INTERPRETING HEALTH METRICS FROM A PUBLIC HEALTH PERSPECTIVE; CASE OF USA AND 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 (www.who.int/countries/en/).  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 goeth 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 (www.who.int/countries/en/). 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,” (www.newvision.co.ug).
 
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.
REFERENCES:
Turnock, B. J. (2016). Essentials of public health (3rd ed.). Burlington, MA: Jones & Bartlett.  

IMPORTANT PUBLIC HEALTH PRE-OCCUPATIONS IN THE 21ST CENTURY USA

The main role of public health in the 21st Century will be to protect us from various diseases or life threatening conditions deriving from: climate change; emerging diseases; bioterrorism; racism; stigma; prejudice; and political dilemmas. Public health practitioners of the 21st Century must be in position to understand the complexities of cultural diversity, e.g.,different generational, economic, professional, ethnic, religious, linguistic background, gender, gender identity, sexual orientation, stereotypes, prejudices, physical status, conscious bias, unconscious bias, structural bias, enjoyment of access to resources, access to opportunities, access to options, safety from violence,  affordability of housing, civil rights, access to food, access to jobs, opportunities for job trainings, access to recreation and readiness to be  a compassionate provider. Many clients and communities face bias and discrimination when they attempt to access health and social services and , as a result, receive fewer services and services of poorer quality (Berthold, T. 2009). In order to provide public health services, government has concrete plans such as enacting laws, enforce laws, provide financial support and oversight to ensure promotion of health, prevention of diseases and instituting a preparedness mechanism.The most important new or expanded roles for public health occupations in the 21st century will include:

1. Strengthening the public health activities framework that is interlinked by a network of federal, state and local public health agencies with emphasis on referral mechanisms and oversight processes.
 
2. Ensure a reporting mechanism that dovetails into the overarching design where: the contribution of USA to international health-related interventions continues; the legal foundation gives gives primacy for health concerns to states; allows the federal government to promote consistency and minimum standards across the 50 diverse states; and a practical foundation of LHDs serving as the point of contact between communities and the three-tiered government.
 
3. Shifting mobilization tasks to advocacy entities at community level as a means of having a pulse on changing needs, resource needs and meeting public expectations.
 
4. Investing in early warning mechanisms for threats from fires to bio-terrorism. There will be need to have a contingency for fire hazards now that the globe is getting warmer. This will mean wildfire-prone geographical zones like Mid-Western and California will have more established fire departments. The quarantine points at border entry points, airports and ports need to be strengthened now that there is more likelihood for bio-terrorisms, hostility and acts of sabotage against the U.S. or any other nation by terrorists and enemies (www.nytimes.com). 
 
5. Public health practitioners reaching out to the indigent or marginalized. This will rely on the work of local health agencies. These will in turn report to second tier government levels and different organizations that form the backbone through which the power to protect the public’s health is possible.
 
6. Providing training and promoting competencies for public health professionals in the 21st century mostly in these areas: conducting essential public health services; legislation; regulation; policies; and the ability to negotiate,  justify public funding for many public health initiatives. For public health to be perceived, such essential services as are relevant: monitoring the health status of the population; diagnosing and investigating problems deemed hazardous to the public’s health; educating the population on health issues; mobilizing communities to act on their own health issues; developing policies; enforcing laws and regulations that protect the public; linking people to health services; ensuring a competent healthcare workforce; evaluating the effectiveness, access and quality of health services and researching to continue progress and innovation in healthcare (Turnock, B. J. (2016). Essentials of public health (3rd ed.). Burlington, MA: Jones & Bartlett).
 
