The Effects Of Lack Of Health And Health Care Essay

Approximately 52% leave high school without receiving a diploma and even fewer individuals with I/DD (8%) have any college experience at all (The Arc, 2011). This creates a situation as this group become adults, where their lack of education makes it very difficult for them to understand where to even locate help if they do not have other family members involved in their care. Lack of employment is another barrier to health and health care. It is not that individuals with disabilities do not want to work or cannot work. Jobs that integrate these individuals into their community are just not available. The Arc (2011) reports that 85% of I/DD adults are not employed and of the 15% that are employed, only 57% report making minimum wage. Without government assistance or family support, this group finds themselves unable to afford much if any type of health care. It is not just the I/DD group affected by these barriers. Physical, mental, sensory disabilities are all included and no matter what group of disabilities an induvial may be categorized into they all face similar barriers and disparities and are more vulnerable The Effects Of Lack Of Health And Health Care Essay

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Our optimism is derived not from theory but from our day-to-day work, which ranges from health policy leadership roles to the management of an academic integrated delivery system to hands-on patient care. From this work, we have a frontline view of the good that an organization can produce, but also the inefficiency, missed opportunities, confusion, and occasional harm that cycles the working of a health care organization [2].

While working for a long year within a government organization in the country of India, I came across many wrongs that I could lay account for, which are quite evidently the root cause for poor healthcare within India. Corruption the taboo that infests Indian mainstream medicine, from the physicians to the lowly staff fall prey to this unethical practice. Her life and death expectancy are not measured through the seriousness of the patients health but the way in which he can satisfy the insatiable corruption around.The Effects Of Lack Of Health And Health Care Essay

The biggest killer in India today is not the mosquito, population, poverty, not tobacco, and certainly not the polio bacterium despite the disproportionate effort spent on eradicating it, it is corruption. To make it sound more technical and acceptable to the medical profession perhaps we need to label it.’ Coruptionoma’, which may in the future lead to a global epidemic threat [1].

Today in India where scientist claim to have sent men to the moon polio is still common in existence, somewhere a child dies every minute of every day from diarrhea or due to lack of basic care and every 6 minutes a woman dies from pregnancy related causes (official GoI figures). Infant female feticide is increasingly observed in wealthier districts with high literacy rates. Road traffic accidents in Delhi and Mumbai alone are of epidemic proportions.The Effects Of Lack Of Health And Health Care Essay

It is a myth that high technology and costly medicine are the best ways to treat a patient and bring health reforms, it is easily achievable through age old ways readily available then why are the above problems not catered to and still spreading at an alarming rate? It is the disease of corruption that makes managing a health practice impossible.

2. CORRUPTION in Health Care
While working as a resident medical officer at a government hospital in India I faced innumerous issues in the management but the issue that was commonly causing chaos is corruption. Corruption comes evident in various forms and puts the whole effort of providing good service or trying to salvage the oath taken in service of our patients.

“The things I have personally experienced working in an Indian public hospital for over a period of one year is that the life expectancy of a person depends on the financial background of the person.”

The fact that women in labor die due to late arrival of ambulances and un operational equipments

Adulterated drugs proliferate because high level politicians who encourage or protect the people who sell them.

Doctors don’t attend place of work despite drawing a wage from the Government.

Large amount of medicine wasting before reaching the point of use.The Effects Of Lack Of Health And Health Care Essay

Unwillingness amongst underpaid staff who either sit on months of strike for their appraisals or either find under table ways of moving their files.

Unavailability of clean water and hygienic environments resulting in filthy hospitals due to lack of accountability and supervision.

Issuing of licenses to service providers and manufacturers who are incapable but willing to pay high bribes.

Negligence in documentations in departments and usage of illegal means to alter information for self benefit.

Power breakdowns compromise the safety of hospitals due to surging charges and lack of government help.

Officials elected for the purpose of recuperating the health conditions neglect their sole purpose are busy catering to their political scandals and filling their pockets by the power of their seat.The Effects Of Lack Of Health And Health Care Essay

Unnecessary drug prescribing by doctors making practice a means of advertisement for scrupulous pharmaceutical companies.

Under the desk payments demanded from patients by everyone for the watchman to the doctor.

Buildings constructed at inappropriate sites to please politicians and others, discouraging proper use.

Staff wanting to make their private practices look more efficient than the public sector caters to theft and sabotage of instruments.

Favoritism and relational influences give opportunities to the undeserving candidates for higher post and even educational sponsorships.

Loved ones are made to pay bribes to provide loved ones with immediate medical care due to unethical working standards.

