Essays, poems and Stories of an African-American

Saturday, 14 November 2015

Applying Country Based Health Metrics From a Public Health Perspective; Case of USA and One African Country ( Uganda)

All countries have a Public Health Provision Model that combines maximizing individual positive outcomes as well as minimizing adverse collective outcomes. The countries promote population-based activities, monitor health status, investigate health problems and hazards, inform and educate people about health issues, mobilize communities, develop policies and plans, enforce laws and regulations for the wellness of their citizens.

To promote public health practice, medical health practice and long term care practice that in turn ensure quality life, these countries invest money of different amounts. They commit resources which cause health outcomes. However, the social-ecological factors in these countries make it a unique framework within which to provide public health and medical health services. Biologic, environment, behavioral, social, cultural and health services available in a given country in turn affect the well-being of the citizens.  These in turn affect the impact of the strategies or interventions. 

The US has a population total of 320,051,000. Its total expenditure on health as a percentage of GDP for the year 2013 was $ 17.1, a total expenditure on health per capita for 2013 at $ 9,146 and life expectancy of males at 76 and females at 81 (  It has committed over 15 million workers in the Public Health workforce and $ 3.0 trillion in resources. The public health needs presently facing the US include: slowing population growth rate, and older population, increasing diversity of population, changes in the family structure, a persistent lack of access to needed health services for many Americans and relative prevalence of particular diseases (Turnock, B. J. 2016).

On the other hand, Uganda has a population total of about 37, 579,00, its total expenditure on health as a percentage of GDP for the year 2013 was $ 9.8 a total expenditure on health per capita for 2013 at $ 146 and life expectancy of males at 57 and females at 61 ( faced with lukewarm commitment in funding the health sector. The funds keep vacillating below or above $294,117, 000 as in the case of 2011. This amount is far below what the international ceiling ( e.g., Abuja Declaration) calls for.  Uganda still battles parasite infestation e.g., malaria-causing mosquitoes.  Plans to commit to eradicate malaria are half hearted pronouncements made at electoral campaigns most of the time. “The Government also committed itself towards developing and implementing a comprehensive strategy to eradicate malaria and strengthen its prevention, diagnosis and treatment. It also committed itself to reduce morbidity and mortality from the major causes of ill health and premature death,” (

In order for public health to be a collective effort that promotes quality health outcomes, countries need to back public health initiatives with a funding commitment and not just lip service. Public Health Provision can be effective if it combines maximizing individual positive outcomes as well as minimizing adverse collective outcomes. 


3. Turnock, B. J. (2016). Essentials of public health (3rd ed.). Burlington, MA: Jones & Bartlett.  

Monday, 9 November 2015

Health Promotion, Ethics, Food and Vaccines from a Public Health Perspective

Promotion of health is possible through a vast health system. This relies on moral obligation, skills and resource mobilization appropriate for prevention and treatment of illnesses and injury. Planning for financing, programming and service providing are some examples of the resources.  A successful health system must deploy and integrate a variety of strategies and activities in terms of their strategic intent, level of prevention, and community and individual focus. Wellness and illness are dynamic states influenced by cultural, social, behavioral,, environmental and health service factors that interact within a social-ecological framework. The strategies intervene prior to the development of disease or injury by altering factors in ways to avert or alter occurrence of injury/disease. Or when disease/illness strike there is need for care, limiting disability, eradicate diseases, prevent death and lastly, return individual to the maximum level of function consistent with their capacities (Turnock, B. 2016). But, this is not enough.

Public health practitioners have a duty to promote practical strategies for qualiy life. This is both a mind set and moral conduct that will help, say, increase immunization attendances or good nutrition. Ethicists link consistency with previous behavior good results to responsible conduct (G. Cornelissen et al, 2013). There are profound emotions attached to, say, health promotion. Ethicists, again, have established the link between moral reasoning and moral action in form of emotions of fear, guilt, love, play a central role in all thinking and behavior, including moral behavior (Association for Psychological Science, 2011).  A trained practitioner will have the skills to do no harm to others. It is this feeling of obligation as well as duty that is a compulsion to have something done using the acquired combination of skills. The skills enable one to engage in planning interventions, moral forecasting and moral action. This could explain the single purpose why a public health practitioner engages in health promotion, disease prevention and preserve life. The commission or omission of interventions become what are known as health outcomes. It is these outcomes that have enabled humans adopt survival and leadership skills. The four domains--movement, food acquisition, within-group conflict mediation, and between-group interactions contribute to the scale of collective action which is critical for survival and reproduction (Smith J.E, 2015). Fulfilling one’s duty has health outcomes and so does promoting good feeding and vaccination. The three cases below illustrate this point.

John is a 55 year old man and he is a soft and hardware inventor who lives in an upper class neighborhood in New York. He comes from an accomplished loving family and all his relatives are well-to-do. He has access to the best healthcare system in the world and can afford the best nutrition on the market. In the last two years he has been a recluse living off his accrued money from three patents with Apple and GM. John has had to visit the clinic 12 times in the last year. It is during one such a visit that John exhibited clinical depression. The last 7 visits were with a psychiatrist who prescribed Trazodone, Venlafaxine, Naproxen (a combination of anti-depressants and sleeping pills) and Omega-3 food supplements.