7. Use of Technology, which will enable complex research to be translated into action in a faster and flexible way. Technology can be used in many other forms as well. One way is establishing a centralized health management information templates that can be used to report for instance compliances to the Healthy 2020 vision and mission. Events in which equity and equality are addressed can be captured at local, state, regional and federal levels. Racial biases are shown to be a part of the social structure of medical practices at both macro and micro levels (Centre for excellence in health care journalism). Use of web-based platforms to share information can help improve on coverage of what works and who is served. Public health will be a means for America to deal with the hot topics that focus on: race, culture, ethnicity, lifestyle, health status and health care in America. This might be the great quest of technology as well. Through technology it will be possible to level the health care playing field. Socioeconomics, individual racism, and institutional racism that represent the three predominant pathways to differential treatment for diseases will be targeted and redress provided. Reporting mechanisms will provide common indicators used to gauge quality of life for women and men irrespective of their gender, sexuality, race and social status.  Compiling reports into a format that can be disseminated to all concerned is another good use of  print technology and the world-wide web. In this format the media can be relied upon to make information available or the applicability of the information by society in form of case reports/studies or any format that is reliable for dissemination. However, newsprint, radio and TV tend to tap into our anxieties focusing on trivia. “The CDC has had to contend with bogus reports of imported banana carrying flesh-eating bacteria, drug addicts placing HIV-infected needles in pay coin-return boxes, virus soaked sponges arriving with the mail,”(Drexler, M. 2010). 
 
8. Understanding the need for post trauma stress counseling and care arising from the link between terrorism, massacres and resultant traumas. A global nightmare envelopes the world every time wars, genocides and terrorist attacks occur anywhere in the world. The rallying call that brings together nations ready to do rescue activities is to profess solidarity with the suffering nations. Rescue efforts are made by nations. This was seen after September 11, 2001, in UK, in Uganda, in Tanzania, in Kenya and most recently in the 10th district of Paris where the most recent attacks have occurred. The San Francisco editorial has this to say, “France’s loss is our loss. Its grief is our grief. And its fight to counter the forces of inhumanity is our fight”  (San Francisco Chronicle, Editorial, November 14th, 2015). 
 
9. The effects of political pronouncements such as the recent debate on mass deportations sends trauma shocks to those who are  not documented yet they many have lived in USA all their life and some are employed. These people may end up not attending social services for fear of being hounded and put on hot lists.
 
 10. Establishing a structure of international partnership to deal with climate change, neglect, poverty and famine  at a global level which in turn make humans and in some cases livestock vulnerable to influenza, Legionnaires’ disease, Lyme disease, toxic shock syndrome, E. Coli 0157:H7, STDs, Ebola virus, AIDS, severe acute respiratory syndrome (SARS), H1N1 influenza (Drexler, M. 2010). 
 
11. Understanding the increasing relation of chronic low-level inflammation, wide range of common debilitating disorders, stealth infections, deadly sepsis, how to balance use of antibiotics and inflammatory-quashing steroids. Research findings recommend Mediterranean style diet for those suffering from inflammatory disorders (Sachs J.S., 2007).
In the 21st Century, stigma discrimination, bias and prejudice will be the issues that need addressing. This in turn will clear the way for addressing neglect, poverty and famine. In situations where equality, respect and dignity are promoted, proper protection of life and ensuring individual well-being will be achievable.
REFERENCES:
1. Berthold, T. 2009. Foundations For Community Health Workers. San Francisco, MA: Jossey-Bass.
Centre For Excellence in Health Care Journalism. 2006.
 
2. Drexler M., 2010. Emerging Epidemics: The Menace of New Infections: H1N1 Flu, SARS, Anthrax, E.Coli.Penguin Books.
 
 
4. Sachs, J.S. 2007. Good germs,Bad Germs: Health and Survival in a Bacterial World. New York, NY: Hill and Wang.
 
6. Turnock, B. J. 2016. Essentials of public health (3rd ed.). Burlington, MA: Jones & Bartlett. 

Corporate Africa Meets Corporate America in a final Tango!

INTRODUCTION:

Africa senses a shift in regard by the American entrepreneurship complex, from a patronizing-know-it-all-relation to one that sees Africa as a potential ally. But, is Africa ready to effectively engage, negotiate and convey an image of an accomplished investment hub in the eyes of America? In order for Africa to learn fast, it has to create a critical number of viable spaces, turn-keys of entrepreneurship formation in order to not miss the investment opportunities America is ready to unleash. This atomization and at the same time an addition of options for Africa is a sure way to creation of infrastructure in Africa that will: eradicate poverty, problematize and erase corruption, be a platform to motivate actors in developing Africa and prepare Africa as a provider for its populace as well as a competitive exporter of goods.

