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Monday, September 18, 2017

Discrimination Among Women

DISCRIMINATION AMONG AFGHANISTAN WOMEN

Afghanistan has the second highest maternal mortality rate in the world, before the Taliban came to power. Afghanistan a country with 23 million inhabitants, is one of the poorest countries in the world. It has low literacy rate among women. Before the Taliban came to power, Afghanistan women participated as women legislators in the parliament, in the 1970s,and helped draft the 1964 constitution. There were teachers, government workers, and medical doctors, in the early 1980s. They also worked as professors, lawyers, judges, journalists, writers and poets  (Annan, 2001)..
Once the Taliban gained power, women and girls were systematically discriminated against and marginalized, their human rights were violated. This result to a decrease in the economic and social conditions among women and girls in the country, especially in the territory of the Taliban.
The rights of women and girls are significantly violated due to strict tribal norms and values with great gender bias, religious extremism and weak law (Sherzai, 2012).
Afghanistan has suffered from chronic instability and conflict. The Taliban’s oppression of women in Afghanistan during their rule between 1996 and 2001, has restricted the movement, the denial of the right to work, beatings, and other physical abuse, arbitrary detention, a near ban to access education, and access to healthcare among women ( M.H. Hasrat and Alexandra Pfefferle, 1391).  
Reports prove cases where females are physically tortured, with severe beatings, cuts, and burnt alive, or thrown acids. Most importantly they are forced into marriage at an early age, being sold for prostitution, compelled for self -immolation and raped.
The Taliban’s policies have limited the freedom of movement among women. They have restricted the movement of women without the company of a male. A decree was implemented in May 2001 by the Taliban, banning women from driving cars, which further limited their social and daily activities. The seclusion of women resulted to a form of solitary confinement, as well as it created walls among women from meeting each other. Women are harassed and beaten by the Taliban if seen in public, as this is a crime or sin to the Taliban edicts (Annan, 2001).

References


1.      M.H. Hasrat and Alexandra Pfefferle. (1391). Violence against women in Afghanistan. Kabul,: Afghanistan Independent Human Rights Commission. Retrieved from http://www.aihrc.org.af/media/files/VAW_Final%20Draft-20.12.pdf
2.       Annan, G. K. (2001). THE SITUATION OF WOMEN IN AFGHANISTAN. Retrieved from http://www.un.org/events/women/2002/sit.htm
3.       Sherzai, D. (2012, March 10). Discrimination Against Women in Afghan Society. Afganistan . Retrieved from http://outlookafghanistan.net/topics.php?post_id=3629

Sunday, May 7, 2017

Intimate Partner Violence


Intimate partner violence (IPV) is considered as the most common public health problem worldwide, and it is common among women and children. IPV involves physical, sexual and emotional abuse, and controlling behaviors by an intimate partner. IPV occurs in all settings and among all socioeconomic, religious and cultural groups. Although women can be violent in relationship with men, often in self-defense, the most common perpetrators of violence against women are male intimate partners or ex partners (WHO, 2012).
In the last previous decades, women and girls are significantly recognized as a human right and public health issue affecting all societies. According to WHO, there’s an estimate of at least one in three women throughout the world have experienced physical or sexual violence by an intimate partner, or sexual violence by non-partner (Devries KM1, 2013). The impact of IPV on the health and well-being of women, and their families can be devastating, as it is a common form of violence against women worldwide (Mary Ellsberg, 2014).  
WHO surveys show that the percentage of abused women who experienced either physical or sexual violence ranged from 15% Japanese, 60% Bangladesh, Ethiopia and Peru  (Garcia-Moreno C1, 2006). Other studies indicate high rate of IPV in Latin America, example, 49% o Peruvian women experienced severe physical abuse in their lifetime, and 38% Columbian women were reported physically and sexually abused by a recent partner (Pallitto CC1, 2004).


