Global Health and Global Health Nursing – Flashcards
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Koffi A. Annan
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"Now I want to pass on 5 lessons I have learned during 10 years as Secretary-General of the United Nations..." -Five lessons
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Lesson 1:
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We are all responsible for each other's security.
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Lesson 2:
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We are responsible for each other's welfare.
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Lesson 3:
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Both security and prosperity depend on respect for human rights and the rule of law.
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Lesson 4:
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Governments must be accountable for their actions.
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Lesson 5:
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Multilateral institutions must hold nations accountable and be organized in a fair and democratic way.
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Context of Interdependency
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>One planet of interdependent nations >Each nation is unique with its own:
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>Each nation is unique with its own:
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1.Geography and environment 2.History 3.Language 4.Cultural traditions 5.Religion 6.Armed conflicts, uprisings, wars, and humanitarian emergencies 7.Ideas about health, wellness, disease, and death
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Populations
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>Complexity of individuals, families, and multinational populations >Diversity of cultures, cultural histories >Includes many health issue concerns, physical symptoms, traditional treatment approaches
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What Is Global Health?
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. . . the area of study, research and practice that places a priority on improving health and achieving equity in health for all people worldwide. >Transcends perspectives and concerns of individual nations. >Emphasizes health problems that transcend national borders or have a global political and economic impact.
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Global Health Goals
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1.Worldwide improvement of health; 2.Reduction of disparities; and, 3.Protection against global threats that disregard national borders.
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Evolution of Global Health Initiatives
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1.Declaration of Alma Alta (1978) 2.U.N. Millenium Development Goals (2000) 3.U.N. Sustainability Development Goals (2015)
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1.Declaration of Alma Alta (1978)
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(WHO/UNICEF conference)...Health for All in the 21st Century 1.Tackle the determinants of health 2. Use of health impact assessment to develop health-outcome-driven programs and investments for development and clinical interventions 3. Integrated family- and community-oriented primary health care with a supported hospital system 4. Participatory process of all stakeholders to promote joint decision making, implementation, and accountability
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3.U.N. Sustainability Development Goals (2015)
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mark the beginning of a new era in global development - the world's "to-do list" for a fairer, safer and healthier world by 2030. The health-related targets are centered in Goal 3, but health will affect or be affected by each of the 17 SDGs.
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Global Health Measures:Global Burden of Disease (GBD)
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;Combines losses from premature death and losses of healthy life that result from disability ;Uses units of "disability-adjusted life-years (DALYs) >35% of impact due to communicable diseases, maternal health, and nutritional deficiencies >54% noncommunicable diseases, e.g. cardiac, respiratory, musculoskeletal
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Global Health— "How does it differ?"
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1.Structurally 2. Culturally 3. Clinically
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1.Structurally—
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how care is delivered, i.e. people, organizations, processes
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2.Culturally—
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differing ethnicities, languages, & sociopolitical environments
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3.Clinically—
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new types of disease & new ways of curing illness
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Global Health Care Systems
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>Pluralistic health care systems found in most developing countries and include -Traditional healing systems -Lay practices -Household remedies -Transitional health workers -Western medicine
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Global Health Care Systems : Multilateral Organizations:
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Receive funding from governmental and nongovernmental organizations (e.g. WHO, IMF, World Bank)
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Global Health Care Systems:Bilateral:
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Single governmental agency, focus is on direct aid to less developed country (US AID)
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Global Health Care Systems:Nongovernmental organizations (NGSs);
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Independent citizen organizations, provide 20% of external aid (e.g., Medshare International, Inc., Doctors without Borders, Partners in Health, International Red Cross)
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World Health Organization
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>Multilateral agency: supports development efforts of governments and organizations in countries throughout the world >Overarching Goal ****Health for All: A Primary Health Care Initiative *****
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Universal Imperatives of Care
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1. mortality 2 .morbidity 3. Daily Functioning 4. Decision Making 5. Cost
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1.Mortality -
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Reduce/eliminate death from illness
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2.Morbidity -
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Prevent & reduce transmission of illness
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3.Daily functioning _--
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Improve quality of life
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4.Decision making —
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Support capacity for healthy decision making
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5.Cost-
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Reduce cost to increase access to care
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WHO: 21st Century initiatives
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7 century initiatives
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Basic Elements of Primary Health Care
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8 Basic Elements of Primary Health Care
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Providers of Health Care
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1. physicians 2. community health workers 3. community health nurses
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2.Community health workers--
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local, respected, responsible persons approved by committee to serve people in health matter, e.g. traditional birth attendants, village midwife, "Barefoot doctors"
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3.Community health nurses
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>90% of global health care >Global nursing programs, issues r/t standardized curricula, trained faculty, licensure, cost >Forces supporting nursing development
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Programs/Interventions
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1. understanding the context 2. support the work of in-country agencies and organizations 3. implement interventions that
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1. Understand the context
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population, cultural norms and beliefs, health status, and health conditions; also dependent on how health care is practiced in the country
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3.Implement interventions that:
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-Address immediate needs -Promote sustainability -Build capacity of workforce -Enhance resources of existing health care structures and systems
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Framework for Global Community Health Nursing: Three Eras
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1.Era of Infectious Diseases 2.Era of Chronic Long-Term Health Conditions 3.Era of Social Health Conditions
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Infectious Diseases
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>Communicable diseases—5 of 10 leading causes of death >Immunizations >Eradication, elimination, control of communicable diseases
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chronic LT
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>decrease infectious disease, increase life expectancy leads to and increase degenerative disease >Epidemiologic transition: decrease infectious disease M&M increase chronic disease M&M
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Social Health
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>Impact of war & violence >Impact of sustained poverty >Impact of natural and human-made disasters
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Summary
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1.Multiple partnerships exist between government and non governmental agencies to promote global health 2.The World Health Organization has primary leadership role in the promotion of global health. 3.Factors impacting global health are multiple, interrelated and driven by available resources. 4.Measurement is difficult making evaluation of program impact extremely challenging. 5.Nursing has been active in promoting the goals of global health and a effective global health workforce.