NURS FPX 8014 Assessment 3 Leading Global Health Strategic Planning and Policy Development notes

By choosing exercise A, I attended a meeting of a professional organization within the community, specifically the local chapter of the American Nurses Association (ANA). Presenting at this meeting allows for direct interaction with nursing professionals who are at the forefront of healthcare delivery and advocacy. My objective is to develop and present comprehensive strategies, policies, and sustainable resource advocacy after extensive research on the topic and affected populations. This presentation will highlight the urgency of the malaria crisis, outline actionable solutions, and emphasize the importance of culturally sensitive approaches. By engaging stakeholders, the  aim is to drive impactful changes and foster collaborative efforts to reduce malaria prevalence and improve health outcomes in the most affected regions.

Culturally Sensitive Strategies and Potential Policies

Being a nurse encourages helps understand the cultural aspect of effective healthcare delivery. Malaria has impacted the SSA region excessively, and one of the reasons it is still an epidemic is their cultural beliefs and values. For that, culturally sensitive interventions are vital in addressing this issue, as malaria is beyond the biomedical concern. It involves the social and cultural factors. This part of the paper proposes and evaluates culturally sensitive interventions to address malaria through awareness campaigns, community-based interventions, increased access to medications, and maternal and child health initiatives. 

Culturally Sensitive Awareness Campaigns

These programs are essential to address malaria in SSA because many communities rely on traditional interventions (such as herbal remedies) due to deep-rooted cultural norms and limited access to healthcare. There are also misconceptions about malaria, for instance, relating it to witchcraft or supernatural forces. This deters people from seeking medical care (Orok et al., 2021). The indigenous population and low-income communities require support which must be provided through provision of educational and medical resources.For that reason, educational/awareness campaigns need to be designed to respect and integrate traditional beliefs while providing information regarding malaria prevention and treatment. Programs should include culturally appropriate messaging and involve women, who are often primary caregivers and crucial in the education process (Aremu et al., 2022).

Community-Based Interventions

The interventions can effectively address malaria by aligning with cultural beliefs and practices. Involving community leaders would be effective in efforts to increase acceptance and integration of modern practices. The community-based interventions should mainly focus on vulnerable groups like children and pregnant women. Community health workers can pay home visits and work with local leaders to promote insecticide-treated bed nets (ITNs), modern treatments, and Indoor Residual Spraying (IRS) (Awasthi et al., 2024).

Integrated Vector Management (IVM) policy advocates for a comprehensive approach to vector control combining various strategies mentioned. This approach helps build trust and ensures that preventive measures and treatments are culturally acceptable. A prominent awareness campaign is “Zero Malaria Starts with Me”, which allows the SSA community to address the disease with knowledge and adequate resources available. It mobilizes resources and keeps malaria elimination a political agenda (Sarpong et al., 2022).

Increase Affordability of Medication and Treatment

The SSA’s 25% of income is used to treat malaria, which discourages the population from seeking care for its prevention. Unaffordability is a huge concern and a barrier to malaria prevention (Haileselassie et al., 2023). Policies that encourage affordable supplies, including artemisinin-based combination therapies (ACTs), can improve early detection and effective treatment. Malaria Vaccine Implementation Programme (MVIP) is an approach to pilot test to see the effectivness of vaccines like RTS,S. Further, international funding initiatives can help subsidize costs and ensure a steady supply, especially for women and children. 

Maternal and Child Health

Specific interventions for maternal and child health are essential to reducing mortality and morbidity rates among the vulnerable population of SSA. For instance, Antenatal care should offer insecticide-treated bed nets and intermittent preventive treatment for pregnant women. Child health services should focus on early diagnosis and prompt treatment of malaria in children under five (Park et al., 2020). Case Management Guidelines by WHO provides detailed guidelines on the use of rapid diagnostic tests (RDTs), appropriate antimalarial medications, and the management of severe malaria.