Consequences of IPV:
IPV is broadly linked to a range of health complications such as intentional injuries, chronic disease, substance abuse, reproductive health problems, HIV/AIDS, and low birth weight (Pallitto CC1 & Violence., 2013). IPV can lead to severe mental health problems such as post-traumatic stress disorder (PTSD), depression, anxiety, and eating disorder. It increases the mortality rate among  (Stöckl H1, 2013).
women through suicide and homicide. Out of all murders among women worldwide, about 38% were committed by a current or former intimate partner
The physical damage resulting from IPV can include bruises and welts, lacerations and abrasions, abdominal or thoracic injuries, fractures and broken bones or teeth, sight and hearing damages, head injury, attempt of strangulation, and back and neck injury (Etienne G. Krug, 2002). In addition to physical injuries, are ailments that are cannot be identified medically, or are difficult to diagnose. These are often referred to as “functional disorders” or “stress-related conditions”, they include: irritable bowel syndrome/ gastrointestinal symptoms, fibromyalgia, various chronic pain syndromes and exacerbation of asthma (Etienne G. Krug, 2002). According to the WHO multi country study, the prevalence of injury among intimate partner abused women ranged between 19% (Ethiopia) and 55% (Peru) (Claudia García-Moreno, 2005).

Prevalence Rate:













































Conclusion: 

Poor access to education, age and non-marital cohabitation increase the risk of domestic violence among women (Ishida K1, 2010).

References

1.      Claudia García-Moreno, H. A. (2005). WHO Multi-country on Women's Health and Domestic Violence against Women. WHO. Retrieved from file:///C:/Users/alina/Downloads/924159358X_eng.pdf
2.       Devries KM1, M. J.-M. (2013, June 28). Global health. The global prevalence of intimate partner violence against women. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23788730
3.       Etienne G. Krug, L. L. (2002). World report on Violence and Health. World Health Organization. Retrieved from http://apps.who.int/iris/bitstream/10665/42495/1/9241545615_eng.pdf
4.       Garcia-Moreno C1, J. H. (2006, Octomber 7). Prevalence of intimate partner violence: findings from the WHO multi-country study on women's health and domestic violence. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/17027732
5.       Ishida K1, S. P. (2010, September 15). Exploring the associations between intimate partner violence and women's mental health: evidence from a population-based study in Paraguay. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/20864237
6.       Mary Ellsberg, a. M. (2014, September 12). Intimate Partner Violence and Mental Health. Global Health Action. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4165041/
7.       Pallitto CC1, G.-M. C., & Violence., W. M.-C. (2013, January 1). Intimate partner violence, abortion, and unintended pregnancy: results from the WHO Multi-country Study on Women's Health and Domestic Violence. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22959631
8.       Pallitto CC1, O. P. (2004, December 30). The relationship between intimate partner violence and unintended pregnancy: analysis of a national sample from Colombia. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15590382
9.       Stöckl H1, D. K. (2013, September 7). The global prevalence of intimate partner homicide: a systematic review. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23791474
10.   WHO. (2012). Understanding and addressing violence against women. Pan American Health Organization, World Health Organization. Retrieved from http://apps.who.int/iris/bitstream/10665/77432/1/WHO_RHR_12.36_eng.pdf




Unintentional Injuries Among Children

Injuries are the third leading cause of death in the European region. In-spite of their magnitude and preventability, Injuries are neglected more than other diseases (Devroey D1, 2006). In the European region, about 26,0000 children under the age of 15 died from injuries, an equivalent of 3 children/hour (WHO, 2005). In Romania, an estimate of 777 children die/year because of unintentional injuries (Alliance, 2012).
Domestic accidents are accidents that occur in homes, or in its immediate surroundings. In European countries, home accidents have more fatality than road traffic accidents. Every domestic accident inflicts different measures of distress to the victims as well as the family members, and the consequences may be disastrous on both community and individual level when resulted in permanent disability (S.Galal, 1999).  
Children being unaware of the dangers of their surroundings, they are more prone to home accidents. The leading cause of domestic accidents among childhood in homes are drowning, falls, thermal injuries and poisoning. The home is of significance when analyzing child injuries as it is an environment where children are brought up, and achieve developmental milestones by interacting with their physical surroundings. The risk factor of injuries among children within the home is a joint interaction between the caregiver, the child and the home surroundings (Laflamme, 2010).

