PA006 Global Health Comparison Grid Template

A Plan for Social Change

TB eradication is possible soon with collaborative global efforts in the diagnosis, treatment, and prevention strategies. Nurses should think globally and act locally in combating global health issues such as TB. As a nurse leader, consuming relevant research, adopting evidence-based strategies, and following well-laid guidelines by responsible bodies such as WHO and USAID are integral in combating global health issues. For example, Kenya has successfully reduced prevalence and Tb mortality by ascribing to the WHO guidelines (Daniels et al., 2019). In addition, participating in local conferences discussing the issues and policies could help shape them to provide the citizens’ much-needed services.

Incorporating these into global perspectives would have effects on practice and the roles as a leader. The nurse leader needs to be an advocate to the insights for their acceptability and implementation. It might also mean altering the scope of practice and job description to include roles in tuberculosis diagnosis, treatment, and prevention beyond regular routines. In addition, it would lead to the creation of policies and laws that regulate the nursing practice and dictate new roles/

Incorporating global perspectives from international bodies such as WHO and UN would bring a marked positive social change. The first effect is adopting practical, evidence-based strategies that would improve the global health issues status. In addition, it creates an international standard of diagnosing, treating, and preventing illnesses, thus enhancing global efficacy and efficiency. The information also helps evaluate healthcare systems and determine the sources of errors, thus aiding in change and continued delivery of quality healthcare services. In addition, it aids in global collaboration to fight specific healthcare issues. Developed countries can effectively help developing countries realize the goals and objectives of eradicating tuberculosis.

References

Daniels, B., Kwan, A., Pai, M., & Das, J. (2019). Lessons on the quality of tuberculosis diagnosis from standardized patients in China, India, Kenya, and South Africa. Journal of clinical tuberculosis and other mycobacterial diseases, 16, 100109. https://doi.org/10.1016/j.jctube.2019.100109
Donkin, A., Goldblatt, P., Allen, J., Nathanson, V., & Marmot, M. (2018). Global action on the social determinants of health. BMJ global health, 3(Suppl 1), e000603. http://dx.doi.org/10.1136/bmjgh-2017-000603
Global Health Policy (2021). The US Government and Global Tuberculosis Efforts. Retrieved November 16, 2021, from https://www.kff.org/global-health-policy/fact-sheet/the-u-s-government-and-global-tuberculosis-efforts/
Harding, E. (2020). WHO global progress report on tuberculosis elimination. The Lancet Respiratory Medicine, 8(1), 19. https://doi.org/10.1016/S2213-2600(19)30418-7
Kyu, H. H., Maddison, E. R., Henry, N. J., Ledesma, J. R., Wiens, K. E., Reiner Jr, R., Biehl, M. H., Shields, S., Osgood-Zimmerman, A., Ross, J. M., Carter, A., Frank, T. D., Wang, H., Srinivasan, V., Agarwa, S. A., Alahdab, F., Alene, K. A., Ali, B. A., Alvis-Guzman, N., Andrews, J., and Murray, C. J. L., (2018). Global, regional, and national burden of tuberculosis, 1990–2016: results from the Global Burden of Diseases, Injuries, and Risk Factors 2016 Study. The Lancet Infectious Diseases, 18(12), 1329-1349. https://doi.org/10.1016/S1473-3099(18)30625-X
Porche, D. J. (2021). Health policy: Application for nurses and other healthcare professionals. (3^rd Ed.). Jones & Bartlett Learning.

Talwar, A., Tsang, C. A., Price, S. F., Pratt, R. H., Walker, W. L., Schmit, K. M., & Langer, A. J. (2019). Tuberculosis—the United States, 2018. Morbidity and Mortality Weekly Report, 68(11), 257. https://dx.doi.org/10.15585/mmwr.mm6811a2

World Health Organization (2020). Tuberculosis (TB). Who. int. Retrieved November 16, 2021, from https://www.who.int/newsroom/factsheets/detail/tuberculosis#:~:text=In%202019%2C%20the%2030%20high,Nigeria%2C%20Bangladesh%20and%20South%20Africa.

Global Health Comparison Grid Template

Use this document to complete the PA006 Assessment.