THE VALUES:

There are values embedded in American entrepreneurship and its high scale of productivity. By productivity is meant the number of skilled people, able to get into a form of work force,  have a purchasing power and contribute to producing consumables. The values are: Thrift and Planning; Knowledge of Navigating Agency; Principles of team building and maintenance; Cognizance of Project cycles; Ability to generate largest possible beneficence; Drive for efficiency; Highly aware populace; Evolving US Foreign and Trade Policies; A really large middle class; and Focused leadership. These 10 points constitute the yeast that leavens the entrepreneurship bread of USA.This paper is the result of my research from 2013-2015 in USA. Corporate Africa can copy these value in order  to behave like corporate America. The objective of this paper is to point out what distinguishes Americans as astute and competitive entrepreneurs who maintain corporate standards.

WHY THIS PRIMER:

Two friends, I talked to as I was breaking down the 10 points that make up the frame of this paper asked me once; “what do you admire most about Americans?” You realise they had used the superlative. I answered without butting my eyes: “Institutionalized social services and redress systems.”  It is through these institutions (an infrastructure of redress, means of claiming rights and execution of responsibilities) that democratic values e.g. individual dignity, diffuse government, freedom of expression and dissent, equality of opportunity, private property and due process of the law are perceptible to an ordinary citizen and resident of USA. It makes it possible for there to be accessible health facilities, education, housing, care for seniors and minorities. Meanwhile, governance is such that the activities of government, civil order, commerce and security go on regularly as citizens and residents pursue a livelihood with a promise of happiness. This paper is for African entrepreneurs who want to trade with America.

“Entrepreneurship brings down barriers between communities and cultures and builds bridges that help us take on common challenges together. Because one thing that entrepreneurs understand is, is that you don’t have to look a certain way, or be of a certain faith, or have a certain last name in order to have a good idea.”

President Obama at the Global Entrepreneurship Summit in Kenya, July 2015.

THE FOOT CALVARY OF ENTREPRENEURSHIP:

America is seeking to work with grass root community entrepreneurs in Africa and the bulk of Trade and Business in which people are involved is what this paper seeks to address. This paper seeks to bring on board ordinary people who don’t run mega-corporations and are not involved in boardroom mega contract deals. This paper is for those individuals who together will form the largest ground swell of entrepreneurs who will be able to promote energy conservation, ford streams and bridge valleys leading in and out of their rural homes. Eventually, with infrastructure of this kind it will be possible  to bring mega corporation officers who are Tech-savvy and familiar with air conditioning and coffee breaks with scones in same negotiation rooms with persons who may not be familiar with corporate world nuance and culture. In the 21st Century and beyond this potential population must have a crier who will prepare a way for them to bring their bit-coins to the Corporate wagering tables.

LESSONS FROM AMERICA:

America has a critical number of consumers and producers in form of: poultry, horticulture, apiary, pisciculture, leather tannery, environment cleaning, environment conservation, construction, heavy machinery, specialized technology and science, heavy machinery operation, jewelry, stationery, clothing, education,  informal sector, formal sector and in the skills development (vocational, business, technical, critical, analytical and practical) areas.

Africa, on the other hand, has to reciprocate by positioning itself as a people centred empowerment and wealth creation continent. Eventually critical numbers to contribute to capital development will be created.  Africa will eventually move out of the production style that transpired in pre-civil-war America.  In order to get there, Africa has to learn the following  soft standards or values from America:

1. Thrift and Planning

Thrift, a level of sacrifice and self-discipline, patiently weighs one’s options and delays self gratification. This is planning for Institutions that last beyond the lifetime of an entrepreneur. There are practical lessons one can learn and use: Developing a wish-list; making priorities depending on cost-benefit outcomes that localizes wealth.