Types of home accident injuries:
Drowning
Drowning the 2nd leading cause of death among children age 0-19 years within the European union. It is accounted for 14 deaths per day and 5000 deaths per year. In addition, for each child that dies from drowning, 2 are estimated to be permanently disabled, resulting to neurological damages in the child. Children can drown within an inch of water such as bath tubs and indoor pools.

Poisoning
Poisoning is the third leading cause of domestic injuries among children in European countries. 3000 children between 0-14 years die/year. The curiosity and desire to put everything in their mouth puts a child in high risk to the exposure of poison. Children eat or drink anything they see that is attractive, regardless the taste of the of the substance (Alliance, Poisoning Among Children, 2009).
Children are more likely to suffer serious consequences when exposed to poison because of their size, and their fast-metabolic rates. Their body is unable to neutralize toxic substances. More than 90% of poisonings occur in the homes, and many of these chemicals are cleaning supplies, pills, pesticides, medicines, cosmetics etc (Center, Harborview Injury Prevention & Research, 2001).   .  

Thermal injuries
Children are naturally curious of their surroundings as they become older and more mobile. They begin to familiarize with their surroundings, as a result, they come In contact with objects that can give them severe injuries such as burns. Thermal injuries are the most painful and devastating experience a child should go through, as it affects them on a long term (Ruth Baker, 2016). According to WHO Global Burden of Disease, in 2004, 30% of the population (310,000) who died from severe burns were under the age of 20 years. Fire related injuries are the 11th leading cause of death for children between 1 and 9 years. In total, children are at high risk for death from burns with a global estimate of 3.9 deaths/100 000 population (Margie Peden, 2008).

Fall
Data shows that falls is the most frequent type o injury resulting in hospitalization emergency. Although it is part of a child growing up, non-fatal falls is a significant burden on healthcare facilities. Falls from heights, or on concrete floors can result to severe injuries, disabilities or even death. Children are at risk as they may underestimate their physical balance or mental ability to perform activities safely. Falls are the most important source of disability because they are common, and have serious long term health consequences. Changing tables, stairs, windows, balconies, and playgrounds are risk factors of falls (Dinesh Sethi)

Magnitude of the Problem











References

1.      Alliance, E. C. (2009, 0ctomber). Poisoning Among Children. Retrieved from http://www.childsafetyeurope.org/publications/info/factsheets/childhood-poisoning.pdf
2.       Alliance, E. C. (2012). CHILD SAFETY REPORT CARD. Retrieved from http://www.childsafetyeurope.org/reportcards/info/romania-report-card.pdf
3.       Center, Harborview Injury Prevention & Research. (2001). Reducing the impact of injury and violence on people’s lives through research, education, training and public awareness.
4.       Devroey D1, V. C. (2006, September 13). The incidence of home accidents is going down in Belgium. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/16943166
5.       Dinesh Sethi, E. T.-G. (n.d.). European Report on Child Injurt Prevention. Retrieved from http://www.euro.who.int/__data/assets/pdf_file/0003/83757/E92049.pdf
6.       Laflamme, M. S. (2010, April 29). Child home injury mortality in Europe: a 16-country analysis. European Journal of Public Health. Retrieved from https://academic.oup.com/eurpub/article/21/2/166/497614/Child-home-injury-mortality-in-Europe-a-16-country
7.       Margie Peden, K. O.-S. (2008). World Report on Child Injury Prevention. Retrieved from file:///C:/Users/alina/Documents/2nd%20year,%202nd%20semester/VIP/World_report.pdf
8.       Ruth Baker, a. L. (2016, November 4). Differing patterns in thermal injury incidence and hospitalisations among 0–4 year old children from England. NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5062947/
9.       S.Galal. (1999). working with families to reduce the risk of home accidents in children. Retrieved from http://applications.emro.who.int/emhj/0503/EMHJ_1999_5_3_572_582.pdf


10.   WHO. (2005, May 30). Preventing children accidents and improving home safety in the European Region. WHO Europe. WHO European Centre for Environment and Health, Bonn Office . Retrieved from http://www.euro.who.int/__data/assets/pdf_file/0008/98666/Bonn_accident_rep.pdf

