Health And Disease In Communities Health And Social Care Essay

5369 words (21 pages) Essay

1st Jan 1970 Health And Social Care Reference this

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The different agencies responsible in identifying levels of health and disease in communities are the following: World Health Organisation, Health Protection Agency and the Primary Care Trusts. This three may have different specifics in terms of their objectives and targets but they are commonly working on towards a safer and health risk-free environment.

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The World Health Organisation (WHO) functions are mainly in providing support and services to the different health care institutions around the globe especially those who primarily need it e.g. low performing health care providers on a per country basis, newly debilitated areas and the likes. The organisation also joins forces with other necessary health care organisations in order for them to acquire help in the implementation of certain programmes or activities locally. Their outreach deeds are most especially recognized during national disasters, calamities, outbreaks and other world-wide alarming situations.

Another agency that aids in discovering levels of health and diseases is the Health Protection Agency (HPA). According to HPA (2010) ‘The functions of the Agency are “to protect the community (or any part of the community) against infectious diseases and other dangers to health” (HPA Act 2004).’ This means that any changes in the level of health in a certain community especially those which are caused by the involvement of a certain person to dangerous materials/chemicals/equipments is being watched by the HPA. The agency is specifically designed to cater this kind of concerns and are tasked to prevent harmful incidences from occurring and to avoid breakouts if such situation occurs.

On the other hand, Primary Care Trust (PCT) is basically more specific in terms of care provision since they focus on a certain area assigned to them. For example, if Wandsworth is the area coverage of a certain PCT then they are specifically tasked to meet the needs of the people residing in that said place. They must do their best to reach out to every single resident and provide them the care that they need since this is seen as one of the health seeker’s privilege. When outbreaks happen PCT is also responsible for identifying the community’s status.

Word count: 351

Answer 1 – 1.2

An epidemiological study last 2007 in Africa showed a significant increase in incidence rate as seen in Appendix A table 1 [page 20]. Over all, from the year 2006 to 2007, there was an additional 0.9% of cases added leaving the incidence data markedly higher than the number of prevalence cases. The 2015 target prevalence rate was set to 384 per 100,000 population. The current surveillance displayed 692 cases per 100,000 population. The number of deaths related to the TB disease even displayed a more erratic rate. Mortality rate was 230 per 100,000 population per year with a target number of 39 for this coming 2015. This means that Africa still has a long way to go in reducing the number of cases (deaths and incidence), eight years might be substantially enough from detection to management process but all are still in the hands of the health care providers, organisations and programmes involved with it.

Referring still to table 1, multidrug-resistant TB cases’ percentage is at the same time spiking together with the incidence rate. The only positive projection showed by the tables is the DOTC case detection rates which have been meeting the desired goals of the anti-TB programme. Additionally, there is a steady increase in new sputum smear (positive/negative), new extrapulmonary, relapse and retreatment notifications. On table 2 [page 20], the unfavourable outcomes percentages resulted to death, failures, defaults, transfers and non evaluation. Large rates of new sputum smear positive cases lead to death, defaults, transfers and nonevalutaion while new sputum smear negative cases lead to huge number of deaths and defaults. Same thing goes with new extrapulmonary cases but few cases resulted to failure alone. Retreatment cases were also high which resulted to all unpleasant factors. The DOTS coverage have been performing well since 2003 and above, but treatment plans did not go well throughout the significant period although case detection rates were all good. The problem significantly lies on the treatment management and behaviour. Case detection rates were already found to be greatly improved which means areas on management plans are now becoming the eye of objectives.

Diabetes rates in Africa weren’t that high (see Appendix B image 1 page 21). Table 3 Appendix B shows the population sample for the diabetes case prediction. Only 3-5% in ages 35-64 years old is affected although this can increase significantly or double up in several years. Africa did not either enter the roll of leading countries who are likely to be part of the world’s highest diabetes cases for both year 2000 and 2030 prediction. Compared to the TB disease rates, diabetes is more likely less of a concern for the health organisations and all efforts must be concentrated on TB prevention and eradication.

Word count: 454

Answer 1 – 1.3

The tuberculosis (TB) case report show a gradual annual increase from the year 2005 to 2009 on the number of people infected in United Kingdom with exception on the year 2007 where the cases dropped down to -0.7%. England has the largest number of TB cases reaching to several thousands while the other countries are only having an average of hundreds and less. The country that got the lowest rate of cases was Northern Ireland with year 2005 as the highest. The table showed that the measures taken to lower down the incident rate were clearly effective. This situation was, however, opposite with Scotland, England and Wales. Although the second and third countries aforementioned showed a small dip in the percentage of cases for one particular year, the consistency of disease multiplication outweighed the occurrence of the small unappreciable fluctuation.

The second chart regarding the regional cases of tuberculosis seems to have the ability to catch the reader’s eyes. Obviously, London has the highest number of cases and this is quite expected and logically true. The city is known for its multicultural and multidiverse race, this means that the approach can become a lot harder since each culture has its own unique characteristics towards health care. When a certain act is done in order to reduce the number of incidence, different people with distinct customs will react to this inimitably and this is one factor that can greatly affect the goal of the national health agencies to lower down and eliminate such disease. South East, West Midlands, Yorkshire and the Humber showed a constant climb in the number of cases. South West and North West both have a steady rate with the year 2009 as the highest. East Midlands, East of England and North East had unpredictable fluctuations. Generally, the gap of cases between London and the other regions range from 2500 to 3000. The diagram clearly gave out a conclusion that the scope of area and population mass are just few factors that can give out a good relation on the incidence rate.