[[1], edited based on true personal experience]

Corruption In Its Various Forms

3. FINANCIAL Management Corruption
Corruption is seen in every aspect of healthcare mainly financial management of the organization. In a recent report in an Indian daily — “Indians pay bribes worth Rs 2,728 cr” (equivalent to approximately US$570m annually), the report finds that the public sectors surveyed the health and education sectors were the most corrupt [2].The Effects Of Lack Of Health And Health Care Essay

Factors contributing to financial corruption:

Low Wages for Public servants
Low Wages, Poor patterns of incentives and bad working environment relates to the capacity of an organization to attract and retain honest, skilled and motivated staff in a long term similarly, low wages in the public sector are likely to attract less qualified, poorly motivated and potentially disloyal staff, resulting in an opaque, inefficient and potentially corrupt staff. “Informal fees” Of course, like unofficial fees, are not official nevertheless, developed like more of a “practice.” The underpaid officials and underlying poverty influence the practitioners to fill their pockets by unofficial fees [5].

In my experience Low wages is a greater public tolerance for corrupt practices when the worker incomes are insufficient for living the working environment is intolerable with bleak chances of improvement due to the already existent corruption at the political and higher regions [4]. The existent salaries perceived as unfair in comparison to private sector salaries. Thus subsistence strategy or survival technique that compensate for inequitable working conditions and hardships faced economically make the demanding of under counter money or accepting bribes for poorly paid staff.The Effects Of Lack Of Health And Health Care Essay

Illiteracy amongst masses
The common story amongst people of developing nations is the lack of knowledge and self righteousness. Though the government acts in favor of free medical camps and health coverage the poor due to their lack of awareness fall prey to corruption where they pay for the rights freely available to them at public hospitals.

Free vaccinations for polio, medical camps in rural areas and treatments for HIV/AIDS, tuberculoses, cancer and movements to eradicate malaria have been readily undertaken by the government, but illiteracy amongst the rural and lower sectors (i.e. working class) leads to corruption and future diminishing health conditions.

Lack of funds
The public hospitals rely on government funds or fund raising events which hardly keep pace with the fast growing health sector. The increase in technology has levied a burden on the feeless hospital where the promised care cannot be delivered due to aging population and increasing diseases.

The only way in which the organization avoids complete shutdown is by compromising in the health care by using obsolete technology and unmaintained hospitals with inexperienced staff working in unhygienic conditions. Leading to lesser scope of modernization or remodeling facilities to provide better health care.The Effects Of Lack Of Health And Health Care Essay

This situation also provokes the organizations to remove their staff for balancing their financial need causing a setback in the prosperity of the nation.

4. How can the financial management corruption be dealt with?
Changes in accounting systems
Health systems require clear and simple accounting and procurement standards based on legal framework that encourages transparency participation and due timeliness. An effective supervision and auditing systems is essential in improving the over sightedness that is the root cause to loop holes in an organization and ensure effective enforcement of rules that punish misconduct.

Budget transparency
Transparency accounts for practices and expenditures to be open to public and legislative involving scrutiny and that civil society at all stages of budget formulation, execution and reporting [8]. Budget transparency requires an information system that produces timely, reliable and accurate information in order to hold public officials accountable for the use of allocated resources.

Decentralization
Decentralization is a favored strategy with a view to enabling broader public participation and improves technical as well as allocation efficiency, involving public in the decision marketing process and enhancing the responsiveness of the health system. Research indicates that in poorer countries, higher fiscal decentralization is associated with lower mortality rates and improved health outcomes even in high corruption environments [9].The Effects Of Lack Of Health And Health Care Essay

Privatization in health sector
The lack of accountability arises when institutions are weak public funds is low, privatization of health services can be seen as an alternative method of improving the quality and effectiveness of health services. Privatization limits the powers of the public officials and thus their opportunities of influencing bribery and corruption. Monitoring the quality, reliability and cost-effectiveness of private care and treatments, ensures access to quality health services to the needy and also prevents abuse of the resources. Managing the rates of medicines in private by the displaced informal payments would make a mere difference in public and private care.

Resource management
Tracking the supply demand chain and eliminating the middle men who add to the price of medicines and also influence illegal bribery. Encouraging the tracking the level of stock and recording the expiry of medicines which may harm the patient’s health. Keeping distributions flow constant and eliminating the unused and outdated stock rather than black marketing supplies for personal gain.The Effects Of Lack Of Health And Health Care Essay

5. Drug Management Corruption
The corruption in drug management affects the price, availability and quality of drugs, undermining safe and affordable access to essential medicine in many developing countries mainly India. Due to the complexity, in the opaque system of health services influenced by large flows of money involved, forge fraud and corruption at all points of the organizational chain, from the registration at hospitals to the admissions and selection of medical treatment and distribution to the promotion of medicines. This is likely to have a long term impact on health and economic outcomes especially the health census of a developing nation [3].

