Undertaking health research
CHWs/TTBAs/RHPs[*]. Here there are few constraints. a) the top level professionals including some policy makers do not endorse them fully, hence their information needs is curtailed to initial training and may be annual refresher courses. b) level of education especially the TTBAs and the RHPs(reproductive health promoters) is low, and hence reading materials let alone computers in another language (non English-speaking) is difficult or limited. They will need some audiovisual; a training materials and posters and so on.
I have been amazed at the high number of road carnages in Kenya, although it is known that Kenya has one of the highest road traffic accidents in the world. The old school of thought blames the poor state of the road, over speeding, and influence of drugs as the causation of these accidents. There is a new approach which is common in USA that has it that the medical conditions of the driver can affect his fitness to drive. Specifically, drivers are screened periodically for diseases such as vision defects, diabetes and cardiovascular diseases.
I have been communicated by some 'FGC promoters' (in a western country) asking my help to advocate FGC among teenagers as a solution to help keep some religious minorities virgin until they get married. Despite my personal, religious and professional commitment not to help or advocate for such practices, I find myself faced by some girls who live in these countries and who went (or about to go) through the circumcision operation asking me questions that I had to answer.
It is dangerous to confuse 'omolanke' (wheel barrow) with the 'Space Shuttle' just because they are both means of transportation (Beko Ransome-Kuti). We owe our patients better! And remember, 'at least do no harm' (Hippocrates). Yes I agree that there is something for us so-called 'orthodox' practitioners to learn from folk/herbal/native/traditional/alternate/complementary healers.
I am in the process of designing an Intervention study (Doctorate) on FGM/C whose aim is to influence Behavior Change among the communities that practice Female Genital Mutilation / Cutting. Searches already made indicate that despite high level of anti-FGM awareness and knowledge of health risks associated with the practice, the prevalence of FGM practice is almost 100% in some communities like in Kisii Community, Kenya. Studies show that no single intervention that is known to influence behavior change among the communities practicing FGM/C.
Everything that Martin Carroll lists as causes of high maternal deaths in the third world is true but recent experience complicates the picture: a medical school trained doctor who advanced after several years of practice (more than ten years) to the post of medical superintendent of a general hospital develops Stroke syndrome and takes himself to a village native 'doctor' (who of course is stack illiterate, unkempt and performs regular incantations inviting spirits and gods to his alter) because Stroke treatment is not for hospitals; a university trained female Barrister-at-Law d
What is so wrong with 20 year old books? No need to apologise. Knowledge is incremental. And historical data is just as relevant as current data. At the end of the day safe practice and saving lives preventing morbidity is what really matters by applying knowledge appropriately whether the source is 20 months, 20 years or 2000 years old. Ongoing research of current practice is what is really necessary as we refine and advance on the world wide body of knowledge.
This is obviously a welcome decision, particularly for people like me who is amongst those public health practitioners engaged in strengthening CHW initiatives. However, it is critical to devise the strategies for different national settings, for meeting the huge challenge of deploying trained community health workers for all the needy populations. I am sure that some discussions in this regard shall take place soon, and getting ready to share some views and experiences in this regard.