2.  Knowledge of Navigating Agencies

Business and entrepreneurship is built on social capital as well as cash input. Understanding the world of entrepreneurship is so important. Governments that establish structures through which eligibility is assured as well as allowing consumers to navigate them helps in building investor confidence.  In USA, a number of companies and agencies may be involved at federal, state, local, citizen, business, design, construction and consultant level in case of, say,  road infrastructure establishment. Understand the world view psyche of the American as you work together. Imagine if you are a high-way construction representative from Africa. You need to understand what it takes for a company in Africa to do a business. Your American counterparts , who may be into road-construction, know their system well and theirs comprises of:

FEDERAL-  Federal Highway Administration; US Secretary of Transportation

STATE-   Department of Environmental Protection; Department of Transportation; State Inspector General

LOCAL-       Building Department; Fire; Police

CITIZENS-   Conservation Law Foundations; Historic Review Commission

BUSINESS- Business Roundtable

DESIGNERS- Civil Engineers; Trasport Engineers; Architects; Graphic designers

CONSTRUCTION- Project Managers; Construction Contractors; Material suppliers; Equipment suppliers; Labour; Unions

CONSULTANTS- Testing laboratories; Surveyors; Public Relations

3.  TEAM AND TEAM BUILDING

There are three duties one has to engage in, in order to build a robust team. Partnering; conscious reaching out; and setting aside time to learn how others do their work. One has to be ready to create an environment for making friends. Even if it meant making friends with competitors. Any project to succeed must engage in encouraging both external and in-house team building to improve on organization, skills and motivation of persons involved. This builds confidence for all. The contract or any process language that shapes roles and responsibilities should be studied and  understood. It is possible to create a culture ( rituals, values, stories and conduct) that is common. Other human aspects are shared and learned. Such teams own the vision and mission without so many complications.

4. FULL COGNIZANCE OF PROJECT

It is necessary to understand and ensure the fulfillment of project characteristics such as:

a) defined goal or objective

b) breakdown specific tasks in definable steps which become the project roadmap.

c) define a beginning and end. Defined deliverables become tangible or felt. They are the programme. A  certain quantity of work will be completed according to certain specifications within a certain time frame.

d)forecasting resource consumption (Time, money, equipment, labour, materials, transportation, storage, security).

e) set aside time for interactive processes such as redesigning, reviewing and re-organization.

5. GENERATING LARGEST POSSIBLE BENEFITS

The practice of analyzing benefits and costs as a discipline rather than an option, is a business choice that opens paths to profits and welfare of individuals. This helps investors in committing capital where they will gain.

6. EFFICIENT TECHNOLOGIES AND CONSERVATION PRACTICES

Optimum use and productivity ensure that the following resources: humans; prepared plans; food; homes; work; energy; communities; culture and science are in good supply and that they promote welfare of communities.

7. MOBILIZING COMMUNITIES TOWARDS CREATIVITY AGAINST POVERTY AND STARVATION

Constructive means and designed structures against against social-ills are shaping how societies channel their contribution to development. This pattern involves people. The people are then categorised as producers or consumers. Progress, development and shifting the mindset towards creating value and opportunity for immediate individual creativity become shared goals.

8. EVOLVING US FOREIGN AND TRADE POLICIES

US is increasingly adopting a non-partisan, non-patronizing, non-ideological political approach. It is an active global leadership, promoting intellectual and social upliftment across the globe’s old or new allies (e.g. Cuba and Africa). There is a shift towards reliance on social institutions such as global politics, schools, church, sports teams, hospitality entities, transport networks, chain stores and public-private enterprises to influence fair markets.

9. DEFINING AND MAINTAINING A MIDDLE CLASS STRUCTURE

Such essential services like: Educate to Innovate Campaign, is a nationwide effort to move American students back to the top in science and maths education, taking big chances on big ideas by both private and public sectors supercharged with an infusion of personal responsibility; and revisiting healthy practices are some of the key investments and mainstays keeping a robust middle class in America

10. LEADERSHIP

Pointing out clear distinctions of what leaders do and what constituents expects e.g. the expectation that one is skilled in, say, the five practices of exemplary leadership:

a) Modelling the way

b) Inspire a shared vision

c) challenging the process

d) Enabling others to act

e) Encourage the heart

Engendering commitment to planned activities:

  1. Find your voice by clarifying your personal values.
  2. Set the example by aligning actions with shared value.
  3. Envision the future by imagining exciting and ennobling possibilities.
  4. Enlist others in a common vision by appealing to shared aspirations.
  5. Search for opportunities by seeking innovative ways to change, grow and improve.
  6. Experiment and take risks by constantly generating small wins and learning from mistakes.
  7. Foster collaboration by promoting cooperative goals and building trust.
  8. Strengthen others by sharing power and discretion.
  9. Recognize contributions by showing appreciation for individual excellence.
  10. Celebrate the values and victories by creating a spirit of community.