Areas for Better Preparation of Strategies

To improve the preparation for presenting culturally sensitive malaria strategies, deeper insights into local cultural beliefs and practices are needed. For example, understanding regional variations in traditional treatments and misconceptions about malaria could help tailor education programs more precisely. Incorporating systematic feedback from community members and leaders involved in the interventions could provide real-time insights into the effectiveness and acceptability of the strategies (Finda et al., 2020). Moreover, assessing local resources such as personnel and logistics, infrastructure including healthcare facilities, and the economic impact of interventions will help address feasibility and sustainability. It will help ensure that strategies are practical and well-integrated into existing healthcare systems (Finda et al., 2020).

Sustainable Resources and Policy Development

Addressing malaria in SSA requires a multifaceted approach that emphasizes the importance of sustainable resources and robust policy development. Advocating for policies that promote sustainable resource allocation and systematic improvements is crucial for achieving long-term success in malaria control. The purpose aligns well with the Sustainable Development Goals (SDGs), particularly SDGs 3, which advocates for healthy lives and the well-being of people of all ages (RBM partnership, 2020). First, investing in sustainable resource allocation is critical for ensuring that malaria prevention and treatment measures are consistently available and effective.

Investment in ITNs and IRS should be prioritized with policies that support local production and distribution to minimize dependency on external aid. For instance, evidence by Musoke et al. (2023) shows that communities with regular access to ITNs experience a significant reduction in malaria incidence. Moreover, supporting development and infrastructure maintenance, including training of community health workers, is essential for delivering consistent services. SDG 3 states that sustained investment will help strengthen annual GDP by linking 10% of malaria directly with a 0.3% increase in GDP. It supports education and states no malaria will reduce absenteeism in schools. Particularly in pregnant women, SDG 3 advocated for healthier mothers and newborn babies (RBM partnership, 2020).  

NURS FPX 8014 Assessment 3 Leading Global Health Strategic Planning and Policy Development notes

Advocating for sustainable resources and comprehensive policy development is essential for improving malaria outcomes in SSA. Effective policy development must focus on creating comprehensive malaria control strategies that integrate various prevention and treatment methods. Policies should include support for universal access to diagnostic testing and affordable treatments, ensuring all individuals, especially those in remote and underserved areas, can access timely and appropriate care (Perera et al., 2022). Furthermore, strengthening health systems through investment in infrastructure and workforce training will enhance the delivery of malaria services. Evidence highlights that countries with robust health systems and comprehensive malaria policies see significant improvements in control outcomes (Feng et al., 2022). 

To garner support for these policies, it is essential to present compelling evidence and appeal to international organizations and government agencies’ interests. Highlighting success stories from the countries that have implemented effective malaria control policies can illustrate the benefits of investing in sustainable resources and comprehensive policies. China is one such example, which has successfully controlled an extremely prolonged endemic with government support in areas of research, evidence and finances. To control malaria, China conducted research that looked into new ways of treating it, which led to the testing of ACTs and ITNs.

One significant aspect was surveillance and response by the government that utilized the 1-3-7 approach, meaning one day to report the malaria incident, three days to confirm the case, and seven days to respond completion (Feng et al., 2022). Capacity-building was one way of using sustainable resources that allowed routinely sticking to a 1-3-7 approach at different levels, including airports, medical centres, and research centres. Virtual training sessions have been significant in the discussion of the topic and best practices. With intranational collaboration, the country successfully controlled, highlighting the role of strategic sustainable resources and policy development (Feng et al., 2022).

Investment in Sustainable Resources and Policy Development

Investment in global health issues is sponsored by two major entities, government agencies and Non-Government Organizations (NGOs), both having their structure but with an aim to address public health issues. Government agencies usually gather investment for research, treatment, and support from member states. In this regard, WHO is the governmental organization with 192 member states that contribute to addressing health issues like malaria worldwide (WHO, 2024a). Another source of investment is the public taxes. However, NGOs like The Global Fund are sponsored through grants, donations, fundraising campaigns, and collaboration with government agencies (The Global Fund, 2024a). These two public health agencies (WHO) and NGOs (The Global Fund) have invested profoundly in the fight against malaria and are currently putting efforts that align with SDG. 

