NURS FPX 8014 Assessment 2 Global Issue Problem

Name

Capella university

NURS FPX 8014 Global Population Health

Prof. Name

Date

Global Issue Problem Description

Malaria is a life-threatening public health issue transmitted by infected mosquitoes. According to the World Health Organization (WHO), millions of individuals are impacted by the disease globally, and the African region is substantially influenced (WHO, 2023a). This assessment recognizes the prevalence, affected population, and strategies that are traditionally used to mitigate the global burden, followed by an educational resource/project proposal for a community health officer in the sub-Saharan Africa (SSA) region. 

Description of the Problem

Global Public Health Issue and Epidemiological Data 

Analyzing the data from reputable sources, it is recognized that malaria is a significantly pervasive problem worldwide and in the sub-Saharan Africa region. Universally, in the year 2022, approximately 249 million individuals reported malaria encounters, resulting in 608,000 deaths (WHO, 2023a). This high prevalence underscores the persistent burden of malaria worldwide despite ongoing global efforts to combat the disease. The disease also imposes a substantial economic burden; $ 4.3 billion has been spent by governments and individuals worldwide (Andrade et al., 2022). 

The scope of the disease in SSA is vast, affecting various dimensions of health and socioeconomic development. Malaria leads to severe morbidity and deaths, particularly among children (less than 5 years old). In 2022, Africa had approximately 94% of all malaria cases, and the disease-related mortality rate was 95%. There were 78% malaria deaths among children below five years in SSA (WHO, 2023a). Nations and populations disproportionately affected include Nigeria (26.8%), the Democratic Republic of the Congo (12.3%), Uganda (5.1%), and Mozambique (4.2%) (WHO, 2023a). 

NURS FPX 8014 Assessment 2 Global Issue Problem

Within these areas, vulnerable populations include children under five, pregnant women, and people living in rural and impoverished regions (WHO, n.d.). These groups are at a higher risk due to limited access to healthcare, inadequate housing conditions that favor mosquito breeding, and lower immunity levels. Significant inequities in malaria incidence and outcomes exist across different countries and regions. SSA, despite bearing the significant malaria burden, often has the least resources to combat the disease effectively.

These nations face substantial challenges in malaria control and elimination due to factors such as political instability, limited healthcare facilities, and minimal financial resources for vaccine production and distribution in the region (Oladipo et al., 2022). Thus, research prioritizes political and economic investments by the region’s government and policymakers to control disease burden and prevent individual lives. Continued efforts are essential to address the impact of disease on population health. 

Analysis of the Global Health Issue 

Malaria, as a public health issue, has multifaced impacts on individuals, communities, and populations around the world, particularly in sub-Saharan African regions. 

Impact on Individuals

Malaria has a profound effect on individuals, particularly in high-burden areas such as Sub-Saharan Africa. For infected individuals, malaria causes a range of signs and symptoms, including high-graded temperature, chills, and head and musculoskeletal pain (Bamikole, 2024). Children below five years old and expecting women are especially at high risk, with children experiencing augmented mortality rates and pregnant women facing pregnancy-related complications. They may transmit the disease to the fetus, risking maternal and neonatal lives (Bamikole, 2024). Therefore, poor physical outcomes, the financial burden of treatment, and lost productivity due to illness significantly affect individuals’ quality of life. 

Impact on Communities

At the community level, the high prevalence of malaria strains local healthcare systems, leading to poor healthcare services within the communities. Additionally, the economic impact of the disease is substantial, where communities face direct costs for medical care and indirect costs due to poverty (Andrade et al., 2022). Among children, school absenteeism due to malaria is common, affecting educational outcomes and future economic prospects. Halliday et al. (2020) mention that malaria is estimated to result in 5% and 8% of preventable school absenteeism among African children. Lastly, communities also experience social disruption, as frequent illnesses and deaths weaken social bonds and disrupt community cohesion. 

Impact on Populations

Populations in malaria-endemic regions experience widespread and persistent health challenges that impede broader socioeconomic development. According to Andrade et al. (2022), countries with high malaria prevalence can see reductions in their GDP growth rates by up to 1.3% annually. This economic strain perpetuates cycles of poverty as affected populations struggle to break free from the financial constraints imposed by frequent malaria outbreaks. It hinders economic growth by reducing the workforce’s productivity and increasing healthcare costs. Additionally, high morbidity and mortality rates strain national resources and international aid, requiring significant investment in public health infrastructure and preventive measures to control the disease.

