HEALTH PROMOTION IN…

MADAGASCARLindsay Johnson, Andrea

Crapsey,

Katie Helms, Charissa Deur

Total Population = 22,925,000 Languages are Malagasy and French Average life expectancy for Males=62 and for

Females=65 The legal drinking age is 16 Major health risk factors include Alcohol and Tobacco Majority of the country earns a very low income Top 4 noncommunicable diseases are cardiovascular

disease, cancer, chronic respiratory disease, and diabetes Prevalent diseases are Yellow Fever and Malaria Unsanitary water consumption is a problem for children

Get to know MadagascarGet to know Madagascar

HEALTH PROBLEMS IN MADAGASCAR

MalariaMalaria

Contaminated WaterContaminated WaterDiarrheaDiarrhea

Alcohol/Tobacco UseAlcohol/Tobacco Use

10.9 million people in Madagascar don’t have access to safe water Nursing Diagnosis: The people of Madagascar are at risk for

contamination related to chemical contamination of water, poor personal hygiene practices, and playing outdoors where environmental contaminants are used; as evidenced by the amount of people without adequate, clean water and the mortality rate of children who die from diarrhea.

Nursing Outcome: Within one year, community will reduce negative

health associated effects by 50%.

CONTAMINATED WATERCONTAMINATED WATER

Teach and utilize appropriate universal precautions – hand washing for children.

Contact a program to teach adult community members how to properly clean water for cooking and drinking purposes.

Teach signs and symptoms associated with contamination due to ingesting contaminated water.

NURSING INTERVENTIONSNURSING INTERVENTIONS

Ingesting contaminated water can lead to many diseases including intestinal worms, chronic diarrhea, cholera, malaria, and typhoid

Signs and symptoms include diarrhea, cramps, nausea, and possibly jaundice, and any associated headaches and fatigue

https://www.youtube.com/watch?v=zxlQn7KaCNU https://www.pinterest.com/pin/505388389409232096/ http://www.oici.org/programs/clean-water-sanitation/

TEACHING

DIARRHEA Nursing Diagnoses:

The people of Madagascar area at risk for deficient fluid volume as evidenced by excessive loss of fluids in liquid stools.

Treatment consists of restoring fluid volume and correcting any electrolyte imbalances.

Elderly patients are more likely to develop fluid imbalances Defining Characteristics:

Decreased urine output Output is greater than the intake Thirst Decreased skin turgor Weakness Weight gain is possible

Over 4,000 children die each year from diarrhea caused by unsafe water

NURSING INTERVENTIONS

Observe for symptoms of: Dry tongue Dry mucous membranes Longitudinal tongue furrows

Actions by the health care provider: Get daily weights of the patient Watch for any sudden decreases in weight Observe carefully for a sudden decrease of urine output or signs of

active fluid loss

OUTCOMES

Patient experiences adequate fluid volume and electrolyte balance as evidenced by urine output of >30 ml per hour

Normative BP, HR, consistency in weight, and normal skin turgor

In six months be able to explain measures that can be taken to treat or prevent fluid volume loss.

In one year be able to describe symptoms that indicate the need to consult with health care provider.

TEACHING

Teach causes of fluid loss Parent education

Explain and reinforce rationale and intended treatment plan

Explain the importance of maintaining proper nutrition

Teach interventions to prevent future episodes of inadequate intake:

Importance of drinking clean water, and how to obtain clean water Increase their intake of fluid when diarrhea, fever, or other conditions

occur that cause fluid loss

MALARIA Malaria is a mosquito-borne infectious disease of humans

and animals caused by parasitic protozoans.

Symptoms include fever, fatigue, vomiting, and headaches. In severe cases, it can cause yellowing of the skin, seizures, coma, or death.

Nursing Diagnosis: The people of Madagascar have a readiness for enhanced immunization status as evidenced by the large number of the population who are affected with malaria, related to the desire to enhance behavior to prevent infectious disease and express desire to enhance knowledge of immunization standards.

NURSING INTERVENTIONS

Assess cultural or religious beliefs that may relate to either the decision-making process.

Employ culturally sensitive educational strategies to maximize the individual, family, or community response.

Assess barriers to immunizations, such as, anxiety related to immunization side effects.

OUTCOMES

Patient will ask questions about the benefits and risks of immunizations prior to scheduled immunizations.

Provide evidence of an understanding of the benefits of community immunizations during peak infectious disease seasons.

TEACHING

Main target: Adults

It is important for the people of Madagascar to know how severe Malaria can be. It is widely spread throughout third world countries and it is important for them to take all the precautions necessary to keep the disease away.

If immunizations are against their cultural or religious beliefs, then we will teach them about secondary precautions such as, covering their skin as much as possible, especially at nighttime. Children can sleep under mosquito nets to keep them away.

ALCOHOL AND TOBACCO

Legal drinking age in Madagascar = 16 years old - BAC = 0.08%

Children as young as 12 years old drink frequently 14.3% of the population are considered heavy drinkers Tobacco is one of the main crops in Madagascar – easy to grow Smoking is allowed everywhere, except healthcare facilities

Nursing Diagnosis: The populations in Madagascar show an increase in Risk-prone health behavior as evidenced by the extensive use of Alcohol and Tobacco in the country, related to an abundance of tobacco/alcohol available in the country

NURSING INTERVENTIONS

Perform physical assessment for deterioration of body from usage of alcohol and tobacco

Provide patient education about smoking cessation, decreased tobacco usage, decreased alcohol usage

Give patients alternative options to using tobacco/alcohol

OUTCOMES

In 3 months, clients will have understanding of the dangers of excessive alcohol and tobacco use.

Clients will understand how to use these products in moderation, or will stop using them completely as a result of proper education.

TEACHING

Show patients the difference between a “Smokers lung” and a “Non-smokers lung”

https://www.youtube.com/watch?v=GOZvDrLP-pw

Teach patients about the idea of trading/selling tobacco, not using it for themselves

Teach about liver failure and how it can affect the well-being of the patient

CITATIONS

Davis, A. B. (2013). Tobacco production and trade in Madagascar : (Malagasy Republic). In U.S. dept. of agriculture.

Ladwig, B. (2011). Mosby's guide to nursing diagnosis. 3rd Ed. Elsevier ISBN: 9780323071727

Madagascar (2010). In WaterAid. Razanamihaja, N., Befinoana, M. (2013). Alcohol consumption

by school-going adolescents in Madagascar: Prevalence and associated risk factors. Journal of Alcoholism and Drug Dependence, 2(145).

World Health Organization. (2015). Madagascar. In World health organization.