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Andrew Macnab
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Education Health Professions Medicine & Pharmacology Nursing Public Health

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TEACHERS AS AGENTS OF CHANGE: SCHOOL-BASED DIAGNOSIS AND TREATMENT OF MALARIA POSITIVELY IMPACTS CHILD MORBIDITY Ronald Mukisa; Andrew Macnab; Sharif Mutabazi; Rachel Steed
Proceedings of the International Conference on Applied Science and Health No. 1 (2017)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

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Background: Teachers in developing countries traditionally send home children found sick in class. Yet infection due to malaria is the principal reason a child will miss school in sub-Saharan Africa and the leading cause of death in school-aged children. Rapid diagnostic testing (RDT) and treatment with artemesinin combination therapy (ACT) is the management for malaria recommended by the World Health Organization (WHO) but RDT/ACT are not available in schools. Aims: To evaluate the impact on child morbidity from malaria of engaging teachers to provide RDT and administer ACT in primary schools in rural Uganda, using duration of absence from school as a surrogate measure of morbidity. Methods: This was a 2 year project.Pre-intervention (year 1) we trained teachers to identify probable infectious illness, conduct RDT, and administer ACT; conducted baseline evaluation of malaria knowledge, and monitored days of absence from school. Intervention (year 2) trained volunteer teachers administered RDT to children found to be sick at school and treated those positive with ADT; data collection was ongoing. Results: Teacher administered RDT/ACT was implemented and sustained in 4 rural schools (grades primary 1-5). Teachers participated willingly. Year 1 (pre-intervention) 953 of 1764 pupils were sent home due to illness; mean duration of absence from class was 6.5 (SD 3.17) school days. Year 2: (intervention with RDT/ACT) 1066 of 1774 pupils were identified as sick, 765/1066 (67.5%) tested positive by RDT for malaria and received ACT and their duration of absence fell to 0.59 (SD 0.64) school days (p<0.001); and overall absence decreased to 2.55 days from 6.5 in year 1 (p<0.001). Conclusion: RDT/ACT use by teachers as a school-based health practice is novel and reduced child morbidity significantly. Our model of engaging and training teachers represents a community empowerment approach applicable to other low-resource settings worldwide where malaria is endemic and morbidity high. 
AN EVALUATION OF VIDEO MATERIALS WITH A HEALTH-RELATED MESSAGE AVAILABLE IN INDONESIA Ronald Mukisa; Doni Marisi Sinaga; Andrew Macnab
Proceedings of the International Conference on Applied Science and Health No. 4 (2019)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

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Background:  A core component of health promotion involves education. When we educate children and their parents about health, we need to use words that they can understand and ways to teach them that they find interesting. In schools in Uganda we have found that many children learn important facts from music videos recorded by celebrities that include a health message. This study looked at video material with a health message that is available on-line in Indonesia for those involved in health promotion to use to educate parents and children.Methods: A google question was generated and the videos the respondents suggested were then viewed on YouTube to identify the health topics that they contained. From this search, the availability of other videos with similar or related messages was evaluated.Results: Nine respondents suggested videos with a health message; 8 were female and 1 male, all had a bachelor’s or master’s degree. Four of the videos identified contained general health related messages, the remainder were specific to one of two areas, handwashing and hygiene (3) or tooth brushing and oral health (2). Importantly, when viewing these videos, a large number of related videos in various formats (message for adults/parents, message for children, educational material, songs, cartoons) were cross linked with the targeted video.Conclusion: In Indonesia, a broad range of videos exist that can be used either to educate parents and children about the key health topics that these videos cover, or to act as a model for producing similar materials for newly identified health promotion issues. Engaging and educating parents and children is an important health promotion strategy and community empowerment approach  to improving the determinants of health.
Co-Authors Doni Marisi Sinaga Rachel Steed Ronald Mukisa Sharif Mutabazi