To: Journal of Epidemiology Community Health
Dear Editor,
In my experience as a public health worker, I find that cholera is among the worst contagious diseases in many developing countries, based on the ease of its spread and its ability to kill thousands of people in a short time. The 2012 cholera outbreak in Sierra Leone, which caused widespread human deaths, is a testament to this fact. The death toll from the outbreak reached thousands of people and many more fell sick from it. Local and international health agencies collaborated to introduce numerous interventions to manage the disease and prevent its further spread (World Health Organization, 2012). Some of their interventions included increasing access to freshwater, improving sanitation services, and improving health coordination and communication (World Health Organization, 2012). The agencies not only started these interventions to stop the outbreak and minimize its morbidity and mortality but also strived to improve the country’s preparedness to manage another disaster. Nonetheless, there have been little, or no, efforts to evaluate whether these interventions have achieved their goals, or not.
I believe the importance of evaluating public health interventions cannot be underestimated because public health decision-makers, funders, and practitioners depend on the knowledge they get from the evaluation of public health interventions to inform their decision-making processes (Bombard & Miller, 2012). In line with this reasoning, it is difficult to improve Sierra Leone’s preparedness to manage another cholera outbreak without understanding the efficacy of the existing interventions. Therefore, quality improvement is central to our understanding of the existing public health interventions. This is why Waters, Doyle, Jackson, Howes, and Brunton (2006) say, “Public health organizations must continually improve upon the standards of evidence used in the evaluation of public health so that results can inform management and policy decision-making” (p. 495).
Evaluating the efficacy of public health interventions during the 2012 Sierra Leone outbreak requires the adoption of effective social science tools to understand which interventions work and which ones do not. Ensuring that existing public health interventions are accountable to their stakeholders is another way of addressing the public health issue because, this way, we would know if these interventions have achieved their intended goals, or not (American Public Health Association, 2009). Comprehensively, evaluating the efficacy of interventions introduced during the 2012 cholera outbreak is a noble step towards improving the preparedness, response, and management of cholera in Sierra Leone. This would be a major step in stopping the epidemic from happening again.
References
American Public Health Association. (2009). APHA Health Reform Advocacy Toolkit: Public Health ACTion (PHACT) Campaign. Web.
Bombard, Y., & Miller, F. A. (2012). Reply to Ross’ commentary: Reproductive benefits through newborn screening: preferences, policy, and ethics. European Journal of Human Genetics, 20(5), 486–487.
Waters, E., Doyle, J., Jackson, N., Howes, F., & Brunton, G. (2006). Evaluating the effectiveness of public health interventions: the role and activities of the Cochrane Collaboration. J Epidemiol Community Health, 60(4), 285–289.
World Health Organization. (2012). Cholera in Sierra Leone: the case study of an outbreak. Web.