Global Healthcare Issue

TUBERCULOSIS

Description Tuberculosis is a chronic infection by the mycobacterium bacteria, majorly affecting the respiratory system and blood. It is a significant issue of concern as it causes more deaths than malaria and AIDS combined worldwide. According to WHO, more than ten million people contracted tuberculosis in 2020, and about half of the individuals are men (Harding, 2020). Tuberculosis is a communicable disease transmitted through the air when sneezing, coughing, talking, or spitting, and the particles are released into the air. The disease is curable and preventable and should thus not present such a significant risk to the global community. In most countries, treatment of this condition is mandatory, and many laws and policies regulate the prevention and management of this highly contagious disease. The disease is more severe in immunocompromised and vulnerable individuals such as the elderly, children, and HIV patients (WHO, 2020). SDG 3, “ensure healthy lives and promote well-being for all ages,” targets ending the tuberculosis epidemic by 2030 (Kyu et al., 2018). With the rising tuberculosis cases, governments and responsible bodies should lay effective strategies o prevention, accurate diagnosis, and increasing tuberculosis-related services to control the epidemic (Kyu et al., 2018).

Country United States Kenya

Describe the policy in each country related to the identified healthcare issue. Agency for International Development (USAID) developed a tuberculosis program that aims to control tuberculosis locally and globally (Talwar et al., 2019). The USAID TB Program lays down strategies locally and globally to mitigate the effect of tuberculosis. The US government has laid several strategies to combat tuberculosis.

The US Government TB Strategy 2015-201 aimed to reduce TB incidents by 25% relative to 2015 results, improve diagnosis and treatment of tuberculosis, and maintain treatment success rates to prevent the development of resistant TB (Global Health Policy, 2021). It was a strategy that has been extended to 2022 by the US government to allow for the achievement of the set goals. In addition, The US government has also invested in TB research to accelerate the management of Tb and, more so, address the local and global health concerns of multi-drug-resistant tuberculosis.

Many laws regulate such policies as diagnosing, reporting, treating, and preventing tuberculosis (Talwar et al., 2019).
Kenya was ranked the 13^th among countries with the highest TB incidences (Harding, 2020). Tuberculosis in Kenya is usually managed by various policies such as the TB preventive Treatment (TPT) policy under Komesha Tb programs. The Kenya latent tuberculosis infection policy regulates TB in Kenya. The policy also institutes programs encompassing TB awareness and preventive measures and encouraging diagnosis and treatment in the country (Daniels et al., 2019). TB screening is done at all healthcare centers, emphasizing vulnerable groups such as children and individuals with chronic illnesses. These departments offer free TB awareness training, spread prevention, free treatment, and follow-up of cases to prevent the development of multi-drug resistant TB.

Thus, Kenya is one of the best countries in reducing TB incidences and improving the treatment of active cases (Harding, 2020).

Explain the strengths and weaknesses of each policy. The US government policy’s strength lies in testing, screening, treatment, evaluation, and reporting accuracy that has enabled accurate planning of resources and effective management of tuberculosis resources in the US (Talwar et al., 2019). Research is also highly regulated and active in researching drugs, efficacy, and disease processes to aid effective management.

The main weaknesses in TB Policy are structure malfunctions. There lacks a nationally recognized independent dealing with tuberculosis. In addition, there lacks clear patient follow-up after treatment which often leads to treatment inefficiencies, re-infection, and development of multi-drug resistant tuberculosis.

The primary strength of the policy is ascribing to the World Health Organization guidelines of TB management. International funding and funding from the local government have also made the policy programs succeed.

A significant weakness of the policy is the poor diagnosis tools at work. The Kenyan healthcare system uses the clinical presentation approach to disease recognition and management. It lacks string and practical diagnostic tools to diagnose TB accurately; hence many people still go unrecognized.

Explain how the social determinants of health may impact the global healthcare issue you selected. Be specific and provide examples.

Many factors social determinants may affect the global health issue negatively or positively. The high literacy level of US citizens may increase their healthcare-seeking behavior, which directly affects the diagnosis and management of healthcare services (Donkin et al., 2018). The presence of other comorbid conditions such as HIV/AIDS, cancer, hypertension, and diabetes increases TB patients’ mortality and morbidity rate (Kyu et al., 2018).