The factors influencing drug corruption

Availability
The drug procurement and pharmaceutical expenditure constitute a large part of the health care budget after salary expenditure. More than 20 to 50 % of the funds are promised for making drug available at affordable prices and thus indicating a growth in health care standards. [6]

Corruption in procurement and distribution of pharmaceutical and medical supplies reduces access to essential medicines; doctors prescribe medicines on basis of the cut they are offered by the pharmaceuticals. The vulnerable groups thus fall victim to shortage of the facilities and healthcare. Inadequate provision of drug and medical supplies has a direct bearing on the performance of the organization.The Effects Of Lack Of Health And Health Care Essay

Registrations and legalities
The market approval of the production and distribution sector is highly influenced on the bribes that the companies offer to pay than the adequacy neither capability of the company nor the potency of the drug. It is a regulatory decision of the political bodies concerning the health sector to allow a medicine to be marketed in a given country.

Compliance with regulations elongates the period of drug licensing, accreditation and approvals can prove costly for pharmaceutical companies wanting to launch a new product. Some of them may try to bribe or influence the regulator simply to speed up the approval process.The Effects Of Lack Of Health And Health Care Essay

The middle chain of distribution elongates and also becomes costlier by the amount of unofficial money associated with the drug release of drug release or distribution this can also affect the setting of user fees for drug registration, which are often set well below true cost [6].

Pharmacies and drug stores also require due registration and licensing. The process of licensing pharmacies for operation is corrupted by bribes, favoring kin or political contacts of government agents, geographic inequities, and facilities that do not follow government regulations. As with the registration process the responsible national experts receive compensation from pharmaceutical companies that influence their statistics and thus influencing wrong judgments.

Drug Selection
The selection of essential medicines in a given country needs to use defined criteria and consultative and transparent process. The inclusion of any pharmaceutical on the list of nation’s essential medicines is influenced by means of bribery gain due to the opacity in the selection process [8]. Interested parties may also bribe the committee responsible for deciding which products are reimbursed through government social insurance programs.The Effects Of Lack Of Health And Health Care Essay

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Procurement and lack of skill
Providing health facilities with drug and medical supplies is a very complex process. This involves a large variety of members interacting between the private and public sectors. Government’s health officials lack the managerial skills required to specify technical details, supervise bidding and monitoring the already active contracts and trail their legal fulfillment. Corruption can occur at any stage of the process influence decisions on the model of procurement rather than competitive bidding, on the type and volume of procured supplies rather than the demand enlisted, and on specifications and selection criteria hence compromising access to essential medicines and hampering their quality endangering lives of the poor who are the most vulnerable victims to corruption.The Effects Of Lack Of Health And Health Care Essay

In a context where quality controls are difficult to exercise, an increasing lack of funds results in corruption where officials sell low quality, expired, counterfeit and harmful drugs at cheaper prices. Corrupt procurement officers also purchase sub-standard drugs in place of quality medicines pocketing the difference.

Unmonitored systems and lack of official records
Falling short of finance the systems are obsolete and poorly monitored, record-keeping is ineffective hence the accounting mechanisms make it an easy opportunity for the corrupt, theft of large quantities of drugs and medical supplies depositories and medical facilities, sale of samples for personal gain in private practices or on the black market [8].The Effects Of Lack Of Health And Health Care Essay

Puppets or patients
A Strategy to supplement their meager salaries doctors working for government has been increasingly allowed to open private practices Resulting to which doctors spend official time in public facilities treating private patients, or merely channeling patients to their private practice.Due to the lack of punishment the doctors are either absent or not concerned with their low salary jobs playing with the lives of their patients.

6. How can the drug management corruption be dealt with?
Tracking Registration process
Authorities need to ensure transparency and accountability. A formal committee responsible for registration of medicines needs to be established where the basis of selection remain technical and competitive with easily accessible terms and conditions and fixed payable fees. Training should be provided for the officials who are responsible managing records and performing registration activities.The Effects Of Lack Of Health And Health Care Essay

Drug selection
To limit corruption in the process of drug selection practical involvement and fair practice is a must where adopting lists of essential medicines that are based on standard evidence-based treatment guidelines at national and sub-national levels. Government officials need to ensure that the selection of these essential medicines is based on transparent process with expert committee responsible for this exercise operating according to published terms of reference, whose members will be selected based on expertise, and whose decisions will be influenced by current state of scientific evidence.The Effects Of Lack Of Health And Health Care Essay

Improving access to medicine
In order to tackle this complex problem the causes and manifestations of corruption and the ongoing in the region are too be evaluated to prevent it. Agreements to establish a working group with the industry and NGOs in order to promote transparency in the health sector based on various health standards.

