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Health Promotion capacity building through PhD training in developing countries

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Developing and implementing appropriate health communication messages for home management of fevers ... bednets for nuisance prevention rather than malaria prevention. – PowerPoint PPT presentation

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Title: Health Promotion capacity building through PhD training in developing countries


1
Health Promotion capacity building through PhD
training in developing countries
  • CAPHRI April 3, 2012

2
Content
  • Rational, background and assumptions
  • Supervision
  • Research topics
  • Funding an scholarships
  • A sample of a research theme
  • Relevance does it work?
  • Continuation?

3
Rational and how it started
  • Growing need for disease prevention and health
    promotion
  • Relatively high costs of medical care in
    developing countries
  • Need for HE/HP expertise among young researchers
    from developing countries
  • Summer course participants
  • Personal development needs

4
Basic assumptions and ways of working
  • Motivation of the candidate
  • Candidates have an education comparable with a
    Dutch master diploma
  • Embedding of candidate in a local (research)
    organization
  • Support from local organization (s)
  • Presence of a local supervisor
  • Research preferably focused on a local health
    problem
  • Research primarily conducted in the developing
    country

5
Supervision
  • Focus on development of an independent
    researcher
  • Main focus of supervision is on learning
    application of theories and research methods
  • Candidates receive courses and individual
    teaching and training and instruction based on
    individual needs. (Summer courses like HE/HP
    theories, IM, qualitative research, data
    analysis, systematic reviewing)
  • Candidates have a local supervisor.
  • Candidate receives supervisory visits ones or
    twice/year
  • Candidate visits Maastricht about ones a year
  • Candidates are encouraged to participate in
    international research networks

6
Supervisory team
  • Mostly 2 Dutch supervisors (depending on
    expertise from UM or different)
  • Always one supervisor from developing country

7
Strategies in supervision
  • Candidate prepares proposal (in cooperation with
    supervisors)
  • Provisional publication plan
  • Time planning for publications
  • Attitudes towards authorship

8
Health Promotion Collaborative sites in Africa
Djibouti 1
Rwanda 1
9
Research topics and health problems
  • STI and HIV/AIDS (prevention, stigma, care)
  • Malaria
  • Tuberculosis
  • Lymphatic filariasis
  • Cardiovascular diseases
  • Nutrition, under-nutrition
  • Substance abuse (smoking, drugs)
  • Adolescent health and life style behaviour
  • Mental health (depression, suicide, traumas)
  • Health services organization and use

10
Research funding
  • NOW/WOTRO (5 grants)
  • Nuffic (6 grants)
  • Bilateral research funding (SANPAD) (2 grants)
  • Scholarships from other countries
  • MUNDO
  • Local developing country scholarship/research
    funding
  • International funds acquired by local
    organizations or universities

11
Developing countries dissertation completed and
in progress
  • Dissertations completed 15
  • Dissertations in progress 17
  • (Dutch Master students 20-25)

12
Example Malaria (3 PhDs)
13
The malaria problem
  • Mosquito-borne parasitic disease
  • 300-500 million cases annually
  • gt1 millions deaths annually
  • 90 in African children
  • 1 child death every 30 seconds
  • US 12b annual losses
  • Main control challenges
  • Drug-resistant parasite
  • Insecticide-resistant mosquitoes
  • Poverty
  • Poor infrastructure
  • Weak health systems

14
Insecticide-treated bednets (ITNs) for malaria
control
  • Alaii JA,
  • Kenya Medical Research Institute,
  • Centers for Disease Control and Prevention,
    Atlanta, GA.
  • CAPHRI, Maastricht University, NL.

15
The study location
16
Homestead close range
17
(No Transcript)
18
Effect of insecticide-treated bednets on malaria
19
Study objectives
  • To assess the acceptability of insecticide-treated
    bednets for malaria control
  • To describe sleeping arrangements and existing
    bednet use
  • To describe malaria knowledge, beliefs, and care
    seeking
  • To determine the perceived role of bednets in
    malaria control
  • To determine environmental and social variables
    affecting adherence
  • To assess potential child roles in ensuring
    correct bednet use
  • To make recommendations on ITN use in western
    Kenya

20
Socio-behavioral studies
21
Formative evaluative research
  • Minimal (lt5) bednet coverage
  • Bednets ranked low in household expenditure
    priorities
  • Nuisance biting versus disease prevention
  • Adults given priority access to existing bednets
  • Children predominantly sleep in temporary bed
    spaces
  • Multiple concept of malaria causation
  • Bednets prevent mosquitoes and not malaria per se
  • Safety concerns about use of chemical
    (insecticide) in bednets

22
Malaria knowledge including care seeking
  • Increased perception of mosquito-malaria link
    (85 vs. 75.1)
  • Persistent concept of multiple causation
  • Malaria likely to be treated using modern
    medicines
  • Self-medication the norm
  • Health facility used mainly as a last resort
  • Persistent low rank of bednets in household
    expenditure priorities
  • Lacking perception of bednet re-treatment as
    essential

23
Adherence study
  • Social factors affecting bednet use pose major
    challenge (sleeping arrangements, family
    hierarchy systems)
  • Mothers sometimes not at home to put child to bed
  • Mothers to tired to hang nets after work
  • Older children (6-12) were not involved in
    bednet mounting

24
A section of trainees
25
Tools of the trade mat, net, twine
26
The pre-training and evaluation interviews
27
Okay, lets see you sort out the tools
28
This is how I want it spread out
29
Net too high upchecking where we went wrong
30
Here we go againsorting out the tools
31
Notice how high up the mounting point is
32
The fully mounted and spread net
33
Were this in the bedroom, I would fold it up like
this, and leave it hung there
34
Developing and implementing appropriate health
communication messages for home management of
fevers, Dangme West, Ghana(Uncomplicated malaria
and Pneumonia)
35
TOWARDS MALARIA ELIMINATION AN INTEGRATED
COMMUNITY-BASED APPROACH TO MALARIA CONTROL
(Rwanda)
  • Entomological approach (reduction of malaria
    bearing mosquitos)
  • Medical approach (prompt diagnosis and treatment)
  • Economic approach (Feasible and sustainable
    programme activities)
  • Behavioural approach (community-based approach,
    communication and enhancement of preventive
    behaviours like bednet use, help seeking,
    removing of mosquito breeding places.

36
Relevance for developing country Does it work?
  • Is capacity building sustainable?
  • Do graduates remain working in their own country?
  • Does the research and work of graduates
    contribute to the health of people?

37
Sustainability example
Department of Health Promotion Research and
Development, Medical Research Council SA
38
Example of translation into practice
Results of research on war traumas of female
students at Ahfad University in Sudan (Started 2
years ago)(Alia Badri)
  • Development of a trauma counselling centra at
    Ahfad university
  • Preparations for a Master in trauma counselling
    for the region

39
Relevance for Maastricht University/CAPHRI
  • Testing of theories and methods in different
    socio-cultural contexts
  • Opportunities for international comparison
  • Publication and dissertation output
  • Enhance HE/HP image of MU capacity
  • Expand network and international position
    Maastricht University

40
Continuation of capacity building?
41
Thank you
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