Chapter 13 – Synthesizing Perspectives: Case Studies for Action

Lecturer PowerPoint
Lecturer Lesson Plan
Strategies for Tackling Malaria
Strategies for Tackling Cervical Cancer
3 Papers
3 Websites
3 Media Articles

Strategies for Tackling Malaria

‘Effective control of malaria depends on both curative and preventive measures.’ (Walley, Webber & Collins, 2010:12)

Strategies for tackling malaria involve a range of different activities and interventions at a range of different levels, as illustrated by the discussion of the case study within the chapter itself. These include the following:

• Strategies to increase ITN use
• Strategies to improve maternal and child nutrition in order to improve recovery from infection
• Education (at individual level right through to policymakers)
• Strategies to reduce vector breeding sites
• Access to healthcare once infection has taken place (or suspicion of)
• Social marketing

There are many non-governmental organizations and charities working to tackle malaria as well as in-country, cross-country, regional and global strategizing. What follows here are some examples of different strategies to combat malaria. You can use the live links to find out further information about what is effective and what the evidence is for what works.

UK-based charity – Malaria No More (UK)
Among other things, the charity Malaria No More (UK) cites the link between malaria and poverty, noting that malaria is both a cause of poverty and a consequence (in that sick – infected/ill – people cannot work).

The strategies used by Malaria No More (UK) focus on a combination of approaches, including promoting the use of mosquito nets, testing for malaria for early treatment and providing medicine. In addition, they are supporting research and technological innovation in combating malaria, including the potential development of an effective vaccine.

The website for Malaria No More provides a quote from the Senegalese president Abdoulaye Wade who says that ‘in order to be successful, the fight against malaria must be a comprehensive one which includes giving families and individuals insecticide-treated bed nets to sleep under, taking steps to kill mosquitos where they breed and when they enter houses to feed at night, and making anti-malarial drugs more widely available. At the same time, we must continue the search for a vaccine…’. This quote effectively summarizes what the key issues are and what needs to be done, highlighting the need for a range of simultaneous actions.

Africa Fighting Malaria
Among other things, this website raises the issue of the challenges faced by increased resistance to insecticides and, subsequently, to vector control. It states that new classes of insecticides are needed but that, importantly, this requires political will and also a commitment to funding.

Africa Fighting Malaria advocates for access to proper diagnosis for people infected with malaria and for effective treatment with safe medicines. They highlight the problems which exist with counterfeit (falsified) drugs in some countries.

Without exception, all of the charities and organizations working to combat malaria state that the lack of funding is the key issue. Compared to other public health issues (such as HIV/AIDS), the money put into efforts to combat malaria is considerably less. The reasons for this are complex and political.

Roll Back Malaria: Partnership to end malaria
As cited on the website, the Roll Back Malaria campaign has been one of the most significant, on a global level, of recent years. This is a ‘Global Partnership for a Malaria-Free World’, hosted by the World Health Organization.

Roll Back Malaria consists of a number of different types of strategy aimed at vector control, policy development, monitoring and evaluation, as well as case management. For more information you can visit the website. It is specifically worth looking at the RBM Toolbox to get a better idea of what kind of things are being done to combat malaria.

Strategies for Tackling Cervical Cancer

Towards the elimination of cervical cancer (WHO, 2016)
This background paper states that cervical cancer is a preventable public health and development challenge. It outlines a comprehensive strategy for eliminating cervical cancer and how sustainable national responses can be realized.

Black, E., Hyslop, F. and Richmond, R. (2019) Barriers and facilitators to uptake of cervical cancer screening among women in Uganda: a systematic review. BMC Women’s Health, 19 doi: 10.1186/s12905-019-0809-z.
This systemic review evaluates the barriers and facilitators for Ugandan women accessing cervical cancer and argues that understanding these can guide efforts to increasing screening rates.

Murfin, J., Irvine, F., Meechan-Rogers, R. and Swift, A. (2019) Education, income and occupation and their influence on the uptake of cervical cancer prevention strategies: A systematic review. Journal of Clinical Nursing
A systematic review exploring how education, income and occupation influence the uptake of cervical screening and HPV vaccination in five developed countries. It concludes that education and income have an association with uptake and recommends that interventions to promote cervical cancer prevention strategies should be targeted at women and girls with lower education levels and lower income.

Media articles about Rwanda’s fight against cervical cancer
Rwanda and Unitaid to collaborate on health innovation including screen-and-treat-tools to prevent cervical cancer.

How Rwanda could be the first country to wipe out cervical cancer

3 Papers

Baum, F. (2007) ‘Cracking the nut of health equity: top-down and bottom-up pressure for action on the social determinants of health’. IUHPE – Promotion and Education XIV, 2, pp. 90-95. LINK
This paper looks at the factors that are necessary to encourage governments to adopt policies that can tackle the social determinants of health. Baum argues that governments need to commit to tackling social determinants which involves more than just trying to change behaviour at the individual level. She sees advocacy as an important part of this process, as well as social capital, particularly linking capital.

Raphael, D., Curry-Stevens, A. and Bryant, T. (2008) ‘Barriers to addressing the social determinants of health: Insights from the Canadian experience’. Health Policy, 88, pp. 222-225. LINK
This paper examines the Canadian approach to addressing the social determinants of health, arguing that it is inadequate and exploring the reasons why this is the case. A variety of barriers are reported and a number of policy models highlighted as potential approaches to overcome the barriers.

Wolff, J. (2011) ‘How should governments respond to the social determinants of health?’ Preventative Medicine, 53, pp. 253-255. LINK
This paper highlights the social determinants of health as a key focus within both national and international policy discussions and argues that action related to them falls outside the remit of ministries of health. To address the social determinants of health, the author suggests that ministries of health should use some of their budgets to encourage other governmental departments to develop initiatives.

3 Websites

1. Insight into Inequality
A series of videos offering a contemporary look into BAME people’s lives and health concerns within the West Yorkshire and Harrogate District of the UK.

2. The Life Scientific
A 30-minute radio programme discussing the work of Professor Michael Marmot, who argues that to really understand disease you have to look at the society people live in. His major scientific discovery came from following the health of British civil servants over many years. His Whitehall studies revealed that it is tougher for those lower down the pecking order within a work context. Put simply, the lower your status at work, the shorter your lifespan. This social gradient of health, or what he calls Status Syndrome, is a global phenomenon.

3. WHO – Social determinants of health report and other related resources
This website contains the final report from the WHO Commission on the social determinants of health. You can download the full report, or the executive summary, to read more about the need for health equity across the world. In addition, there are videos of the launch event, press-releases and interviews related to the report.

3 Media Articles

1. Social factors key to ill health
News report highlighting research findings from the work of WHO around the social determinants of health. Summarizing the research findings and the areas where action is required, this is a summary of the work from the Commission on the Social Determinants of Health.

2. Healthy lifestyle role ‘for all society’
The UK government’s latest plans for public health involve tapping into all aspects of society as part of efforts to improve health. This report discusses the roles that schools, industry and local authorities can potentially have in improving health and how there will now be a protected public health budget.

3. Less educated will age faster
This news report discusses findings from an academic study into the effects of education which suggests that people holding fewer qualifications are prone to age more quickly. The article discusses social influences upon health, including the importance of early life and education.