Word count: 345

Answer 1 – 1.4

The effectiveness of the different approaches and strategies in controlling obesity (a noncommunicable disease) and malaria – a communicable one, is greatly shown on the ability of public health teams and organisations to prevent and control the spread of the certain disease in a community. Since the target is laid locally per se, the method becomes more efficient especially when a national post implementation survey is done to check whether the situation has calmed down. Aiming for a group-by-group intervention can make the planned solution and even the epidemiological study more specific and viewed as a case-to-case basis. The epidemiological study is one very important strategy since it determines the incidence and prevalence of such disease in a given area. The results of the epidemiological study are then used as a basis for planning for actions, implementing activities and decision as to whether the disease occurrence has become extensive or not. Due to this information gathered, the extension in terms of number of cases of such disease can be halted. Various programmes will be implemented by several organisations. After some period of time, another survey will be done to check for improvements or worsening of the identified incident.

For noncommunicable diseases such as obesity, also known as the leading factor for hypertension and diabetes, activities will more likely be related to information dissemination through health promotion and education. Usually, programmes will be divided into the following categories: promotion, prevention, curative and rehabilitation. This will allow better results since this can prevent further occurrence through promotion of health and prevention, eliminates cases through curative approach and prevents death rates through rehabilitation. Bogle (2007) states that ‘Prevention is ultimately the most effective strategy.’ This is not only applicable to one disease but to the rest of the identified diseases as well. Communicable diseases, however, does the same programmes but are a lot more extensive and thorough since the rate of increase is greater compared to those diseases which are noncommunicable.

Due to several approaches and strategies done by the public health organisations, diseases which are considered to be very detrimental have been isolated and controlled. However, some of these strategies are proven to be less efficient in TB control basing from the given chart of TB infected people in the United Kingdom.

Word count: 376

Answer 2 – 2.1

There are current priorities in service provision for those people infected with Chlamydia particularly in United Kingdom. One priority recognized comes in increasing epidemiological studies which involves determining the best diagnostic procedure/test. Greenhouse (n.d.) states that:

[t]he poor sensitivity and specificity of clinical signs in symptomatic pelvic infection have long been demonstrated by laparoscopy, which is frequently normal despite pain and proven infection.[4] Laparasocopy has been shown to be inaccurate when audited by fimbrial histology,[5] casting doubt on the findings of some classic epidemiological studies. 

A more extensive research and study must be implemented in order to permanently eradicate diagnostic errors which are proven to be one of the main hindrances in better quality health care provision. Service expansion recently underwent a modification through implementing a national screening program since the appointment of such responsibility to the local sectors did not give out a good result despite the lengthy and expensive measures undertaken (‘Parliamentary business’, 2010). The first intervention turned out to be a failure in the sense that the PCTs weren’t able to properly handle the given responsibility. However, this wasn’t the Primary Care Trust’s fault since according to the Chairman of the Committee of Public Accounts, Edward Leigh (n.d. as cited in ‘Parliamentary business’ 2010):

…the responsibility for delivering a national initiative is pushed down to local level, with little thought about the mechanisms and interventions needed at national and regional level to maintain efficiency and momentum.

Another priority identified is the effective clinical prevention services and high quality sexual health. Prevention is always the key to a most cost effective strategy. Further seen priority is most likely focused on the curative process since when such infection is not treated; it can result to devastating health problems e.g. pelvic inflammatory diseases, chronic pain, infertility.

Approaches to service provision for people with Chlamydia have become more reachable due to the presence of PCTs. Screening and treatment have been widely dispersed; gaps and other necessary trainings have been continually identified and developed in order to avoid the probability of wrong diagnoses, incorrect treatments and wastage of resources. The service provision have become nationwide and this thoroughly helped towards the goal of the National Chlamydia Screening Programme (2010) which is to ‘…meet current targets of 17 per cent testing in community outside GUM and work towards levels of 35 to 50 per cent overall in the community and GUM.’

Word count: 398

Answer 2 – 2.2

Determining the HIV prevalence rate for health care provision becomes the basis in formation of planning and activities to be implemented. Knowing the root cause of such disease incidence helps in targeting the specific issue, this assists in making the designed programmes to become speedy and efficient. It’s like eliminating the need to go around the bushes by knowing one direct responsible path. The requirements needed for health care provision will always depend on how the initial processes turned out. For example, if a certain area has been found to have an alarming number of HIV infected cases then this would require adept resources. Being able to have a partial outlook on the current condition of the outbreak can help in allocating the resources well, implement prioritization and provide the right information that the public needs. The ‘Human Sciences Research Council’ (n.d.) states that ‘The HIV and AIDS and STI Strategic Plan recognises monitoring and evaluation (M&E) as an important policy and management tool.’ Just how explicit the strategies and methods of the UK in battling against HIV are, this is exactly how rigid the health care service provision are too. The levels of HIV prevalence will tell which state actions are then taken by the whole sectors and organisations involved. Consequently, this will pick the necessary requirements to properly address the health concerns and the identified causes will be closely monitored, further investigation will even be done to check whether new form of transmissions has developed. More preventive measures will also be implemented since this can avoid occurrence.

The importance of determining the grounds for HIV disease growth also lies in the significance of being able to properly educate the people (part of the requirement implementation strategy) and identify measures that can help avoid such occurrence by educating the identified vulnerable group. Identification of measures matches up with the causes of HIV. In general, the relationship between HIV prevalence, causes and requirements are intertwined and one area will always look up the other area or else there will be difficulty in the means of eradicating the problem.

