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Cholera Elimination in Nigeria: Framework for a New National Policy
In what has become a yearly festival of deaths in both rural and urban areas, cholera is still a major but neglected public health problem in Nigeria. In 2014, cholera killed more people than Ebola with 635 deaths as at September 2014 and approximately 34000 cases. This paper provides a framework for developing and implementing a national strategy to eliminate cholera in Nigeria.
Methods
We review existing literature, reviewed epidemiologic data about cholera in Nigeria, and conducted an expert discussion and from this, developed a framework for cholera elimination. Each framework category is discussed with examples.
Results
Four interlinked categories informed our framework: 1)Modern surveillance and response systems involving the use of mobile phones and other hand held devices to gather and relay real time data. 2) Public health education campaigns including extensive prevention efforts and the use of the oral cholera vaccination in susceptible areas. 3) Improved case management, contact tracing and isolation. 4)Coordination of efforts, such as multiple visiting teams continuously working with a single local partner, provide an opportunity for centralization of efforts, greater local input, and meaningful impact.
Recommendations
Many developing countries have successfully eliminated cholera. The above framework can help Nigeria to direct new thinking as it strives to eliminate cholera and build a stronger primary health care system
Learning Areas:
Implementation of health education strategies, interventions and programsProvision of health care to the public
Public health or related public policy
Systems thinking models (conceptual and theoretical models), applications related to public health
Learning Objectives:
Identify the current cholera situation in Nigeria and the governments response
Describe the proposed framework and why it has the potential to eliminate cholera in Nigeria
Formulate an action plan that can be relevant in other developing countries facing similar challenges
Qualified on the content I am responsible for because: I have worked as a clinician in Nigeria and managed cases of cholera. I have also led a primary health care center. I am currently a resident physician in community and family medicine. My interests include -Community Health - acccess to and quality of care in low and middle-income countries -Sustainable Development -Sustainable primary health care systems in low and middle-income countries
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.