Sexually Transmitted Diseases in Developing Countries
Sexually transmitted diseases (STD’s) have been a problem for doctors worldwide and governments around the globe for many years.
Pre-screening, diagnosis, and treatment programs are required to stop the spread of STDs.
A host of sexually transmitted diseases have, unfortunately, exploded in large numbers in the continent of Africa. These STD’s include the HIV virus and the HPV virus, or human papillomavirus. HPV causes cervical cancer, and the HIV virus causes AIDS (auto-immune deficiency syndrome).
It is estimated that there are 100 million cases of AIDS worldwide, and that AIDS is now claiming more lives than all wars and natural disasters around the world.
In Africa, the problem is quite tremendous.
In South Africa alone, there are 4.7 million people infected with the AIDS virus. South Africa is the world’s country with the largest infected population.
Sadly, it is estimated that worldwide, less than 1% of people infected with AIDS take drugs for their virus.
Similarly, in third world countries – including Africa – an alarming number of women die each year of cervical cancer, because they have been infected with HPV – the precursor to HPV. Every year, 80 to 90% of the people diagnosed with cervical cancer live in developing countries.
In developing countries such as America, screening and treatment prevent a large number of such cases, and prevent large numbers of deaths from HIV, HPV and cervical cancer. For example, in the United States, cervical cancer has decreased 80% in the last 40 years because of the health resources available to American women.
Unfortunately, in developing and third world countries, health and medicine resources are minimal, in the vast majority of cases.
Therefore, these cases often go undiagnosed, as there is no pre-screening and in fact, no health treatment at all.
Also, even if these third world countries do have health care facilities, they are often inadequate to detect and pre-screen for these types of viruses.
For example, in the case of cervical cancer, the best detection method is the Pap smear (or the Papanicolaou smear). However, this treatment is expensive even by American standards, and certainly economically out of reach for residents of most developing and third world countries.
The result is that, in the case of cervical cancer alone, almost 200,000 women in third world nations die of cervical cancer each year.
Some experts estimate that as many as 70 million people could die of AIDS in the next 20 years if actions are not taken to help victims of HIV and AIDS.
Evaluation and Planning of a Program
Any effective program addressing the problem of sexually transmitted diseases in developing countries must start with the problem of funding.
For example, in the cases of AIDS alone, billions of dollars will have to be spent in treating and pre-screening for the disease.
Also, proper drugs would need to be readily available to carriers of the disease.
In many cases, inexpensive alternatives to the expensive screening and treatment health solutions used in first-world countries do exist and should be utilized in programs launched in the third world.
For example, one anti-cervical cancer program currently in progress in South Africa carries “an estimated average lifetime cost of $41 per woman, and reduced the incidence of cervical cancer in the population by one-third.”
Similarly, another alternative treatment program only currently in progress costs only $39 per woman, reduces the number of cervical cancer cases by one-third, and merely involves the health care practitioner applying “vinegar to the cervix and examining it with her naked eye. Certain whitening of the tissue indicates precancerous cells.”
Therefore, when it comes to third world health care, cost-effectiveness is a crucial requirement.
Health care workers willing to work on programs dedicated to developing countries are another requirement.
Furthermore, culturally-appropriate workshops, educational-seminars, and other methods of spreading health education are needed to ensure that residents of developing countries know how to prevent, manage and treat sexually transmitted diseases.
In addition to such community education and outreach, counseling is required in regard to the prevention of sexually transmitted diseases, as well as the diagnosis of diseases and methods of living with STDs.
Particularly in countries such as Africa, where viral diseases like AIDS are rampant, have taken so many lives, and have become such a tragic part of the social milieu, such counseling is an important part of the health treatment.
Evaluation Questions & Data Collection Methods
What are the possible funding sources?
How will the program be funded? If, as is mostly the case, the program will be funded with outside sources, what funding sources exist that would be amenable to this program idea?
Books listing grant funding sources would be the best source of collecting this information. Local libraries generally carry these funding texts.
What other programs already exist that address the problem?
Usually, if a social or health problem exists, there also exist at least several programs and organizations somewhere already addressing the problem in some way.
Therefore, research will need to be conducted on what programs similar to the proposed program are already in existence.
Such information can be found online and in books that compile listings and other information on Non-profit Organizations.
How is this program different than these other programs?
The proposed program will probably need to be different enough than the programs already in existence to warrant outside funding. Therefore, comparison research will need to be conducted to highlight the similarities and differences between the proposed program and the existing organizations.
Again, this information will be obtained through the listing of Non-Profit Organizations, and also by conducting more detailed research – if necessary – by contacting the individual organizations by phone.
If it is not sufficiently different than the other programs, is another such program needed?
Often, there is enough room in a field for several similar institutions. Therefore, if a problem is widespread enough or complex enough to warrant another program, the proposed program should go forward despite similarities with existing programs.
This conclusion can be reached by looking at whether the particular problem you are attempting to solve is actually getting better, for example, have the numbers of HPV cases in sub-Saharan Africa gone down in the last ten years since X, Y, and Z. organizations attempting to address the HPV problem in that geographic location began addressing the problem?
In this type of situation, however, interviews with experts in the field would probably be the better data collection method. This is known as qualitative methodology. Also, surveys with those in the industry could be conducted.
On which geographic locales will the program focus?
This can be determined by doing data research on where the health problem you are attempting to address is most severe. This might be where you want to focus your initial efforts.
Jerome Socolovsky, AIDS parley Ends on Note of Resolve, The San Diego Union Tribune, July 13, 2002, A15.
Nell Lake, Medicine by Model, Harvard Magazine, July-August 2002, 44.
See Lake, at 44.
See Socolovsky, at A10.
Nell Lake, Medicine by Model, July-August 2002, Harvard Magazine, 46.
See.American Social Health Association, http://www.asha.com/programs/ccpp.html
See also Qualitative Methods, Cornell. Edu. Located at http://trochim.human.cornell.edu/kb/qualmeth.htm.
USDA Information Quality Guidelines for Statistical Information, located at http://www.ocio.usda.gov/irm/qi_guide/stats.html. Seealso Qualitative Methods, Cornell. Edu. Located at http://trochim.human.cornell.edu/kb/qualmeth.htm.
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