Word count: 349

Answer 2 – 2.3

The impact of tobacco smoking in the health service provision planning in the future is the increase in greater prevention investment according to the ‘NAO Report on tackling health inequalities: References to smoking’ (n.d.). The continuous increase on the number of tobacco smokers must have made the awareness campaign become stronger due to the adaptation of the phrase ‘prevention is always better than cure’. Health officials are aware of the challenging situation that nicotine addicts must overcome, that is why there is no better way than preventing the people from engaging in this kind of vice.

One study also proved the necessity of obesity reduction in relation to the good declining rates of smokers. According to Stewart (2009), it is necessary that both of the issues must be addressed with importance altogether because ‘If past obesity trends continue unchecked, the negative effects on the health of the U.S. population will increasingly outweigh the positive effects gained from declining smoking rates.’ This suggests that the impact of tobacco smoking not only touches one area of a health service programme which is the nicotine dependence eradication since the effect can also ruin other health service concerns such as the anti-diabetes/obesity campaign. Due to the ability of smoking problems to influence other existing health care problems, the impact to future health service provision planning might result to a more rigid and tight policies. This can become a good ground for issuing a mandatory result that consists of a target goal. The key to the ability of the entire nation to implement such challenging actions or interventions would come from the willingness of the health officials, organisations and teams to introduce the planned services and strategies instantly. We are already running out of time since the disease trend itself is presenting a gradual increase, there shall be no more excuses made and everyone must also be called to work hand-in-hand.

Word count: 316

Answer 2 – 2.4

People who have been suffering from obesity require professional help especially that today’s trend with regards to unhealthy lifestyle effects have been increasing. One organisation that can effectively deliver out a service for free is the National Obesity Forum (NOF). Most of today’s health ogranisations have been becoming alarmed with the lack of preventive measures that people must be exercising. NOF is one strategy implemented due to the alarming disease rates, according to them:

[w]e are particularly concerned with the lack of focus on prevention and structured management of overweight and obese individuals in primary care and the effect this has on society. Obesity, as a disease, is an issue which affects not just the health service but has a knock-on effect for the economy, industry, education and government. 

Aside from the preventive services, management is also one factor that needs to be taken into consideration. A lot of obese people are having a hard time in adjusting to their lifestyle (eating habits, exercise and etc.). This factor makes it so stressful for obese patients since altering habits can be difficult. The NOF has recently released a new standard for managing health service users namely the Very Low Energy Diets. Whichever institution a client may choose to acquire the health services needed, this standard can be helpful since this is where other private institutions are going to base their mode of care.

Another mode of management is the obesity surgery; this can be acquired from any institution of choice and has been proven to be an effective way to eliminate obesity although this hasn’t been found to be a cost-effective measure. According to the BBC News (2006), other measures that can be helpful for obesity eradication are the health checks, inclusion of sports facilities on housing projects, free obesity surgery services, taxation of food high in calories and providing cycle lanes.

Word count: 311

Answer 3 – 3.1

Priorities for the children’s well being must be based in accordance to the common health issues that the younger age groups are facing and are forecasted to be facing. Issues that children commonly face are infectious diseases, hazardous environment, abuse and malnutrition. Infectious diseases such as the H. Pylori which is commonly acquired by children in the low socioeconomic group are to be detected on children having the symptoms and treated early. Infectious diseases can result to debilitating long term effects and therefore appropriate health solutions such as prevention and immediate cure are important. A hazardous environment can include children having parents who are smoking tobacco on their presence, a non child safe room structure e.g. reachable hot surface and the likes. Accidents account for a large number of children who are handicapped and of mortality rates. The Child Safety Week (2010) states:

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[s]erious accidents can cause injuries to children that take months or years to heal. The psychological damage caused to children and their families often lasts a lifetime. Yet many of these accidents can be prevented by taking just a moment, to move a hot drink, check a smoke alarm, lock the medicine cabinet, switch off the dryer or take your foot off the accelerator.

A great deal of attention must also be given to this area in order to protect the children very well. Abuse is another issue that doesn’t only result to physical injury but wounding including the emotional aspect of the child. Health services such as the Child Protection Agency are the handlers of this issue and services provided are not only limited to one area since this require a continuous and multi service provision.

Another health condition that is quite taken for granted is the malnutrition issues that children are facing. Obesity is becoming a major concern and most of the cases involved people who have been overweight since birth. There’s no better way than addressing the problem by targeting the early ages since control is still better handled compared to obese people who are already living a considerable amount of years in their life. Generally speaking, all of these health hazards can be properly managed, controlled and prevented by the community care institutions that are responsible for care provision. As long as plans, interventions and goals are all taken seriously, health priorities for children will be met.

Word count: 392

Answer 3 – 3.2

The effectiveness of policies implemented for the well being of the children can be seen on the incorporation of laws to centres which involve child care. Several agencies which are regarded as a big contributor to implementing child health care were also being tapped and now are currently working together in one goal. According to Great Britain Department for Children, Schools and Families (2010), partnerships of organisations have been structured and designed in order to allow early incorporation of child health care services, this includes the involvement of PCTs and other local health authorities. Due to the modifications made in the health continuity care strategy, several services particularly those which targets child care have been found to be very effective. Modifications also resulted to the birth of other policies or refinement of rules in order to create a better way of care provision.

