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Example research essay topic: African Countries Policy Makers - 1,162 words

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... n men and women. The threat from malaria is a global and not an African issue. One billion people are at risk from malaria and between 1 - 2 million deaths per year are due to malaria and 90 per cent of the deaths are in Africa.

Given the global warming and increased international travel, urban malaria is now a major public health problem in Africa and persons from developed countries who have no immunity are at great risk. On March 13, 1998 a new global initiative was announced by the new Director General of WHO, Dr Brunt land to Roll Back Malaria. The program aims at reducing malaria deaths (2. 7 million deaths per year) by 50 per cent by year 2010 primarily through control activities including rebuilding health care services. The Roll Back Malaria is initiative a new opportunity to the African region to control malaria but several issues need to be carefully considered in implementation of this new attack to avoid past mistakes which resulted to both insecticide and drug resistance. In the search for new insecticides it will be useful to explore the potentials of traditional herbs in use in the communities by local people as mosquitoes repellents (e. g local herb, Nchawu - which the Igbos of Nigeria burn to ward off mosquitoes).

Also, such local coping mechanisms, and or capacities should be explored. In the last two decades, it is estimated that 40 per cent of fevers are due to malaria (Brinkman and Brinkman, 1991), therefore, strategies for the control of malaria have shifted with a major focus on reducing mortality and morbidity with prompt and presumptive treatment of fever. There has also been increasing recognition that the success of any control strategy would depend on a number of factors including the behaviour of patients especially mothers and caretakers of young children, the need to understand treatment seeking behaviours (Oaks et al, 1991) the choice of treatment. Research studies have shown that women's choice and time of treatment are dependent on such factors as: b) access to health facilities; attitudes of providers, cultural beliefs about the cause and treatment of malaria. Self-medication is a common approach by people when they experience signs and symptoms of malaria. Given the high incidence of malaria in Africa, the lack of or near absence of laboratory facilities at peripheral levels for clinical (biomedical) diagnosis, malaria has remained a problematic issue.

Studies for a better understanding of the criteria used by women and village health workers in predicting malaria are highly desirable. Such studies, will afford experts insights into malaria transmission modes and have already been identified in Nigeria (Okonofua et al, 1992), Liberia (Jackson, 1985) and in Zimbabwe. The transmission of malaria is not, and should not be seen as a matter for only health professionals. Because women are the primary care takers control initiatives as the Roll Back Malaria should focus on and harness the benefits of participatory planning by involving women from the outset in the determination of the needs and priorities of malaria control, planning and implementing measures that are feasible and acceptable to improve health. The role women can play in malaria control partnership programme will be discussed later in this paper.

In order to establish sustainable control programmes, strong partnerships between local women's groups and health services is necessary. It must be recognized that as stake holders, the lead role must be shared by both in the control of malaria at least until Africa can boast of adequate number of trained health staff and availability of functional facilities at the peripheral levels. Presently, the acute lack of both staff and facility at the peripheral level underscores the need for the role of women in the home treatment of malaria and in control to be encouraged. In order to circumvent this anomaly, active involvement of communities, in particular, women's groups to the fullest extent possible, should be an integral part of policy in malaria control for every country in the subregion. Tuberculosis is the single biggest infectious killer in women. It kills nearly 2 - 3 million people yearly.

It is primarily a lung infection caused by inhalation of droplets containing tubercle bacilli of cough spray from tuberculosis patients. Mycobactarium tuberculosis and M. African are two predominant causative strains in Africa. In many Sub-Saharan African countries especially Central and East Africa, the incidence of TB has increased with the advent and increasing occurrence of human immunodeficiency virus (HIV) sero positivity.

In a number of these countries one in three people with HIV die from TB due to neglect, they also infect hundreds of HIV-negative persons with TB bacteria. Surprisingly, policy makers in most Sub-Saharan African countries are still unaware that TB is a great threat, that 95 per cent of the eight million new TB cases every year occur in developing countries, Africa with an incidence of 272 per 100, 000 population which is approximately a ten-fold incidence rate compared with an incidence rate of 27 per 100, 000 for European countries. Equally sad is the observation that many policy makers have continued to neglect TB despite current knowledge that untreated TB follows a rapidly fatal course in HIV infected persons - hence Chreiten (1990) reference to both diseases as "the cursed duet." The presence of Mycobacterium tuberculosis leads to accelerated replication of HIV; evidence that AIDS and TB accelerate each other has been documented (Pope et al, 1993). Worst still, in HIV sero-positive TB patients, because of poor health status, there is increase incidence of adverse reactions to available drugs and poor response to therapy compliance to TB therapy is as low as 30 - 45 per cent in Sub-Saharan Africa. According to WHO Global Tuberculosis Programme (GTP) recent reports over 900 million women are infected with TB world-wide and they are also at greater risk from HIV infection. Directly observed treatment short-course (DOTS) is the WHO/GTP recommended strategy for the detection and treatment of TB, a strategy described in the 1993 World Development Report, as one of the most cost-effective strategies.

In a collaborative TB control programme of the Ministry of Health in Guinea and the WHO, Guinea's TB cure rates using DOTs are today recorded as over 80 per cent. Because patient compliance is the most important determinant for success in the treatment of tuberculosis health sector initiatives must be designed to promote compliance by women. Given that stigma attached to Tuberculosis often leads to isolation and divorce of women health policies should emphasize on community directed programmes with inputs from different community groups, in a fashion acceptable within the specific cultural setting of the population. Partnership with women for health reform There is no gainsaying the fact that women play crucial roles both in family and society's health care. It is imperative that such roles remain focal points for health care reforms to ensure their full participation. Experience has shown however, that sustaining women's participation in health-related projects is difficult.

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