Thursday, February 21, 2019
To What Extent do Western Concepts of Ill-Health Limit Policies and Projects Aimed at Improving the Health of Those in the Developing World
Executive SummaryCurrent wellness policies on mal feed and human immunodeficiency virus transmittance ar focused in achieving the Millennium organic evolution Goals (MDGs) of the joined Nations. Specifically, these closes include reduction of mal support relative incidence since 1990 by 50% and lapse in the trend of human immunodeficiency virus epidemic by 2015. This strain aims to searingly analyse these two policies in achieving their respective aims and objectives and the factors that contribute to the conquest of these policies. A brief interchange on the westbound concepts of ill- health and how these relate to the concepts of ill-health in create countries is in addition made.Results of the analysis come out that engaging communities and allowing them to take professership of strategies to save mal animated is effective in reducing incidence of malnutrition. The Scaling Up provender ( sun) campaign illustrates how ontogenesis countries could positively serve to healthcargon policies introduced by true countries. However, non all ontogenesis countries be nearing or save achieved the 50% reduction in malnutrition incidence. Lack of federation involvement has been manifestn to affect the go on of the SUN campaign. The same principle of community-based interventions is in addition used on the insurance indemnity for human immunodeficiency virus transmittance. Success rate for human immunodeficiency virus policy is high with millions of unnatural individuals approaching health kick services comp bed to still 400,000 in 2004. This would show that policies to increase word nominate succeeded. However, prevention of human immunodeficiency virus transmitting remains challenging. Analysis would show that engaging in unsound rideual behaviour is a critical factor in ontogenesis human immunodeficiency virus infection in sub-Saharan Africa. Changing the behaviour of a target population is established to be difficult.While commu nity-based interventions and participation live contributed to the victory of these policies, analysis would reveal that on that point is a need to increase the technical competencies of the stakeholders in the communities. This would ensure sustainability of programmes huge after external aid has stopped. The differences in the concepts of ill-health in addition appear to deflect the success of policies in maturation nations. It is in like manner deald that achieving all the aims and objectives of the policies might not necessarily solve the problem of malnutrition and human immunodeficiency virus infection. Both conditions nurture nine-fold underlying pisss and placeing all these would take considerable time and effort. In shoemakers last, policies have made not bad(p) strides in improving nutrition of squirtren and mothers and decreasing the incidence of HIV infection. Concerted effort from various stakeholders is still needed to deliver changes sustainable.Intro ductionThe main aim of this brief is to critically analyse the policies, less(prenominal)en Hunger and Malnutrition in Developing Countries ( subdivision for International Development, 2013) and the planetary policy on HIV/ take epiphytotic (KFF, 2013). Both healthc atomic number 18 policies are intentional to improve the health and well-being of mothers and young electric shaverren and those scathe from HIV/ support in developing countries. The first part describes these two policies while the piece part discusses the Western concepts of ill health and how these limit policies and projects aimed at developing countries. The third part provides a theoretical assessment of the policies. A discussion on the underlying assumptions and views of healthcare in terms of belief structures and school of thought will be included. The fourth part presents the practical problems with implementation. Finally, a conclusion will summarise the main points raised in this essay. Recommendati ons will as well be made at the end of this brief.Policies on Malnutrition and HIV/acquired immune deficiency syndromeThe Reducing Hunger and Malnutrition in Developing Countries (Department for International Development, 2013) aims to help individuals take on access to nutritious diet, ensure that food is distributed fairly across the demesne and mitigate environmental lucks and damages that could deflect food output. In draw with the Millennium Development Goals (MDGs), the policy has set out several(prenominal) objectives that should be achieved by 2015. This includes reducing malnutrition since 1990 by 50%.Meanwhile, the Global HIV/ aid Epidemic policy (KFF, 2013) aims to stop and reverse the spread of HIV/AIDS. This is unchanging with the United Nations MDGs that by 2015, the HIV/AID epidemic will be controlled and incidence will decline. It is estimated that a total of 18.9 one thousand thousand USD have funded HIV/ back up preventive and treatment programmes in 2012 (KFF/UNAIDS, 2013). Although in that respect is a global decrease in the trend of this epidemic, incidence of HIV/AIDS is still