Nswemu is a 60 year old, indigenous and semi-literate man from the Baganda people of an East African country. He has lived all his life as an agriculturalist in Bigasa, Bukomansimbi District, South of Kampala City. This area experiences ample rains and is the bread basket of Buganda. The people are essentially hunters, foragers, few are engaged in wholesale business, professions such as teaching and administration, and some are into animal and crop husbandry whose products are either sold or used as food crops.  Their diet consists of:  legumes, nuts, cereals, edible insects, small rodents, red-meat, fish, game, fresh-fruits and leafy vegetables. The people are extremely active and most use the two-wheel bicycle for most of their transport needs. Nswemu, has visited the clinic twice in the last two years for malaria-related complaints. The primary-care provider used both these opportunities to gauge depression and in both there were no exhibited signs of depression. Nevertheless, the primary-care provider encouraged Nswemu to engage in day to day activities within his extended family and emotionally supportive community.
Vaccination is one way of preventing infections in humans of say, measles. Those who are not vaccinated or are under-vaccinated are highly susceptible to becoming ill. Measles can easily be eradicated from countries. It is still prevalent and is acquired through direct contact and droplets that can spread through the air. Measles is one of the most contagious of the vaccine-preventable diseases (Infectious Diseases Society of America, 2015)

The above three cases show the prevailing circumstances in which life is either put at risk or preserved.  We see two different default means to accomplish a good feeding status. For John, it is the norm to feed properly given the existing first class public health system in his country. For Nswemu, it is the cultural default on which he falls back to feed so well as the fore parents had fed. In John’s case large amounts of processed foods in form of snacks and fast foods have tended to increase his supply of Omega-6 while reducing intake of Omega-3.  Home cooked meals in his case has been something he did in his early 20’s. He confessed that he occasionally has a diet full of fresh whole foods, including leafy greens, raw fruits and vegetables at home. He said he consumes much coffee and alcohol. A good recipe for good mental an physical health should involve low caffeine and alcohol consumption as well as regular diet full of fresh whole foods, leafy greens, raw fruits  and vegetables (Leap Dennis, 2012). The brain which is the physical component of the mind functions so well when fed healthy foods. This food is primarily fat (Leap Dennis, 2012). The human brain is 60% fat by dry weight. Fat molecules, such as cholesterol and saturated fats, play a very important role in the construction of brain cells,  their repair work and insulation of nerve fibres. The brain needs healthy fats to thrive and these fats are found missing in the blood of depressed people. Omega-3 fatty-acids can be found in such foods like fish, flaxseeds, kale, brussels sprout, green leafy vegetables, olive oil, salad greens, walnuts, spinach, avocado. Omega-6 fatty-acids can be found in non-hydrogenated cold press olives, coconut  oil, palm oil, butter, seeds and nuts or oils produced by them. A healthy diet must balance both these fatty-acids.  Highly processed foods contain large amounts of Omega-6 fatty-acids (cereals, cookies, chips, crisps, crackers, shakes and fast-food). If not for reasons of general health, it should be good practice to provide the brain with good nutrition.

To function well, the brain needs oxygen-rich blood. This can be inexpensively got by engaging in outdoor activities. Invigorating walks are an inexpensive way to remain physically fit and mentally balanced.  The average Baganda walk long distances a day, carry firewood, use the bicycle, hunt, forage for fruits, engage in mock battles, engage in cheer leading using traditional songs, sleep for at least 8 eight hours and volunteer their time for all social activities such as funerals, community clean up campaigns and attending spiritual gatherings. Exercise and activity as treatment for depression have proved that walking briskly for 30 minutes only three times a week is better ( Leap, D., 2012). Obligation to feed well has its good side. In the next paragraph we see the need for vaccination against, say, Measles.

In the case of vaccination, there should be mechanisms to balance administering vaccines to those who need them and to find other ways to provide cover to those other people to whom administering this vaccine may end up causing more harm. Children should receive two doses of measles containing vaccines at the recommended ages. There is concern for children who haven't received any doses for any of a variety of reasons, including: lack of access, being unaware of the need for vaccines and being opposed to vaccines. In addition, doctors need to ensure those who received only one dose receive a second dose at the recommended age. The Measles, Mumps and Rubella (MMR)  vaccine is given to children in two doses, the first at 12 to 15 months and the second at four to six years old. While children are required to receive the MMR vaccine before attending school, some are exempt because they have a medical issue, such as an immune disorder or cancer. (The weakened live virus, and while it does not cause disease, it is not recommended for those whose immune systems are compromised.) Further, most states offer exemptions for religious or personal reasons (Infectious Diseases Society of America, 2015).

There are lessons to be drawn from the above scenarios and these include: qualifications prepare one for responsibilities in given callings, vaccination and nutrition are two areas that show why there is need to promote health in communities, lifestyles affect the brain and in turn our brains have an effect on our ability to adjust to our social-ecological environment. Lastly, there are easy ways that can be adopted to improve on the quality of life.

Association for Psychological Science. (2011, February 23). Are we more -- or less -- moral than we think?. ScienceDaily. Retrieved November 9, 2015 from
Association for Psychological Science. (2013, March 7). Do-gooder or ne'er-do-well? Behavioral science explains patterns of moral behavior. ScienceDaily. Retrieved November 9, 2015 from
Cell Press. (2015, November 6). What makes a leader? Clues from the animal kingdom. ScienceDaily. Retrieved November 9, 2015 from
Leap, D. January 2012

5.  Turnock, B. 2016. Essentials of Public Health. Johns and Bartlett. Burlington, MA