Executive summary
It is evident that Malaria remains to be one of the main issues affecting children in Sierra Leone. Essentially, the high child mortality rate resulting from Malaria infections in Sierra Leone has become a critical concern. This position has been reiterated by the National Health Sector Strategic Plan. The organization revealed that Malaria has become both a health, social and economic challenge to the country. In essence, it has been identified that the disease is the primary causative agent of children deaths in the nation. Although there are other diseases that account for children deaths, Malaria still remains a major cause of morbidity and deaths in the country.
The United Nation Development Programme (UNDP) reports that Sierra Leone is a nation in which 68% of its population lives below the poverty line. Data collected from Gap minder World shows that the mortality of children within the 0 to 5-years age bracket is at 133 deaths per 1000 newborns (Gapminder 2013). A similar research was conducted in 2008 by World Health Organization indicating that 195 children died for every 100 newborns (World Health Organization 2008). In addition, WHO noted in 2007 that Malaria accounts for 48% of the outpatient attendances (World Health Organization 2007). Among these patients, 25% comprised of children whose age was less than five years. In 2010, it was noted that the disease accounted for 41% of children mortality. In 2014, the World Health Organization articulated that 38% of the deaths were as a result of Malaria. In the same light, the most vulnerable were children below the age of 5.
Further, the country’s service availability assessment revealed that only 26% of children below 5 slept under insecticide nets, it further expounded that only 15% of the infected children took anti-malarial medicine within 24 hours of infection. It is therefore imperative to put in place health promotion activities which help curb the disease. One of the promotion initiatives is to employ measures which will work towards preventing and controlling the disease. Health promotion programs such as maintaining a clean environment and a strong health system will help in eradicating the problem.
Section One: Description of Health Issue and Statistics
1.1 Introductory Statements
Malaria has become a critical health concern in Sierra Leone since it accounts for most deaths in the country. Considerably, children have been immensely affected because the large number of deaths resulting from Malaria consists mainly of children deaths. The malarial prevalence among children reached its peak in 2009. In this particular year, one child died after every half an hour. This is an indication that the disease had reached devastating levels of prevalence. As such, this section sheds light on the actual challenges and problems surrounding the disease while presenting crucial statistics.
1.2 Crucial Statistics
In 2014, Malaria infection contributed to 35% of child mortality rate. In addition, it accounted for 25% of deaths that occurred in other age brackets. Notably, the most affected individuals are children aged below five years and pregnant women. In the same regard, the World Health Organization presented an analysis in 2014 which showed that malaria contributed to 38 % of the total deaths within that year. Among these deaths, the organization discovered that the majority were children. The assessment conducted in 2011 by Sierra Leone Service Availability articulated that 24% of children below five years contacted Malaria two weeks before the data analysis. This was an indication that the disease was still live and in effect. The report also indicated that only 15% of the children with the fever took anti-malarial drugs within one day of signs symptoms detection. Essentially, this data as analyzed in 2011 is very crucial because it makes a fundamental comparison between different age brackets showing that Malaria is more problematic to children as compared to adults. Further, it compares Malaria with other diseases. In particular, based on that analysis, it compares Malaria with Anemia, RTI, and Diarrhea. From the graph below it is clear that among the five diseases analyzed, Malaria accounts for the highest percentage of children mortality rates. Figure 1 is a graphical representation of different diseases, including Malaria, RTI, Anemia, and Diarrhea against the percentage of deaths caused by the respective diseases.
Whereas the prevalence of this disease is a problem that should be curbed, the availability of data is yet another challenge in this case (Merson et al, 2012). It cannot be disputed that the data available in regard to Malaria infections and deaths is not detailed. In perspective, additional data concerning the number of children who succumb due to malaria peril should be presented. Such data should include weekly and gender analysis so as to provide a more specified understanding on the issue. Moreover, there is no clear distinction of data concerning the rural and urban areas. Understandably, the experiences of people living in urban and rural areas are different due to the accessibility of resources and exposure to information. It is, therefore, undisputable that the data should be presented in different categorizations such as gender and residence. This is actually affirmed by the fact that malaria is caused by factors that are influenced by locality. In addition, such data would help in identifying the areas which are more affected than others. Besides data unavailability, it must be remembered that, whereas this paper focuses on the malarial infection among, the entire population is at risk of contracting the disease. Yet, the disease is known to cause fatal effects of the health of human beings. For instance, in the long term, the disease is known leads to severe anemia.
