RGS-IBG Annual International Conference 2017

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51 The Health Millennium Development Goals: Global Strides, Local Meanders
Affiliation Geographies of Health and Wellbeing Research Group
Convenor(s) Anthonia Onyeahialam (Aberystwyth University, UK)
Chair(s) Adegbola Ojo (Liverpool John Moores University, UK)
Timetable Wednesday 30 August 2017, Session 2 (11:10 - 12:50)
Room Skempton Building, Lecture Theatre 201
Session abstract The UN MDG in summary reports great strides made globally on the health MDGs. For example, between 2000 and 2015, 37% and 60% decline in malaria incidence and mortality rates respectively has been reported. This is often not the case at many local levels where disease rates contrast amidst elite populations, health behaviours and spaces that are often overlooked. There are “suspicions” at local levels on the economic, social and political underpinnings to the global interest placed on these illnesses perceived to be part of everyday living, and trans-national health care provision as an avenue for the (re)-enforcement of presence in local spaces. Despite the reported progress, biosecurity concerns exist and on the increase.

This session intends to thematically explore challenges around the health MDGs, and other cross cutting MDGs like the MDG1 (extreme poverty and hunger), but yet not limited to:
• Deviations and contrary reports to progress reported globally on the health MDGs – malaria, HIV/AIDS and Tuberculosis, maternal and child health; poverty, hunger; wellbeing.
• MDGs as a global commodity
• Local interpretations and perceptions about the health MDGs
• Hidden and often overlooked local risks, behaviours, space and place and the emergence of spatially constructed diseases
• Health MDGs, biosecurity and border concerns
• The role of transnational health care provision, delivery and education including medical missions in the knowledge gaps created between the local and global scale;
• Insights using local, national and global primary and secondary data sources that contradict or complement findings from multiple scales including analytical methods
Linked Sessions WITHDRAWN - The Health Millennium Development Goals: Global Strides, Local Meanders (2)
Contact the conference organisers to request a change to session or paper details: AC2017@rgs.org
A GIS-based Micro-level Exploration and Mapping of Malaria Risk in Surulere LGA, Lagos State
Chinyere O. Oraukwu (University of Lagos, Nigeria)
Nna Oscar Uluocha (University of Lagos, Nigeria)
Ademola Omojola (University of Lagos, Nigeria)
Malaria imposes great social, economic and health burdens on people, thereby constituting a serious threat to their peace, security, and development, especially in the developing nations. A major hindrance to effective control of malaria is usually the lack of appropriate local-level information on the spatial and temporal distribution of the disease and the actual population at risk. This is as a result of the fact that most malaria eradication studies, policies and programmes are carried out at a macro or “global” level whereas the problem exists at a micro or local level. This study utilizes a GIS-based micro-level spatial analysis and mapping approach to examine and identify the local geographical variations in the distribution of the factors, occurence and effects of malaria burden in the study area – Surulere Local Government Area of Lagos State, Nigeria. The project involved the use of questionnaire survey conducted at the household level to generate primary data on the prevalence and effects of malaria in the study area. Global positioning system (GPS) was used to map the locations and distribution of mosquito breeding sites, households and health facilities in the study area. Geographic information System (GIS) was used to manage, statistically analyze and cartographically explore and visualize the data. To achieve the aim of revealing local malaria hotspots and spatio-temporal variations in the pattern of malaria risk in the study area, the data was aggregated, analyzed and mapped at the ward level. The specific variables that were considered in this study include, environmental, climatic and socio-economic variables, which strongly influence the occurrence of malaria. Also considered were the social, economic, psycho-physical and health burdens of malaria on the people as well as the burden malaria imposes on the available health personnel and facilities. Spatial interpolation techniques (kriging and IDW) were used to generate predictive maps that showed local spatial variations in malaria prevalence in each ward. The micro-level malaria maps are essential to proper and effective geographical targeting of malaria control measures. The capability of map as a decision policy support tool is necessary to provide information for targeted malaria eradication. The use of map and mapping in perceiving and correlating the spatial patterns of malaria burden at micro-level particularly the relationship among the distribution of the disease in terms of economic, socio-demographic and health will be a more effective approach to malaria eradication.
Rolling Back, Rolling Forward the Malaria MDG: Insights from fieldnotes and data of an Insider Outsider
Anthonia Onyeahialam (Aberystwyth University, UK)
This paper is a summary of efforts in form of evidence, setbacks and progress doing research on malaria in Lagos state, Nigeria, a mega city and the largest in Africa and top ten in the world with a very large economic base. Theory is not the emphasis; neither is the empirics, but rather more on practical, hands on collection and records of fieldwork and analytical results.

