Question

You will have to write a paper focusing on health disparities and interventions in a population outside of the United States. Choose any of the issues or diseases (or make your own up!) from the list below that are considered global public health problems.

TB

Malaria

HIV/AIDS

Access to water

Water quality

Air pollution

Ebola

Sanitation

Cholera

Climate change

Healthcare

In your introduction, briefly describe your issue or topic. Also, provide epidemiological information on the following: morbidity and mortality among the specific group, community, or country. Next section will be your methods, in which you describe keywords and how you conducted your literature review. Then, in your discussion section, discuss at least three interventions published in the scholarly literature to address the crisis in a country of your choice. Evaluate the progress and outcomes of such prevention programs. Describe the intervention (e.g. target audience, experimental/control group, intervention methods and materials, intervention outcomes) Assess the methods used in the intervention (e.g. level of the intervention, strengths and weaknesses of the intervention, potential impact/generalizability of the intervention). Conclusion offers a good wrap-up of everything discussed wherein!

E.g. Access to water in Kenya. Approximately 11% of the world’s population does not have access to safe or affordable drinking water; unfortunately, 46% of the population continues to have inadequate access to quality water in Kenya. Some interventions addressing this issue include: water kiosks, household water pumps, rock catchments, and boreholes. One program was implemented in Nairobi, Kenya …. It was successful because… Another program was implemented in Kitui, Kenya… It was unsuccessful because

Answer 1

Consequences of EBOLA on Health:

• Ebola is a rare but deadly virus that causes fever, body aches, and diarrhea, and sometimes bleeding inside and outside the body. As the virus spreads through the body, it damages the immune system and organs. Ultimately, it causes levels of blood-clotting cells to drop. This leads to severe, uncontrollable bleeding.The disease was known as Ebola hemorrhagic fever but is now referred to as Ebola virus.
• It kills up to 90% of people who are infected.
• The outbreak of Ebola is a significant shock to the health systems and can lead to fear and mistrust of the health services, the closure of health facilities, and the deaths of health service staff. During the outbreak, health workers were 20- 30 times more likely to be infected with Ebola than the general adult population.
• Overall decrease in healthcare utilization, especially in regards to maternal delivery care, malaria treatments, and vaccinations.
• It greatly affects maternal and child health.
• Increase in mortality and morbidity rates.

Economic consequences:

• The economic impact of the Ebola crisis includes loss of gross domestic output, threat to food security, fall in employment and livelihoods, and decline in foreign investment.
• Fall in Household income, financial reserves are being used up and large numbers of people can experience food insecurity.
• The Ebola can affect the macroeconomic activity and budgetary resources results in negative consequences for the livelihood and food security of the population due to slow economic growth as a result of disruptions to activities in agriculture, mining, construction, manufacturing, trade, tourism and transport.
• There can be a drop in sales in the manufacturing and construction sectors which in turn causes a drop in economy and sources of capital investment and foreign spending . This drop can result in increasing unemployment.
• The government and donors will divert financing for different sectors to combat Ebola. This will create a critical funding gap for non-Ebola related government services.
• Rural and urban households experience significant declines in income from most sources, including agricultural labour, petty trade, and the sale of forestry products, bush meat, and crops as a result of the effects of a general economic slowdown and major market disruptions.

Social consequence:

• Progress in human development is likely to be reversed due to the impact of the Ebola crisis on health, education and standard of living.
• There will be increase in unemployment due to drop in econo mic system.
• An increase in mortality and morbidity rate due to malnutrition as there will be food scarcity.
• Those affected by Ebola or working to combat it (such as healthcare workers and burial teams) face stigmatisation. Social cohesion is also weakened by ‘do not touch’ policies.
• Women and children are particularly affected by the crisis.
• Children don't attend school due to school closures, which means loss of education and increased risks of drop-out, teen pregnancy and child labour, crime rates.
• There will be Health systems collapse and non-Ebola related mortality increases.

WHO immediately mobilized its collaborating laboratory in Lyon, France, together with West African laboratories located in Donka, Guinea, Dakar, Senegal, and Kenema, Sierra Leone, to prepare for the diagnosis of more cases. MSF, which had a well-established presence in the region, rapidly set up isolation facilities.

The first team drawn from institutional partners in the WHO Global Outbreak Alert and Response Network, or GOARN, travelled to Guinea on 28 March. The team was headed by a senior WHO field epidemiologist. As a reporter covering early events in Guinea for Vanity Fair later noted, the international response was “rapid and comprehensive – exactly what you would hope.”