Now, the prevalence of Malaria and the extent to which it causes deaths also prompts a different discussion on the state of the country holistically. Evidently, these worrying statistics are partly as a result of the poverty striking the country (Lee 2007). The country undergoes a challenge when it comes to providing clean water and draining dirty stagnant waters that act as breeding grounds for the mosquitoes. Most people lack the resources which may shield them from the disease such as the treated mosquito nets and mosquito repellents (Nets for Life 2011). Further, the political instability in the country is also a contributing factor to the poor health situation in the country. For many decades, the country has undergone a series of wars locally. This has contributed to underdevelopment and less concern for creating a good healthcare system.
2.0 Section two: Health Promotion Activities
2.1 Introductory Statements
The alarming malarial condition in Sierra Leone requires quick and effective initiatives promote health, prevent morbidity, and reduce mortality. Primarily, these initiatives will be aimed to control the main causative agent of Malaria. Essentially, the pursuit to prevent and control the disease must be based on sound and scientific models that have been proven and tested (Perlmann & Troye-Blomberg 2002; Bloland, & Williams 2003). These interventions must touch on social, political, and economic aspects of the target population (Greene & Danubio 1997). In addition to this, the disease control interventions must be considerate of the cultural orientations of the people (Carneiro 2012; Selendy 2011)). Such a holistic interventional approach ensures that these interventions are sustainable and effective over a long period of time (Guttmacher, Kelly, & Ruiz-Janecko 2010). According to the analysis of the problem presented in section one, the following are some of initiatives that can be implemented to curb malaria in Sierra Leone.
Summary point form summary;
Environmental cleanup
Improving the living conditions
Stipulate an Instant Malarial Response Program around the Country
Creating awareness through mass education and communication
Improving the People’s Lifestyle
2.2 Policy based Environmental Clean Up
The main causative agent of malaria is related to the level of environment cleanliness (Whitehead, 1992). In particular, the malaria causing mosquitoes breed in stagnant water and other dirty places in the environment as far as they are wet (Person 2011); Aregawi et al. 2011). This is an indication that Sierra Leone should come up with a procedural and well planned cleanup program that helps to reduce the stagnant water especially in residential areas. Essentially, this initiative is based on the behavioral change model which targets to transform the manner in which people live. As such, starting an initiative to clean up the environment is a fundamentally vital undertaking because it encourages the community to take care of their surroundings with an aim to prevent continued infections (Packard 2007; Selendy 2011). This is based on the fact that most of the places are surrounded by stagnant water.
2.3 Improving the Living Conditions
The government should work to improve the access of welfare services such as proper sanitation, public amenities, and clean water (Whitehead, 1992). It was evident that most people in Sierra Leone live below the poverty line. As such, they are not in a position to afford important requirements such mosquito repellents and nets. As a result, the country should also come up with initiatives that will work towards supplying the repellents and the nets to those people who cannot access them. In addition, parents also have a crucial role to play when it comes to the improvement of children’s living conditions (Dinho 2009). In this regard, it is upon the parent to ensure that the necessary preventative measures are put in place in case they can afford. In particular, parents should ensure that children sleep under mosquito nets. This measure can help decrease mortality rate significantly. Evidently, this initiative is based on the empowerment approach because it seeks to provide access to preventative materials especially to those who cannot afford.
