr. Michael Mucedola.

Cholera In Africa

Africa is the second-largest continent in the world with quite the large population of human beings. It has been home of the most significant outbreaks of cholera in the world over the past years. Africa takes the most extensive record of global disease burden where cholera is among the rampant diseases that have been taken history by the world health organization. African countries report about forty-six percent of suspects that were made by world health organization, globally. (Abubakar at el 2018) Many conditions in the continent make it fertile for the occurrence and rapid transmission of cholera. There is inadequate access to clean water and sanitary facilities, mainly in the urban areas where necessary infrastructure is not sufficient.

Cholera is an infectious disease that causes severe watery diarrhea that can result to dehydration and death within a small duration of time if not treated. Individuals who are malnourished or living with HIV have high risks of death if they contract the infection. The bacteria can be transmitted from one person to another using the fecal-oral route. Also, by consuming contaminated food and water. When the disease has infected a human being, it is shown by symptoms that include severe diarrhea, vomiting dehydration that is caused by a lot of vomiting and diarrhea. (Dalhart at el 2014) When the patient is not treated at an early stage, it can lead to weakening and, finally, death.

When a human host has not yet been infected, vibrio’s, survival strategy in the water environment is the most common interaction that happens between the bacteria and copepod that becomes the first host before finding its way to human beings’ body system. The bacteria develops in the copepod until it gains strength that can be able to move in water bodies on its own. When the bacteria have aggregated on the copepod, it produces means of transmission to the human host.

Some communities do not believe in hospital treatments; instead, they take local herbal medicine that does not provide a full dose of the medication to the patient. Through this method, they retain strains of the disease in the community. Mountain burial has a high impact on increasing cholera attack rates because the water sources go from the mountain towards the low laying places. (Moore at el 2017) This will result in carrying out the disease pathogens in the water; once a person drinks such water, they get infected. Understanding the community’s perceptions of exposing people to risks and illnesses can help public health agencies to have the proper response of outbreaks.

Communities speak different languages and call names that have different meanings but are similar things. Some communities regard cholera as a deadly disease, and it is a serious matter in the community while other cities perceive the illness as a common ailment that can be handled like any other disease. The diet that human beings eat contribute to illnesses that they are likely to suffer from. In the African communities, they mainly eat food that is more of vegetables and fruits, which have more water content than cereals. (Hemson at el 2015) Fruits are imported to patients who are suffering from vomiting and diarrhea; equally, when they are planted in cholera-stricken places and swamps, they become hosts of the bacteria.

Expectations of health care on patients who are suffering from cholera is high since the disease kills in hours. Traditional healing is another factor that has held people in African hostage. They believe in local treatment rather than medication in hospitals. Local medicine is not keen to affect immediately in the human body; thus, many deaths result in such therapies.

Climate change has influenced human beings to change their activities because of use of untreated sewage waste and farm activities that have facilitated the spread of cholera. Due to the prolonged drought that results in scarcity of food, people end up growing vegetables on sewage grounds where plants cannot dry up since there is no rain.(Weill at el 2017) This activity has fueled the spread of cholera because of eating food that is not safe for human consumption. When there is an outbreak of cholera, the government imposes money to protect people for suffering and to prevent it from spreading further to other people. Through this method, the economy of the country is confiscated by budgets that were not planned. Politically, it affects the ruling government when it fails to put measures that will facilitate the prevention of cholera in the future.

Reference

Abubakar, A., Bwire, G., Azman, A. S., Bouhenia, M., Deng, L. L., Wamala, J. F., … & Martin, S. (2018). Cholera epidemic in South Sudan and Uganda and the need for international collaboration in cholera control. Emerging infectious diseases, 24(5), 883.

Dalhart, M. M., Isa, A. N., Nguku, P., Nasir, S. G., Urban, K., Abdulaziz, M., … & Poggensee, G. (2014). Descriptive characterization of the 2010 cholera outbreak in Nigeria. BMC public health, 14(1), 1167.

