CHL5700H Global Health

a. The first part of a needs assessment involves quantifying the level of a health need of a population. In order to do this, you must determine the current state of a self harm in US prisons and compare this to self harm in Canadian prisons (target state). Determine the gap between the current state and target state as the magnitude of need.

b. To provide a concrete example, let’s say that child mortality is currently 150 per 1,000 live births in a given country. If the ideal state for child mortality is set to the rate experienced in Canada (about 5 per 1,000), then the need is to reduce the child mortality rate by 145 per 1,000 (about 3000%).

c. To effectively quantify the health need of a population you must: 1) find an appropriate metric for the current level of need (i.e. incidence, prevalence, DALYs), and 2) justify why you chose the target state (e.g., explain why you chose a particular country’s rate or why you used a goal set by the WHO).

d. Identify a number of possible root causes of the health need. Make an argument for the relative impact of the root causes on the population’s health needs (prisoners). Next, choose one root cause that you would like to address, explaining why you selected it at the exclusion of the others.

e. For example, if you chose children in Kenya as your population and chose HIV transmission of the virus at birth as your health problem, you may come up with the following possible root causes: lack of prenatal care, lack of affordability of HIV medications for the mother and traumatic deliveries as possible reasons for the high rate.  You may decide that the most cost-effective place to focus your attention would be to find ways to improve the access of HIV medications to pregnant mothers. Remember that the root cause that you choose here will be your focus in the next assignment, where you will be designing an intervention to improve the situation, so try to frame your choice keeping that in mind.

f. Identify and discuss barriers and enablers to addressing the root cause of the health need. Barriers are understood as obstacles that could harm the feasibility of an intervention. Examples of barriers include civil unrest, governmental policies or agendas, physical barriers (e.g., lack of infrastructure), or cultural barriers (e.g., mistrust of western medicine). Enablers relate to factors or resources that can be leveraged to increase the feasibility or effectiveness of an intervention. Examples of enablers include the willingness of the community to participate in an intervention or governmental programs that could make additional resources available for addressing the issue.