Informative Persuasive Paper
Comparing healthcare systems and health disparities helps implement effective interventions to manage/eradicate healthcare conditions. Different countries are affected differently by healthcare issues, and some nations must come to the aid of others in the interest of global health. Malaria is a life-threatening tropical disease spread by the bite of the female mosquito. Kenya is a country in East Africa marked as a high malaria burden country. The mosquito thrives in the tropical region with a hot climate like Kenya’s lake regions. On the contrary, the US malaria burden is remarkably low. Malaria in Kenya is an epidemic that requires keen analysis, data evaluation, and evidence-based strategies to reduce its mortality, morbidity, and healthcare costs to the individuals and the system.
Malaria in Kenya
Malaria population of interest
Malaria affects the nation with varying intensity. The population with the highest malaria risk is individuals living in the counties marked as high-burden counties (Kapesa et al., 2018). The counties with the highest malaria transmission rates in Kenya are Homa Bay, Busia, Vihiga, Kakamega, Siaya, Kisumu, Migori, and Bungoma. The disease is endemic in these areas, and transmission rates are high throughout the year with slight fluctuations. Most of the clinical cases and mortalities are also reported from these regions (Kapesa et al., 2019). Children are more affected by malaria and account for a significant percentage of the clinical cases and a third of the fatalities. The disease is preventable and thus should not pose such a substantial burden to the population.
Malaria Significance
Malaria is a huge problem in Kenya and accounts for more than 10,700 deaths annually (CDC, 2018). The CDC also notes that there are about 3.5 million cases yearly. Malaria prevalence is higher in rural (12%) than in urban areas (5%), worsened by the poor access to healthcare services in rural areas (Kapesa et al., 2018). According to Watts et al. (2018), the average cost of malaria treatment is $42 for inpatient care (currently about Ksh4600). Thus malaria costs the government and individuals over $10 million cases considering a significant percentage of malaria patients get admitted. These costs increase when malaria is associated with other comorbidities such as diarrhea. The CDC estimates the global disease burden at $12 billion yearly (CDC, 2028).
Consequences of not Addressing the Malaria Health Issue
Malaria eradication is possible by harmonizing local and international efforts to manage the disease. Failure to address the problem will lead to the further spread of the disease and fewer containment measures increasing mortality and morbidity. It will also lead to loss of life and decreased productivity due to morbidities. Kenya’s healthcare systems will also suffer higher costs of care, and the possibility of spread of the disease to other countries, will also increase, worsening the global malaria burden (Essending et al., 2019). Malaria is also associated with other morbidities such as self-limiting psychiatric disorders, liver or kidney injury, and spleen rupture, all being life-threatening illnesses that can significantly affect individuals’ quality of life. Failure to address the issue of malaria will thus increase healthcare costs and give room to more severe complications.
Social determinants of health impacting malaria
Social determinants of health conditions in which people live, work, and interact. These factors significantly affect how they access and utilize healthcare services. Studies have identified and explained the reasons for healthcare disparities in the areas with high malaria burden. The major social determinants of health affecting malaria are low education levels, poor income, and unemployment (Kapesa et al., 2018). Essendi et al. (2019) studied the burden of malaria and discovered that malaria prevalence was higher in unemployed fathers, low-income families, and families with uneducated parents. Low literacy levels are more connected with employment in low-paying jobs and unemployment. Lack of education prevents the families from knowing how to prevent malaria, while funds limit their effort because most families struggle to afford basic needs.
Malaria in the US
Population Affected by Malaria in the US and its Significance
Malaria is not a significant health issue in the US. Unlike in Kenya, the US government achieved malaria elimination in the 1950s by implementing preventive interventions nationwide (Mace et al., 2021). These measures included using insecticide-treated nets, clearing bushes and drainage, and installing gazes on doors and windows to prevent the entry of mosquitoes into houses. The malaria cases have then dropped significantly, and malaria has been eliminated in the US (Mace et al., 2021). Transmission cases have decreased to negligible numbers (close to zero) in the last decades (CDC, 2018). The CDC (2018) reports about 1500-2000 cases each year that result from travelers and immigrants going to the country. The US has very cold seasons that significantly affect malaria proliferation, unlike in Kenya, with favorable temperatures throughout the year. The government of the US, through the USAID program, has helped save millions of lives and malaria cases.
The Burden of Malaria in the US Compared to Kenya
Malaria claims over 10000 lives yearly in Kenya, while the number is negligible in the US. The cases fluctuate depending on the season, but some areas in Kenya have high transmission rates throughout the year. Unlike in Kenya, the US has no reported transmission cases over the last decade, and cases are from immigrants and travelers. The burden is thus negligible in the US, yet an epidemic in Kenya, with about 76% of the population at risk for contracting the disease (CDC, 2018).