Procurement management
The prerequisite for curtailing corruption in the procurement process consists of defining rules and guidelines that reduce discretionary powers where they are likely to be abused and to increase the probability for corrupt practices to be detected and sanctioned. Promoting transparency in the procurement process can be achieved by offering clear documentation and public access to bidding results, if possible using an electronic bidding system where interference is not possible, and involving civil society at all stages of the process. Technical assistance and to manage competitive bidding training for procurement officers can also improve standards of the government [3].The Effects Of Lack Of Health And Health Care Essay

Distribution rights
To reduce illegal practices at the distribution stage of medical supplies include establishing controlled inventory systems, improving record keeping providing security against robbery in repositories. Providing tools for improving drug distribution systems, including guidelines for forecasting, supply chain management and managing process flow in the distribution system.

Promotion
Other possible measures include banning practices of gift and sponsorship, following WHO ethical guidelines on medicines promotion [10], and promoting codes of ethics in marketing through trade and professional organizations. The practitioners should be educated against the promotional propaganda of the pharmaceutical companies.The Effects Of Lack Of Health And Health Care Essay

7. summary
Addressing the issue of rising health care costs is critical to the economic health of our country, and the physical health of its residents. In this situation when corruption enters the developing nations mainstream it soils the whole system from the lower working class to the managerial level. They participate in the malpractice of endangering the lives of their patients, rather than making medical supply and health services readily available?

National health officials are interested in pocketing the differences they earn by under counter money and unofficial fees for items termed as free. Financial management faces corruption due to its poor accountability and inadequate supervision. The Lack of trained officials leads to unmaintained records, wastage of medical supplies and unavailability of required medicines.The Effects Of Lack Of Health And Health Care Essay

As a resident official in one of the busiest hospitals I observed the lack of enthusiasm amongst the working staff and also the practitioners this attitude is mainly influenced by the lack of funds, insufficient salaries and unhygienic working environments. The only alternative to satisfy their mere day to day needs , officials are forced to accept bribes and get involved in illegal activities.

The drugs not for sale are robbed and distributed at private institutes or also black marketed during times of high demand. The supply is irrespective of demand. Competition in the pharmaceuticals has lead to influencing of doctors in prescribing high cost medicines for their personal benefits and gifts. The respect of human life and the oath of serving our nation with honesty has long been forgotten especially in the Indian sub continent.The Effects Of Lack Of Health And Health Care Essay

Lots of ways have been prescribed in books of many volumes but corruption as a disease may blame politicians, poverty and many other uncontrollable traits but the only virus for this disease is human nature and the lack of self control and honesty. The selections of political power is always in the hands of the masses then blaming our leaders and giving them opportunities is like blaming ourselves for the condition we find ourselves in.

As an Indian belonging to the middle class I too have observed the corruption in our country, not done much to prevent or stop it but have done enough to encourage and kindle its existence.The Effects Of Lack Of Health And Health Care Essay

This assignment deals with the impact that social and cultural issues have on attitudes towards healthcare using their chosen nation as an example; I should evaluate healthcare policy in one national context and explain the influences on policy formation, including impacts of funding issues. The comparison should be made to other national policies to show how different national policies arise. I should explain the structure of healthcare delivery in their chosen nation including an analysis of the organisations involved in healthcare and showing how this represents the translation of policy into practice. And also I should analyse practical barrier to the provision of healthcare in their chosen national context. All of these are covered in task 1 of this unit. Under task 2; Student should identify national and international public health campaigns and analyse their impact on the demand for healthcare in their chosen nation. Their analysis should look at the promotion of public health issues and how well this is achieved. And one thing more, student should identify current international or national health issues and assess how national policy accommodates these issues and the practical responses to these issues in their chosen national context. These assignments bring us new insight to the healthcare in the international sector as well as national. The example that I can cite is the issue of tuberculosis in national and international context.The Effects Of Lack Of Health And Health Care Essay

