Case Studies in Global Health is a book by Dr. Ruth Levine, global development and population program director at the Hewlett Foundation. The book describes twenty successful global health programs.
This post has some brief notes listing the interventions that worked in each case.
Case 1: Eradicating Smallpox
• supplying countries with vaccine and kits for collecting and sending specimens
• using bifurcated needles for vaccination
• concentrated surveillance and containment of outbreaks
Case 2: Preventing HIV/AIDS and Sexually Transmitted Infections in Thailand
• requiring all sex workers in sex establishments to use condoms with clients
• providing boxes of condoms free of charge
• holding meetings involving police, sex establishment owners, and sex workers
• men seeking treatment for STIs being asked to name the sex establishment they had used
Case 3: Controlling Tuberculosis in China
• adopting directly observed treatment shourtcourse, through which trained health workers watch patients take their treatment at local TB county dispensaries
• sending treatment outcomes in quarterly reports to the National Tuberculosis Project Office
Case 4: Reducing Child Mortality Through Vitamin A in Nepal
• providing twice-yearly supplements of vitamin A capsules to children in priority distrcits
• treating xerophthalmia, severe malnutrition, prolonged diarrhea, and measles
• encouraging dietary intake of vitamin A and breast-feeding
• involving a large cadre of women who served as community-based volunteers
Case 5: Eliminating Polio in Latin America and the Caribbean
• implementing national vaccine days twice a year to immunize every child under 5, regardless of vaccination status
• using house-to-house vaccinations in communities reporting polio cases and with low coverage
• setting up a surveillance system to track outbreaks
Case 6: Saving Mothers’ Lives in Sri Lanka
• providing free services to the entire population, including in rural areas
• professionalizing midwives
• using health information to identify problems and guide decision making
• targeted quality improvements to vulnerable groups
Case 7: Controlling Onchocerciasis (River Blindness) in Sub-Saharan Africa
• weekly aerial spraying with environmentally safe insecticides
• distribution of ivermectin to more than 45 million people
Case 8: Preventing Diarrheal Deaths in Egypt
• promoting the use of locally manufactured oral rehydration salts
• distributing salts along with information about the appropriate treatment of children with diarrhea through public and private channels using mass media
• training physicians and nurses
Case 9: Improving the Health of the Poor in Mexico
• providing financial incentives for behaviors such as preventive and other basic health services, nutrition counseling, supplementary foods, and increases in school enrollment and attendance
Case 10: Controlling Trachoma in Morocco
• mobile teams performing simple and inexpensive surgeries in small towns across the provinces
• distributing azithromycin treatments
• health education efforts to promote face washing and hygiene
• construction of latrines
• supplying safe drinking water
Case 11: Reducing Guinea Worm in Asia and Sub-Saharan Africa
• providing safe water (through deep well digging, applying larvicide, and purifying water through cloth filters)
• health education
• case containment, management, and surveillance
Case 12: Controlling Chagas Disease in the Southern Cone of South America
• treating homes with long-lasting pyrethroid insecticides
• improving houses in poor rural areas to eliminate the insect’s hiding places
• screening blood for Chagas disease
Case 13: Reducing Fertility in Bangladesh
• sending female outreach workers door to door to provide information, motivate clients, and provide commodities
• using mass media to stimulate a change in attitudes about family size
Case 14: Curbing Tobacco Use in Poland
• passing groundbreaking tobacco-control legislation (which included the requirement of the largest health warnings on cigarette packs in the world, a ban on smoking in health centers and enclosed workplaces, a ban on electronic media advertising, and a ban on tobacco sales to minors
• health education campaigns to raise awareness of the dangers of smoking
Case 15: Preventing Iodine Deficiency Disease in China
• raising awareness of the health impact of iodine deficiency
• strengthening the capability of the salt industry to iodize and package salt
• monitoring and enforcing the quality of the salt
• promoting compliance among the salt industry through enforcement of licensing regulations and legislation banning noniodized salt
Case 16: Preventing Neural-Tube Defects in Chile
• introducing legislation that all domestically produced wheat flour must be fortified with folic acid
• flour mills producing, distributing, and marketing wheat flour in compliance with the new legislation
• government regulation and monitoring the quality of fortified flour
Case 17: Eliminating Measles in Southern Africa
• routine immunization for babies at nine months
• a nationwide catch-up campaign to provide a second opportunity for immunization to all children aged nine months to 14 years
• follow-up campaigns in young children every three to four years
• surveillance for cases of measles and improved laboratory facilities so that suspect cases could be confirmed
Case 18: Preventing Dental Caries in Jamaica
• producing and selling fluoridated salt
• government provided biological and chemical monitoring of the salt
Case 19: Treating Cataracts in India
• introducing a new and more effective surgical technique
• shifting from a strategy of providing treatment in mass camps to one in which fixed sites were used
• partnering with Aravind Eye Hospital and other nongovernmental organizations for delivery of services
• improving management and training at all levels
Case 20: Preventing Hib Disease in Chile and the Gambia
• introducing the Hib vaccine into the routine immunization program for infants
• administering the vaccine routinely as part of the national immunization program
