In this Assignment, you will examine a global health issue and consider the approach to this issue by the United States and by one other country.
The Assignment: (1- to 2-page Global Health Comparison Matrix; 1-page Plan for Social Change)
Part 1: Hepatitis B compare and contrast the US and the Phillipines
Focusing on Phillipines and the U.S.,. Be sure to address the following:
• Consider the U.S. national/federal health policies that have been adapted for the global health issue you selected from the WHO global health agenda. Compare these policies to the additional country you selected for study. The Global Health Issue Essay
• Explain the strengths and weaknesses of each policy.
• Explain how the social determinants of health may impact the global health issue you selected. Be specific and provide examples.
• Using the WHO’s Organization’s global health agenda as well as the results of your own research, analyze how each country’s government addresses cost, quality, and access to the global health issue selected.
• Explain how the health policy you selected might impact the health of the global population. Be specific and provide examples.
• Explain how the health policy you selected might impact the role of the nurse in each country.
• Explain how global health issues impact local healthcare organizations and policies in both countries. Be specific and provide examples.
Part 2: A Plan for Social Change
Reflect on the global health policy comparison and analysis you conducted in Part 1 of the Assignment and the impact that global health issues may have on the world, the U.S., your community, as well as your practice as a nurse leader.
In a 1-page response, create a plan for social change that incorporates a global perspective or lens into your local practice and role as a nurse leader.
• Explain how you would advocate for the incorporation of a global perspective or lens into your local practice and role as a nurse leader.
• Explain how the incorporation of a global perspective or lens might impact your local practice and role as a nurse leader.
• Explain how the incorporation of a global perspective or lens into your local practice as a nurse leader represents and contributes to social change. Be specific and provide examples.
The Global Health Issue: Hepatitis B and the Comparison between the US and Philippine
The selected issue is Hepatitis B. Evidence illustrates that Hepatitis B is among the leading infectious diseases globally. Statistics indicate that more than 257, 000, 000 have chronic hepatitis B and within 2015 hepatitis B led to the about 887 000 deaths (Si et al., 2019). Hepatitis B is the leading cause of liver disease, a condition associated with a high mortality rate. Despite the hepatitis B vaccine being available, the infection is associated with high mortality and morbidity because of liver diseases resulting from hepatitis B infection (Si et al., 2019). Hepatitis B infection is not only associated with a high mortality rate but also cause a disproportionally high burden in many countries. This paper will compare the issue of hepatitis B between the US and the Philippine.
Comparison of Hepatitis B between the US and Philippine
In the US, there is a universal vaccination against hepatitis B for all infants within 24 hours of birth. All pregnant women in the US are tested for Hepatitis B as well as post-vaccination testing for all newborns whose mother’s hepatitis B status is not known. Additionally, all newborns whose mothers have hepatitis B are given single-dose revaccination of they do not respond to the first vaccination dose. All people with chronic liver disease, hepatitis C virus, fatty liver disease, cirrhosis, and autoimmune hepatitis in the US are required to be vaccinated against Hepatitis B (Schillie et al., 2018).
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High-risk groups such as blood donors, household contacts of HBV-infected individuals, healthcare providers exposed to blood or body fluids, individuals sharing needles, hemodialysis patients, and people with HIV are also required to test for the infection and get vaccinated. Hepatitis B screening in the US is also widespread (Schillie et al., 2018).
The Philippines also implemented the hepatitis B vaccine for all infants. All infants are supposed to be vaccinated against hepatitis B within 24 hours post-delivery. However, the birth dose coverage for hepatitis B remains low in the Philippines. The screening and vaccination, as well as treatment of hepatitis B, are limited (Gish et al., 2016). There is no policy covering the high-risk groups within the Philippines.
Policies in the US regarding hepatitis B have led to the dramatic reduction of new cases of hepatitis B. This is because apart from the mandatory vaccination for the newborns, high-risk groups in the US are also required to get a vaccination against hepatitis B (Schillie et al., 2018). However, the reuptake of the hepatitis B vaccine among American adults at high risk of the infection is low (Gish et al., 2016). The unvaccinated are at risk of acute hepatitis B infection and they can transmit the infection and are also at risk of progressing to chronic hepatitis B infection. The Global Health Issue Essay
In Philippines, despite the adoption of the policy on vaccination for hepatitis for children, there is limited use of the vaccination. Additionally, unlike in the US where the high-risk groups are required to be immunized against hepatitis B, this is not the case in Philippines. There is also no widespread screening of the infection in Philippines. Thus, there are many risks and long-standing consequences of lack of screening, limited vaccination, and untreated hepatitis B. As evidence shows, the rate of hepatitis B is very high in the Philippines and this can be attributed to lack of adequate policies to address the infection. Moreover, unlike in the US where there is effective medical monitoring and management hepatitis B, this does not happen in the Philippines. This explains the high rate of cirrhosis and hepatocellular carcinoma in the Philippines (Gish et al., 2016).