However, although some of the strategies and systems have been found to be effective in dealing with the problems concerning the children, there are still several areas that call out for immediate and rigid intervention. Such cases would include improvement of outcomes for looked after children and improving collaboration with health sectors. These areas have proven to be quite unsatisfactory in meeting the desired outcomes. Authorities have been constantly finding ways in order to promote the strategies which were being set. Parental support is also incorporated as a way to effectively address the issues of the children’s welfare. Community programmes have been constantly monitored and being remodeled especially on today’s growing crisis. The mode of care is being matched up with the current situation in order to increase the feasibility of the designed plans, strategies, policies and systems. Overall, the impact of the regulations that are set in order to increase the progress of outcomes on the child’s care has been moderately effective. Several regulations need to be reconstructed and reviewed while other policies need more action.

Word count: 317

Answer 3 – 3.3

Several changes still need to be implemented for the children’s well being. These changes include ‘promoting the social and emotional wellbeing of children in primary education’ (National Institute for Health and Clinical Excellence, 2008), educational information dissemination targeting children’s parents, social reform, restructuring of inter organisational cooperation and widening of social programmes on communities. The primary education has been considered to be one of the crucial stages of children since this is the point where their values are being honed and how their emotional response is being triggered by the numerous social elements present in their environment. Human behaviour is shaped according to how people are being raised and the establishment of a more sold foundation is the key to decrease health behaviours which are very dangerous.

Educating parents must also be done in every community since this is one of the effective ways to help and guide the direct carer of the child’s wellbeing. Social workers must also concentrate not only to the child’s condition alone but also in looking after how his/her environment has been affecting the child. Parenting programmes and activities in coordination with other worker organisations can be done since this can help employers become sensitive to the needs of their workers. The current environment right now is already requiring unique ways to approach every dilemma. Pressures coming from the working environment that are affecting every working household especially parents are very much affected with this type of situation. There is too much demand from work leaving other responsibilities in life abandoned which are seen to be supposedly a lot more important. We cannot deny the importance of jobs now a days and neglecting them on the other hand is neither the best option. The greater solution would be to allow the different sectors to join together and cooperate so that each side will be fairly heard, considered and met. Having this done, we can say that a social reform and inter organisational linkages have been built. Adopting a “child friendly” logo in all areas can absolutely help lessen the burden that children are now unconsciously facing.

Word count: 350

Answer 3 – 3.4

Note: Please refer to the table cited in Appendix C [page 22]

Inculcating the significance of exercise early on the child’s lifestyle not only increases their wellbeing during their childhood days but it also allows them to be acquainted with such health wellness practice. Even during the child’s infancy, passive exercise had already been found to be a very effective way to develop the child’s muscular and skeletal growth. Primary children are especially known to be hyper active in terms of activities and making exercise as one of their day-to-day activities can help them not only physically but in all aspects. One of the goals enumerated is the importance of the child to express a positive attitude towards exercise; this can encourage the children to become cooperative and it helps build a positive effect on them thus allowing them to love the feeling of having their bodies on the move. Teachers must also always point out what advantages they will be getting in a simple manner or in a method wherein children would appreciate and understand. This can be done by placing a picture of a child’s body in a board while exercising; every movement would then be matched up with the certain part of the body that has benefited the move.

Implementing a special week for a family sports fest won’t only target the children’s wellbeing but it also fosters parental or family bonding. This can be made successful by asking coordination with family organisations that exists in a community. Social community care organisations or sectors can also be invited and allow this opportunity to become part of the pilot testing of the effectivity of the planned program. This kind of activity can help both related sectors to work together and become one or unified on their goal. It also increases the effectivity of the goals targeted for the different sectors involved. Continuity of the exercise activity can even go as far as having interschool competitions; this can be introduced to primary and tertiary level institutions.

Word count: 325

References

BBC News, 2006. Obesity ‘could bankrupt the NHS’ [Online]. Available at: http://news.bbc.co.uk/2/hi/health/6180991.stm [Accessed 26 July 2010]

Bogle, V., 2007. Haringey Obesity Strategy 2007-2010 [Online]. p.12. Available at: http://www.haringey.nhs.uk/services/specialist/care_pathways_and_guidelines/obesity/obesity_strategy_adults.pdf [Accessed 26 July 2010]

Child Safety Week, 2010. The ‘Make time for safety’ theme [Online]. Available at: http://www.childsafetyweek.org.uk/child-safety-week/ [Accessed 26 July 2010]

Great Britain Department for Children, Schools and Families, 2010. Sure Start children’s centres: statutory guidance: response to the consultation [Online]. London: Great Britain. Department for Children, Schools and Families. Available at: http://www.scie-socialcareonline.org.uk/profile.asp?guid=5bcdbe7b-0d02-46f4-a984-33f856a7ef34 [Accessed 26 July 2010]

Greenhouse, P., n.d. The 4th Bandolier Conference: Chlamydia. Perspectives from the hospital [Online]. Available at: http://www.medicine.ox.ac.uk/bandolier/bandopubs/bandocon4/chlamyd.html#Heading4 [Accessed 26 July 2010]

Health Protection Agency, 2010. What the Health Protection Agency Does? [Online]. Available at: http://www.hpa.org.uk/AboutTheHPA/WhatTheHealthProtectionAgencyDoes/ [Accessed 25 July 2010]

‘Human Sciences Research Council’, n.d. Social Aspects of HIV/AIDS and Health [Online]. Available at: http://www.hsrc.ac.za/SAHA.phtml [Accessed 26 July 2010]

‘NAO Report on tackling health inequalities: References to smoking’, n.d. Key Recommendations [Online]. p.1. Available at: http://www.ash.org.uk/files/documents/ASH_736.pdf [Accessed 26 July 2010]