Monday, February 20, 2017

Why Privatization is not the answer in the Nigerian's Government (Hospitals should not be privatized in Nigeria)

 Why privatization is not the answer in the Nigerian’s Government

Privatization is the transfer of ownership, property or business from the government to the private sector. It is regarded to bring more efficiency and objectivity to the organizations that government companies have no concern with (The Economic times , 2016). That is to say that it gives the private sectors an opportunity to make decisions about what, where and how to produce goods and services (Andrew Berg; and Elliot Berg, 1997). Privatization aims at:

Fiscal relief by cutting government subsidies to money-losing State-owned Enterprises (SOEs) and/or by establishing new revenues from their sale

 Increase the efficiency of the enterprise

 Increase the efficiency of the entire economy through more competitive markets and better allocation of revenues/resources across firms and sectors

 Increase the political support and broadened institutional underpinnings for market-based economy or further liberalization

 Establish stronger financial markets
 Investment and stimulate entrepreneurship (Andrew Berg; and Elliot Berg, 1997).

Privatization in Nigeria:
In Nigeria, in the unitary system of government such as indstries or assets owned by lower levels of government example: municipalities, being transferred to the central government to be operaed and owned at the national level (Prof. Taiwo Asaolu, 2015). Industries that are usually operated by nationalization include transportation, communication, energy, bank and natural resources and they become state owned enterprises; they aim to achieve social, political and economic objectives ( Ademola Ariyo and Afeikhena Jerome, 2004).
In the 1960s and 70s, many of the nationalized corporations went through a process of denationalization in other words privatization. The reason is because some state owned enterprises ran out at a loss by the government. They are characterized by low productivity, inefficiency, corruption and nepotism. Therefore, privatization is a strategy adopted by the government to improve the delivery of services by state owned enterprises as a means of economic re-engineering embarked upon to solve the problems related with state owned enterprises by the government (Ladipo Adamolekun , 2005).
1   
     No! National corporations should not be privatized.

    Why?
     In Nigeria, privatization over some time has not been a popular reform. It has received so much
     criticism from labor, academia and individuals. As it is seen as a means of instrument for an efficient
      resource management for rapid economic development and poverty reduction, privatization inflicts damage on the poor through loss of employment, reduction in income and reduced access to basic social services or leads an increase in prices (Chudi-Oji Chukwuk, 2013). That is to say that it abuses the public interest”. For example; if the National Emergency Management Agency whose aim is to manage natural disasters in Nigeria is being privatized, then the public will have to pay their services (Nigerian Association, n.d.).

      Government loses out on potential dividends: A lot of issues arise from ownership, management and control of public enterprises operated in the public interest. These includes the political interference, miss-allocation of resources, loss of revenue, corporation, lack of management autonomy; scarcity of foreign exchange leading to rampant in both private and public sectors due to economic deterioration (The impact of Privatization in Nigeria, 2015).

The problem of externalities: The utilities create negative externalities (i.e. pollution, damaging the environment). The public sector companies, the government can regulate the output and make sure that it is at the socially optimal level. In the private sector, the maximization of profit is the only concern, therefore leading to the occurrence of socially damaging externalities.

Job losses:Privatization increases enforcement among private companies to be efficient or at least find some way of reducing their costs in order to make a profit given by the regulators (Economics on Privatization , 2013).


Conclusion:              
Intergovernmental relations are to play a “bridge building” role to establish a degree of coordination and cooperation to divided powers (Okafor, J,C, 2007). In developing countries, such as Nigeria, it is necessary for the state to take active roles in matters associating with the economic development considering the absence of strong private sector. The available resources to the private sector are inadequate to provide certain goods and services. For instance, the investment in establishing a hydroelectricity-generating plan or water scheme for a large urban center is huge for a private sector to handle. Since the development is related to social services, post-independent African governments need to acknowledge the need to be involved in providing certain social and economic services (Prof. Taiwo Asaolu, 2015).
Ngadiuba Alina
Cluj School of Public Health
2nd Year student
(The Economic times , 2016)


REFERENCES:

