BSN FP4014 Global Perspectives of Community

BSN FP4014 Global Perspectives of Community and Public Service

Maternal and Child Health

Introduction

Global health in this context is used to refer to a health issue that has a direct impact on the population.  There is a wide range of global issues that relates to ill-defined intersections between environmental health, bioethics, anthropology, veterinary medicine, political science, economics, and health services research (Birbeck, 2013).  Current research has placed more emphasis on the challenges associated with global health delivery and public health improvements in the global setting that has limited resources (Birbeck, 2013).  With the increasing concern of global healthcare, this paper focuses on maternal and child health with a special focus on childhood vaccination, midwife education, and prenatal care.  

Background Information and Statistics

Recent years has seen an increasing research on global health not only from the general public but also among the academic community.  Maternal and health care (MCH) is a critical health care service that is provided to mothers who in this case are at the age of childbearing, the service is extended to their children mostly in terms of vaccination.  MCH targets women at their reproductive age, which is cited to range between 15 to 49 years (Dykens, Hedrick, Ndiaye & Linn, 2014).  Increased cases of adverse maternal and child health results from poor accessibility to prenatal and antenatal care, inequities in access to health services, and poverty.  According to the World Health Organization (WHO) (2018), almost 99 percent of all maternal and child deaths occur in developing nations. WHO also noted that at least 50 percent of these deaths are reported in sub-Saharan Africa and one third in South Asia (WHO, 2018).  In addition, most maternal and child deaths occur in humanitarian and fragile settings.  Other factors that hinder women from developing countries to seek and receive prenatal and antenatal relate to cultural practices, lack of information, and inadequate infrastructure.  This has contributed to increased cases of maternal complications that arise during pregnancy and after childbirth hence widening the gap between the rich and the poor.  WHO noted that the maternal mortality ratio in developed countries is 12/100,000 live births compared to 239/100,000 live births in developing countries.

Across the globe, an increasing interest and concern in maternal and child health care have significantly skyrocketed in order to implement sustainable development goals meant to promote health for women, children, and adolescents.  Following the 1991 summit for children, emphasis and serious consideration outlined the major areas to be focused in order to address the provision of MCH services.  However, nearly thirty years down the line, research confirms that the projected objectives are yet to be achieved.

This turn out of events is confirmed by a myriad of statistics and research findings.  It has been established that mothers and children in sub-Saharan Africa and South Asia still need a major consideration in matters of health services.  This is important because children and mothers accounts for two-thirds of the whole population in the world.  Research also indicates that women reproductive age is between 15 to 49 years, which in this case pregnant women constitute a 4.5%.  Children under the age of 15 years constitute 47% while those under the age of 5 account for 18%, under the age of 3 constitutes 12% and infants amount to 4% (NASEM, 2017).

The maternal mortality rate has a significant effect on the outcome of most pregnancies.  In fact, cases of induced abortion and miscarriage among other aspects are the cause of more than 40% of pregnancy complications in most developing countries (Kana, Doctor, Peleteiro, Lunet & Barros, 2015).  This impact is also coupled with other detrimental effects including maternal and newborn deaths as well as permanent disability among the mothers.  An estimated 80 percent of the maternal deaths are associated with directed obstetric (Lu et al., 2015).  This is caused by obstetric complication associated with the pregnancy state due to errors such as incorrect treatment, omissions, and futile interventions.   

Factors That Affect Health and Healthcare Delivery in the Global Areas

Healthcare delivery faces a myriad of challenges that renders it insufficient or ineffective.  For instance, research show that most pregnant women in the developing countries are victims of insufficient prenatal care and the delivery is done by healthcare providers who lack appropriate training (Lassi, Salam, Das & Bhutta, 2014).  Research also estimates that more than seven million of the newborn deaths are attributed to mental health problems coupled with mismanagement of proper health practices.  In addition, there is poor maternal health, which is associated with sub-standard family welfare and poor social economic status.  This low standard of living has led to chronic illnesses among women in developing countries, which not only weaken their immune system but also subject them to premature death during pregnancy.     

In developing countries such as Nigeria, infectious diseases are more prevalent among the pregnant women as compared to non-pregnant one, which are common during their first pregnancy (Kana, Doctor, Peleteiro, Lunet & Barros, 2015).  Additionally, it has been established that in sub-Saharan Africa there is a high probability that women infected with HIV will pass the infection to the new born due to inadequate and poor health services (Kana et al., 2015).  The economic status in developing countries further jeopardizes pregnant women since it leads to nutrition problems.  In fact, in the year 2003, it was established that an estimated 60 to 70 percent of pregnant women in the developing countries had anemia (Lu et al., 2015).  

Lack of political goodwill in developing countries due to poor strategies and insufficient support in terms of finances, technical know-how as well as prenatal knowledge escalate the cases of maternal and child deaths.  Women are unable to access relevant information training, suppliers, emergency support among other essential services in these areas.  This coupled with negative cultural practices and attitude impedes women to using the available services.