‘National Chlamydia Screening Programme’, 2010. Commissioning [Online]. Available at: http://www.chlamydiascreening.nhs.uk/ps/commissioners/summary.html [Accessed 26 July 2010]

National Institute for Health and Clinical Excellence, 2008. Promoting children’s social and emotional wellbeing in primary education [Online]. p.3. Available at: http://www.headsupscotland.co.uk/documents/PH012Guidance.pdf [Accessed 28 July 2010]

National Obesity Forum, n.d. Welcome to the National Obesity Forum [Online]. Available at: http://www.nationalobesityforum.org.uk/ [Accessed 26 July 2010]

‘Parliamentary business’, 2010. Report examines chlamydia screening program [Online]. Available at: http://www.parliament.uk/business/news/2010/01/report-examines-chlamydia-screening-programme/ [Accessed 26 July 2010]

Stewart,S., Cutler, D. & Rosen, A., 2009. The New England Journal of Medicine. Forecasting the Effects of Obesity and Smoking on U.S. Life Expectancy [Online]. 361, p.2252-2260. Available at: http://www.nejm.org/doi/full/10.1056/NEJMsa0900459 [Accessed 26 July 2010]

Wild, S., Roglic, G., Green, A., Sicree, R. & King, H., 2004. Diabetes Care. Global prevalence of diabetes [Online]. 27 (5), p.1048. Available at: http://www.who.int/diabetes/facts/en/diabcare0504.pdf [Accessed 30 July 2010]

World Health Organization, 2010. Global Tuberculosis Control WHO Report 2009 [Online]. p.145. Available at: http://apps.who.int/globalatlas/predefinedReports/TB/PDF_Files/zaf.pdf [Accessed 29 July 2010]

World Health Organization, 2010. Prevalence of Diabetes [Online]. Available at: http://www.who.int/diabetes/actionnow/en/mapdiabprev.pdf [Accessed 29 July 2010]

The different agencies responsible in identifying levels of health and disease in communities are the following: World Health Organisation, Health Protection Agency and the Primary Care Trusts. This three may have different specifics in terms of their objectives and targets but they are commonly working on towards a safer and health risk-free environment.

The World Health Organisation (WHO) functions are mainly in providing support and services to the different health care institutions around the globe especially those who primarily need it e.g. low performing health care providers on a per country basis, newly debilitated areas and the likes. The organisation also joins forces with other necessary health care organisations in order for them to acquire help in the implementation of certain programmes or activities locally. Their outreach deeds are most especially recognized during national disasters, calamities, outbreaks and other world-wide alarming situations.

Another agency that aids in discovering levels of health and diseases is the Health Protection Agency (HPA). According to HPA (2010) ‘The functions of the Agency are “to protect the community (or any part of the community) against infectious diseases and other dangers to health” (HPA Act 2004).’ This means that any changes in the level of health in a certain community especially those which are caused by the involvement of a certain person to dangerous materials/chemicals/equipments is being watched by the HPA. The agency is specifically designed to cater this kind of concerns and are tasked to prevent harmful incidences from occurring and to avoid breakouts if such situation occurs.

On the other hand, Primary Care Trust (PCT) is basically more specific in terms of care provision since they focus on a certain area assigned to them. For example, if Wandsworth is the area coverage of a certain PCT then they are specifically tasked to meet the needs of the people residing in that said place. They must do their best to reach out to every single resident and provide them the care that they need since this is seen as one of the health seeker’s privilege. When outbreaks happen PCT is also responsible for identifying the community’s status.

Word count: 351

Answer 1 – 1.2

An epidemiological study last 2007 in Africa showed a significant increase in incidence rate as seen in Appendix A table 1 [page 20]. Over all, from the year 2006 to 2007, there was an additional 0.9% of cases added leaving the incidence data markedly higher than the number of prevalence cases. The 2015 target prevalence rate was set to 384 per 100,000 population. The current surveillance displayed 692 cases per 100,000 population. The number of deaths related to the TB disease even displayed a more erratic rate. Mortality rate was 230 per 100,000 population per year with a target number of 39 for this coming 2015. This means that Africa still has a long way to go in reducing the number of cases (deaths and incidence), eight years might be substantially enough from detection to management process but all are still in the hands of the health care providers, organisations and programmes involved with it.

Referring still to table 1, multidrug-resistant TB cases’ percentage is at the same time spiking together with the incidence rate. The only positive projection showed by the tables is the DOTC case detection rates which have been meeting the desired goals of the anti-TB programme. Additionally, there is a steady increase in new sputum smear (positive/negative), new extrapulmonary, relapse and retreatment notifications. On table 2 [page 20], the unfavourable outcomes percentages resulted to death, failures, defaults, transfers and non evaluation. Large rates of new sputum smear positive cases lead to death, defaults, transfers and nonevalutaion while new sputum smear negative cases lead to huge number of deaths and defaults. Same thing goes with new extrapulmonary cases but few cases resulted to failure alone. Retreatment cases were also high which resulted to all unpleasant factors. The DOTS coverage have been performing well since 2003 and above, but treatment plans did not go well throughout the significant period although case detection rates were all good. The problem significantly lies on the treatment management and behaviour. Case detection rates were already found to be greatly improved which means areas on management plans are now becoming the eye of objectives.

Diabetes rates in Africa weren’t that high (see Appendix B image 1 page 21). Table 3 Appendix B shows the population sample for the diabetes case prediction. Only 3-5% in ages 35-64 years old is affected although this can increase significantly or double up in several years. Africa did not either enter the roll of leading countries who are likely to be part of the world’s highest diabetes cases for both year 2000 and 2030 prediction. Compared to the TB disease rates, diabetes is more likely less of a concern for the health organisations and all efforts must be concentrated on TB prevention and eradication.