1.       Ademola Ariyo and Afeikhena Jerome. (2004, July 04). Utility privatization and the poor: in Nigeria. Global Issues Paper. Retrieved from https://www.boell.de/sites/default/files/assets/boell.de/images/download_de/internationalepolitik/GIP12.pdf
2.       Andrew Berg; and Elliot Berg. (1997). Methods of privatization. Journal of International Affair. Retrieved from http://fspac.ubbcluj.ro/moodle/pluginfile.php/20769/mod_resource/content/0/Berg1-Methods%20of%20Privatization.pdf
3.       Chudi-Oji Chukwuk. (2013). Nigerian Economy – Effects Of Privatization And Commercialization Policies. Nigeria. Retrieved from http://www.doublegist.com/nigerian-economy-effects-privatization-commercialization-policies/
4.       Economics on Privatization . (2013). S-cool. Retrieved from Disadvantages of Privatization : http://www.s-cool.co.uk/a-level/economics/privatisation/revise-it/the-disadvantages-of-privatisation
5.       Ladipo Adamolekun . (2005, November). Re-Orienting Public Management in Africa: Selected Issues and Some Country Experiences. Economic Research Working Paper. Retrieved from http://www.afdb.org/fileadmin/uploads/afdb/Documents/Publications/00457497-FR-ERWP-81.PDF
6.       Nigerian Association. (n.d.). Dept for Nigerian Related Website . Retrieved from Nigeria Info net: http://www.nigeriainfonet.com/Directory/associations__organizations5.htm
7.       Okafor, J,C. (2007). Comparative Models and Patterns of Intergovernmental Relations. In J. a. Onuoha, Theory and Practice of Intergovernmental Relations. Enugu, Enugu state , Nigeria : Quintagon Publishers. .
8.       Prof. Taiwo Asaolu. (2015, November 08). The Nation. Privatization in Nigeria: Regulation, deregulation, corruption and the way forward. Retrieved from http://thenationonlineng.net/privatization-in-nigeria-regulation-deregulation-corruption-and-the-way-forward/
9.       The Economic times . (2016, November 18). Retrieved from Privatization : http://economictimes.indiatimes.com/definition/privatization?from=mdr
10.    The impact of Privatization in Nigeria. (2015, March 23). UK essays. Retrieved from https://www.ukessays.com/essays/economics/the-impact-of-privatization-in-nigeria-economics-essay.php


Thursday, February 9, 2017

Vulnerable Children in Nigeria


 
With high priority of The National Government and International Stakeholders across the Globe, there are negative outcomes of the growing of orphans and vulnerable children (OVC) population worldwide. It is recognized that such negative outcome is of a result of the issue with the social, economic and human rights dimensions (Boston University Center for Global Health and Development: Initiative for Integrated Community Welfare Nigeria, 2009).
With evidence based data, there is a huge proportion of orphans and vulnerable children. With the population of 187, 430, 718; the number of adults and children living with HIV is one of the highest in the world (Boston University Center for Global Health and Development: Initiative for Integrated Community Welfare Nigeria, 2009).
In Nigeria there has been a response to crisis of orphans and vulnerable children due to HIV/AIDS in largely community driven with the extended family providing the safety net for protection; care and support (HIV/AIDS: Problems Of Orphans; Vulnerable Children in Nigeria, 2013).
In 2003, 7 million of the population were orphans with an approximate of 1.8million which were affected with HIV/AIDS. The increasing level of poverty; as result of low resources, lack of basic credits and employment facilities, has jeopardized the realization of the wellbeing of orphans and vulnerable children in Nigeria (HIV/AIDS: Problems Of Orphans; Vulnerable Children in Nigeria, 2013).
In Nigeria, 10.7% of the 69 million children are vulnerable (UNICEF, 2007), 10% of children are orphans, (7% in North-West to 17% in South-East), 10% in Rural, 11% in Urban, Benue state has the highest prevalence of orphans (25%), followed by Akwa Ibom (22%); while Niger state has the lowest (2.7%). Benue state has the highest prevalence of Orphans and Vulnerable Children (OVC) aged 6-17yrs (49%), followed by Imo (45%), and Rivers (41%); with Kwara having the lowest (9%) (NSAA, 2008). One of the important challenges in countries like Nigeria that have increased number of children infected or affected with the HIV/AIDS epidemic, is the need to assist families and communities to care for these children ((NDHS), 2008).
In some of the world’s poorest countries in Sub-Sharan Africa, the adverse effects of the AIDS Epidemic are felt more severely, where its consequences have been as upsurge in the sum of children orphaned as a result of death of both parent because of its complication. Orphans are not only affected by HIV/AIDS, but also makes children more vulnerable in a number of ways (The Impact of HIV/AIDS on children in Nigeria, 2015).
HIV/AIDS significantly affects children’s life and families of children’s caregivers. Parents of HIV positive children go through trauma of sickness and eventually death. Certain children carry the burden of caring for a sick parent and this may result to drop-out of school, and carry on the responsibilities of an adult (NSAA, 2008).  Due to parental HIV-related illness costs, and eventually death, this substantially reduces household resources, causes unemployment, or renders a caregiver jobless; which may lead to poor health care of a child, lack of education, and the nutritional status of child significantly declines.
Recent studies show that 17.5 million children are orphans or vulnerable children: 2.5million of these orphans are HIV/AIDS positive in Nigeria. The capacity and resources of the individuals and households have been overextended by the growing number of OVC and the complexity of their needs (Onoh, 2014)
Also, gender-related stereotypes; gender profiling and inequalities between men and women contribute to the public health problems in Nigeria (Effanga, 2014).