Social determinants of health affect hepatitis B. The inability to access screening, vaccination, and treatment of the infection may be affected by factors such as weak social protection and low social-economic status (Greene et al., 2017). For example, in the Philippines, majority of people cannot afford the national medical insurance program and this hinders them from accessing screening, treatment, and vaccination of hepatitis B. Low health literacy on hepatitis B and the consequences of untreated hepatitis B is also associated with people not seeking prompt treatment or screening for the condition.
Policies addressing hepatitis B in both countries significantly impact the role of the nurse. Even though in the US, adequate policies are addressing the issue of Hepatitis B, the reuptake of vaccination among adult risk groups is still low. The nurse, therefore, has the role of providing education and awareness to the community, and particularly the high-risk groups regarding the burden of hepatitis B and the significance of the vaccination (Carrico et al., 2018). In the Philippines, nurses have both the role of increasing awareness about the significance of hepatitis B vaccine, being treated and also the role of being a patient advocate. The nurse should advocate for the implementation of policies that support the prevention, management, as well as the treatment of hepatitis B (Carrico et al., 2018). In both countries, the nurse has the role of raising awareness about hepatitis B to end the stigma associated with the condition.
A Plan for Social Change
As a nurse leader, it is important to ensure that vaccinations and treatment for hepatitis B are in best practice guidelines for applicable adults such as patients with diabetes or HIV to make sure hepatitis B vaccination is integrated into their routine care (Richmond et al., 2018).
Providing hepatitis B vaccination in settings such as churches, programs for drug addicts to target people injecting drugs, and reproductive clinics to facilitate reuptake of hepatitis B vaccination among community members and the high-risk groups (Carrico et al., 2018). The Global Health Issue Essay
The fear of social stigma and being discriminated against for having hepatitis B discourage individuals from testing. Therefore, as a nurse leader, I would advocate for the establishment of anonymous testing sites to increase the willingness among individuals to undergo hepatitis B testing. I would also recommend point‐of‐care (POC) testing in all healthcare organizations to simplify patient screening and lower per‐patient cost.
Vaccine administration should also be tracked to make sure that all patients complete their doses. Therefore, the nurse leader could recommend the use of strategies such as the use of vaccination registries, provision of transportation, and the use of telehealth to monitor patients.
Improving awareness about hepatitis B and its consequences, as well as increasing coverage for hepatitis B vaccination can contribute to increased reuptake of vaccinations and individuals seeking treatment. For example, educating community members, including high-risk adults regarding the importance of being screened, vaccinated, and treated reduces the prevalence of hepatitis B (Richmond et al., 2018). Reduced incidence of hepatitis B prevents the associated serious chronic conditions such as liver cancer and cirrhosis and also reduced the mortality rate.
The US has implemented universal vaccination for infants and high-risk populations against hepatitis. In Philippines, even though there is a policy for all infants to be vaccinated, there is limited coverage. Social determinants of health affect the issue of hepatitis B because lack of access to care, low health literacy, and low socio-economic status is associated with the inability to get the appropriate screening, vaccination, and treatment for hepatitis B. The nurse leader has different roles in addressing the issue of hepatitis B, such as increasing awareness about the condition and advocating for the implementation of policies that address the issue.
Carrico, R. M., Garrett, H., Balcom, D., & Glowicz, J. B. (2018). Infection Prevention and Control Core Practices: A Roadmap for Nursing Practice. Nursing, 48(8), 28–29. https://doi.org/10.1097/01.NURSE.0000544318.36012.b2.
Gish, R. G., Sollano Jr, J. D., Lapasaran, A., & Ong, J. P. (2016). Chronic hepatitis B virus in the Philippines. Journal of gastroenterology and hepatology, 31(5), 945-952.
Greene, K. M., Duffus, W. A., Xing, J., & King, H. (2017). Social Determinants of Health Associated with HBV Testing and Access to Care among Foreign-born Persons Residing in the United States: 2009 – 2012. Journal of health disparities research and practice, 10(2), 1–20.
Richmond, J. A., Sasadeusz, J., & Temple-Smith, M. (2018). The Role of Primary Health Care in Hepatitis B Testing and Management: A Case Study. Journal of community health, 43(1), 38–47. https://doi.org/10.1007/s10900-017-0385-9.
Schillie, S., Vellozzi, C., Reingold, A., Harris, A., Haber, P., Ward, J. W., & Nelson, N. P. (2018). Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports, 67(1), 1–31. https://doi.org/10.15585/mmwr.rr6701a1.
Si, J., Yu, C., Guo, Y., Bian, Z., Meng, R., Yang, L., Chen, Y., Jin, J., Liu, J., Guo, Z., Chen, J., Chen, Z., Lv, J., Li, L., & China Kadoorie Biobank Collaborative Group (2019). Chronic hepatitis B virus infection and total and cause-specific mortality: a prospective cohort study of 0.5 million people. BMJ Open, 9(4), e027696. https://doi.org/10.1136/bmjopen-2018-027696.