CASE A:

After viewing the media presentation for this week, one of the biggest takeaways for me a nurse, is that I should be prepared and take initiative to educate my community. Being prepared means that I as the nurse should be learning continuously, keeping up with evidence-based data, and in this case furthering my education so that I will then be a resource to my community. The education being provided to the community may vary from population to population, and should be able to be presented in multiple languages. Providing education, teaching and interacting with the community as the health care professional is important to alleviate fears, encourage learning and allow for questions to be asked and answered. One of the largest teaching points, which would be aimed at all demographics, but especially towards those who are immigrating into the country, is for providing vaccinations for children, and presenting facts and statistics to help open minds and decrease the adversity to vaccinations, and when possible administer vaccinations at free or low cost clinics to target the everchanging population in America.

In suggesting free or low-cost clinics, we should take into consideration is that the United States of America we have today, is vastly different than the American of 20 years ago.  Transcontinental transportation has improved, more international flights are arriving and departing America daily, cruise ships are visiting and leaving more ports, sometimes visiting underdeveloped countries as well as increased immigrants arriving into the country have all shaped the America of today, and has led to the rapid spread of once nearly eradicated diseases in developed countries. In addition to ease of travel, more parents are choosing to not vaccinate their children, leading to the return of diseases such as measles, and the spread of disease from unvaccinated Americans to other countries as well.

According to the World Health Organization (WHO) measles is still common in many developing countries such as Africa and Asia. “The overwhelming majority (more than 95%) of measles deaths occur in countries with low per capita incomes and weak health infrastructures.” (WHO 2018). What this means for the nurse is that the nurse should be vigilant in ensuring vaccination as being administered when indicated, while also emphasizing the importance of vaccination to the general public.

I recently moved to Arizona, only about 3 hours north of the America- Mexico border. Being this close to an underserved country, with immigrants flooding into the country daily, I have taken notice of the increase in Measles outbreaks. Not all of the recent outbreaks have been associated immigrants, and the information from this article was rather interesting. Seeing this quote in a recent article “The U.S. exported [the] measles virus to Mexico.” As being quoted from a member of the CDC was eye opening. This again goes back to the need to education and track immunization compliance.

CASE B:

Today one can leave Arizona and land in Durban, South African, within twenty-seven hours.  Our advances in travel make the world seem smaller, more comfortable to travel and make it easier to spread disease. Dr. Louise Fitzpatrick emphasized how public health in one location requires nurses to think globally. What happens in another country affects us at home due to travel and immigration (Laureate Education, 2010).  Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) is an infectious disease that began on one part of the world and made its way to the United States.  For this discussion, a comparison of the United Kingdom (a developed country), South Africa (a developing country), and the United States HIV/AIDs epidemic and how they rate with one another.

The United Kingdom (U.K.) has a population of about 64 million people.  The UK is considered a leader in world finances and considered a developed country. It has a National Health System (NHS) to provide health care to all its residents.  The UK has an estimated 101,600 people living with HIV or 1.7 per 1000.  The number of people living with HIV has decreased over the last ten years. The NHS has a combination HIV prevention of free condom programs and pre-exposure prophylaxis (PrEP) to reduce the risk of individuals who are HIV from becoming infected. The NHS has improved HIV testing in hospitals, general practices, for people with HIV indicator conditions and those with an increased risk or have a sexual partner diagnosis with HIV (Progress towards ending the HIV epidemic in the United Kingdom, 2018).  The United Kingdom implemented programs such as the treatment as prevention for those diagnosed with HIV and free syringe distribution.

In contrast, South Africa has a population of about 53 million people.  While this country is economically a developed country, yet it has an unemployment rate of 25% and most of its citizens make less than $1.25 per day, making it an underdeveloped country as well.  The disparity of wealth from the small minority of white citizens and the majority of black citizens makes providing equality in healthcare nonexistent.  South Africa has basic primary health care offered free to all its residents, yet the private sector uses 46% percent of the expenditures for less than 15% of the citizens. The inequitable 54% spent on the remaining 85% of its populace leaves many of indigenous people in rural areas, lacking healthcare. South Africa has the highest rate of HIV/AIDS in the world. There are currently 6.4 million people living with HIV/AIDS, and 235,000 dies from it yearly.  That means 900 people get infected with HI daily while 500 die every day (Holtz, 2017). South Africa implementation of HIV treatment and free syringe programs are located sparsely in its urban areas, leaving those in rural areas without help. (Needle and syringe programs (NSPS) for HIV prevention, 2019)(HIV and VAIDs in South Africa, 2019).

The United States is considered a developed country with a population of 320.5 million and is considered a leader in technology and industry. Healthcare is paid for by an employer or individual insurance, government Medicare or Medicaid and self-pay. People living with HIV/AIDS is 1,200,000, of which 17,000 die each year (Holtz, 2017). Despite being a leader in industry, the United States rates last of the developed countries in healthcare access, equity, and outcomes, and next to last in administrative deficiency performance (Schneider, Sarnak, Squires, Shah, Doty, 2017). The United States healthcare system leaves many people under or nonfunded and left behind. 

So, what can these countries learn from one another?  First, equality for all.  A nation can provide equal healthcare for all its citizens. Thus, cutting the overabundance of administrative costs frees up dollars to provide direct care to its citizens.  Systems such as these often require something to be lost to provide healthcare for everyone.  So secondly, allow for private insurance to make up the difference in what national healthcare does not provide.

While Sweden’s health care system, considered to be the highest level in the world, (Holtz, 2017) is outstanding; we need to remember this is a country the size of California. It has different demographics, and what works for a smaller country may not translate well to one much larger in size and populace. All of the developed countries of the world are facing challenges. From these countries challenges and examples, the US can learn how to provide and pay for healthcare for its populace. 

INSTRUCTIONS:   need assistance with feedback response to fellow class mates post. 2 are listed above. Additional information can be added or questions to their initial post. 2 resources are to be included. Below is what the post was related to …

Post your analysis of one health problem between one developed and one developing country in comparison with the United States in terms of the WHO outcomes and criteria listed above. State your opinion about how well the United States is doing in terms of public health. Share what you think countries with worse outcomes could learn from countries with better outcomes. Explain the nurse’s role in public and global health and why nurses should be concerned with global health issues. Conclude by summarizing your view of the role of the nurse in public health. 

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