Precede-Proceed Model

Precede-Proceed Model

PRECEDE-PROCEED Model Based on the review of global health epidemiological applications (methods), apply and analyze data to international public health programs to determine stability/instability of health and wellness of these countries. Select any one of your three countries used in an earlier assignment and determine a serious health issue that country struggles with. Using the PRECEDE-PROCEED model, design a model to promote health promotion for this public health issue. Country: S. Africa or Ghana

SAMPLE ANSWER

Precede-Proceed Model

Introduction

While HIV/AIDS is the highest disease killer in South Africa, tuberculosis (TB) takes the highest distinction. Over 80 percent of South Africans are thought to have latent TB. Additionally, individuals who have HIV/AIDS are more likely to get infected with TB (Nieburg, 2015). When people with HIV/AIDS get infected with active TB, they experience accelerated progression of their HIV/AIDS disease. While the South African Department of Health is creating policies and programs to control TB infections, it still faces several challenges. The country has slow GDP growth and high rates of unemployment that limit resources to address health challenges (Nieburg, 2015). A structure to assess and analyze the health needs of a population and to guarantee health promotion like the Precede-proceed model will improve health programs proposed by the South African Department of Health to control TB infections.

Precede-Proceed Model to Promote Health Promotion in South Africa

Precede

            Social Assessment: with over 450,000 people developing TB every year, TB has become a public health issue in South Africa. The country has made significant strides towards the eradication of the disease especially in people with HIV/AIDS. However, more needs to be done.

            Epidemiological Assessment: poverty is a key determinant of TB in South Africa. Therefore, alleviating poverty reduces the risk of TB transmission (“Addressing the Social Determinants of TB”, 2019). An effective model should; design effective poverty reduction strategies, reduce food insecurity, improve living standards, control environmental pollutants, and address lifestyles conditions including reduction of drug use and smoking.

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            Ecological Assessment:  minority races in the country are at a higher risk of contracting TB. Additionally, low income and lack of education are strong risk factors for transmission of tuberculosis. Congestion and pollution accelerate the spread of TB in public areas and in slums (Alvaro-Meca et al. 2016).

Administrative and Policy factors: some of the policy factors include; training for TB infection control for all healthcare workers, improved TB infection and spread control policy guidelines, creation of awareness and education of TB infection control measures, improved hygiene practices and destigmatisation (Zinatsa, Engelbrecht, Rensburg & Kigozi, 2018). Administrative strategies to control the spread of TB in South Africa include; the National Strategic Plan on HIV, TB and STIs 2017-2022, Global Plan to End TB 2016-2020 and the Treatment Action Campaign (Kanabus, 2018).

Proceed

            Implementation: At the individual level, isoniazid preventive therapy (IPT) has been seen to reduce TB infections by 60%. Additionally, rapid molecular techniques should be developed to facilitate rapid treatment (Dowdy et al. 2017). Decongestion is also critical since TB is airborne. To implement the proposed strategies, efforts should be intensified in the geographical areas hard hit by TB. Resources should be provided by the national government in collaboration with other relevant health promotion bodies.

            Process Evaluation: healthcare workers and the South African Health Department should carry out regular program checks to determine if the programs implemented are reaching the targeted population and that program goals are met.

            Impact Evaluation: changes in the rate of new TB infections in the country will be used to determine success of the programs.

            Outcome Evaluation: A decrease or increase in the prevalence of TB in the country will be analyzed. Decreasing rate of TB infections will indicate success of interventions while increasing rates of TB infections will indicate failure of interventions.  

References

Alvaro-Meca, A., Diaz, A., Diez, J.M., Resino, R. & Resion, S. (2016). Environmental Factors Related to Pulmonary Tuberculosis in HIV-Infected Patients in the Combined Antiretroviral Therapy (cART) Era. Public Library of Science, 11(11). Doi: 10.1371/journal.pone.0165944

“Addressing the Social Determinants of TB”. (2019). World Health Organization. Retrieved from https://www.who.int/tb/areas-of-work/treatment/social-determinants/en/

Dowdy, D.W., Grant. A.D., Dheda, K., Nardell, E., Fielding, K. & Moore, D.A. (2017). Designing and Evaluating Interventions to Halt the Transmission of Tuberculosis. The Journal of Infectious Diseases, 216(6), 654-661. https://doi.org/10.1093/infdis/jix320

Kanabus, A. (2018). Information About Tuberculosis. TBFACTS.ORG. Retrieved from www.tbfacts.org

Nieburg, P. (2015). South Africa’s Health Challenges: An Elephant in the Room. Center for Strategic & International Studies. Retrieved from https://www.csis.org/

Zinatsa, F., Engelbrecht, M., Rensburg, A.J. & Kigozi, G. (2018). Voices from the Frontline: Barriers and Strategies to Improve Tuberculosis Infection Control in Primary Health Care Facilities in South Africa. BMC Health Services Research, 18, 269. Doi: 10.1186/s12913-018-3083-0

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