Health: Communicable and poverty-related diseases
By Fonju Ndemesah
Communicable and other poverty-related diseases remain the leading causes of morbidity and mortality in Africa; the major ones being HIV/AIDS, malaria and tuberculosis (TB). We learnt that in the last decade the prevalence of malaria has continued to escalate worldwide at an alarming rate, especially in Africa. An estimated 300-500 million cases each year cause 1.5 to 2.7 million deaths; more than 90% of the deaths are in children under 5 years of age in Africa. Malaria ranks third among major infectious diseases in Africa after pneumococcal acute respiratory infections and tuberculosis. In children under the age of five years, the leading causes of death are malaria, acute respiratory and diarrheal diseases. About 60% of the world’s HIV/AIDS victims live in Sub-Saharan Africa, where about 80% of the transmission is through heterosexual contact. The most affected persons are those who are most productive economically and in the age group 20-40 years old. HIV/AIDS has had a devastating effect in Africa by leaving millions of orphans to fend for themselves. Deaths worldwide from HIV/AIDS are expected to rise from 2.2 million in 2008 to a maximum of 2.4 million in 2012 before declining to 1.2 million in 2030.
Information for better health
Adequate communication is a requisite in the provision of better health. Not only do health workers need to understand the current disease patterns in order for them to design proper interventions, but also policy makers need to set appropriate guidelines for resource mobilization.
Various studies have argued that “choosing a healthy lifestyle, knowing how to seek medical care, and taking advantage of preventive measures require that people understand and use health information. This promotes the need of health literacy programmes on the use of preventive services. Research studies have shown that persons with limited health literacy skills are more likely to skip important preventive measures, more likely to have chronic conditions and less able to manage them effectively. They are also associated with increase in preventable hospital visits and admissions”.
Health inequality is a serious problem in many parts of Africa. Most often the poor and vulnerable section of the population in many parts of the continent have the least access to information, communication technologies, health care, and supporting services. Many health projects in Africa have focused on the clinical side of the disease prevention and care. This narrow strategy of prevention and care has produced very little result.
Capacity building in health research most often ends at informing the clinicians in the strictly medical components of prevention and care, forgetting or most often putting in the second level social aspects that lead to poor health behaviors. Many studies have shown that lack of health literacy leads to poor health behavior and a bad use of the available services and resources.
Social determinants of Health
The Algiers Declaration recommends expanding the health research agenda to include broad multidimensional determinants of health; today, there is a growing consciousness that many key health issues at the local, regional and national level cannot be solved only by the traditional biomedical approach. New research clearly shows that the most important determinant of good health or ill health is the condition in which a person is born, lives, works and ages (Final Report of the WHO Commission on the Social Determinants of Health, 2008). For example, heart disease is associated with the well-known risk factors (high cholesterol and sugar levels, high blood pressure, overweight, etc), but it is also favored by unhealthy lifestyles, which are shaped by the environment in which people live. Furthermore, social and economic conditions, such as poverty, education and poor housing, strongly influence health. They contribute to inequities in health, and explain why people living in poverty get sick more often and die sooner than those living in more privileged conditions.
Hence, there is an urgent need to focus on the upstream causes of ill-health, and to tackle the social and economic determinants of communicable and non-communicable diseases. Health professionals and especially young researchers should enhance their knowledge on modifiable risk factors, learn how to collect, evaluate and analyze these determinants (in addition to the conventional biological markers) and start including them in clinical trials. Health workers and researchers are also asked to play an important role in health education in order to reduce cultural barriers or misconceptions about both communicable and non-communicable diseases, to enhance awareness of individuals on the benefits of healthy lifestyles, and to foster demand and/or support of health services. Addressing the social determinants of health would also reduce health inequities, thus improving daily living conditions and providing a more equitable distribution of resources.
Communicable and other poverty-related diseases remain the leading causes of morbidity and mortality in Africa; the major ones being HIV/AIDS, malaria and tuberculosis (TB). We learnt that in the last decade the prevalence of malaria has continued to escalate worldwide at an alarming rate, especially in Africa. An estimated 300-500 million cases each year cause 1.5 to 2.7 million deaths; more than 90% of the deaths are in children under 5 years of age in Africa. Malaria ranks third among major infectious diseases in Africa after pneumococcal acute respiratory infections and tuberculosis. In children under the age of five years, the leading causes of death are malaria, acute respiratory and diarrheal diseases. About 60% of the world’s HIV/AIDS victims live in Sub-Saharan Africa, where about 80% of the transmission is through heterosexual contact. The most affected persons are those who are most productive economically and in the age group 20-40 years old. HIV/AIDS has had a devastating effect in Africa by leaving millions of orphans to fend for themselves. Deaths worldwide from HIV/AIDS are expected to rise from 2.2 million in 2008 to a maximum of 2.4 million in 2012 before declining to 1.2 million in 2030.
Information for better health
Adequate communication is a requisite in the provision of better health. Not only do health workers need to understand the current disease patterns in order for them to design proper interventions, but also policy makers need to set appropriate guidelines for resource mobilization.
Various studies have argued that “choosing a healthy lifestyle, knowing how to seek medical care, and taking advantage of preventive measures require that people understand and use health information. This promotes the need of health literacy programmes on the use of preventive services. Research studies have shown that persons with limited health literacy skills are more likely to skip important preventive measures, more likely to have chronic conditions and less able to manage them effectively. They are also associated with increase in preventable hospital visits and admissions”.
Health inequality is a serious problem in many parts of Africa. Most often the poor and vulnerable section of the population in many parts of the continent have the least access to information, communication technologies, health care, and supporting services. Many health projects in Africa have focused on the clinical side of the disease prevention and care. This narrow strategy of prevention and care has produced very little result.
Capacity building in health research most often ends at informing the clinicians in the strictly medical components of prevention and care, forgetting or most often putting in the second level social aspects that lead to poor health behaviors. Many studies have shown that lack of health literacy leads to poor health behavior and a bad use of the available services and resources.
Social determinants of Health
The Algiers Declaration recommends expanding the health research agenda to include broad multidimensional determinants of health; today, there is a growing consciousness that many key health issues at the local, regional and national level cannot be solved only by the traditional biomedical approach. New research clearly shows that the most important determinant of good health or ill health is the condition in which a person is born, lives, works and ages (Final Report of the WHO Commission on the Social Determinants of Health, 2008). For example, heart disease is associated with the well-known risk factors (high cholesterol and sugar levels, high blood pressure, overweight, etc), but it is also favored by unhealthy lifestyles, which are shaped by the environment in which people live. Furthermore, social and economic conditions, such as poverty, education and poor housing, strongly influence health. They contribute to inequities in health, and explain why people living in poverty get sick more often and die sooner than those living in more privileged conditions.
Hence, there is an urgent need to focus on the upstream causes of ill-health, and to tackle the social and economic determinants of communicable and non-communicable diseases. Health professionals and especially young researchers should enhance their knowledge on modifiable risk factors, learn how to collect, evaluate and analyze these determinants (in addition to the conventional biological markers) and start including them in clinical trials. Health workers and researchers are also asked to play an important role in health education in order to reduce cultural barriers or misconceptions about both communicable and non-communicable diseases, to enhance awareness of individuals on the benefits of healthy lifestyles, and to foster demand and/or support of health services. Addressing the social determinants of health would also reduce health inequities, thus improving daily living conditions and providing a more equitable distribution of resources.