The Influence of Altruistic Organizations

Altruistic organizations play fundamental roles in enhancing maternal and child healthcare through various initiatives.  For instance, the United Nations has systematically been developing millennium development goals geared towards mitigating maternal and neonatal morbidity and mortality rate across the world.  This includes providing resources, training personnel, and educating the affected population on how to fight such challenges (Graner, Mogren, Duong, Krantz & Klingberg-Allvin, 2010).  Other organizations such as World Health Organization defines antenatal care as healthcare service offered to pregnant women and articulates that it should be offered using the evidence-based interventions that have proved to be beneficial (Graner et al., 2010).  Essentially, WHO articulates that all women should be offered a tetanus toxoid immunization as well as screening and treatment of syphilis, and anemia. Further, WHO suggests that women should be examined of other complications such as mal-presentation and hypertensive disorder.

Additionally, organizations such as Peace Corps’ Maternal and Project Hope play an important role in maternal and newborn health training.  For instance, Peace Corps offer a training package to volunteers on how to handle maternal and newborn health by exposing the trainee to global trends and key concepts (Dykens et al., 2014).  Moreover, the organization is better positioned to give insights on local contextual aspects since there is a closer working relationship between local leaders and the volunteers.  

USAID is a key partner in reducing newborn mortality in order to attain sustainable development goals.  It is estimated that 3 million kids die each year during the first month due to complications and diseases.  However, these factors have known interventions and cost-effective prevention measures.  In this regard, USAID emphasizes on increasing the quality of services and care during labor, birth and the earliest days of the life of the child.  This period is termed as crucial and thus it requires high intervention before, during, and after birth.  For instance, USAID has taken an active role in helping bring a public-private partnership where it trained more than 335,000 healthcare providers in rescue strategies in more than 80 countries from the year 2010 to 2016.  These programs have marked a significant impact in countries such as Nepal and Tanzania since the program has helped to reduce the early neonatal death of the child within the first 24 hours by more than 50 percent.   

Interventions Implemented to Address the Healthcare Issue Associated with the Topic

According to family health nursing, in order to improve healthcare delivery in maternal and child health, it is paramount to ensure that healthcare is available within the context of the community.  This is aimed at ensuring that the patient is able to access health care within the locality in which they are situated.  In this case, the person-centered care is the heart of maternal service delivery.  This intervention articulates that the effective way of promoting well-being and health is to support people in their effort to look after themselves either while they are at home or within the community surroundings (Lassi et al., 2014).

This intervention articulates that it is paramount to ensure that community-based services are available in the event of the occurrence of health-related crises.  This will help to ensure that essential support systems are available for disposal to help solve the health problem without necessarily having to remove patients from the local setting.  At this level, the caregivers include the community health workers in collaboration with outreach workers.  

The next level of intervention is the first or outreach level or the outreach.  In this level, the healthcare providers are the community health workers, outreach workers, and professions.  This intervention includes the Alma Ata Declaration for the Primary Healthcare that is approved by World Health Organization.  Recently, WHO recommended the use of healthcare services that interface between community programs and families and are in compliance with hospital and national health policies.  The third level of intervention is known as the referral.  This level is used to refer to the general hospitals which include district and referral hospitals.  At this level, the healthcare providers are professionals.   

How the Health Care Decisions and Practices at the Local Level Relate to Health and Healthcare Delivery in Other Global Areas

Healthcare decision and practices made at the local level are geared towards enforcing or emulating those made at the national or international level.  At the local level, the health care decisions and practices include the local community health workers and the outreach team.  While healthcare delivery at the global level includes healthcare workers drawn from various ethnic and social lines, professionalism at this level is highly emphasized.  At the local level, decisions and practices utilize the local resources such as community trust and confidence, local knowledge and volunteers as a way of channeling and delivering interventions related to simple treatments and prevention, nutrition and safe motherhood.

However, at the global level, participants include global organizations such as WHO that receive support from donors, and decisions, and practices are made by volunteers and professionals drawn from different parts of the world.  In some case, global organizations use the community or locally based organizations such as community health workers as a channel of promoting prevention actions and healthy behavior in an effort to mobilize demand for the necessary resources at other levels (Lassi et al., 2014).  Nevertheless, success at both community and global area healthcare delivery is subject to the context of infrastructural development social economic resources and services.  

Evidence-Based Interventions That Are Effective, Efficient, Cost-Effective, and Equitable For Promoting Wellness and Disease Prevention

There is a myriad of challenges in the whole sector concerning women and children particularly at the local level, researchers propose a number of evidence-based interventions and practices, which are not only effective, efficient, and cost-effective but also equitable in nature.  These include five key areas including access to contraceptives, safe pregnancy, enhancing nutrition to pregnant women, infants, newborns, and children in an integrated management of illness associated with childhood and most importantly ensuring proper immunizations.  

Conclusion

To sum up, though tremendous efforts have been made towards mitigating the mortality among women and children in developing countries through measures such as prenatal care, midwife education, and child vaccination, more than 6 million children die every year before attaining the age of five years.  Moreover, about 303,000 women die every year due to preventable pregnancy issues.  Therefore, investing in children and women is vital because it has brought about tangible short and long-term benefits.  In addition, efforts should be made towards escalating investment in interventions based approach of vaccinations, inclusive management of childhood illnesses, midwife education, nutrition of children, pregnant women and newborns, safe prenatal care and delivery, and easy access to contraceptives.