These ten questions were formed in my mind as a result of meeting with various people in Boston, Chicago, Los Angeles, Oakland, San Jose and San Francisco. I got insights from friends at the Black and Filipino Chambers of Commerce. As someone introducing them to Africa and the opportunities  this would avail to entrepreneurship, I realised there was a discordance in beliefs and values African entrepreneurs needed. We had a conference with delegates from Africa in 2014. I engaged the delegates in pointing out their understanding of what it took to do business with Americans. Some answers were vague, nebulous and sure to confuse than to cause partnerships. I developed these 10 points with the help of many friends at the African Empowered Communities-USA. This write-up is dedicated to all those African entrepreneurs who want to do business with Americans.

BIBLIOGRAPHY:

1. Ellen Ruppel Shell, 2009. Cheap: High Cost of Discount Culture, Penguin Press New York.

2. Fredrick E. Gould, 2005. Managing the Construction Process: estimating, scheduling and project control. Prentice Hall, New Jersey, 2005.

3, 4, 5. Glaister Stephen, 1994. Cost Effectiveness. Cambridge University Press.

6. John Michael Greer, 2009. The Ecotechnic Future. New Society Publishers

7. Anita Roddick, 2001. Take it Personally. Conari Press.

8.  i. Alonzo L. Hamby, 1992. Liberalism and its challenges. Oxford University Press.

     ii. George Lakoff, Farrar, Strauss and Giroux, 2006. Communicating Our American Values and Vision. New York

    iii. George Friedman, 2011. The next decade. Doubleday, New York.

9. Arianna Huffington, 2009. Third World America. Crown Publishers, New York

10. Kouzes-Posner, 2002. Leadership; the challenges. Jossey-Bass, San Francisco.

I understand San Francisco through Poem-stories!

Yes, I come from another culture and another country very much different from America…….but so much the same in many ways!! I come from Uganda. It is in a very large continent called Africa.

Puzzling, misleading, not easy to follow! Right???

Isn’t it the feeling that first meets one who travels to unfamiliar grounds? Have you ever walked around your neighbourhood? Have you noticed those signs saying “This neighborhood is under surveillance?” Or something to that effect? What first comes to your mind? Imagine you are as civil and good-natured as they come. This is enough to stop you in your tracks,then you turn back and go to your house. There goes your exploration or excursion!!!

So, you go back and think of how the ancients were able to move about unencumbered. One way was to perfect the art of communication, story-telling, poetry, music, dance, drama and knowledge of places. They were the itinerant performers!!! They roamed continents and were able to talk of distant lands and cultures. I happen to come from such kind of persons. I am told my great, great, great (Phew!!) fore parents so many sun rises and sun sets back were itinerant artisans and experts in survival. I only happened to learn about herbal medicines and story telling from one of grannies.

I am using the skill of composing and writing poem-stories to meet other people in a formal way. That way,I have got to visit places I would not have gone to I think!!

This is the first poem I wrote for San Francisco:

Three birds I met in San Francisco
Have your lunch,
snack,
somewhere,
in the gardens,
by the UN Plaza,
San Francisco,
California,
hold on to your snack,
guard it,
for not far away,
is a meeting,
a planning meeting,
to ambush you,
the feathered conveners,
are so happy,
the prospect of food,
motivator,
the leader,
hooded,
with a red bill,
smiles,
laughs,
it was so easy,
away goes your snack,
at the moment,
when it is sweeter,
it becomes,
the Laughing Gull’s meal,
food, wrapping and plastic,
gobbled down,
so fast,
you of the keeled tail,
foraging,
scavenging,
ferreting,
eating,
your iridescence,
a purple sheen,
so striking,
belies your inelegance,
shown,
by your noisy,
quarrelsomeness,
nevertheless,
I am glad,
I met you Grackle,
with your black crown,
you must be Harris’s Sparrow,
the famed one,
well sung,
well cared for
‘eye is on the Sparrow.’