Original Research Article
Year: 2018 | Month: August | Volume: 8 | Issue: 8 | Pages: 261-266
Supply Chain Management in Global Public Health Activities: Opportunities for Improving Sanitation and Preventing Malaria in Mali
DBA, MPH, MBA, University of Phoenix, Associate Faculty, 3157 E. Elwood St, Phoenix, AZ 85034
Introduction: Despite it now being the 21st century, poor sanitation continues to impact resource-poor populations in many developing countries, such as Mali. The availability of better sanitation and housing supplies has the potential to help Mali and other resource-poor populations improve their standard of living (including improving housing) as a way to help improve the health of the population. In this report, we consider a number of urban and rural households with improved or not improved types of toilet facilities and whether or not the household dwelling was sprayed for the prevention of mosquitoes to see if these have any effect on the incidence of malaria. Finally, we discuss this experience in the context of a public health supply chain.
Methods: Using a cross-sectional study design and utilizing methods consistent with secondary data analysis, we examined secondary data related to the control of malaria in Mali from the perspective of residential housing and basic household sanitary plumbing. The dataset comprised 4,240 Malian households, and the unit of analysis was the concept of the household. Two groups were constructed on the basis of the study households classified as either belonging to rural districts or urban districts in Mali. The outcome variable chosen was whether or not a household was sprayed for mosquitoes. We examined the differences in the incidence of malaria in rural and urban households, and then performed a chi-square analysis of two independent samples. The SPSS Statistics software package was used to analyze the survey data.
Results: For a household with improved toilet facilities, whether in an urban or rural setting, if the household had been sprayed with insecticide, the risk of exposure to malaria is lower: Improved (OR) = .404, 95% CI (.280 - .582) and Unimproved (OR) = .118, 95% CI (.017 - .836). If household had not been sprayed, the risk is greater: Improved (OR) = 1.066, 95% CI (1.040 - 1.093) and Unimproved (OR) = 1.059, 95% CI (1.040 - 1.078).
Discussion: The results showed that the incidence of malaria among members of a household living in a household with improved sanitation that has also been sprayed to prevent mosquitoes will likely be lower than for households that have not been sprayed. The effect is different in rural and urban centers if the household sanitation facilities had not been improved. Spraying made an obvious difference. However, a challenge in Mali, at present, might be ensuring an adequate supply of insecticide and materials to evacuate liquid and solid waste in a safe manner at an affordable cost to the communities. In Mali, there is an urgent need to encourage the development of small trash-hauling services equipped with mobile solid and liquid waste removal containers and tools such as trash trucks.
Key words: Fecal Pathogens, Public Health Supply Chain, Sanitation environment Improvement .