The government agency WHO has introduced “The Global Technical Strategy for Malaria 2016–2030” with four major goals majorly: a 90% reduction in mortality and cases each, making 35 countries accessible to malaria and preventing re-establishment (WHO, 2021). The WHO’s Global Malaria Programme aims to reduce the global burden through coordinated action and comprehensive policy development. They aim to develop evidence-based strategies and utilize innovative technologies. The WHO supports countries in scaling up interventions such as ITNs, indoor residual spraying (IRS), and rapid diagnostic testing.

NURS FPX 8014 Assessment 3 Leading Global Health Strategic Planning and Policy Development notes

Moreover, The distribution of the RTS, S/AS01 malaria vaccine, Mosquirix, has shown promise in preventing malaria among children, covering over 650,000 children across several African countries. The vaccine is claimed to be effective against malaria for children, potentially saving thousands of lives every year, according to the World Health Organization (WHO, 2024b). Their policies emphasize the importance of universal access to malaria prevention, diagnostic and treatment services, aligning with their goal of 90% reduction by 2030. These efforts align with the goal of WHO that is to promote health, keep the world safe, and serve the vulnerable and the vision is to achieve the highest possible level of health for all people.

The Global Fund is another important means of sustainable investments. The organization’s mission is to accelerate the end of malaria as an epidemic. The Global Fund played a crucial role, investing over $17.9 billion since 2002. They have made efforts through the provision of Dual-insecticide mosquito nets, Seasonal Malaria Chemoprevention (SMC) for high-risk children, Intermittent Preventive Treatment (IPTp) and IRS.

The New Nets Project initiatives have allowed to avert 13 million cases and 24,600 mortalities in 2019-2022 (The Global Fund, 2024). Their investment has brought outcomes by a 60% reduction in malaria deaths in countries where they operate. Their investment also supports the training of healthcare workers and strengthening local health systems, ensuring long-term sustainable impact. Their contributions directly align with the mission to accelerate the end of malaria as epidemics and vision of a world free of the burden of malaria.

NURS FPX 8014 Assessment 3 Leading Global Health Strategic Planning and Policy Development notes

Evidence shows that the availability of ITNs, vaccines, medications, and training has brought effective and efficient malaria control efforts. For instance, Rwanda’s malaria program, supported by both The Global Fund and the WHO, saw a significant decline in malaria cases due to the widespread use of ITNs, IRS, and practical policy implementation (RBC, 2020). The tangible aspects of policy development and sustainable investment encourage buy-in from stakeholders like other public health agencies and NGOs. For instance, improved living standards, increased GDP, and better community health outcomes will eventually reduce the burden of treating malaria (RBM Partnership, 2020). 

Experience in Presenting and Advocating for Sustainable Resources

Reflecting on the experience to improve malaria outcomes in SSA reveals several key insights and learning moments. First, preparation for the presentation involved extensive research on the current state of malaria in SSA, the interventions supported by the Global Fund and the WHO, and the impact of the interventions. This preparation was crucial in building a solid and evidence-based case for the necessity of sustainable resources and effective policy development. Further, presenting the information required clear and compelling communication to engage the audience effectively. I tailored the message to highlight the successes and ongoing needs of malaria programs, which helped capture attention and emphasize the urgency of continued investment. It was essential to use relatable examples and success stories, such as the reduction of malaria cases in Rwanda, to illustrate the tangible benefits of the proposed initiatives (RBC, 2020).. 

Receiving feedback during and after the presentation was valuable for me. It highlighted areas where the argument could be strengthened, such as providing more detailed cost-benefit analyses and addressing potential challenges in policy development, especially culturally appropriate; this feedback informed revisions and allowed for a more robust advocacy strategy. One of the main challenges I encountered was addressing the diverse perspectives of the audience, as nurses were from various specializations and with varying levels of experience. Balancing technical details as if for maternal and child health with broader appeals to the humanitarian and economic benefits of malaria prevention was essential (VanderWeele, 2023). This experience underscored the specific concerns and interests of nurses, including patient care, resource availability, and professional development.