The OVC situation in the context of HIV/AIDS in Nigeria:
Orphans and children in very difficult circumstances have been of major concern in most child-enrolled programs before the HIV/AIDS epidemic. The OVC issue existed long before due to the fact that there are other causes of orphanage and vulnerability; which has significantly worsened by the impact of the AIDS Epidemic ((UMN), 2007).
Recent estimates show that there are about 1,800 new HIV infections every day, and 1,400 deaths from AIDS-related illness among children below the age of 15 (UNAIDS, 2007).  Children between this age are victimized for one in six AIDS-related deaths worldwide, and one in seven new HIV infections mostly through mother-to-child transmission of HIV. Many children are further infected with HIV through parental illness, or death from infection((UMN), 2007).
2006 Global AIDS epidemic shows that Nigeria had 930,000 children orphaned by AIDS at the end of 2005. New estimates show that 1.8-2million children are orphaned by AIDS in Nigeria, and  1 in every 10 households provides care for an orphan((UMN), 2007).

Socio-economic Ramifications to the OVC Issue:
Children suffer from psychological because of the experience of poverty resulting from loss of family income. Social dislocation, stigma, and discrimination, loss of childhood: children having the responsibilities of a caregiver towards a sick parent; siblings or other family members with HIV or anyother poor health conditions((UMN), 2007).

OVC Problem in Nigeria:
Globally, the position of youths echoes a deeping and widening neglect and invincibility of children in Nigeria. There has been a high steady prevalence of HIV/AIDS in 2005 as it declined from 5.8% to 4.45 in 2001,  since the HIV/AIDS incidence of a 13 years old child in 1986; which it has been estimated that a million chidren orphaned by AIDS were living in Nigeria (Onyebuchi, HI/AIDS: Problems of Orphans and Vulnerable Children in Nigeria, 2003).
The impact of HIV/AIDS has had an increasing rate on a number of orphans: those who lost their parents to AIDS as a result; leaving them vulnerable. Although there is an insufficient available data, there has been a call of desperation for those who are social excluded, exploitation, and abuse facing a large percentage of orphaned children in Nigeria  (Onyebuchi, HI/AIDS: Problems of Orphans and Vulnerable Children in Nigeria, 2003).
1.       39% of children are involved in sexualactivities
2.      43% of women aged 20-24 were married before the age of 18;
3.      High rate of infant, child and adolescent mortality
4.      Unavailabilty of healthcare services
5.      Lack of education, poor school performance, the education enrollment is low
6.      Rejection of intra household: maltreatment, and abuse/harassment from other peers