Social and Political Ramifications 

If malaria remains unaddressed, it could have severe social and political consequences, particularly in high-burden areas like Sub-Saharan Africa. Socially, the persistent high morbidity and mortality rates will strain individuals and communities, aggravating economic challenges and reducing overall quality of life (Andrade et al., 2022). Academic disruptions for children due to illness will hinder human capital development, limiting future economic growth. On the other hand, politically, governments may face increased pressure to address the health crisis, potentially leading to social unrest if they fail to deliver effective solutions (Oladipo et al., 2022).

The financial implications of malaria could divert resources from other critical areas, further destabilizing already fragile economies. Additionally, ongoing health crises could undermine public trust in government institutions and international organizations, potentially leading to political instability and weakened governance. Addressing malaria is thus crucial not only for health outcomes but also for maintaining social cohesion and political stability.

Social Determinants That Impact the Problem 

The population most affected by malaria primarily resides in SSA (94%) ((WHO, 2023a). Rural populations are particularly affected due to poor living conditions and higher exposure to mosquito vectors. Several Social Determinants of Health (SDOH), such as poverty, lack of education, and limited healthcare accessibility, exacerbate the risk, trapping these communities in a cycle of disease and deprivation. 

• Poverty limits access to preventive solutions like insecticide-treated nets (ITNs) and timely medical treatment. According to a study, Sub-Saharan Africans have limited availability of ITNs, distributed only 17% (Haileselassie et al., 2023), due to limited resources. Moreover, treatment for malaria takes over 25% of household income, which prevents individuals from seeking medical services.
• Education levels influence knowledge related to malaria prevention and treatment. According to the United Nations Educational, Scientific and Cultural Organization (UNESCO), literacy in Sub-Saharan Africa is the lowest globally (61%), affecting the ability to disseminate and understand health information effectively (Zua, 2021). 
• Limited access to quality healthcare services hinders early diagnosis and treatment for malaria. In many rural areas of the African region, a shortage of healthcare workers, few healthcare facilities, and long travel distances have led to exacerbation of the diseases, increasing the likelihood of morbidity and mortality (Bamikole, 2024). 

Cultural Impact on the Global Health Issue

In Sub-Saharan Africa, traditional beliefs and practices significantly impact malaria treatment and prevention. Many communities rely on traditional interventions, such as herbal remedies, due to deep-rooted cultural norms and limited access to healthcare. Moreover, some individuals have misconceptions about the causes of malaria, such as attributing it to witchcraft or supernatural forces, which deter them from seeking proper medical intervention (Orok et al., 2021). Education and community engagement are crucial in overcoming these barriers and promoting effective malaria prevention and treatment.

Geographical Impact on the Global Health Issue

Sub-Saharan Africa’s tropical climate, characterized by high temperatures and rainfall, creates ideal breeding conditions for Anopheles mosquitoes, thus creating a conducive environment for disease progression and spread (Fall et al., 2023). Moreover, rural and remote areas face higher malaria prevalence due to inadequate preventive measures and limited medical assistance facilities. Addressing geographical challenges requires comprehensive vector control strategies, improved infrastructure, and targeted interventions in high-risk areas.

Political Systems Impact on the Global Health Issue

Political instability and weak healthcare infrastructure in many Sub-Saharan African countries hinder effective malaria control and treatment. Corruption, inadequate funding, and poor governance often lead to insufficient healthcare services and a lack of essential medical supplies (Oladipo et al., 2022). Political priorities don’t focus on public health, resulting in limited support for malaria prevention programs. Therefore, international aid and partnerships are crucial for supplementing local efforts. Moreover, it is vital to strengthen political commitment, ensure transparency, and enhance healthcare infrastructure for sustainable malaria control and improving health outcomes in the region.

Future changes in enhancing malaria prevention efforts, socioeconomic development, geographical management, and political stability will significantly influence malaria’s trajectory. Advancements in socioeconomic conditions, such as poverty reduction and improved education, could enhance community resilience and decrease malaria incidence. Political stability and strengthened healthcare systems will be crucial in sustaining malaria control efforts and ensuring effective resource allocation. Innovative technologies, such as mobile-based applications and drone-based technologies, also hold promise for reducing the malaria burden (Chibi et al., 2023). However, ongoing challenges will require adaptive strategies and continued international collaboration to achieve long-term malaria eradication.