Most importantly, advocating for interventions in SSA necessitated a deep understanding of cultural contexts. Recognizing the role of traditional beliefs and practices in malaria treatment and prevention was crucial. This highlighted the need for culturally sensitive approaches and the importance of involving community leaders or local healthcare providers in the design and implementation of interventions (Pinto et al., 2021). For future improvements, additional preparation focused on gathering more localized data and success metrics from specific regions within SSA would be beneficial. This would have strengthened the argument by providing concrete evidence of effective practices in cultural and geographical contexts. Involving representatives from the field in affected communities in SSA would have provided firsthand accounts, enhancing the impact of the presentation. 

Summary of Key Takeaways and Outcomes

I will summarize the presentation for my audience by highlighting some of the takeaways regarding the global health issue of malaria, which is profoundly affecting the SSA region. The audience can utilize these takeaways and learn from the outcomes in their professional practices, irrespective of their specialization or experience level. 

• It emphasizes the integration of traditional beliefs and practices with modern medical approaches for effective malaria prevention and treatment. It also highlights culturally tailored health education for awareness purposes that resonate with local communities (Aremu et al., 2022). 
• Another takeaway is affordable and accessible interventions. The presentation stresses the necessity of making malaria interventions, such as bed nets, ACTs, and sprays, both accessible and affordable ((Bamikole, 2024; Haileselassie et al., 2023).
• It also demonstrates the importance of diverse perspectives within the nursing community to tailor advocacy efforts effectively. For instance, a nurse in a maternity ward can advocate for pregnant women diagnosed with malaria, or a nurse in a child ward can better advocate for children under five who are vulnerable to malaria (VanderWeele, 2023). 
• It encourages ongoing education and collaboration with other healthcare professionals and organizations to stay informed and enhance advocacy initiatives (Fambirai et al., 2022). 

Outcomes

• The first outcome of the advocacy presentation is the audience’s positive response to culturally tailored health awareness campaigns and interventions. 

• I was achieving recognition from the audience regarding the need for affordable and accessible malaria interventions. The audience also recognized the alignment of organizational goals, reinforcing the relevance and urgency of the advocated strategies. 
• The presentation identifies key areas for improvement in future advocacy efforts, such as enhancing community engagement while acknowledging the diverse perspectives of the nursing community on addressing the health issue (malaria). 

Resultantly, nurses can continue to integrate cultural sensitivity into health initiatives to ensure they resonate with local communities. Advocate for policies and programs that make malaria interventions more affordable and accessible. Further, nurses can engage in continuous learning and collaborate with other healthcare professionals and organizations to improve advocacy efforts. Moreover, advocacy messages should be tailored to address the diverse perspectives within the nursing community for more effective communication and impact (VanderWeele, 2023). .

Conclusion

In conclusion, addressing malaria in SSA requires culturally sensitive approaches, affordable and accessible interventions, and robust policy development. By considering traditional beliefs and integrating modern medical practices while fostering collaboration among healthcare professionals, we can drive significant improvements in malaria prevention and treatment. Continued advocacy and investment in sustainable resources are crucial for achieving long-term success and enhancing health outcomes in the most affected regions. Together, we can make substantial progress towards eliminating malaria.

References

Aremu, T. O., Singhal, C., Ajibola, O. A., Frimpong, E. A., Safo, A. A. A.-N., Ihekoronye, M. R., Nabirye, S. E., & Okoro, O. N. (2022). Assessing public awareness of the malaria vaccine in Sub-Saharan Africa. Tropical Medicine and Infectious Disease, 7(9), 215. https://doi.org/10.3390/tropicalmed7090215 

Awasthi, K. R., Jancey, J., Clements, A. C. A., Rai, R., & Leavy, J. E. (2024). Community engagement approaches for malaria prevention, control and elimination: A scoping review. BMJ Open, 14(2), e081982. https://doi.org/10.1136/bmjopen-2023-081982 

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

Fambirai, T., Chimbari, M. J., & Ndarukwa, P. (2022). Global cross-border malaria control collaborative initiatives: A scoping review. International Journal of Environmental Research and Public Health, 19(19), 12216. https://doi.org/10.3390/ijerph191912216 

NURS FPX 8014 Assessment 3 Leading Global Health Strategic Planning and Policy Development notes

Feng, X., Huang, F., Yin, J., Wang, R., & Xia, Z. (2022). Key takeaways from China’s success in eliminating malaria: leveraging existing evidence for a malaria-free world. BMJ Global Health, 7(4), e008351. https://doi.org/10.1136/bmjgh-2021-008351 