Word count: 454

Answer 1 – 1.3

The tuberculosis (TB) case report show a gradual annual increase from the year 2005 to 2009 on the number of people infected in United Kingdom with exception on the year 2007 where the cases dropped down to -0.7%. England has the largest number of TB cases reaching to several thousands while the other countries are only having an average of hundreds and less. The country that got the lowest rate of cases was Northern Ireland with year 2005 as the highest. The table showed that the measures taken to lower down the incident rate were clearly effective. This situation was, however, opposite with Scotland, England and Wales. Although the second and third countries aforementioned showed a small dip in the percentage of cases for one particular year, the consistency of disease multiplication outweighed the occurrence of the small unappreciable fluctuation.

The second chart regarding the regional cases of tuberculosis seems to have the ability to catch the reader’s eyes. Obviously, London has the highest number of cases and this is quite expected and logically true. The city is known for its multicultural and multidiverse race, this means that the approach can become a lot harder since each culture has its own unique characteristics towards health care. When a certain act is done in order to reduce the number of incidence, different people with distinct customs will react to this inimitably and this is one factor that can greatly affect the goal of the national health agencies to lower down and eliminate such disease. South East, West Midlands, Yorkshire and the Humber showed a constant climb in the number of cases. South West and North West both have a steady rate with the year 2009 as the highest. East Midlands, East of England and North East had unpredictable fluctuations. Generally, the gap of cases between London and the other regions range from 2500 to 3000. The diagram clearly gave out a conclusion that the scope of area and population mass are just few factors that can give out a good relation on the incidence rate.

Word count: 345

Answer 1 – 1.4

The effectiveness of the different approaches and strategies in controlling obesity (a noncommunicable disease) and malaria – a communicable one, is greatly shown on the ability of public health teams and organisations to prevent and control the spread of the certain disease in a community. Since the target is laid locally per se, the method becomes more efficient especially when a national post implementation survey is done to check whether the situation has calmed down. Aiming for a group-by-group intervention can make the planned solution and even the epidemiological study more specific and viewed as a case-to-case basis. The epidemiological study is one very important strategy since it determines the incidence and prevalence of such disease in a given area. The results of the epidemiological study are then used as a basis for planning for actions, implementing activities and decision as to whether the disease occurrence has become extensive or not. Due to this information gathered, the extension in terms of number of cases of such disease can be halted. Various programmes will be implemented by several organisations. After some period of time, another survey will be done to check for improvements or worsening of the identified incident.

For noncommunicable diseases such as obesity, also known as the leading factor for hypertension and diabetes, activities will more likely be related to information dissemination through health promotion and education. Usually, programmes will be divided into the following categories: promotion, prevention, curative and rehabilitation. This will allow better results since this can prevent further occurrence through promotion of health and prevention, eliminates cases through curative approach and prevents death rates through rehabilitation. Bogle (2007) states that ‘Prevention is ultimately the most effective strategy.’ This is not only applicable to one disease but to the rest of the identified diseases as well. Communicable diseases, however, does the same programmes but are a lot more extensive and thorough since the rate of increase is greater compared to those diseases which are noncommunicable.

Due to several approaches and strategies done by the public health organisations, diseases which are considered to be very detrimental have been isolated and controlled. However, some of these strategies are proven to be less efficient in TB control basing from the given chart of TB infected people in the United Kingdom.

Word count: 376

Answer 2 – 2.1

There are current priorities in service provision for those people infected with Chlamydia particularly in United Kingdom. One priority recognized comes in increasing epidemiological studies which involves determining the best diagnostic procedure/test. Greenhouse (n.d.) states that:

[t]he poor sensitivity and specificity of clinical signs in symptomatic pelvic infection have long been demonstrated by laparoscopy, which is frequently normal despite pain and proven infection.[4] Laparasocopy has been shown to be inaccurate when audited by fimbrial histology,[5] casting doubt on the findings of some classic epidemiological studies. 

A more extensive research and study must be implemented in order to permanently eradicate diagnostic errors which are proven to be one of the main hindrances in better quality health care provision. Service expansion recently underwent a modification through implementing a national screening program since the appointment of such responsibility to the local sectors did not give out a good result despite the lengthy and expensive measures undertaken (‘Parliamentary business’, 2010). The first intervention turned out to be a failure in the sense that the PCTs weren’t able to properly handle the given responsibility. However, this wasn’t the Primary Care Trust’s fault since according to the Chairman of the Committee of Public Accounts, Edward Leigh (n.d. as cited in ‘Parliamentary business’ 2010):

…the responsibility for delivering a national initiative is pushed down to local level, with little thought about the mechanisms and interventions needed at national and regional level to maintain efficiency and momentum.

Another priority identified is the effective clinical prevention services and high quality sexual health. Prevention is always the key to a most cost effective strategy. Further seen priority is most likely focused on the curative process since when such infection is not treated; it can result to devastating health problems e.g. pelvic inflammatory diseases, chronic pain, infertility.

Approaches to service provision for people with Chlamydia have become more reachable due to the presence of PCTs. Screening and treatment have been widely dispersed; gaps and other necessary trainings have been continually identified and developed in order to avoid the probability of wrong diagnoses, incorrect treatments and wastage of resources. The service provision have become nationwide and this thoroughly helped towards the goal of the National Chlamydia Screening Programme (2010) which is to ‘…meet current targets of 17 per cent testing in community outside GUM and work towards levels of 35 to 50 per cent overall in the community and GUM.’