Another factor is the accessibility of healthcare services. Hospitals in the US are relatively accessible compared to many nations worldwide, improving access to tuberculosis services. Regions with less access to healthcare facilities may suffer more considerable burdens of the disease due to a lack of accessible healthcare services.
Poverty is one of the major social determinants affecting tuberculosis in Kenya. It affects healthcare access and healthcare funding available for TB-directed health promotion activities (WHO, 2020).

In addition, poor access to healthcare facilities is due to fewer hospitals in this developing country.

Literacy levels in Kenya are relatively low, negatively affecting healthcare-seeking behavior, access to information on healthcare access and treatment, and health promotion strategies (Donkin et al., 2018).

Analyze how each country’s government addressed cost, quality, and access related to the global healthcare issue selected. The US government has provided resources for testing, diagnosing, health promotion, and illness prevention (Global Health Policy, 2021). In some states, such as California, tuberculosis treatment is mandatory. The federal government lays strategies on public health prevention by ensuring that public places are well ventilated, and people maintain personal hygiene.

The US government also ensures that tuberculosis services are available at all healthcare centers to improve access to these healthcare services. Integration of these services with other services, such as HIV services, has also increased healthcare quality and the accuracy and efficacy of testing and management (Harding, 2020).

Through funds from international organizations such as WHO, USAID, and the UN, the government of Kenya has made the treatment of TB free for all patients (Daniels et al., 2018). Healthcare costs are a significant hindrance to healthcare access, and thus, patients are encouraged to access healthcare services by waiving the healthcare costs. Thus, it cuts costs and increases access to these healthcare services because they are available in all healthcare centers in Kenya. The free healthcare services also ensure the standard and quality care for all citizens.

Explain how the healthcare policy you selected might impact the global population. Be specific and provide examples. USAID is an international agency that developed policy’s regarding the management of tuberculosis internationally through the USAID TB Program. The program focuses on the US and 23 other priority countries in Southeast Asia, sub-Saharan Africa, and South Asia (Harding, 2020). The program funds and controls TB prevention, treatment, and control measures and thus directly impacts the global health issue. The program thus helps reduce incidences of TB and treatment efficiencies globally, contributing positively to the mitigation of the global issue. Through the WHO, UN, and CDC, the US government also funds research and health promotion to reduce the prevalence and incidences of tuberculosis (Global Health Policy, 2021).

Through the Kenya latent tuberculosis infection policy, Kenya acts as a transportation hub for most of the sub-Saharan aid by the USAID. In addition, the Kenyan TB policy that has led to a marked decrease in TB prevalence can be used and duplicated in neighboring countries to effectively prevent and control tuberculosis (Daniels et al., 2019).

Explain how the healthcare policy you selected might impact the role of the nurse in each country. Nurses play significant roles in the development, implementation, and evaluation of policies affecting healthcare.

Nurses should also actively participate in the policy’s activities such as TB screening, diagnosis, management, and reporting to implement these policies effectively.

Nurses will also have a role in improving TB awareness, teaching preventive behavior, and helping the population prevent infection with TB (Porche, 2021).

Nurses are the professionals closest to the patient, and policies introduce added roles to the nurses. They collect assessment data for diagnosis and treatment. They are integral in collecting data to inform these policies. The nurses might have an added role in implementing the policies, laws, and regulations, and reporting data (Porche, 2021). In addition, they might have an added role of participating in developing and amending the policies in place.

Explain how global health issues impact local healthcare organizations and policies in both countries. Be specific and provide examples. Global health issues such as Ebola, Coronary heart disease, and Covid-19 cause sudden and unexpected costs in healthcare and the need for swift policies to manage them effectively.

Healthcare organizations must thus lay strategies to handle such global health issues when they arise

Global health issues impact negatively on the healthcare sector. For example, COVID-19 caused a significant stretch on healthcare resources, including personnel and funds. They also create a need for new policies, further stretching available resources. A lack of funds often leads to a slow response to these conditions and associated preventable mortality and morbidity surges (Daniels et al., 2019).

General Notes/Comments The US government has been a formidable source of funds to help manage global health issues. TB remains a leading preventable cause of death which needs urgent attention.

TB management strategies are hindered by a high population that is uneducated and the lack of funding. However, with funding from programs such as USAID, tuberculosis should be effectively prevented and controlled.