Strategies and Gaps

Historically, several strategies have been employed to combat malaria, with varying degrees of success. One of the earliest initiatives in the African region is the Roll Back Malaria (RBM) initiative. This program focused on increasing resources and awareness among communities to eradicate malaria’s global health burden. These efforts resulted in a decline of 37% in malaria prevalence and a significant reduction in mortality rate (60%) (Maharaj et al., 2019). Nevertheless, the initiative faced challenges due to residual malaria and outdoor biting.

This program also promoted the use of insecticide-treated nets (ITNs) and indoor residual spraying (IRS), two more widely used strategies for combatting the disease. While ITNs create a protective barrier against mosquito bites, significantly reducing malaria transmission, IRS involves using insecticide spray within the homes to kill mosquitoes. Both methods have proven effective in reducing malaria incidence and mortality rates (Pryce et al., 2022). However, these strategies also faced challenges, such as insecticide resistance, which reduced their long-term effectiveness.

Another key strategy has been the distribution of antimalarial drugs for both treatment and prevention. Historically, chloroquine and later artemisinin-based combination therapies (ACTs) have been central to malaria treatment. Mass drug administration (MDA) campaigns have been used to provide antimalarial medications to entire populations in a mainly geographical location, which is an effective method to rapidly reduce the transmission and global burden of the disease (CDC, 2024). Yet, these campaigns have also been hindered by issues such as logistical challenges and resource limitations in reaching remote populations. Moreover, the economic cost of sustaining widespread drug distribution and ensuring adherence to treatment regimens has been significant.

Current Prospects and Future Success 

Current prospects for malaria eradication appear promising, with ongoing research and establishment of new tools and strategies. The development of the RTS, S/AS01 malaria vaccine, also known as Mosquirix, marks a significant milestone. This vaccine has shown improvements in preventing malaria in children, and several African countries have demonstrated its potential to reduce malaria incidence and mortality. More than 1.7 million vaccines are administered, covering up to 650,000 children (Mumtaz et al., 2023). Ongoing research into more effective vaccines offers hope for an even more significant impact in the future.

Additionally, genetic strategies, such as gene drive technology, are also being explored to reduce mosquito populations or render mosquitoes incapable of transmitting malaria. This innovative approach provides long-term solutions to malaria control by targeting the vector itself (Tajudeen et al., 2023). However, the technology faces ethical and regulatory challenges that must be carefully navigated. Political commitment and international collaboration remain crucial for future success. Strengthening health systems, improving surveillance, and ensuring equitable access to preventive measures and treatment are essential components of sustained malaria control.

Conclusion

In summary, malaria is a highly prevalence public health issue, particularly in sub-Saharan Africa, significantly impacting individual health, community well-being, and economic development. High-risk populations, especially children (below 5) and expecting women, face severe health risks. Several SDOH, cultural, tropical climate, poor living conditions, and political instability exacerbate the problem in the sub-Saharan Africa region. Despite global efforts and strategies like the Roll Back Malaria initiative, insecticide-treated nets (ITNs), indoor residual spraying (IRS), and antimalarial drugs, impediments such as insecticide resistance and limited medical access persist. Prospects, including the vaccine and genetic strategies, create hope for improved malaria control. However, it is crucial to overcome socioeconomic, cultural, and political barriers through international collaboration, governmental support, and innovative solutions to achieve long-term malaria eradication and improve health outcomes in affected regions. 

References

Andrade, M. V., Noronha, K., Diniz, B. P. C., Guedes, G., Carvalho, L. R., Silva, V. A., Calazans, J. A., Santos, A. S., Silva, D. N., & Castro, M. C. (2022). The economic burden of malaria: A systematic review. Malaria Journal, 21(1). https://doi.org/10.1186/s12936-022-04303-6

Bamikole, T. H. (2024). Confronting malaria – Addressing a critical health crisis among vulnerable groups in Nigeria. In www.intechopen.com. IntechOpen. https://www.intechopen.com/chapters/1151895

CDC. (2024, May 9). Alternative and novel drug-based prevention approaches. cdc.gov. https://www.cdc.gov/malaria/php/public-health-strategy/alternative-drug-prevention.html 