Word count: 398

Answer 2 – 2.2

Determining the HIV prevalence rate for health care provision becomes the basis in formation of planning and activities to be implemented. Knowing the root cause of such disease incidence helps in targeting the specific issue, this assists in making the designed programmes to become speedy and efficient. It’s like eliminating the need to go around the bushes by knowing one direct responsible path. The requirements needed for health care provision will always depend on how the initial processes turned out. For example, if a certain area has been found to have an alarming number of HIV infected cases then this would require adept resources. Being able to have a partial outlook on the current condition of the outbreak can help in allocating the resources well, implement prioritization and provide the right information that the public needs. The ‘Human Sciences Research Council’ (n.d.) states that ‘The HIV and AIDS and STI Strategic Plan recognises monitoring and evaluation (M&E) as an important policy and management tool.’ Just how explicit the strategies and methods of the UK in battling against HIV are, this is exactly how rigid the health care service provision are too. The levels of HIV prevalence will tell which state actions are then taken by the whole sectors and organisations involved. Consequently, this will pick the necessary requirements to properly address the health concerns and the identified causes will be closely monitored, further investigation will even be done to check whether new form of transmissions has developed. More preventive measures will also be implemented since this can avoid occurrence.

The importance of determining the grounds for HIV disease growth also lies in the significance of being able to properly educate the people (part of the requirement implementation strategy) and identify measures that can help avoid such occurrence by educating the identified vulnerable group. Identification of measures matches up with the causes of HIV. In general, the relationship between HIV prevalence, causes and requirements are intertwined and one area will always look up the other area or else there will be difficulty in the means of eradicating the problem.

Word count: 349

Answer 2 – 2.3

The impact of tobacco smoking in the health service provision planning in the future is the increase in greater prevention investment according to the ‘NAO Report on tackling health inequalities: References to smoking’ (n.d.). The continuous increase on the number of tobacco smokers must have made the awareness campaign become stronger due to the adaptation of the phrase ‘prevention is always better than cure’. Health officials are aware of the challenging situation that nicotine addicts must overcome, that is why there is no better way than preventing the people from engaging in this kind of vice.

One study also proved the necessity of obesity reduction in relation to the good declining rates of smokers. According to Stewart (2009), it is necessary that both of the issues must be addressed with importance altogether because ‘If past obesity trends continue unchecked, the negative effects on the health of the U.S. population will increasingly outweigh the positive effects gained from declining smoking rates.’ This suggests that the impact of tobacco smoking not only touches one area of a health service programme which is the nicotine dependence eradication since the effect can also ruin other health service concerns such as the anti-diabetes/obesity campaign. Due to the ability of smoking problems to influence other existing health care problems, the impact to future health service provision planning might result to a more rigid and tight policies. This can become a good ground for issuing a mandatory result that consists of a target goal. The key to the ability of the entire nation to implement such challenging actions or interventions would come from the willingness of the health officials, organisations and teams to introduce the planned services and strategies instantly. We are already running out of time since the disease trend itself is presenting a gradual increase, there shall be no more excuses made and everyone must also be called to work hand-in-hand.

Word count: 316

Answer 2 – 2.4

People who have been suffering from obesity require professional help especially that today’s trend with regards to unhealthy lifestyle effects have been increasing. One organisation that can effectively deliver out a service for free is the National Obesity Forum (NOF). Most of today’s health ogranisations have been becoming alarmed with the lack of preventive measures that people must be exercising. NOF is one strategy implemented due to the alarming disease rates, according to them:

[w]e are particularly concerned with the lack of focus on prevention and structured management of overweight and obese individuals in primary care and the effect this has on society. Obesity, as a disease, is an issue which affects not just the health service but has a knock-on effect for the economy, industry, education and government. 

Aside from the preventive services, management is also one factor that needs to be taken into consideration. A lot of obese people are having a hard time in adjusting to their lifestyle (eating habits, exercise and etc.). This factor makes it so stressful for obese patients since altering habits can be difficult. The NOF has recently released a new standard for managing health service users namely the Very Low Energy Diets. Whichever institution a client may choose to acquire the health services needed, this standard can be helpful since this is where other private institutions are going to base their mode of care.

Another mode of management is the obesity surgery; this can be acquired from any institution of choice and has been proven to be an effective way to eliminate obesity although this hasn’t been found to be a cost-effective measure. According to the BBC News (2006), other measures that can be helpful for obesity eradication are the health checks, inclusion of sports facilities on housing projects, free obesity surgery services, taxation of food high in calories and providing cycle lanes.

Word count: 311

Answer 3 – 3.1

Priorities for the children’s well being must be based in accordance to the common health issues that the younger age groups are facing and are forecasted to be facing. Issues that children commonly face are infectious diseases, hazardous environment, abuse and malnutrition. Infectious diseases such as the H. Pylori which is commonly acquired by children in the low socioeconomic group are to be detected on children having the symptoms and treated early. Infectious diseases can result to debilitating long term effects and therefore appropriate health solutions such as prevention and immediate cure are important. A hazardous environment can include children having parents who are smoking tobacco on their presence, a non child safe room structure e.g. reachable hot surface and the likes. Accidents account for a large number of children who are handicapped and of mortality rates. The Child Safety Week (2010) states:

[s]erious accidents can cause injuries to children that take months or years to heal. The psychological damage caused to children and their families often lasts a lifetime. Yet many of these accidents can be prevented by taking just a moment, to move a hot drink, check a smoke alarm, lock the medicine cabinet, switch off the dryer or take your foot off the accelerator.