2.4 Stipulate an Instant Malarial Response Program around the Country
It was evident that a section of children who died as a result of malaria infection did not access medication within 24 hours of infection. As such, the authorities of Sierra Leone should design a quick response program where parents can report any signs that might indicate malarial infection. The response program will enable healthcare professionals to communicate directly with the patient and give directions on what the parent should do (Long 2006). Importantly, the communication would inform the parent or guardian about the nearest hospital where they should seek assistance.
2.5 Creating awareness through mass education and communication
Creating awareness is one of the most effective ways of promoting health, preventing morbidity, and subsequent mortality (Naidoo & Wills, 2000). In this case, the reason as to why most of the infected children die can be attributed to the parents’ lack of specific information on how to respond once the symptoms are detected (Fung 2010). It was indicated in section one that there is a significant percentage of infected children who are unable to access doctor’s attention within 24 hours of symptoms detection. Evidently, creating awareness within the public is actually based on the education approach (Cooper, & Mulvey 2012). In principle, education approach is aimed to instill the necessary skills required to prevent and contain the disease.
2.6 Changing the People’s Lifestyle
Individual lifestyle factors are also very crucial when it comes to the improvement of general health status of the public and the inherent mortality among children. These include nutrition and physical fitness (Whitehead, 1992). In this case, malnutrition has been identified as a major factor that contributes to child mortality rate Sierra Leone and other developing countries (Carew 2005; Mihrshahi 2007). Many cases have been attributed to poor diet among young children (Campbell & Pierce 2004). In this regard, severe malnutrition can put the infants at a high risk of contracting malaria since their immunity is weak. As a result, it is imperative that the children be fed with a rich diet so as to strengthen their immunity. The government of Sierra Leone should supply the poor with food and empower them to make their livelihood sustainable especially when it comes to feeding. In addition to this, the awareness program above should ensure that members of the community are equipped with the needed knowledge on good feeding.
3.0 Expounding on the Various Models
3.1 Social Change Model
The theory focuses on the social inequalities that are based class, gender and ethnic origin (Upton 2010). The model involves the use of political inputs to make changes in the social circles. This model is evident in the initiative concerning the improvement of people’s living conditions. It is evident in the sense that the government should ensure that the healthcare facilities are distributed equally in the process of such empowerment programs.
3.2 Behavioral Change Approach
In the approach, it is evident that people are responsible for their own well-being (Bunton & Macdonald 2002). The objective of the approach is to change the attitudes, conducts, and the beliefs of individuals. In this paper, it is evidently utilized in the initiative where healthy lifestyle and nutrition is recommended. Indeed, this is an initiative where citizens are encouraged to change their feeding behaviors. As such, children would strengthen their immunities due to such measures. Expectedly, children malnutrition is capable of impacting their health negatively.
3.3 Medical Approach
The medical approach is also used in light of making the recommendations in this research. The approach indicates that, in order to improve health, people should have access to healthcare services (Scriven & Orme 2001). These services include drugs and consultancy services given to patients. In this case, the clients are assisted by the experts over a considerable amount of time until the situation improves. On the other hand, the patient is expected to comply with the medical prescriptions and directions
3.4 Empowerment Approach
The main objective of this approach is to increase individual’s capability to accomplish an undertaking (Lucas & Lloyd 2005). In this case, the experts provide useful information to patients and general public on how to combat the health problem at hand. In this paper, a recommendation was made to the effect that healthcare professionals and government should work to empower the public with skills and finances
4.0 Conclusion
In light of the above discussion, it cannot be disputed that this disease is the main causative agent of child mortality in Sierra Leone. Following the statistics obtained from various surveys, it is clear that the high death rates in Sierra Leone are as a result of Malaria infections. Environmental conditions such as the existence of stagnant water form part of the malarial risk factors. In addition, poverty has also aggravated the malarial prevalence in Sierra Leone. In this regard, most people in the country are not in a position of affording mosquito repellents and nets. As a result, it is important for the authorities to support the parents with the required facilities so as to prevent the spread of the disease. Education programs and change in lifestyle should also be used as tools of improvement as far as malaria control is concerned.
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