How would one select two countries and develop a health policy for the country while considering the following:
- Explain the rationale for selecting the country.
- Describe the social determinants of health in the country that you would need to address. Explain why you need to address these determinants.
- Explain the possible public issues you might encounter in health literacy and cultural awareness in this country.
- Describe the relationship between health inequality/inequities and life expectancy for the population in your selected country.
- Describe two current efforts in this country (you selected) to reduce health inequities.
- Taking into account the culture of the country, explain how you might develop a health policy so that it gets the support of the country you selected.
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Health literacy refers to the "degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions" (National Network of Libraries of Medicine, "Health Literacy"). Health literacy coincides with literacy, or the ability to read, but also extends beyond reading ability. To be health literate, one must also have "listening, analytical, and decision-making skills, and the ability to apply these skills to health situations" ("Health Literacy"). To be health literate, one most be able to read and understand directions on prescription labels, time indications in doctor's appointment notifications, brochures aimed at educating patients about medical issues, and directions and consent forms issued by doctors. To be health literate, one must also be able to read charts and graphs, work computers, be "information literate," and be able to calculate figures and "reason numerically" ("Health Literacy"). While health literacy and literacy are not necessarily the same thing, literacy certainly does have a direct effect on health literacy. Those who cannot read or write will not be health literate, even though those who can read and write may or may not also be health literate. Since there is a correlation between literacy and health literacy, the United States Department of Health and Human Services has been found that culture also has a direct effect on health literacy because culture alters the way "'people communicate, understand and respond to health information'" ("Health Literacy"). Therefore, you will have an easier time choosing your two countries for which you want to develop health policies by focusing on countries with the lowest literacy rates. Focusing on literacy rates will both help you easily narrow your focus and be beneficial because literacy rates do affect health literacy, and health literacy rates will help you decide what health policy needs to be developed and exactly how to promote that policy.
Literacy rates are especially affected by educational opportunities and the country's economy. There is a list of the top 10 most illiterate countries in the world, starting with Niger being the most illiterate country and including Burkina Faso, Afghanistan, Sierra Leone, Gambia, Guinea-Bissau, Senegal, Benin, Ethiopia, and Mauritania; therefore, choosing and further researching two of either of these countries would be a good idea and a good start ("Top 10 Most Illiterate Countries in the World").
As an example, if we focus on Niger, we learn that it is considered the poorest country in the world based on the UNDP Human development multidimensional poverty index. The majority of the country consists of the Sahara desert, a desert that keeps spreading ("Major Problems Facing Niger Today"). Of the population, 84.3% are illiterate, and 80% of adults are illiterate. While school is mandatory for the first 6 years, most children cannot enroll and attend because children are needed for labor ("Top 10 Most illiterate Countries"). The major health problems that the citizens of Niger face include "malaria, diarrheal diseases, acute respiratory infections, malnutrition and HIV/AIDS/STIs" (Relief International, "Niger"). Your next step will be to choose a health problem to further research and its social determinants of health in order to develop your health policy.
As an example, let's focus on researching the problem of malaria in order to develop a health policy for Niger. The first question to ask yourself and further research is, what are the social determinants of health that make malaria a persistent problem for the people of Niger? Social determinants of health include any situations people are born into, grow up in, live in, work in, age in, and established systems to cope with illness. Such situations are also influenced by economic, social, and political factors. One of Niger's social determinants of health for the contraction of malaria is climate. Malaria is caused by being bitten by female mosquitoes infested by parasites; therefore, malaria will most be a problem in mosquito infested territories (CDC, "Malaria"). Mosquitoes need water to lay eggs, so a wetter climate is needed for mosquito infestation. The Niger climate is divided into three different regions: the Sahara desert to the north, the Sahel south of the desert, and the Sudan in the southwest of the country (Encyclopedia of Nations, "Niger--Climate"). Problems with mosquito will arise in the Sahel, which is semi-arid and the Sudan, which has the most rainfall of any part of the country. A semi-arid climate, like the Sahel, is a climate that is a cross between a dry desert and a humid climate that makes farming possible. In the Sudan region lies the steppe, or grasslands, as a result of more rainfall. Mosquitoes will also become dormant during dry spells in dry regions like the Sahara but resurface during rain spells.
Many things can be done to help prevent the contraction of malaria upon which you can base your health policy. Though still in the testing phrase, a malaria vaccine was produced and has been being tested since 2009. In 2013, the vaccine was shown to have a "100% success [rate] in protecting subjects" (CNN, "U.S. Reports a Breakthrough in Malaria Vaccine"). Hence, one thing your public policy can do is promote the use of the vaccine once it has been fully released. In the meantime, there are other known treatments for preventing malaria that your public health policy can promote. Treatments include a wide variety of antimalarial drugs, "sleeping under insecticide-treated bed nets, using insect repellent, and wearing long-sleeved clothing" (CDC, "Malaria"). Hence, your public health policy can also promote the use of the above. Since the country is poor, your public health policy will also need to include intervention measures to ensure more citizens of Niger have access to the above malaria-prevention solutions.
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