My findings and reflection is based on three instances of field work (pilot study, main study and follow up study) carried out between 2010 and 2014 in Lagos, Nigeria and consisting of interviews, household surveys and GPS tracking of household participants done as an insider outsider.

I focus my discussion on four themes. First is an emerging type of malaria – “urban malaria” that is often overlooked due to the somewhat deceptive perception of affluence in urban locations, second is on data quality issues and the difficulties connecting routinely collected health data to the population. The third on the shifting social dynamics of African communities and its consequences for time use of “place” that interacts with vector mosquitoes the carrier of malaria parasite and the last is the cultural tension between malaria understanding at local and global levels.

Finding suggest a disconnect between local happenings and global understandings of malaria in this case study in Lagos, Nigeria and recommend greater connection between the local and the global in order to record greater progress in SDG replaced MDG goals.
Emigration of Health Professionals: An Impediment for achieving Health Millennium Development Goals in the Developing Countries
Muyiwa Abejide (University of Ibadan, Nigeria)
Aside the apathy of health professionals towards the rural health delivery due to lack of basic infrastructure and poor working condition, emigration of health professionals from the developing countries to developed and rich countries had been a major impediment for achieving the health Millennium Development Goals (MDGs) in its 15 years of implementation. The designers of the programme had failed to take into cognizance emigration of health providers (the implementing tools of health MDGs) and its effects on achieving the targeted goals in the developing and poor countries. Literature on emigration of health professionals before and during the implementations of health MDGs revealed that health professionals were moving out in large numbers to other destinations and consequently, the developing countries were left with very small fragment of supply of health providers as against their increasing population. The paper therefore examined the effects of emigration of health professionals on the indicators of MDGs 4 and 5, as well as the spatio-temporal trends of their destinations. Push-Pull and Good Governance Models provided the frameworks. Primary data was used to analyze the spatio-temporal trends, factors and consequences of emigration of health professionals in Nigeria between 1896 and 2010 in three selected health institutions in Southwestern Nigeria, while secondary data were sourced from the Nigeria Demographic and Health Survey (NDHS) 2008 and 2013 reports. These were used to explain the inadequacy of health providers in the country vis-à-vis their impacts on the indicators of MDGs 4 and 5 in the Six Geo-political Zones of Nigeria. In addition, the spatio-temporal trajectories of emigrated health professionals were mapped and analyzed to show the benefited countries. The findings showed that emigration of health professionals has been on the increase over time. This has contributed majorly to the inability of achieving the targeted MDGs 4 and 5 in some parts of the country, particularly in the rural areas and crisis prone geo-political zones in Nigeria. The benefiting destinations were majorly the United Kingdom followed by the United States of America, Canada, Saudi Arabia and UAE, where the need of health professionals is seemed to be superfluous. The study concludes that the rate of emigration of health professionals is alarming due to push factors in the country and which if not checked, could hamper the nascent achievements of MDGs 4 & 5 and health delivery in Nigeria.
WITHDRAWN BY AUTHOR - Weight of infectious diseases such as malaria in the mortality burden, health transition or cumulative risk?
Assane Niang Gadiaga (University of Namur, Belgium)
Catherine Linard (University of Namur, Belgium)