Category Archives: Education

New Fully Online Global Health Learning Programs at JHU

Continuing professional development has often been a challenge for people in the field. They may not be able to get study leave, but they do need advanced training in order to progress. The Johns Hopkins Bloomberg School of Public Health as started a new Online Programs for Applied Learning (OPAL) that offers completely online Masters and Certificate degrees.

The Department of International Health is Offering three Master of Applied Learning (MAS) and one Certificate covering global health. The Certificate can be completed in one year minimum and the MAS in two years minimum. More information on these programs can be obtained at the links below.

Educating the Media on Malaria Control

The mass media – electronic, print and now social – play an important role in the fight against malaria.  The media reach diverse audiences from villagers to policy makers.  Because of their potential influence, the media must have the story right when it comes to malaria.

DSCN2402A news story published online this morning from a highly malaria-endemic country shows how some subtle but important mistakes can give wrong impressions and lead to wrong actions. The fact that the information is attributed to “medical science experts” does not mean that the reporters quoted them in the correct context.

The first example from the story is, “Spending on malaria and dengue fever treatment programmes should be controlled, with more efforts directed to preventive measures …”  As a disease caused by a virus, dengue does not have a definitive treatment, if by treatment we mean a cure.

Life saving palliative care is important in dengue, but dengue in Africa usually goes undiagnosed and is unfortunately often treated by wasting malaria drugs. The issue is not reducing treatment funds, but using rapid diagnostic tests so that we will not waste our expensive malaria medicines on non-malarial fevers.

The article next talks about how scientists in the country, “are advising the government to authorise controlled use of the banned pesticide DDT to strengthen mosquito eradication and bite control programmes in the country.”  DDT has been used for indoor residual spraying against the malaria carrying anopheles mosquitoes.  This fits into the anopheles behavior of resting on walls after biting.

By contrast dengue is carried by Aedes aegypti mosquitoes.  They are the ones that breed in pots, tins, etc. around the house, and DDT is not a major part of the efforts to control them. Household members are responsible for removing or not even allowing such small collections of water to occur in their houses, on their property and among their neighbors.

A final odd claim is that, “Donor funded health programmes are disadvantaged because the in-country implementers ‘accept each and every thing directed to them by the donors without challenging their ideas.’” For the biggest malaria funding programs this is not true.  The Global Fund for years has required that countries submit their own proposals that were developed and passed through their own national country coordinating mechanisms.

Now Global Fund is requiring countries to submit their own national malaria strategies as a basis for funding. The Global Fund is a financial organization, not a technical one, and thus is not directing countries what to do other that spend their money well on scientifically sound interventions.

Other donors work together with national malaria control programs and their partners to develop country specific and relevant operational plans. Donors do encourage countries to implement scientifically proven guidance that is developed by international technical committees whose members include scientists from endemic countries.

The points above could create unfortunate misunderstandings by the public (about insecticides), professionals (about treatment) and policy makers (about donor support). The media should foster appropriate and timely action against malaria, not confuse the public.

Health Literacy as a component of primary care in Ante-natal and Pediatric clinics in Northern Nigeria

This guest blog is re-posted from the course blog for Social and Behavioral Foundations of Primary Health Care. The lesson about health literacy pertains as much to malaria as it does to cholera and handwashing. We thank Elohor Okpeva for sharing these experiences.

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Source: Jimmy Nyambok/USAID

In September 2011, there was a cholera epidemic across several States in Northern Nigeria, notably Yobe and Borno States. The Federal and State health Ministries were certainly overwhelmed and ill-equipped to handle the challenge. Repeated outbreaks of preventable diseases are not uncommon.

The Centers for Disease Control and Prevention (CDC) describe cholera as a disease caused by the bacteria vibrio cholerae, rare in industrialized nations, yet on the increase in many other places including Africa. It is a life threatening disease but easily preventable.

As a nation, Nigeria pledged to fulfill the indices of the MDGs. The fourth index of the MDG elaborated in the child survival strategies lists health education as its component. Locally, the Federal Ministry of Health also developed the National health promotion policy.

Following the cholera outbreak of September 2011, an informal health education session in the pediatric clinic at the Umaru Shehu Ultramodern Hospital (Maiduguri, Nigeria) with focus on hygiene was undertaken by a corps’ Doctor. The women listened with rapt attention, often accompanied by incredible nods, as they were told the benefits and impacts of hand washing in curtailing the disease. It was an unfamiliar message.

The Nation’s leaders, health team and key affiliates must recognize the crucial role of health education in general public health. The maintenance of a healthy status begins with prevention and not clinical treatment. The advantages of disease prevention and consequent reduction in morbidity and mortality cannot be over-emphasized.

Promoting Education Promotes Malaria Control

Millennium Development Goal Number Two focuses on Universal Primary Education for all girls and boys by 2015.  BBC informs us that “The global figure for the number of children without access to schools has fallen to 57 million, according to the United Nations Educational, Scientific and Cultural Organization,” a fall from an estimate of 61 million missing school in 2010. Unfortunately the improvement is unlikely to be enough to meet the MDG pledge.

The BBC further notes that, “More than half of the children missing out on school are now in sub-Saharan Africa. The last annual report showed that in some countries, including Nigeria, the problem is getting worse rather than better.”

What does education have to do with the elimination of malaria?  We can look at the Malaria Indicator Survey (MIS 2012) from Nigeria to get some ideas.  The attached chart shows that several important maternal health variables are linked with improved educational levels.  It is not that education per se makes women more aware and take action, but education opens their lives and minds to the possibilities of better health and development.

education-level-prevention-of-malaria-in-pregnancy-sm.jpgThe chart shows that women with higher education report greater exposure to malaria messages in the media.  It is not a simple matter of understanding, since many media programs are in local languages. We are talking about being more attuned to health messages in the available media because of improved education.

Life saving behaviors like attending antenatal care (ANC) and getting services offered there, like intermittent preventive treatment (IPT) for malaria, are enhanced by education.  Interestingly the MIS shows an opposite trend for sleeping under insecticide treated bednets among all women of reproductive age:

  • 42% with no education
  • 22% with primary education
  • 17% with secondary education
  • 17% with post-secondary education

This may appear odd until one realizes that campaigns to distribute ITNs intentionally or not address equity issues, reaching less educated (and poorer) households.  More educated and possibly more wealthy households are more likely to have window screening and other aspects of house construction (ceilings) that help keep out mosquitoes.

One wonders then if community campaigns are successful in reversing the education gap in ITN access and use whether such approaches should be used with IPTp.  In fact we have successfully shown that community health volunteers, under the guidance of ANC staff are able to reach poor rural communities and increase IPTp coverage.

Increased access to education will enhance uptake of health interventions. In the meantime we can make every effort to bring these interventions closer to the communities through their own efforts.