high in middle and low-income countries (UNAIDS, 2013). Most of those worthless from this health condition do not have access to healthcare services, treatment and management (UNAIDS, 2013). Importantly women and young girls are more than fictile of the infection compared to men (British HIV Association, 2012). Of the 35 million individuals believed to be suffering from the condition, 3.3 million of these are children (UNAIDS, 2013). Majority (71%) of persons living with HIV/AIDS remain in Sub-Saharan Africa (Health Protection Agency, 2012). The objectives of this policy include decreasing HIV prevalence amongst the young population aged 15-24 years increase guard use curiously in high-risk sex increase the residual of young people with correct knowledge on HIV/AIDs infection and increase the proportion of individuals with advanced stages of the dis ease make water access to antiretroviral medications.Western Concept of Ill-HealthWestern concepts of ill-health could limit the policies on malnutrition and HIV/AIDS when introduced in developing nations. First, definitions of ill-health could vary between Western and developing countries. in that respect is variation in how ill-health is perceived even amongst professional, academic and the familiar (Wikman et al., 2005). Ill-health is also viewed dissimilarly across disciplines. For instance, the medical form of health has been accepted for several years in Western healthcare in the past (Wikman et al., 2005). This model states that ill-health is caused by pathogenic microorganisms or underlying pathologies (Dutta, 2008). However, even this concept has changed within healthcare systems. Today, many healthcare professionals have recognised that ill-health is not only caused by pathogenic organisms but social determinants of health such as measly nutrition, unemployment or s tress could all influence ill-health (Dutta, 2008). Wikman et al. (2005) acknowledges that ill-health could be unsounded by using a multi-perspective approach.Concepts of ill-health are also considered as historically and culturally specific (Blas and Kurup, 2010). This means that ill-health varies across culture and time. For instance, in Western culture, obesity is considered as ill-health (Blas and Kurup, 2010). In other countries, obesity is viewed as socially acceptable since this is a sign of wealth. In Western culture, findings of scientific publications are used to underpin health policies against HIV (Bogart et al., 2011). Use of condoms to protect against HIV infection is viewed as acceptable. In nigh African countries, use of condoms is seen to abridge ones masculinity (Willis, 2003 MacPhail and Campbell, 2001). Importantly, anal sex in some of these countries is practised to avoid pregnancy or viewed as a purgatorial method against the virus for HIV/AIDS (Bogart and Bird, 2003). Hence, these differences in the concept of ill-health could influence the uptake of global health policies in developing nations. To illustrate this argument, the policies on malnutrition and HIV/AIDS will be critiqued. A discussion how westerly concepts of ill health influence the uptake of these policies in the developing countries would also be done.Analysis and DiscussionAttention on subtile and continuing malnutrition is unprecedented in modern years (Shoham et al., 2013). The involvement of the UK, through its policy for malnutrition and aridity, with other countries in the scaling up nutrition (SUN) campaign has brought evidential changes on the lives of children who are malnourished. The policy on malnutrition is underpinned by the philosophy on health equity and social determinants of health (Ezzati et al., 2003). Western concepts of ill-health focus on the social determinants of ill-health as a factor in promoting malnutrition in developing countries. Fo r example, unemployment of parents, low trains of education, early(a) years, privation, homelessness are some social determinants of health strongly suggested to promote malnutrition amongst children (Marmot and Wilkinson, 2005). Uptake of policies for malnutrition in developing countries might be expressage if these determinants are not properly addressed. Farmer (2003) explains that cultural beliefs on food, scant(p) knowledge on the nutritional value of food and food production practices have long contributed to malnutrition in many countries.Policies on malnutrition might no be effective if these do not address the root causes of malnutrition, which are poverty, poor knowledge on food nutrition and poor landed estate practices (Farmer, 2003). Power structure also pushovers a role in how policies are implemented. Farmer (2003) stresses that unless the poor are empowered and their rights protected would true schooling occur. In recent years, in that location have been im provements in the lives of the poor, specifically on nutrition military position. Marmot and Wilkinson (2005) emphasise that presence of poverty and unemployment could all influence health. However, in that location is evidence that in some developing countries, malnutrition policies have gained success. An analysis would show that involvement of the community plays a crucial role