Malaria and Social Determinants of Health in the US
The US population is educated with a literacy level of 85% for those who can read compared to Kenya’s 61%. In addition, about 13.5% of the US population have a university degree, while only 3.5% have a university degree in Kenya (NationMaster, n.d.). Similarly, the country enjoys a significantly high household income, several times that of Kenya. The Gross Domestic Product per capita is $63,000, while that of Kenya is $3700 (about 14 times) (Georank, n.d.). The US government and the individuals combine efforts to help eliminate malaria in the US; travelers and immigrants report most malaria cases. Thus, social determinants of health have a less significant role in malaria in the US.
Interventions to Address Malaria
The malaria burden requires attention, and various interventions can be used to reduce the burden and produce better population outcomes. Community Education and long-lasting insecticide-treated nets are the chosen interventions for controlling malaria in Kenya. A majority of the population in Lenya is illiterate, and education is vital. They have a basic understanding of malaria but do not know the burden and prevention interventions. The information will help leverage individual efforts in managing the disease. The efforts include purchasing a mosquito net, clearing bushes around homes, and installing gazes on windows and doors to prevent mosquitoes from entering the homes. Supply mosquito nets will help bridge the gap created by insufficient finances (low-paying jobs and high unemployment rates). Essendi et al. (2019) showed that ITN use was the leading factor for low malaria prevalence in families. In addition, families with unemployed fathers and those with low income reported the lowest ITN use rates and the highest malaria incidences (Essendi et al., 2019). Kapesa et al. (2018) investigated the differences in the burden of malaria throughout the year, showing a marked disparity in malaria incidences and prevalence. Particular focus should be given to these high-burden areas mentioned early for successful; malaria control in the nation.
Differences or Similarities in Interventions in Kenya and the US
The CDC (2018) show that the burden of malaria in the US arises from immigrants and travelers. Interventions that effectively manage the problem could include screening measures at the airport. Mandatory screening for immigrants would also help manage the problem. All travelers going to high-burden countries should also get malaria prophylaxis to protect them from contracting the disease. The government requires screening for diseases such as tuberculosis and COVID-19, and screening for malaria could help eliminate the disease in the US. Individuals in Kenya from low-endemic areas could also benefit from malaria prophylaxis when visiting high endemic areas. While the interventions could have clinical significance, statistics show that prophylaxis in Kenya only accounts for a small percentage of malaria prevention (Gachelin et al., 2018). Kenya and the US have different burdens and causes of malaria, and thus
Intervention, Health Issue, and Social Determinants of Health Interactions
The use of mosquito nets can prevent malaria because the majority of the mosquitos are active at night. The chosen interventions, community education, and provision of insecticide-treated nets act on the social determinants of health and bridge the gaps in their utilization. The most significant hindrances are a lack of finances and education on the importance of sleeping under an insecticide-treated net. Pryce et al. (2021) note that insecticide-treated nets are the most effective long-term methods of preventing malaria. The financial constraints and a lack of education prevents their usage, and providing education and ITNs to these communities will thus relieve the malaria burden and significantly reduce the risk for malaria.
Conclusion
Analyzing healthcare issues using data and literature expands understanding and helps professionals make decisions regarding care delivery. Malaria in Kenya is a huge problem, and the population is at risk of contracting the disease. The disease costs over $10 million annually, making it expensive to the nation and individuals. The lack of education and finances are vital social determinants of health in spreading and preventing malaria in Kenya. Educating communities on the disease and providing them with insecticide-treated nets are long-term interventions to help contain the malaria epidemic. The US enjoys a low disease burden due to previous efforts to eliminate the disease. The current problem can be eradicated by proper screening and malaria prophylaxis for travelers.