With the estimation of previous studies, 40% children may have been involved in child trafficiking, drug trafficking, or engaged themselves in prostitution to earn money. An estimated population of 50million Nigerians below the age of 18 are from low income population, and 40% of them do not acquire primary education due to discrimination due to the result of HIV/AIDS  (Onyebuchi, HI/AIDS: Problems of Orphans and Vulnerable Children in Nigeria, 2003)

Monday, February 6, 2017

Help improve the health of other


Improving Access to Emergency Healtcare



Improving people’s access to emergency medical services by strengthening Integrated emergency system and its further development 

The reality and practice of improving health care service is complex, and as different programs and sectors are varying approaches towards the same objectives of improving access, quality and efficiency. But before we get to the objectives of the improvement of people’s access to health care services, let us understand the concept and purpose of such task.
Improving access to health services is a priority case in Romania. This case study helps in accessing the primary and specialty care suggestions at a great opportunity of improvement. And with this, it is entitled that public health officials should develop a strategy plan for the improvement of health care accessibility.
As Romania has a high prevalence of both communicable and non communicable diseases, polices should be implemented for the occurrence of diseases such as cancer and tuberculosis (TB).  These policies need to be conceptualized to give it a means of achievement.

Accessibility of medical care services: -

Medical care services should be available for not just the high income population but also for the low income population. It is the public health officials’ responsibilities to ensure that there are adequate supplies of medical care services such as clinical services and hospitals. Under this strategy we have the following:

Care is available:

As initially stated, it is important that the availability of health care services is assured to both low income and high income populations. Sufficient supply of clinics and hospitals at both urban and rural communities where people can be diagnosed and treated promptly, and can obtain quality preventive care early enough to avoid illness or complications. Services should be offered within a reasonable distance from where people live.              
Volunteers should enroll their patients in public programs, ensure transportation to health care appointments, provide translation and interpretation services and/or case study manage those with chronic and costly illness. Low income population should be privileged for they do not understand their medical conditions or are able to afford the health care services.  
                                   
Care is appropriate:

The right mix of health care professionals exists to attend to people’s most frequent needs. Cultural and linguistic barriers are addressed in such a way that patients get proper diagnoses and can communicate effectively with their providers. For this to be achieved there should be an organized “training” among both the health care professionals and public health officials. This educates them more on how to communicate with their patients and approach a problem effectively. Also, the health care professionals such as doctors, chemists, nurses and so on can prescribe or educate their patients more about their prescribed medications.

Sufficient supply of ambulances; Emergency Medical Services (EMS): -
This is defined as a comprehensive system which provides the arrangements of personnel facilities and equipments for the effective, coordinated, and time delivery of health and safety services to victims of sudden illness or injury.
The purpose of EMS focuses on providing timely care to victims of sudden and life-threatening injuries and/or emergencies in order to prevent needless mortality or long-term morbidity. They function as the following: -                                                                                         Accessing emergency
Care in community
Care in route
Care upon arrival to receiving care at the health care facility
As Romanian medical care is not up to the Western standards due to the fact that basic medical supplies are limited, especially outside major cities, it is significant that the public health officials meet up to such criteria of sufficient of EMS. Collaboration with private medical hospitals or investors can contribute in the improvement of EMS.

Reducing the cost of medical services: -
One major problem of the health care system in Romania is financial stability. As the cost of health care services increases, the chances of accessibility declines by half, leaving the low income population defenseless (that is to say, their medical conditions increases for they cannot afford the services provided by the health care).  If the government emphasizes on the high price of the health care services, it is at least expected for the health care professionals to take matters into their own hands. It is easier for them to organize fund raising because they have contacts who can invest in such campaigns. With fund raising as well as  the collaboration with public health officials, projects can arise. Such projects can align with non-governmental organizations whose responsibilities are to ensure that the low income populations are enrolled in programs, and provided free medical privileges.

Conclusion: -
With such strategy, health accessibility will be improved. The prevalence of diseases will decline.

REFERENCES
  1.     Embassy of the United States; Bucharest Romania. http://romania.usembassy.gov/acs/health4.html
  2.    Arora N (2003). Interacting with cancer patients: The significance of physicians’ communication behavior. Social Science & Medicine; 57:791-806.
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