Let me give you a bird’s eye view regarding tuberculosis. Tuberculosis remains one of the most devastating diseases in the world, affecting people of all ages across the globe. Despite rumours of its demise, tuberculosis remains one of the most deadly, and disabling, diseases in the developing world. According to the World Health Organization’s Global Burden of Disease project (Mathers 2002), in 2000 it was the eighth highest cause of death, and the tenth highest cause of disability adjusted life years (DALYs).The Effects Of Lack Of Health And Health Care Essay

Tuberculosis (TB) is a common and often deadly infectious disease caused by mycobacteria, usually ”Mycobacterium tuberculosis” in humans. Tuberculosis usually attacks the lungs but can also affect other parts of the body. It is spread through the air, when people who have the disease cough, sneeze, or spit. Most infections in humans result in an asymptomatic, latent infection, and about one in ten latent infections eventually progresses to active disease, which, if left untreated, kills more than half of its victims. Tuberculosis is most prevalent in developing nations and often coincides with malaria prevalence and acquired immune deficiency syndrome, or AIDS, and human immunodeficiency virus, or HIV, infections. As an opportunistic disease, tuberculosis easily seats itself in carriers with weakened immune systems. When tuberculosis is a secondary infection in those with a primary infection that is as dire as AIDS, HIV or malaria, it is often a fatal disease.The Effects Of Lack Of Health And Health Care Essay

Diagnosis relies on radiology which is commonly known as chest X-rays, a tuberculin skin test, blood tests, as well as microscopic examination and microbiological culture of bodily fluids. Treatment is difficult and requires long courses of multiple antibiotics. Contacts are also screened and treated if necessary. Antibiotic resistance is a growing problem in (extensively) multi-drug-resistant tuberculosis. Prevention relies on screening programs and vaccination, usually with Bacillus Calmette-Guérin vaccine. Tuberculosis has been contagious for a long period of time. The signs and symptoms usually dormant or they called it as latent period. It can stay up to 5 years, until you will experience loss of appetite, weight loss, fever, easy fatigability, night sweat and persistent coughing with or without blood. This said bacteria are treatable if caught in an early stage. But also it is deadly if left untreated. Mostly the treatment is provided by the government; the course of treatment is quiet long and has to take religiously.The Effects Of Lack Of Health And Health Care Essay

Task 1
One of the healthcare policies of the World Health Organisation regarding tuberculosis is to reduce the transmission of TB in households, any information, education and communication activity for prevention and management of TB should include behaviour and social change campaigns. Such campaigns should focus on how communities and, in particular, family members of smear-positive TB patients and health service providers can minimize the exposure of non-infected individuals to those who are infectious. This will ultimately translate into healthier behaviour of the entire community in relation to prevention and management of TB.

Healthcare in the UK is mainly provided by the country’s public health provider – the National Health Service (NHS). Established in 1948, the NHS was the first state organisation in the world to provide free healthcare. Today, it is the largest health service in the world providing services such as hospitals, General Practitioners (GPs/doctors), specialists, dentists, chemists, opticians and the ambulance service. The majority of these are free to those who are entitled (see below), but patients pay fixed fees for prescriptions, sight tests, NHS glasses and dental treatment, unless they are exempt for a particular reason.The Effects Of Lack Of Health And Health Care Essay

The state system is supported by private health providers. These offer the opportunity to receive treatment more quickly, always see an expert specialist and be seen in clean and comfortable surroundings. The private health providers are not paid for by the state but through private health insurance or personally.

Those entitled to free or subsidised treatment on the NHS include:

Anyone with the right to live in the UK and who currently resides there (excluding British citizens who are resident abroad)

Anyone who has been resident in the UK for the previous year

EU Nationals

Anyone with a British work permit

Students on courses longer than six months The Effects Of Lack Of Health And Health Care Essay

In addition, nationals from countries with reciprocal health agreements can also get treatment on the NHS, although this is usually limited to emergencies. (A full list of these countries can be found on the NHS website – www.nhs.uk).

The number of patients using the NHS is huge. On average, it deals with one million patients every 36 hours and each GP sees an average of 140 patients a week. The NHS struggles to cope with these numbers and it is not uncommon to have to wait several months to see a specialist. As a result, many people opt to pay for private health insurance (or have it provided by their employer) to avoid long waiting times for appointments and treatments.

