CLO #1 - Describe demographic and epidemiologic transitions and the challenges of measuring health and disease. Explain barriers to measuring disability. Explain the benefits and limitations of the western biomedical approach to health in other cultural contexts. Describe some of the dominant types of cultural explanations of disease causation and methods for understanding culture.

CLO #2 - Explain the concept of the health gradient and how it is measured and the relationship between social determinants and health. Describe the challenges of improving health for all populations and implement a preventative strategy.

CLO #3 - Examine the most common infectious diseases affecting low- and middle-income countries as well as the current approaches to their prevention and control. Describe the vulnerable stages of life during which malnutrition and micronutrient deficiencies are particularly dangerous and explain the underlying causes of food insecurity as well as local and global events that can exacerbate the extent of the insecurity.

CLO #4 - Appraise the leading chronic diseases and the leading risk factors for chronic diseases in low-, middle-, and high-income countries. Determine how to mitigate risks due to cumulative exposure to risk factors that impact health outcomes and describe policy responses to the growing burden of chronic diseases.

CLO #5 - Summarize the historical development of public mental health and explain the link between mental illness and other health and social concerns. Assess the limits of psychiatric knowledge and evidence to non-Western cultures and describe common mental illnesses and their interventions.

CLO #6 - Describe the key elements and typologies of health systems. Explain the objectives and impact of health care reform. Evaluate the key elements in resource management and the values that underpin management decisions. Describe and list the major actors in global cooperation in health at global and regional levels.

Scenario

Action Aid, an international non-governmental organization (NGO), has just hired you for its global health programs as the field program officer. Your previous manager from the World Health Organization recommended you for the job and now you are required to do a comprehensive Assessment for a USAID funded project in Kigali, in the Republic of Rwanda. Kigali has been hit with COVID-19 few months ago, but the cases have dwindled since last week. Unfortunately, in the last three days, there has been another outbreak of a new variant of COVID. Experts say it is highly infectious and the death rate has been increasing especially among the elderly and children. International organizations and foreign governments have been collaborating to help.

Food shortages, malnutrition, and lack of water supply are problematic in Kigali because of lack of irrigation. Action Aid is helping with the construction of water wells, but they have a long way to go especially in dealing with the culture and beliefs of the local citizens.

One of the issues you discovered was that the new variant affected only a specific demographic. The government in Kigali has changed health policies to favor nations that came in to help and many primary health organizations are teaching the population preventive measures and other infection control measures. To save lives certain risk behaviors were banned by the government and a mask mandate was instituted for everyone in the community.

1)Describe the challenges and barriers of measuring health and disease among people of a non-western culture like those in Kigali.

2)Explain the benefits and limitations of the western biomedical approach to health in other cultural contexts.

3)How could you apply those measures to the situation in Kigali?

4)Describe some of the dominant types of cultural explanations of disease causation and methods for understanding culture

5)Explain the relationship between social determinants and the challenges of improving the health population in the community.

6)Describe why the children and elderly were more vulnerable to the disease outbreak in Kigali, and what role did malnutrition and micronutrient deficiencies play in this case.

7)Do you believe the situation would have been different if it were a western country? Why?

8)How did the difference in income level of the population become a factor in the spread and severity of the disease?

9)Discuss mitigation to the cumulative exposure to risk factors, as well as alleviation strategies that impact health outcomes.

10)Describe policy responses you would recommend to the government in Kigali to help mitigate the problem.