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Three bchs students present at dean's day 2006
Yll Hyseni (MPH)
Title: A multi-disciplinary analysis on the impact of HIV/AIDS on economic, social and health dynamics in Botswana.
Botswana has been recognized by the international community as a model for rapid and continuous economic, social and health sector development. Since its independence in 1966, Botswana has implemented strict and rational economic development strategies by investing in its vast natural resources and has develop national strategies for the improvement of social and health sectors of the society.
Botswana’s fast rate of human development, as measured by the Human Development Index (HDI) showed a very promising and prosperous future for the people of Botswana.
Today some 40 million people are infected with HIV or living with AIDS, and the current incidence is 4 million new cases each year. Today only 0.6 % of world’s population is affected by HIV/AIDS, and many people see it only as a disease which impacts the life of the individual infected with HIV/AIDS. But in the case of Botswana, a country of 1.8[1] million with an adult HIV/AIDS prevalence rate of 37.5%, the disease will impact the whole society, from the health sector, population structure and economy to its investments and future.
Since 1985, when the first case of HIV was diagnosed in Botswana, HIV/AIDS has been emerging as one of the main threats to the health, society and economy of Botswana.
This presentation attempts to present an analysis of the impact of HIV/AIDS in the whole society of Botswana. The presentation tries to compare different aspect of Botswana society with and without HIV/AIDS and to present an image of Botswana 20 years from now.
The presentations uses reports published by institutions such as the International Monetary Fund, World Bank, United Nations Development Program, in assessing the current impact of HIV/AIDS in the economy, society and health sector of Botswana.
The presentations uses epidemiological data from the UNAIDS program of the UN in regard to HIV/AIDS incidence and prevalence in Botswana from 1985 until 2005. The presentations also reviews important development indicators identified by the Human Development Index, and compares the current human development indicators with those of the past. Click here to see powerpoint presentation.
Eric Hulsey (DrPH)
Title: Mountains and Plains: Exploring HealthCare and Health Inequalities in Rural Haiti
Hôpital Albert Schweitzer (HAS) is an integrated rural health system providing medical care and community health and development programs for 285,000 impoverished people in the Artibonite Valley of central Haiti. Significant health differences exist between individuals living in the lower valley area of this region compared to those living in mountainous regions. Health systems research has previously identified a variety of barriers to accessing healthcare among individuals living in rural areas in resource-poor settings. This research intended to explore barriers in the context of a rural mountain community within the cachement area of HAS. The Director of Community Health at HAS approved the research. Initially, I interviewed hospital staff for perceptions about these health differences and then designed an interview questionnaire. I then partnered with the local community health agent of Damier, living in this mountain community for approximately two weeks during which time I systematically interviewed local residents about their experience with the hospital services. While some of the previously understood barriers to accessing healthcare, such as geography, were present in this context other barriers, such as methods of payment for services and class/race issues, appeared to be unique to the context. I conclude with a few suggestions for improving access to care for communities similar to Damier. The implications of this research are to broaden the concepts of applied research in identifying and remedying barriers to accessing healthcare in resource-poor settings. Click here to see powerpoint presentation.
Faith Brebnor (DrPH)
Title: MMSE Score, Culture and Education in a Tobago Population Study
Authors: Faith Brebnor, HM Crooks, AL Patrick, CH Bunker
Objectives/Research Questions: The Mini-Mental State Examination (MMSE) is an assessment tool used to quickly measure cognitive function. This study (1) Calculated the MMSE scores for men aged 40 and older in the Tobago population, (2) Determined whether the MMSE is a culturally appropriate cognitive-impairment screening instrument for this population, and (3) Determined whether the scores are affected by educational attainment.
Methods: Tobago men aged 40 – 79 were interviewed face-to-face using a modified 19-item MMSE questionnaire. Using SPSS, the total MMSE scores were calculated. Incorporating age and educational attainment, correlations and other statistical calculations were done.
Results: In analyses for 772 men, mean MMSE score was 27.01 (range 3 – 30), which decreased across increasing age groups. Scores increased with increased formal education (26.04 with less than 8 years of education, to > 29.00 with some or completed college).
Conclusions: Tobago MMSE scores were similar to US and other population studies. Approximately 13.7% of the study population has some cognitive impairment (cut-off point of 23). Incorrect answers on culturally sensitive questions were very common. Questions that require formal education were also commonly missed. MMSE does not only measure cognitive function; it is culturally biased and is influenced by educational status.
Implications for Public Health: In international settings, the MMSE can be useful. However it must be altered to reflect the local culture. The cut-off points to determine cognitive decline should vary depending on age and educational attainment. Click here to see powerpoint presentation.