In the UK life expectancy has been rising and infant mortality has been falling since the NHS was established. Both figures compare favourably with other nations.The Effects Of Lack Of Health And Health Care Essay

On the other hand, in USA they have these kinds of free medical services to those who are less fortunate. Medicaid is a highly specific, means-tested health coverage/insurance program. It covers those who are (primarily financially) unable to acquire health coverage. It covers low-income individuals, including children, pregnant women, parents of eligible children, and people with disabilities. Medicaid was created to help low-income individuals who fall into one of these eligibility categories pay for some or all of their medical bills. Medicaid helps eligible individuals who have little or no medical insurance. And for those who are able to pay their insurance they have Medicare which covers wide scope of individual in Unites States. These Medicaid and Medicare are both run by the government. So the government is the one deciding which one is beneficial to their people but they both get a better treatment in terms of healthcare.The Effects Of Lack Of Health And Health Care Essay

As I have discussed TB as my example in healthcare issues again, tuberculosis is an infectious disease. Mycobacterium tuberculosis is the most common tuberculosis-causing pathogen in humans. Tuberculosis impacts society greatly by hindering economic growth in developing countries. Along with AIDS and malaria, tuberculosis is considered one of the three diseases of poverty. Tuberculosis can be extremely isolating for those infected with the disease. During the beginning stages of being a carrier of the active germs, you are required by medical professionals to stay physically isolated for a two-week period while receiving treatment that results in no longer being contagious. For those who are not treated in a timely manner but are aware that they are infected, this isolation may be extended for an inordinate amount of time. This isolation process has created an impact to the society, they become stereotyped that once you are isolated due to the said TB you are contagious for the whole course of treatment. That is why health education in the community, media information and also by giving leaflets are very helpful way to lessen the emotional burden of the victim or the patient.The Effects Of Lack Of Health And Health Care Essay

In the recent study, in Asia India has the highest percentage incident of TB. In a study conducted by the Department of Community Medicine at Maulana Azad Medical College in New Delhi, India, it was shown that tuberculosis patients rated their quality of life as significantly lower than those test cases of non-infected patients. Women, in particular, felt that the effects of being a carrier of the disease were devastating to their romantic lives as well as their abilities to parent their children due to fears of infecting them.

The social determinates of tuberculosis are very clear. Poverty is one of the biggest problems and housing. The impact on women is quite serious because they are at the bottom of everything whether it comes to health services or economic empowerment and whether it is access to food and nutrition. Women are really in the bottom strata of the society, and, coupled with that is the effect of gender discrimination against women. There is no equal opportunity, so it affects a lot of women. Access to health is a big problem for women.The Effects Of Lack Of Health And Health Care Essay

So, tuberculosis is complicated by all of these things and while, yes, it does affect everyone in the society, women tend to suffer a lot more just because their access to healthcare is so low, and it is so difficult for them. In fact, the health-seeking behaviour of women is very poor in the communities, and part of the empowerment process is to help them put their health first and to make them understand that their own health is important. They must begin to put their own health first rather than putting their family first and neglecting their own health. Since the cultural aspect in India are very strong that woman has to take care of the family while the father is the main bread winner; that is why most women tends to ignore their health problem even they were suffering from the said disease. And also one of their cultures is having extended family. In one small house maybe 2-3 families are living together, so the mode of transmission of TB is very evident and that is why increasing number of incident in the said country.

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According to the study of British Thoracic Society; in London the cases of tuberculosis have been increasing since year 2000 – 2008 to 37% – 45% roughly estimated. Over 40% of TB Cases are Indian but not born here in London. 65% of new cases are aged 15-44yrs old. And it is common in male which is 55% and female 45%.

Other issues of service user (TB Patient in London) had been determine and it become barrier to the provision of healthcare namely:The Effects Of Lack Of Health And Health Care Essay

GPs slow to recognise and act on symptoms

Non TB staff lack empathy / understanding

TB clinics a source of emotional and social support as well as health care

Advocacy services lacking

Psychological impact on being “isolation inpatient”

Geographic barriers

rural and inner-city health professional shortage areas

Cultural barriers

health beliefs and behaviors, practitioner beliefs and behaviors

Socioeconomic barriers

lack of health insurance, inability to pay out of pocket, poor education

Organizational barriers lack of interpreters, long appointment wait times, referral between hospital departments is troublesome

Combinations of these barriers may occur at the same time

According to the survey, 43% of BTS (British Thoracic Society) respondents gave the Department of Health in England a rating of poor or very poor in the priority they give to TB. The 2007 BTS survey saw 71% poor or very poor so this is a marked improvement. This reflects the increased priority the Department of Health has given TB, with much service improvement attributable to Department of Health funded projects such as Restructuring TB Services ‐ the multidisciplinary team project undertaken by BTS. Since it has given a priority in the year 2008, the incidents of TB are stable. But across England, the number of cases of the illness appears to be on the increase. According to the Health Protection Agency the number of people infected by the illness per year has gone up from 8,496 to 8,679. People who had been affected by the said disease are not the local once but people coming from outside the country like the migrants from Africa and Asia.The Effects Of Lack Of Health And Health Care Essay