Chibi, M., Wasswa, W., Ngongoni, C., Baba, E., & Kalu, A. (2023). Leveraging innovation technologies to respond to malaria: A systematized literature review of emerging technologies. Malaria Journal, 22(1). https://doi.org/10.1186/s12936-023-04454-0 

NURS FPX 8014 Assessment 2 Global Issue Problem

Fall, P. A., Diouf, I., Dème, A., Diouf, S., Sène, D., Sultan, B., & Janicot, S. (2023). Enhancing understanding of the impact of climate change on malaria in West Africa using the Vector-borne Disease Community Model of the International Center for Theoretical Physics (VECTRI) and the Bias-corrected Phase 6 Coupled Model Intercomparison Project Data (CMIP6). Microbiology Research, 14(4), 2148–2180. https://doi.org/10.3390/microbiolres14040145 

Haileselassie, W., Adam, R., Habtemichael, M., David, R. E., Solomon, N., Workineh, S., Haider, J., Belachew, A., Deressa, W., Yan, G., Kassaw, N. A., & Parker, D. M. (2023). Socio-demographic and economic inequity in the use of insecticide-treated bed nets during pregnancy: A survey-based case study of four sub-Saharan African countries with a high burden of malaria. Archives of Public Health, 81(1). https://doi.org/10.1186/s13690-023-01075-6 

Halliday, K. E., Witek-McManus, S. S., Opondo, C., Mtali, A., Allen, E., Bauleni, A., Ndau, S., Phondiwa, E., Ali, D., Kachigunda, V., Sande, J. H., Jawati, M., Verney, A., Chimuna, T., Melody, D., Moestue, H., Roschnik, N., Brooker, S. J., & Mathanga, D. P. (2020). Impact of school-based malaria case management on school attendance, health and education outcomes: A cluster randomised trial in southern Malawi. BMJ Global Health, 5(1), e001666. https://doi.org/10.1136/bmjgh-2019-001666

Maharaj, R., Kissoon, S., Lakan, V., & Kheswa, N. (2019). Rolling back malaria in Africa – challenges and opportunities to winning the elimination battle. South African Medical Journal, 109(11b), 53–56. https://doi.org/10.7196/SAMJ.2019.v109i11b.14250

Mumtaz, H., Nadeem, A., Bilal, W., Ansar, F., Saleem, S., Khan, Q. A., Tango, T., Farkouh, C., Belay, N. F., Verma, R., Farkouh, M., & Saqib, M. (2023). Acceptance, availability, and feasibility of RTS, S/AS01 malaria vaccine: A review. Immunity, Inflammation and Disease, 11(6). https://doi.org/10.1002/iid3.899 

Oladipo, H. J., Tajudeen, Y. A., Oladunjoye, I. O., Yusuff, S. I., Yusuf, R. O., Oluwaseyi, E. M., AbdulBasit, M. O., Adebisi, Y. A., & El-Sherbini, M. S. (2022). Increasing challenges of malaria control in sub-Saharan Africa: Priorities for public health research and policymakers. Annals of Medicine and Surgery, 81(104366). https://doi.org/10.1016/j.amsu.2022.104366

NURS FPX 8014 Assessment 2 Global Issue Problem

Orok, A. B., Ajibaye, O., Aina, O. O., Iboma, G., Adagyo Oboshi, S., & Iwalokun, B. (2021). Malaria interventions and control programes in Sub-Saharan Africa: A narrative review. Cogent Medicine, 8(1), 1940639. https://doi.org/10.1080/2331205x.2021.1940639

Pryce, J., Medley, N., & Choi, L. (2022). Indoor residual spraying for preventing malaria in communities using insecticide-treated nets. Cochrane Database of Systematic Reviews, 2022(1). https://doi.org/10.1002/14651858.cd012688.pub3 

Tajudeen, Y. A., Oladipo, H. J., Oladunjoye, I. O., Oladipo, M. K., Shittu, H. D., Abdulmumeen, I. F., Afolabi, A. O., & El-Sherbini, M. S. (2023). Transforming malaria prevention and control: the prospects and challenges of gene drive technology for mosquito management. Annals of Medicine, 55(2), 2302504. https://doi.org/10.1080%2F07853890.2024.2302504 

WHO. (2023a, December 4). Malaria. www.who.int.  https://www.who.int/news-room/fact-sheets/detail/malaria

WHO. (2023b, August 26). Mobile clinics fill health care gap. WHO | Regional Office for Africa. afro.who.int. https://www.afro.who.int/countries/madagascar/news/mobile-clinics-fill-health-care-gap 