Findings from the investigation were reported on 8 April during a Geneva press conference, where WHO officials alerted reporters to “one of the most challenging Ebola outbreaks that we have ever faced”. The challenges observed included the wide geographical dispersion of cases in both Guinea and Liberia, cases in the capital city, Conakry, and a high level of public fear, anxiety, rumours, and misperceptions.

WHO convened a special ministerial meeting about the outbreak of EVD. The meeting was held on 2-3 July 2014 in Accra, Ghana. “It brought together ministers of health and senior health officials from 11 African countries as well as response partners, Ebola survivors, representatives of airlines and mining companies, and the donor communities." The outcome of this meeting was the WHO’s Ebola Virus Disease EVD) Outbreak Response Plan in West Africa (“the Plan”).

Its overriding objectives were to:

• “Stop transmission of EVD in the affected countries through scaling up effective, evidence-based outbreak control measures.
• “Prevent the spread of EVD to the neighbouring at-risk countries through strengthening epidemic preparedness and response measures."

Clear Objectives
The objectives were clearly defined and maintained throughout the life of the Plan: to stop transmission of EVD in the affected countries and prevent its spread to other countries, particularly neighbouring nations in West Africa.

Stakeholder Engagement
The main stakeholders were the WHO, the UN and the most affected nations – Guinea, Liberia and Sierra Leone. There were other NGO stakeholders, including medical NGOs, such as the Centers for Disease Control and prevention (CDC) and Médecins Sans Frontières [Doctors Without Borders] (MSF), financial NGOs such as the World Bank, and aid organisations such as the Tony Blair Africa Governance Initiative (AGI). All the stakeholders shared a common interest: eradicating EVD.

Evidence
The Plan developed by the WHO was based upon the collective experience it had gained in response to similar epidemics: “SARS, pandemic influenza A(H1N1), and Middle East respiratory syndrome coronavirus (MERS-CoV) The activities set out in this plan are based on the ERF grading system." The health NGOs had also learned lessons from the various outbreaks of Ebola Haemorrhagic Fever in Africa during the 2000s, especially in the Democratic Republic of the Congo and Uganda.

Feasibility
The financial feasibility of the Plan, as well as the economic recovery plans for the three countries most affected, were addressed by the relevant NGOs. The World Bank’s response was to mobilise funding from the International Development Alliance (IDA) and the International Finance Corporation (IFC): “the World Bank Group has mobilised nearly US$1 billion in financing for the countries hardest hit by the Ebola crisis. This includes US$518 million from IDA for the epidemic response, and at least US$450 million from IFC, a member of the World Bank Group, to enable trade, investment, and employment in Guinea, Liberia, and Sierra Leone.” The feasibility of the health-based response was based on the fact that it was based on previous initiatives and the knowledge and experience of the national ministries of health and the health NGOs.

Management
The WHO has a sound management structure with three levels of organisation: headquarters and regional and national offices. There was also a sub-regional operations coordinating center to streamline the efforts of the WHO: the Sub-regional Operations Coordinating Center (SEOCC) located in Conakry, Guinea. The SEOCC was the main operations hub for West Africa and served as a coordinating platform bringing together WHO and its partners to consolidate, harmonise, and streamline the technical support to affected countries. “The WHO and the Regional Office for Africa will coordinate international and regional deployments and activities, respectively, and will provide surge capacity to the SEOCC." Each of the countries managed the Ebola response through a national task force or committee.

Measurement
The WHO published regular weekly updates of the progress of EVD. The parameters were principally: Total Cases (Suspected, Probable, and Confirmed); Laboratory-Confirmed Cases; and Deaths. “The Ebola response is made up of different activities like contact tracing; identifying and monitoring people who have been in contact with those who have Ebola, and burials; ensuring that everyone is buried safely, quickly and in line with cultural and religious practices."

Alignment
Apart from the initial delay in taking action, the main actors collaborated to eradicate the epidemic. The WHO also partnered with agencies like UNICEF, CDC and MSF to provide clinical and public health interventions. The WHO also provided technical, normative, material and operational support to the relevant ministries of the three main affected nations. “In accordance with the International Health Regulations (IHR 2005), the Ministries of Health of Guinea, Liberia, and Sierra Leone, together with WHO and other partners, are implementing a coordinated response to the outbreak." The IDA and the IFC cooperated with the World Bank to fund the medical response and support the economies of the three countries mainly affected, which suffered significant downturns in economic activity as a result of EVD