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In the recent issue in Afghanistan, they begun to work on a $30 million hospital for the treatment of tuberculosis[TB], a disease that health officials say kills more than 10,000 Afghans every year,” VOA’s “Breaking News” blog reports. “The Japanese government is paying for the 80-bed center in the Afghan capital, which will also treat malaria and AIDS patients,” the news service writes, noting, “Japan is the second-largest donor to Afghanistan, after the United States.” VOA adds, “During Thursday’s groundbreaking in Kabul, Afghan Health Minister Suraya Dalil said Afghanistan ranks in the top 20 worldwide for the most TB patients,” and she noted the country has 2,000 centers nationwide that can diagnose and treat the disease. So in this, other first world countries like Japan are helping them to lessen or eventually eradicate the incident of TB and other deadly diseases.

According to the World Health Organisation, tuberculosis is a continuing public problem in developed and developing countries. Due to this, the World Health Organisation had come out with the plan of implementing the DOT or the Direct Observe therapy which started in 2006 and the result were remarkable that is why up to the present they are still using the said method of treatment in tuberculosis. One thing more is the implementation of screening test (chest X-ray) to all migrants who will enter to the specific country like in United Kingdom. They have policy that all migrants who will stay in the country for more than 6 months should have chest X-ray done and have valid reading result. They can bring their result from their own country but if they cannot produce the result in the immigration area, chest X-ray should be done before letting them inn in the country.The Effects Of Lack Of Health And Health Care Essay

TASK 2
First let me define what “Public Health” is? It is the approach to medicine that is concerned with the health of the community as a whole. Public health is community health. And it has been said that it is vital to all of us at all times. Public health professionals are the one monitoring and diagnosing the health concerns of entire communities and promote healthy practices and behaviours to assure our populations stay healthy.

I have read an article about the campaign regarding tuberculosis world wide. It was held last March 2012 the 2012 World TB Day campaign will allow people all over the world to make an individual call to stop TB in their lifetimes. The Department of Health strategy for tackling TB is to help the NHS strengthen TB services in order to detect cases of TB early, and ensure completion of treatment. In addition to developing the TB Action Plan for England has: developed a set of resources, the “TB Toolkit”, on what constitutes a good TB service with advice on how to assess local needs and commission appropriate services in line with National Institute for Health and Clinical Excellence (NICE) clinical guideline. The Effects Of Lack Of Health And Health Care Essay The Toolkit has been presented to Primary Care Trust (PCT) commissioners and their local service providers/public health teams via a series of regional workshops. Provided funding for the BTS (British Thoracic Society) to establish a national clinical advice network, with a multi-disciplinary make-up, offering peer support and best practice advice for the management of TB cases; implemented improvements to the current Health Protection Agency (HPA) surveillance system to enable local services to have rapid, timely and accurate information, allowing them to monitor TB cases and outcomes in their locality; funded an evaluation of the use of mobile X-ray screening in London as a tool for active case-finding. Provided funding for a TB ‘Find & Treat’ programme to support TB services in London in following-up suspected cases of TB, and diagnosed cases who have been ‘lost to follow-up’; introduced X-ray screening equipment in a number of key prisons in order to improve detection of cases among prisoners; Commissioned research on awareness of, and knowledge about, TB among certain migrant groups at higher risk of TB, and among primary care professionals. This forms the basis of further work to raise awareness of TB. For example, the DH is funding TB Alert to develop materials to raise awareness among higher risk groups, and work closely with PCTs to target these materials locally; reduced the cost of TB drugs to patients who would normally pay a prescription charge. A small amendment to the medicines charging regulations allows TB drugs to be given via TB clinics or patient group direction without a prescription charge being levied; held an expert meeting to review the TB Action Plan in England in order to identify gaps and priorities for further action.The Effects Of Lack Of Health And Health Care Essay

On the other hand, tuberculosis impacts society greatly by hindering economic growth in developed and developing countries. The WHO estimates that globally tuberculosis causes $12 billion annual economic loss. Mycobacterium tuberculosis contaminates about one-third of the entire Earth’s society. It is also one of the most averaged single death affecting factors in adolescents.The Effects Of Lack Of Health And Health Care Essay

