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In not less than 250 words. You are expected to critically evaluate and challenge the ideas of your classmate to help them develop better and more sustainable programming.


Lankester notes that there are several advantages to utilizing a horizontal program approach. Of those there is the opportunity for community involvement, there is a greater potential for sustainability, and the ability to focus on more than one problem while also focusing on prevention.1 The characteristics of a horizontal program lends itself to targeting maternal and child health. A necessary focus of healthcare for refugee populations in the Democratic Republic of the Congo (DRC) would be prenatal care as DRC has one of the highest infant mortality rates in the world.2 Broadly defined it takes into account the entire well-being of the pregnant woman. Research in DRC has shown that neonatal health, as assessed by birthweight, is impacted by maternal stress such being a refugee.3 Certain aspects of this well-being can be addressed as necessitated based on health concerns pertinent to the refugee population of DRC. A community based (or camp based) prenatal clinic could provide treatment and prevention of malaria, prenatal check-ups, and evaluation of malnutrition and diarrhea all targeted to treat pregnant women and their small children.


            DRC has one of the highest rates of malaria infections in the world.4 It has been found that those living in refugee camps in DRC face a higher rate of malaria infection than people living in villages.4 Further, malaria in pregnancy can be fatal, therefor focusing on malaria treatment and prevention as part of prenatal care in a refugee camp is a significant concern. Also, within the refugee setting it would be difficult to focus on prenatal care but not focus on the illnesses of children under the age of 5. Residence within a refugee camp has been shown to significantly increase the risk of malaria in children under the age of 5.4 Therefor, malaria prevention and treatment should also be available to children under the age of. Further, it is estimated that 40% of children in DRC are malnourished.5 Malnourishment increases the risk for illness such as diarrhea which is a leading cause of death in children under the age of 5.


Interventions to target pregnant women and their small children within refugee camps can be done with the consideration of limited funding. Prenatal care and the care of children under the age of 5 could be accomplished with routine weight checks to evaluate for malnutrition. A handheld Doppler and tape measure are the essentials for prenatal check –ups to evaluate the progress of the pregnancy. Management of diarrhea could be accomplished with the use of inexpensive oral rehydration salts and educating new mothers on the many benefits of breastfeeding to include preventing diarrhea. Lastly, the most costly interventions would be the treatment and prevention of malaria. Malaria medications would need to be provided and prevention of malaria infections would require the distribution of insecticide treated bed nets. We are to use the example set forth by God and take care of those in need, “He defends the cause of the fatherless and the widow, and loves the foreigner residing among you, giving them food and clothing” (Deuteronomy 10:18).


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