WHO. (n.d.). Background on World Malaria Day 2023 campaign. www.who.int. https://www.who.int/campaigns/world-malaria-day/2023/background

Zua, B. (2021). Literacy: Gateway to a world of exploits. International Journal of Education and Literacy Studies, 9(1), 96. https://doi.org/10.7575/aiac.ijels.v.9n.1p.96 

Appendix A: Project Proposal 

Project Title 

“Strengthening Malaria Control in Sub-Saharan Africa: An Integrated Approach”

Target Population

In underserved communities, the project is mainly for women and parents of children under five years old.

Project Setting

This project will be implemented in rural regions of Nigeria, one of the countries most affected by malaria. The setting includes community centers, local healthcare clinics, and homes.

Project Objectives

• Increase ownership and proper use of insecticide-treated nets (ITNs) by 80% among households with children under five within two years.
• Achieve 90% coverage of indoor residual spraying (IRS) in targeted communities annually.
• Reduce malaria-related morbidity and mortality rates by 50% within five years.

Project Strategies

Education and Awareness

• Develop and distribute culturally sensitive educational materials (e.g., pamphlets and posters) to raise awareness about malaria. 
• Conduct community workshops and school programs to educate residents about the importance of ITNs, IRS, and environmental sanitation (Orok et al., 2021).

Preventive Measures

• Distribute ITNs through local healthcare clinics and community programs (Pryce et al., 2022). 
• Implement regular IRS campaigns in collaboration with local health authorities and trained community health workers (Pryce et al., 2022). 
• Promote environmental management practices to eliminate mosquito breeding. 

Healthcare Strengthening

• Training healthcare workers on updated malaria treatment protocols and surveillance methods.
• Maintaining an adequate supply of antimalarial medications (CDC, 2024) and malaria diagnostic kits in local clinics.
• Establish mobile health units to reach remote areas and provide testing, diagnostic kits, medicines, and education (WHO, 2023b). 

Community Engagement

• Form community health committees to facilitate ongoing education (Orok et al., 2021).

• Foster partnerships with local leaders, NGOs, and international organizations to ensure sustained support and resource allocation.

Evaluation

• Monitor progress through regular household surveys and community feedback.
• Assess ITN usage, IRS coverage, and malaria incidence rates to measure impact.

Sustainability

• Secure funding and support from local governments, international donors, and NGOs.
• Train local health workers and community members to continue program activities.
• Promote community ownership of malaria prevention initiatives through ongoing education and engagement (Orok et al., 2021). 

Relevant Stakeholders

This proposal is targeted at public health officials involved in malaria control and public health initiatives.

Assumptions of the Proposal

This proposal is developed based on several assumptions. Firstly, it is assumed that the project will receive adequate funding and logistical support from the public health office to implement four project strategies effectively. Moreover, we presume political stability and support from local authorities to facilitate program implementation and sustainability. Finally, the project assumes that community members will actively participate and adhere to malaria prevention measures. 

Appendix B: Meeting Summary

Presenting my project proposal on malaria control in Sub-Saharan Africa to a public health officer was an enlightening practicum experience. It allowed me to apply evidence-based knowledge to practical public health issues and effectively communicate a comprehensive strategy aimed at reducing malaria transmission. I felt a combination of nervousness and excitement conveying the proposal, knowing the importance of addressing such a critical health issue. During the meeting, I was pleased to see that the proposal was received with interest and thoughtful consideration. The public health officer appreciated the integrated approach and emphasized the importance of community engagement and sustainability in malaria control efforts. Additionally, receiving constructive feedback during the meeting allowed me to refine aspects of the proposal, such as enhancing metrics for program evaluation and ensuring alignment with local healthcare priorities.

This experience highlighted several areas of learning and growth. Firstly, I honed my skills in presenting complex public health initiatives clearly and persuasively. I learned the significance of tailoring messages to resonate with diverse stakeholders, emphasizing practicality and feasibility. Looking ahead, I would underline the cultural relevance of the proposal even more and the need for continuous stakeholder engagement to strengthen program acceptance and effectiveness. Overall, this practicum deepened my understanding of malaria control strategies and sharpened my ability to navigate the complexities of advocating for public health initiatives in diverse settings.

NURS FPX 8014 Assessment 2 Global Issue Problem