in ensuring success of these policies. For example, Shoham et al. (2013) report that the community based management of acute malnutrition (CMAM) approach contributed to its success in some 65 developing countries across the world.Communities are mobilised and they gain ownership of the programme. Individuals help in detecting uncomplicated severe acute malnutrition (SAM) and refer children to established out-patient centres. Complicated cases are referred as in-patients in the health sector staff. While the UNICEF (Nabarro, 2013) reported that 10% of the 20 million suspect cases of SAM have been treated through the scaling up nutrition campaign, other target countries have not kept up with the campaign. Policies that have gained acceptance in developing countries are those that empower communities to take satisfys for their own health. Empowering women through education has been shown to lead to more positive changes in the health of children ages 5 years old and below (Farmer, 2003). Policies that increase the educational levels of women were shown to keep down erroneous perceptions on the causes of malnutrition (Wikman et al., 2005). Shoham et al. (2013) observe that failure to implement the CMAM approach and educating women on malnutrition limits the success of malnutrition policies in communities.A total of studies (Bhutta, 2013 Black et al., 2013 Pinstrup-Andersen, 2013 Nabarro, 2013 Loevinsohn and Harding, 2005) have shown the potency of engaging communities and empowering them to improve the nutritional status of women and children. While factors such as engaging communi ties and allowing them to take ownership of programmes have been shown to promote uptake of policies, there are still factors that limit policy uptake. These include failure to address the social determinants of health such as poverty, low levels of education, poor support of the children during early living years and unemployment (Loevinsohn and Harding, 2005). It has been shown that when these factors are present, malnutrition is also high (Pinstrup-Andersen, 2013). there is also a need to understand the perceptions of women and children on food and nutrition to better understand why malnutrition continue to exist in a number of developing countries.Meanwhile, the policy on HIV/AIDS also promote health by engaging communities in implementing projects aimed at preventing HIV transmission (KFF, 2013 British HIV Infection, 2012 Department for International Development, 2013). To date, HIV infection epidemic has stabilised and the number of individuals receiving treatment has chang e magnitude to 9.7 million in 2012 (UNAIDS, 2013). In contrast, only 400,000 individuals with advanced HIV infection receive treatment in 2004. A closer analysis of the cause of HIV infection would still point to risky behaviours of those engaging in unprotected sex and injecting dose users as factors that promote HIV infection (KFF/UNAIDS, 2013). This is a cause of concern since there is still the prevailing cultural belief in a number of African countries that use of condom is unmanly (Willis, 2003 MacPhail and Campbell, 2001).Connolly et al. (2004) argue that changing behaviour of the target population is most difficult. Consequences of HIV infection extend to uninnate(p) children of mother infected with HIV (UNAIDS, 2013). To date, there have been various interventions to prevent HIV infection. These include behaviour changes, increase in HIV screening, male circumcision, use of condoms, harm reduction amongst in injecting drug users and blood supply safety (UNAIDS, 2013). Amon gst these strategies, changing behaviour remains to be an important intervention that could prevent further spread of the virus. Experts suggest that risky sexual behaviour could only be changed through the use of different health models. For example, the health belief model could be used to maintain the target population on the risk of HIV (Health Protection Agency, 2012). In addition, facilitators to behaviour change, such as decreasing steel on HIV infection, increasing access to healthcare services could help individuals adopt less risky sexual behaviour (Greeff et al., 2008). Patients with HIV often perceive stigma from their own healthcare workers (Kohi et al., 2006 Holzemer and Uys, 2004). This could impact not only the quality of care received by those with HIV infection but might also limit them from gaining further medical treatment.On the other hand, reducing malnutrition by 50% since 1990 has not been achieved in most countries yet (UNICEF, 2014). This is important sin ce the United Nations aims to achieve this target by next year. Food production is constantly affected by stronger typhoons and turbulent tolerate patterns (KFF, 2013). Droughts appear to be longer, affect agriculture and livestock production (KFF, 2013). Specifically, the UNICEF (2014) acknowledges that the most vulnerable groups to increasing weather disturbance brought by climate change are the poor people. This is especially challenging in the light of the MDGs since decreases in food production in developing countries could further have an impact on the nutritional status of the women and children (Bryce