References
Center for Disease Control and Prevention (CDC) (2018). Elimination of Malaria in the United States (1947-1951). Retrieved from https://www.cdc.gov/malaria/about/history/elimination_us.html
Center for Disease Control and Prevention (CDC) (2018). Malaria. CDC Activities in Kenya. https://www.cdc.gov/parasites/malaria
Gopal, S., Ma, Y., Xin, C., Pitts, J., & Were, L. (2019). Characterizing the spatial determinants and prevention of malaria in Kenya. International Journal Of Environmental Research And Public Health, 16(24), 5078. https://doi.org/10.3390/ijerph16245078
Gachelin, G., Garner, P., Ferroni, E., Verhave, J. P., & Opinel, A. (2018). Evidence and strategies for malaria prevention and control: a historical analysis. Malaria Journal, 17(1), 1-18. https://doi.org/10.1186/s12936-018-2244-2
Mace, K. E., Lucchi, N. W., & Tan, K. R. (2021). Malaria Surveillance— the United States, 2017. MMWR Surveillance Summaries, 70(2), 1. https://doi.org/10.15585/mmwr.ss7002a1
Watts, C., Atieli, H., Alacapa, J., Lee, M. C., Zhou, G., Githeko, A., Yan, G., & Wiseman, V. (2021). Rethinking the economic costs of hospitalization for malaria: accounting for the comorbidities of malaria patients in western Kenya. Malaria Journal, 20(1), 1-9. https://doi.org/10.1186/s12936-021-03958-x
Kapesa, A., Kweka, E. J., Atieli, H., Afrane, Y. A., Kamugisha, E., Lee, M. C., Zhou, G., Githeko, A. K., & Yan, G. (2018). The current malaria morbidity and mortality in different transmission settings in Western Kenya. PloS One, 13(8), e0202031. https://doi.org/10.1371/journal.pone.0202031
Gopal, S., Ma, Y., Xin, C., Pitts, J., & Were, L. (2019). Characterizing the spatial determinants and prevention of malaria in Kenya. International Journal Of Environmental Research And Public Health, 16(24), 5078. https://doi.org/10.3390/ijerph16245078
NationMaster (n.d.). Education Stats: compare key data on Kenya & United States. Retrieved from https://www.nationmaster.com/country-info/compare/Kenya/United-States/Education
Georank (n.d.). Kenya VS the United States: Economic Indicators Comparison. Accessed 30th July 2022 from https://georank.org/economy/kenya/united-states
Pryce, J., Richardson, M., & Lengeler, C. (2018). Insecticide‐treated nets for preventing malaria. Cochrane Database of Systematic Reviews, (11). https://doi.org/10.1002/14651858.CD000363.pub3
MODULE 7 Informative and Persuasive Paper
Overview
The final project for NRSES 3700J is a paper of about 1500 words (approximately six [6] pages).
The paper is due in the last module of the course (Module 7). The paper has two purposes:
1. The first purpose is to inform the audience about a health issue that exists in the
country/community selected in Module 1 and reaffirmed in Module 3.
2. The second purpose is to persuade the audience that a specified intervention (or
interventions) would address the health issue in a positive way.
Instructions
1. The paper is to be approximately six (6) pages in length excluding the title page and the
references cited page.
2. The chosen health issue is to be compared to a similar issue in the United States (US).
Use the following questions/topics to focus the paper.
2.1 Discuss the health issue in the selected country/community.
• What is it?
• Who is impacted?
• Why is the chosen health issue important?
• What are the consequences of not addressing the health issue?
• Identify the two (2) or three (3) social determinants of health that have the
most impact on the chosen health issue. Explain the influence.
2.2 Is the same health issue present in the US?
• Who does the health issue impact in the US?
• Compare the size of the health issue in the US with that in the selected
country/community.
• What is similar about the health issue in the two countries?
• What is different about the health issue in the two countries?
• Identify the two (2) or three (3) social determinants of health that have an
impact on the chosen health issue in the US. Explain the influence of
each.
• If the health issue does not exist in the US, explain the reasons for this
being so.
2.3 Identify an intervention (or interventions) that could address the identified health
issue. There is no specified number of interventions required, but if education is
chosen as an intervention it cannot be the only intervention.
• In what ways, if any, would the proposed interventions differ between the
selected country/community and the US?
• If the intervention in the two countries would not differ, explain why they
would not.
Module 7 Final Paper, continued
• Identify the connection between the social determinants of health, the
health issue, and the intervention(s).
• Persuade the audience that the identified intervention(s) would be useful in
addressing the chosen health issue. Again, education cannot be the only
intervention, but it can be used in combination with other interventions.
Technical Aspects of the Paper
1. DO NOT include an abstract.
2. The paper must include:
2.1 A title page formatted according to the student title page information in the APA
Manual 7th edition.
2.2 An introduction that includes a thesis statement.
2.3 The body of the paper supports the thesis organizes and fleshes out the main
ideas, and topics are sequenced so the follow of the thinking/writing makes sense.
2.4 A conclusion.
3. Include a minimum of five (5) references. References must be no older than five (5)
years (unless you are using a seminal or classical piece of literature to make a specific
point). References need to be on a References Cited page following the actual paper.
Acceptable references include peer-reviewed databases, peer-reviewed journal articles,
textbook materials, and any source that has been peer reviewed. References that are not
acceptable include, but are not limited to: UpToDate, Epocrates, Medscape, WebMD,
hospital organization publications, insurance recommendations, and secondary clinical
databases. Do NOT include the annotated bibliography.
4. Use the Times New Roman or Arial font in size 12; one (1) inch margins on all sides;
double spaced throughout according to the format of the APA Manual 7th edition.
5. Use APA Manual 7th edition formatting throughout the paper.
Previous Assignments that May Be Useful
1. Choice of country/community
2. NGO Business Letter
3. SDOH Impact Analysis and Email
4. Introduction to Final Paper
5. Outline of Final Paper
6. Annotated Bibliography
7. Patient Education Materials
CLICK on the link titled “M7 Final Paper Submission†in Blackboard to submit the paper.
Points: 45 Due Date: See the Course Calendar/Checklist