Finda, M. F., Christofides, N., Lezaun, J., Tarimo, B., Chaki, P., Kelly, A. H., Kapologwe, N., Kazyoba, P., Emidi, B., & Okumu, F. O. (2020). Opinions of key stakeholders on alternative interventions for malaria control and elimination in Tanzania. Malaria Journal, 19(1). https://doi.org/10.1186/s12936-020-03239-z 

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 

Musoke, D., Atusingwize, E., Namata, C., Ndejjo, R., Wanyenze, R. K., & Kamya, M. R. (2023). Integrated malaria prevention in low- and middle-income countries: A systematic review. Malaria Journal, 22(1). https://doi.org/10.1186/s12936-023-04500-x 

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

NURS FPX 8014 Assessment 3 Leading Global Health Strategic Planning and Policy Development notes

Park, S., Nixon, C. E., Miller, O., Choi, N.-K., Kurtis, J. D., Friedman, J. F., & Michelow, I. C. (2020). Impact of malaria in pregnancy on risk of malaria in young children: Systematic review and meta-analyses. The Journal of Infectious Diseases, 222(4), 538–550. https://doi.org/10.1093/infdis/jiaa139 

Perera, R., Wickremasinghe, R., Newby, G., Caldera, A., Fernando, D., & Mendis, K. (2022). Malaria control, elimination, and prevention as components of health security: A review. The American Journal of Tropical Medicine and Hygiene, 107(4), 747–753. https://doi.org/10.4269/ajtmh.22-0038 

Pinto, L. de S., Arroz, J. A. H., Martins, M. do R. O., Hartz, Z., Negrao, N., Muchanga, V., Cossa, A., & Zulliger, R. (2021). Malaria prevention knowledge, attitudes, and practices in Zambezia province, Mozambique. Malaria Journal, 20(1), 293. https://doi.org/10.1186/s12936-021-03825-9 

RBC. (2020). Rwanda malaria strategic plan 2020-2024 republic of Rwanda ministry of health.  RBC.gov. https://www.rbc.gov.rw/fileadmin/user_upload/report23/Rwanda%20Malaria%20Strategic%20Plan%202020-2024.pdf 

RBM partnership. (2020). Malaria & sustainable development goals. Endmalaria.org. https://endmalaria.org/about-malaria/malaria-sustainable-development-goals#:~:text=The%20objectives%20of%20reducing%20the 

Sarpong, E., Acheampong, D. O., Fordjour, G. N. R., Anyanful, A., Aninagyei, E., Tuoyire, D. A., Blackhurst, D., Kyei, G. B., Ekor, M., & Thomford, N. E. (2022). Zero malaria: A mirage or reality for populations of sub-Saharan Africa in health transition. Malaria Journal, 21(1). https://doi.org/10.1186/s12936-022-04340-1 

NURS FPX 8014 Assessment 3 Leading Global Health Strategic Planning and Policy Development notes

The Global Fund. (2024a). How we raise funds. Www.theglobalfund.org. https://www.theglobalfund.org/en/how-we-raise-funds/ 

The Global Fund. (2024b). Nearly half the world’s population is at risk for malaria. https://www.theglobalfund.org/media/13753/publication_malaria_overview_en.pdf 

VanderWeele, T. J. (2023). Viewpoint diversity in public health. Frontiers in Public Health, 11. 1263767. https://doi.org/10.3389/fpubh.2023.1263767  

WHO. (2021, September 9). WHO global technical strategy for malaria 2016–2030 (2021 Update) . Reliefweb.int. https://reliefweb.int/report/world/who-global-technical-strategy-malaria-2016-2030-2021-update 

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

WHO. (2024a). How WHO is funded. Www.who.int. https://www.who.int/about/funding#:~:text=WHO%20gets%20its%20funding%20from 

WHO. (2024b, January). The RTS,S malaria vaccine. Www.who.int. https://www.who.int/publications/m/item/the-rts-s-malaria-vaccine#:~:text=The%20RTS%2CS%2FAS01%20(