It is about two point five percent of all the diseases in the world combined, there are huge consequences globally because of tuberculosis approximately two billion people in the world are infected. It is the seventh most death causing disease worldwide. About seventy-five percent of people fifteen years old to fifty-four are afflicted with this disease. In places like South East Asia and sub-Saharan Africa the rates of death caused by tuberculosis can range from ninety-five and ninety-nine percent. There are some productive drugs that sparingly helps prevent tuberculosis, for about 50 years there has been a statistics saying that every 15 seconds, one person dies due to tuberculosis. People say that this statistic is supposed to remain until the year 2020. One person with tuberculosis usually contaminates about ten to fifteen people every year.The Effects Of Lack Of Health And Health Care Essay

It usually takes 1.6 billion US dollars to budget for tuberculosis control for just one severely affected country. Tuberculosis is a huge epidemic in Yemen. The majority of patients in Yemen that are contaminated by tuberculosis between the range of fifteen years old to fifty-four years old, seventy-two percent of that majority of the patients have pulmonary tuberculosis and twenty-eight percent of them have extra-pulmonary. Tuberculosis is transmitted very easily, when a person coughs they discharge a droplet nuclei which holds about ten bacilli. They are then transported by air currents, once they are breathed in they are anchored in the upper respiratory tract. Because the droplets are very small it is easier for them to stay in the air for a long amount of time. The risk of being contaminated with tuberculosis is very high in poor ventilated ares and crowded places.The Effects Of Lack Of Health And Health Care Essay

There are many ways one can be infected by tuberculosis. An exposed victim will have a hundred percent chance of getting tuberculosis if they are in a very small, enclosed place with the infectious person. Poor ventilation can increase the risk because ventilation is used to remove the contagious droplet nuclei. The amount of time that you are exposed is another key factor. If the individual is exposed and is very susceptible that individual will be contaminated. There are many treatments for tuberculosis, one of them is a drug called Isoniazid it is widely used and it is for prevent tuberculosis. Another one is Rifampicin, it is very effective is non toxic. There are many others like Pyrazinamide, Thioacetazone, Streptomycin, and Ethambutol.The Effects Of Lack Of Health And Health Care Essay

In Yemen, there were no studies or research conducted for a treatment for tuberculosis. But there have been many advances around the world in the past one hundred years, like in 1885 Cantan discovers nonpathogenic bacteria that reduce the amount of Mycobacterium tuberculosis. In 1944 the worlds first single anti-tuberculosis drug. Many scientists in Europe have worked hard to find a cure for Tuberculosis and in 1946 they succeeded in creating an acid that resist the bacteria, it is called PAS which stands for para-aminosalycilic acid. Soon after that they started to discover a lot more new drugs to treat tuberculosis; isoniazed was discovered in 1951, in 1954 pyrazinamide was discovered, cycloserine was discovered in 1955, ethambutol in 1962, and rifampicin was discovered in 1963. All of these have helped the spread of tuberculosis significantly lessen.The Effects Of Lack Of Health And Health Care Essay

Even though many anti-tuberculosis drugs exist around the world, tuberculosis is still and epidemic in some countries because of the low economy some of the countries have. Since the countries that have tuberculosis as their epidemic have a low economy, this means that the country could not provide enough money to trade with other countries who have these drugs or the country could not afford money to provide research and studies for prevention of tuberculosis or for a cure. If each country with the anti-tuberculosis drugs would share their information with the other countries maybe tuberculosis can be eliminated from this world, because it affects the society of today’s world.The Effects Of Lack Of Health And Health Care Essay

Conclusion:
Having discussed the issues regarding tuberculosis in national and international aspect; it was an eye opening to the community how to lessen the transmission of disease and at the same time how to get information; give solution to the problem. By identifying the barriers in the issue of tuberculosis such as; GPs slow to recognise and act on symptoms; non TB staff lack empathy / understanding; Psychological impact on being “isolation inpatient”; rural and inner-city health professional shortage areas; long appointment wait times, referral between hospital departments is troublesome. And another thing is the cultural beliefs about healthcare. In these barriers, the NHS is trying their best to intervene and look for a possible and healthy solution.The Effects Of Lack Of Health And Health Care Essay

Further more, the link between tuberculosis and diminished growth suggests that there is a role for health programmes such as DOTS in improving not only the health of those living in the developing world, but also such individual’s wealth. Any policy would need to take into account the problems involved in scaling-up treatments in countries with limited healthcare staff and health infrastructure. Both sets of guidelines appear to support a dedicated programme to treat tuberculosis using community based methods such as those of DOTS, which do not require long periods of hospitalisation or high-level infrastructure. The Effects Of Lack Of Health And Health Care Essay