et al., 2008 Taylor et al., 2013). Climate change has important implications on policies for malnutrition. Even if community-based initiatives are strongly in place and individuals have learned to produce their own food, changes in weather patterns could impact agriculture activities. The UNICEF (2014) has highlighted this issue and using current experiences, community rehab ilitation after a typhoon or drought would mean increased challenges in addressing malnutrition amongst the poorest of the poor.Even if all objective are achieved, there is no full guarantee that malnutrition will be completely eradicated in developing nations. To date, there are best practices (SUN, 2013) showing that community involvement and confederation with government and non-government organisations could arrest severe acute and chronic malnutrition. A number of developing countries, especially in the Sub-Saharan Africa are still assay with malnutrition despite external aid. The same observation is also made in this region on HIV infection where the poorest amongst the poor remain to be most vulnerable to the infection (SUN, 2013). Hence, it would be necessary to investigate the authorized cause of malnutrition and HIV infection in developing countries.There are multiple underlying causes of malnutrition and all interact to increase the risk of children for malnutrition. F irst, poverty has been highlighted earlier in this essay as an important factor for breeding of malnutrition (Horton and Lo, 2013). This essay also argues that maternal level of education is a epochal factor in the nutrition of children (Black et al., 2013). The World Health agreement (2011) acknowledges that children born to mothers with at least a high school education enrapture better health compared to children with mothers who have lower educational levels. This observation is reproducible across literature (UNICEF, 2014 Black et al, 2013) and illustrates the importance of increasing the education level of mothers.In Sub-Saharan countries that often experience conflicts, malnutrition is often caused by transmutation of families and children from their homes and livelihood to evacuation centres with minimal food support (UNICEF, 2014). Apart from conflicts, recent do of climate change have also changed the way create countries respond to problems of food security (Taylor et al., 2013). As shown in the UK policy for hunger and malnutrition, funds are also directed to innovations and research on how to respond to environmental damages caused by climate change (UNICEF, 2014). It should be historied that changes in weather patterns, flooding and drought could have a great impact on food security and sustainability (Department for International Development, 2013).In compare with the policy on HIV infection, the policy on hunger and malnutrition would have a greater impact on the health of the nation. It has been shown that improving nutrition during the first 1000 days of a childs life could lead to better health outcomes, higher educational attainment and productiveness later in adult life (Bhutta, 2013). Malnutrition during a childs first two years of life could have irreversible effects on the childs health (Bhutta, 2013). This could lead to stunting, cognitive impairment, early death and if the child reaches adulthood, difficulty in finding a line age (Nabarro, 2013). The number of children and mothers suffering from malnutrition is also higher compared to individuals suffering from HIV infection. However, HIV infection could also have an impact on maternal and child health since infected mothers could transmit the virus to their unborn child (KFF, 2013). Women with HIV also suffer more stigma compared to their male counterparts (Sandelowski et al., 2004).Recommendations and ConclusionIn conclusion, the two policies discussed in this brief reveal strategies in preventing and treating malnutrition and HIV infection. Responses of developing countries to these strategies differ. Countries where communities are problematical in the implementation of strategies are generally more successful in addressing these health problems. This would show that community involvement play a crucial role in the uptake of Western policies in developing countries. However, the lack of success in some countries might be attributed to the difference s in the concept of ill-health between affluent and developing countries, socio-economic context of poor countries and difficulty in changing ones health behaviour. Finally, this essay suggests that a more holistic approach should be taken in addressing the social determinants of health to ensure that children have access to nutritious food and HIV infection is prevented.ReferencesBhutta, Z. (2013). Early nutrition and adult outcomes pieces of the puzzle Online. The Lancet, 382(9891), pp. 486-487.Black, R., Alderman, H., Bhutta, S., Gillespie, S., Haddad, L., Horton, S., Lartey, S., Mannar, V., Ruel, M., Victoria, C., Walker, S. & Webb, P. (2013). parental and child nutrition building momentum for impact. The Lancet, 382(9890), pp. 372-375.Blas, E. & Kurup, A. (2010). Equity, social determinants and public health programmes. Switzerland