Hemson, D., & Dube, B. (2015). Water services and public health: the 2000-01 cholera outbreak in KwaZulu-Natal, South Africa.

Moore, S. M., Azman, A. S., Zaitchik, B. F., Mintz, E. D., Brunkard, J., Legros, D., … & Lessler, J. (2017). El Niño and the shifting geography of cholera in Africa. Proceedings of the National Academy of Sciences, 114(17), 4436-4441.

Sinyange, N., Brunkard, J. M., Kapata, N., Mazaba, M. L., Musonda, K. G., Hamoonga, R., … & Nanzaluka, F. (2018). Cholera epidemic—Lusaka, Zambia, October 2017–May 2018. Morbidity and Mortality Weekly Report, 67(19), 556.

Weill, F. X., Doman, D., Njamkepo, E., Tarr, C., Rauzier, J., Fawal, N., … & Bercion, R. (2017). The genomic history of the seventh pandemic of cholera in Africa. Science, 358(6364), 785-789.

Running head: SOUTH AFRICA HEALTH                                  1

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SOUTH AFRICA HEALTH SYSTEM

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SOUTH AFRICA HEALTH SYSTEM

South Africa Health System

Diamond DeWindt

December 22, 2019

Author Note

This paper was prepared for BHS380: Global Health and Health Policy, Session 2019NOV11FT- 1, Module 3, SLP 3 Assignment, taught by Dr. Michael Mucedola.

South Africa Health System

South Africa has a healthcare system which is structured at different levels. There are clinics, community health centers, and hospitals. The first level in the hospital structures are the clinics which treat the common needs of the people. It is these clinics that will refer someone further to the hospitals when one needs the further treatment. The clinics are either satellite or mobile clinics which are run by primary healthcare nurses. The community health centers are larger than the clinics and they have both nurses and doctors taking care of the patients. The last level of healthcare facilities are hospitals. The hospitals are for surgery, serious illnesses or emergency treatment that cannot be handled at the clinic levels. An individual can only go to the hospitals if they are referred by doctors in the clinics or in the case of an emergency. Basic healthcare is provided for free by the government through the healthcare services at the provincial level (Masquillier et al., 2015). There is also private healthcare insurance and those who get it receive tax benefits.

There are several gaps that are present in the healthcare gaps in South Africa that have contributed to the rapid spread of the HIV pandemic. South Africa has one of the highest HIV epidemics in the world with over seven million people living with it (Masquillier et al., 2015). The spread of HIV has been caused by gaps which are there in dealing with healthcare awareness for marginalized groups. There are several demographics who do not get the sexual health care that they need such as sex workers, transgender women, gay men, as well as those who inject themselves with various drugs. The second gap that is there is lack of sufficient funds to get people to test for HIV. There is also lack of sufficient facilities to serve poor populations especially in slums to give them access to critical drugs such as ARVs. The healthcare system does not have sufficient capacity to deal with nutritional issues.

One strategy that can be used to deal with the HIV/AIDs issue in South Africa is raising of public awareness through door to door campaigns especially in the slum areas. It is important for everyone to understand the importance of HIV/AIDS treatment and prevention. The local community needs also to realize that it is not good to have stigmatization of the minority groups such as gay men who do not get the healthcare which they deserve. All of this should be done to ensure that these groups of people are getting the care that they need. The importance of ARVs should also be emphasized for those already suffering from the disease to get the treatment that they deserve. The healthcare clinics in the community should also be encouraged to teach people on the value of nutrition when dealing with HIV.

There are various options that are there for financing of this strategy. Internally, the government has a healthcare budget and such a strategy can get funding from there. It is important for the government to improve its healthcare allocation specifically to HIV to deal with the situation before it gets worse. Globally, organizations such as USAID and the World Healthcare Organization (WHO) can come in and deal with the problem.

References

Masquillier, C., Wouters, E., Mortelmans, D., & le Roux Booysen, F. (2015). The impact of community support initiatives on the stigma experienced by people living with HIV/AIDS in South Africa. AIDS and Behavior, 19(2), 214-226.