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Understanding Vertical Programming: An Analysis Of Hookworm In Java

1198 words - 5 pages

Given all the health issues public health practitioners must be aware of, why does a vertical public health program seem so appealing? A vertical public health program is one in which the majority of resources and expertise accumulated by health organization(s) are concentrated on one health issue, usually eradicating a particular disease. Strengths of vertical programming are the goals are straightforward and progress is easily measurable. A major weakness of this approach is it diverts attention and resources away from health organizations and initiatives aimed at treating all illnesses. We will look at how vertical programming was applied in the hookworm initiative carried out by the Rockefeller foundation during the early 1900’s. Being able to understand how vertical programming works will allow public health practitioners to tailor health programs and initiatives to their communities more efficiently and effectively. Some public health practitioners believe because vertical programming concentrates resources and expertise towards one health issue, it is efficient in addressing health issues. While this approach may have aspects of it that are appealing, it frequently neglects other issues and makes them seem less important, which should not be the case. Vertical programming draws resources and expertise away from primary care and the prevention of public health problems, contributing to the exacerbation of illnesses due to lack of sanitation, nutrition, and primary prevention, and is therefore inefficient.
Vertical Programming and Sanitation
Vertical programming is often not compatible with the priorities and characteristics of local health problems. Because hookworm infection was due to fecal transmission, the Rockefeller foundation focused the majority of their resources on recruiting locals from the Java populations and training hygiene mantri or hygiene technicians where they were trained in hygiene community outreach consisting of hygiene education and latrine construction (Stein 547). The latrine was the symbol of heightened sanitary conditions for the campaign, and thus was a main component of hookworm eradication success. However, for the locals, building them was time-consuming and costly, which were never factored into the public health organizations plans. Most of the Java population, in fact, did not want to construct latrines because they would wash away during monsoon season (Stein, 550). Therefore, this shows that vertical programming fails to tailor appropriate interventions to the population of interest and puts the organizations prioritizes over the populations. This approach imposes health organization’s ambitions on the population of interest and forces them to embrace their practices. Vertical programming often lacks community input, participation, commitment, and buy-in. Even after 30 years, the hookworm infection rates only slightly declined (Stein, 551). Though the strength of vertical programming is that...

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