Assignment task
Critically appraise epidemiological approaches to understand health and social care needs.
Systematically summarize and interpret relevant data to inform strategic planning for the health care needs of local groups and communities.
There are two questions each with two parts. You need to answer both questions and both parts of the question. Question 1. Almost 37 million people are living with HIV globally and Sub-Saharan Africa (SSA) is the region most severely affected by the epidemic (UNAIDS). Despite a general decline in the number of people newly infected with HIV in most SSA countries, differences in rates between population subgroups remain. Understanding the changes over time and differences across population groups is important for health professionals, epidemiologists and policy makers to design and implement targeted preventive interventions.
Table 1 below presents data from the Demographic and Health Surveys (DHS) and the AIDS Indicator Surveys (AIS) in 11 SSA countries for 2001-2014. The data show HIV prevalence in females and males aged 25-49 years by urban and rural areas in each of 18 countries.
- a) describe and critically analyse the patterns and trends in HIV prevalence that you observe in table 1 (10 marks; maximum word length 500 words).
- b) discuss the possible reasons for these patterns and trends and based on the evidence from the literature, outline two recommendations for a local policy maker to reduce disparities in HIV burden (10 marks; maximum word length 500 words).
Table 1 Age-adjusted female and male HIV prevalence by country and urban/rural
Residence.
Urban Rural
Country Female Male Female Male
HIV+ (%) n HIV+ (%) n HIV+ (%) n HIV+ (%) n
Cameroon
2004 10.76 1 277 8.09 1 184 5.77 1 530 4.18 1 343
2011 9.50 1 917 5.18 1 659 5.98 2 197 4.27 1 860
Côte d´Ivoire
2005 11.54 1 027 5.45 805 8.52 1 504 4.17 1 458
2011–12 8.25 1 084 5.26 911 4.68 1 678 3.24 1 449
Guinea
2005 5.81 607 1.46 401 1.02 1 882 1.08 1 034
2012 5.47 934 2.24 737 1.39 1 856 1.54 1 165
Mali
2001 4.10 522 3.11 401 2.00 1 817 1.51 1 203
2006 2.93 891 1.88 697 1.54 1 924 0.88 1 339
2012–13 2.68 871 2.71 538 1.12 2 402 0.67 1 643
Ethiopia
2005 12.32 812 4.82 557 0.72 2 642 1.05 2 104
2011 9.35 2 524 5.03 2 009 1.10 6 543 0.70 5 083
Rwanda
2005 12.45 691 9.44 548 3.84 2 514 2.71 1 783
2010 12.70 654 8.14 627 4.04 3 355 2.86 2 456
Kenya
2003 16.10 547 11.15 463 9.15 1 310 6.01 1 026
2008–09 13.94 637 5.08 597 9.17 1 565 7.56 1 062
Tanzania
2003–04 17.55 836 12.75 613 7.48 2 691 6.91 2 185
2007–08 14.46 1 106 10.19 686 6.72 4 020 6.27 2 836
2011–12 12.14 1 408 7.35 916 7.07 4 737 5.29 3 293
Lesotho
2004 39.79 439 31.93 226 33.16 1 210 32.89 741
2009 39.44 563 33.72 319 35.92 1 569 30.47 1 074
Malawi
2004 22.69 176 26.84 205 15.57 1 452 12.37 1 187
2010 31.26 570 20.47 453 15.23 3 768 11.26 3 015
Zambia
2001–02 36.85 357 29.91 308 15.53 819 12.7 1 702
2007 32.72 1 358 24.71 1 099 13.83 1 987 13.26 1 719
2013–14 28.98 4 100 21.05 3 146 13.12 4 958 11.21 4 058
Question 2.
Please refer to the following paper:
Daivadanam M, Absetz P, Sathish T, et al. Lifestyle change in Kerala, India needs assessment and planning for a community-based diabetes prevention trial. BMC Public Health 2013; 13:95
This is an open access paper. You will also find a copy in the assignment folder. Please answer both sections below, which relate to the methods and findings of this paper.
- a) Describe the methods used to collect evidence for a needs assessment for a diabetes prevention programme in Kerala and discuss their strengths and limitations (10 marks; maximum number of words = 500)
- b) What are the major barriers to behaviour change in India and how these barriers can be overcome (10 marks; maximum number of words = 500)
