Investigating The Community-Level Variation In Hookworm Prevalence In The Kpandai District, Ghana: A Mixed-Methods Study

Soil-transmitted helminths are a major cause of disability and morbidity in resource-poor settings: over 1.5 billion are estimated to be at risk of infection. Human behaviors and household socioeconomic conditions that facilitate contact with contaminated soil may increase exposure to parasites. The primary objective of the study was to investigate the community-level variation in hookworm prevalence in the Kpandai district of Ghana. We used a mixed-methods approach to investigate behavioral, societal and environmental risk factors to hookworm exposure. 264 individuals from three neighboring villages (Jagbigbingdo [JG], Takumdo [TK], Wiae Chabor [WC]) were recruited using a convenience sampling strategy. Household questionnaires regarding WASH were administered, and a representative from each household answered a semi-structured interview. Soil samples were taken to assess environmental hospitability for parasites. JG had a 24.4% hookworm prevalence, compared to 1.5% for TK, and 6.9% in WC, noting a continued community-level variation. Household size was a significant risk factor (OR = 2.09, 95% CI [1.17, 3.74]), while severely food insecure status was a protective factor (OR = 0.32, 95% CI [0.12, 0.85]). Qualitative interviews revealed that there is potential for regional WASH interventions and educational campaigns have penetrated at the community level. Environmental conditions did not vary significantly between the three villages, and nor did behavioral patterns. Infrastructure improvements may be needed to actualize behavioral changes from latrine construction, to achieve a sustainable reduction in parasite transmission. Concentrated foci of hookworm infected households may continue transmission patterns in JG, retarding efforts to reduce transmission at the community-level

Identifying Health Resources and Community Perceptions in the Greater New Haven Area

As required by new laws of the Affordable Care Act, non-profit hospitals are required to produce a Community Health Needs Assessment (CHNA) on a triennial basis in order to receive Medicaid funding, among others. Identification of community health assets is now a requirement by the IRS, in order for the hospital to keep their non-profit status. Community asset mapping (CAM) is an important new component of the community health needs assessment required by the Affordable Care Act for non-profit hospitals. CAM allows these hospitals and the communities they serve to identify key fixtures in their communities that can be leveraged to promote better health and well-being, especially when external resources (e.g. grants) are not available. In partnership with Yale New Haven Health and UnitedWay 2-1-1, we compiled health assets from various towns and communities in the broad Connecticut region. They were classified into six broad areas of need. We conducted interviews with community leaders and residents from the Greater New Haven area, more specifically the West River neighborhood. We hoped to gather insight and perceptions of residents about health assets in their area. Lastly, we generated asset heat maps with GIS to visualize health asset service areas and possibly identify areas of need. Our project sought to expand upon the scope of the mandated CHNA to include community input. Outside of the list of health assets, we went a step further to try to identify possible areas of need based on low coverage by assets on the heat maps.https://elischolar.library.yale.edu/ysph_pbchrr/1028/thumbnail.jp