Developing and executing a research intervention that is based on locally-identified needs, demonstrates cross-cultural collaboration and has long-term impact is vital for making sustainable gains in global health. This point is according to Emory University psychiatry resident Brandon Kohrt who shared his research with DGHI in Wednesday’s Global Health Exchange.
Kohrt’s work is focused on the mental health and psychosocial care of former child soldiers of Nepal’s Maoist Army. After the war which ended in 2006, Kohrt found that former child soldiers returned to communities where they were feared, stigmatized, and vulnerable to a myriad of abuses, including torture. Kohrt said children exposed to torture are six times more likely to develop mental health problems than other children.
To address these unmet mental health needs and cultural stigmas, Kohrt worked with Nepali community partners to design an intervention in eight districts. The project trained Nepalis as community psychosocial workers (CPSW) to deliver specialized services related to the education and reintegration of former child soldiers of the Nepal’s Maoist Army into the community.
As a result, Kohrt’s intervention reduced the prevalence of depression and post traumatic stress disorder (PTSD) among former child soldiers and helped to reduce the stigmas associated with the Maoist culture. Kohrt’s research helped build capacity for addressing psychosocial and mental health needs in Nepal, and the CPSW training is being integrated into the government’s curriculum. Listen to a podcast of his lecture.
In another Global Health Exchange held this week, senior research scholar in the Duke Department of Economics Alessandro Tarozzi shared his research on micro-loans and insecticide-treated bednets (ITNs), in which he found surprising results.
The randomized-controlled trial was conducted in 141 villages in the Indian state of Orissa, where malaria is a major public health problem. It involved the distribution of ITNs to 1,800 households, some who received ITNs for free and others who had to purchase them on credit with a one-year repayment.
Tarozzi compared the health outcomes of both groups and found that neither micro-loans nor free distribution led to improvements in malaria and anemia prevalence. His research is contradictory to other randomized evaluations which conclude that ownership and usage of bednets and ITNs can reduce malaria prevalence. Tarozzi said the most likely reason for this lack of health benefit is insufficient village-wide coverage of ITNs. He also found that free bednets were used more often than those that were purchased. Based on his findings, Tarozzi concluded that the free distribution of ITN’s coupled with village-wide coverage is most likely essential to reduce malaria burden.