World Health Organization.Bogart, L., Skinner, D., Weinhardt, L., Glasman, L., Sitzler, C., Toefy, Y. & Kalichman, S. (2011) HIV misconceptions ass ociated with condom use among nasty South Africans an exploratory study, African Journal of AIDS Research, 10(2), pp. 181-187.Bogart, L. & Bird, S. (2003) Exploring the affinity of conspiracy beliefs about HIV/AIDS to sexual behaviours and attitudes among Afrian-American adults, Journal of the field of study Medical Association, 95(11), pp. 1057-1065.British HIV Association (2012) Standards of care for people living with HIV in 2012, London British HIV Association.Bryce, J., Coitinho, D., Darnton-Hill, I., Pelletier, D. & Pinstrup-Andersen, P. (2008). Maternal and child undernutrition effective action at national level. The Lancet, 371(9611), pp. 510-526.Connolly, C., Colvin, M., Shishana, O. & Stoker, D. (2004) Epidemiology of HIV in South Africa- results of a national, community-based survey, South African Medical Journal, 94(9), pp. 776-781. Department for International Development (2013). Policy Reducing Hunger and malnutrition in developing countries, London UK Legislation O nline. addressable at https//www.gov.uk/government/policies/reducing-hunger-and-malnutrition-in-developing-countries (Accessed 25th March, 2014).Dutta, M. (2008) communication health A culture-centred approach, London Polity Press.Ezzati, M., Vander, H., Rodgers, A., Lopez, A., Mathers, C. & Murray, C. (2003) The comparative risk collaborating group. Estimates of global and regional potential health gains from reducing multiple major risk factors, Lancet, 362, pp. 271-280.Farmer, P. (2003) Pathologies of Power Health, Human Rights, and the new war on the poor, Berkeley and Long Angeles University of calcium Press. Greeff, M., Uys, L., Holzemer, W., Makoae, L., Dlamini, P., Kohi, T., Chirwa, M., Naidoo, J. & Phetlhu, R. (2008) Experiences of HIV/AIDS Stigma of persons living with HIV/AIDS and nurses involved in their care from volt African countries, African Journal of nurse and Midwifery, 10(1), pp. 78-108. Health Protection Agency (2012) HIV in the United estate 2012 Report. L ondon Health Protection Services, Colindale. Holzemer, W. & Uys, L. (2004) Managing AIDS stigma, Journal of fond Aspects of HIV/AIDS, 1(3), pp. 165-174. Horton, R. & Lo, S. (2013). Nutrition a quintessential sustainable development goal, The Lancet, 382(9890), pp. 371-372.KFF/UNAIDS (2013). Financing the response to AIDS in low- and middle-income countries International Assistance from bestower Governments in 2012. Washington KFF/UNAIDS.KFF (2013). The Global HIV/AIDS Epidemic Online. Available at http//kff.org/global-health-policy/fact-sheet/the-global-hivaids-epidemic/footnote-KFFUNAIDS (Accessed 25th March, 2014).Kohi, T., Makoae, L., Chirwa, M., Hozemer, W., Phetlhu, D., Uys, L., Naidoo, J., Dlamini, P. & Greeff, M. (2006) HIV and AIDS violates human rights in five African countries, treat Ethics, 13(4), pp. 404-415.Loevinsohn, B. & Harding, A. (2005). Buying resultsContracting for health service delivery in developing countries. Lancet, 366(9486), pp. 676-681.MacPhail, C. & Campbell, C. (2001) I think condoms are good but, aai, I abominate those things, Social Science & Medicine, 52(11), pp. 1613-1627.Marmot, M. & Wilkinson, R. (2005). Social Determinants of Health. Oxford Oxford University Press.Nabarro, D. (2013). Global child and maternal nutrition- the SUN rises. The Lancet, 382(9893), pp. 666-667.Pinstrup-Andersen, P. (2013). Nutrition-sensitive food systems from rhetoric to action. The Lancet, 382(9890), pp. 375-376.Sandelowski, ., Lambe, C., Barroso, J. (2004) Stigma in HIV-positive women, Journal of Nursing Scholarship, 36(2), pp. 122-128. Shoham, J., Dolan, C. & Vostelow, L. ENN (2013). The management of acute malnutrition at scale A review of giver and government financing arrangements. Summary Report Online. Available at http//scalingupnutrition.org/ (Accessed twenty-fourth March, 2014).SUN (2013). Scaling up nutrition in practice effectively enjoying multiple stakeholders Online. Available at http//scalingupnutrition.org/ (Accessed 24th March, 2014).Taylor, A., Dangour, A. & Reddy, K. (2013). Only collective action will end undernutrition. The Lancet, 382(9891), pp. 490-491.UNAIDS (2013). Report on the Global AIDS Epidemic 2013. Washington UNAIDS.UNICEF (2014). The State of the Worlds Children 2014 In Numbers every(prenominal) child counts Online. Available at http//www.unicef.org/sowc/ (Accessed 25th March, 2014).Wikman, A., Marklund, S. & Alexanderson, K. (2005) Illness, disease, and sickness absence an experimental test of differences between concepts of ill health, Journal of Epidemiology & Community Health, 59, pp. 450-454. Willis, J. (2003) Condoms are for whitefellas barriers to Pitjzntjztjzrz mens use of safe sex technologies, Culture, Health & sex activity An international Journal for Research, Intervention and Care, 5(3), pp. 203-217.World Health Organization (2011). Global Health Observatory (GHO) Underweight in Children Online. Available at http//www.who.int/gho/mdg/poverty_hunger/underweight_text/en / (Accessed 25th March, 2014).
Subscribe to:
Post Comments (Atom)
No comments:
Post a Comment