A great deal of attention must also be given to this area in order to protect the children very well. Abuse is another issue that doesn’t only result to physical injury but wounding including the emotional aspect of the child. Health services such as the Child Protection Agency are the handlers of this issue and services provided are not only limited to one area since this require a continuous and multi service provision.

Another health condition that is quite taken for granted is the malnutrition issues that children are facing. Obesity is becoming a major concern and most of the cases involved people who have been overweight since birth. There’s no better way than addressing the problem by targeting the early ages since control is still better handled compared to obese people who are already living a considerable amount of years in their life. Generally speaking, all of these health hazards can be properly managed, controlled and prevented by the community care institutions that are responsible for care provision. As long as plans, interventions and goals are all taken seriously, health priorities for children will be met.

Word count: 392

Answer 3 – 3.2

The effectiveness of policies implemented for the well being of the children can be seen on the incorporation of laws to centres which involve child care. Several agencies which are regarded as a big contributor to implementing child health care were also being tapped and now are currently working together in one goal. According to Great Britain Department for Children, Schools and Families (2010), partnerships of organisations have been structured and designed in order to allow early incorporation of child health care services, this includes the involvement of PCTs and other local health authorities. Due to the modifications made in the health continuity care strategy, several services particularly those which targets child care have been found to be very effective. Modifications also resulted to the birth of other policies or refinement of rules in order to create a better way of care provision.

However, although some of the strategies and systems have been found to be effective in dealing with the problems concerning the children, there are still several areas that call out for immediate and rigid intervention. Such cases would include improvement of outcomes for looked after children and improving collaboration with health sectors. These areas have proven to be quite unsatisfactory in meeting the desired outcomes. Authorities have been constantly finding ways in order to promote the strategies which were being set. Parental support is also incorporated as a way to effectively address the issues of the children’s welfare. Community programmes have been constantly monitored and being remodeled especially on today’s growing crisis. The mode of care is being matched up with the current situation in order to increase the feasibility of the designed plans, strategies, policies and systems. Overall, the impact of the regulations that are set in order to increase the progress of outcomes on the child’s care has been moderately effective. Several regulations need to be reconstructed and reviewed while other policies need more action.

Word count: 317

Answer 3 – 3.3

Several changes still need to be implemented for the children’s well being. These changes include ‘promoting the social and emotional wellbeing of children in primary education’ (National Institute for Health and Clinical Excellence, 2008), educational information dissemination targeting children’s parents, social reform, restructuring of inter organisational cooperation and widening of social programmes on communities. The primary education has been considered to be one of the crucial stages of children since this is the point where their values are being honed and how their emotional response is being triggered by the numerous social elements present in their environment. Human behaviour is shaped according to how people are being raised and the establishment of a more sold foundation is the key to decrease health behaviours which are very dangerous.

Educating parents must also be done in every community since this is one of the effective ways to help and guide the direct carer of the child’s wellbeing. Social workers must also concentrate not only to the child’s condition alone but also in looking after how his/her environment has been affecting the child. Parenting programmes and activities in coordination with other worker organisations can be done since this can help employers become sensitive to the needs of their workers. The current environment right now is already requiring unique ways to approach every dilemma. Pressures coming from the working environment that are affecting every working household especially parents are very much affected with this type of situation. There is too much demand from work leaving other responsibilities in life abandoned which are seen to be supposedly a lot more important. We cannot deny the importance of jobs now a days and neglecting them on the other hand is neither the best option. The greater solution would be to allow the different sectors to join together and cooperate so that each side will be fairly heard, considered and met. Having this done, we can say that a social reform and inter organisational linkages have been built. Adopting a “child friendly” logo in all areas can absolutely help lessen the burden that children are now unconsciously facing.

Word count: 350

Answer 3 – 3.4

Note: Please refer to the table cited in Appendix C [page 22]

Inculcating the significance of exercise early on the child’s lifestyle not only increases their wellbeing during their childhood days but it also allows them to be acquainted with such health wellness practice. Even during the child’s infancy, passive exercise had already been found to be a very effective way to develop the child’s muscular and skeletal growth. Primary children are especially known to be hyper active in terms of activities and making exercise as one of their day-to-day activities can help them not only physically but in all aspects. One of the goals enumerated is the importance of the child to express a positive attitude towards exercise; this can encourage the children to become cooperative and it helps build a positive effect on them thus allowing them to love the feeling of having their bodies on the move. Teachers must also always point out what advantages they will be getting in a simple manner or in a method wherein children would appreciate and understand. This can be done by placing a picture of a child’s body in a board while exercising; every movement would then be matched up with the certain part of the body that has benefited the move.

Implementing a special week for a family sports fest won’t only target the children’s wellbeing but it also fosters parental or family bonding. This can be made successful by asking coordination with family organisations that exists in a community. Social community care organisations or sectors can also be invited and allow this opportunity to become part of the pilot testing of the effectivity of the planned program. This kind of activity can help both related sectors to work together and become one or unified on their goal. It also increases the effectivity of the goals targeted for the different sectors involved. Continuity of the exercise activity can even go as far as having interschool competitions; this can be introduced to primary and tertiary level institutions.

Word count: 325

References

BBC News, 2006. Obesity ‘could bankrupt the NHS’ [Online]. Available at: http://news.bbc.co.uk/2/hi/health/6180991.stm [Accessed 26 July 2010]

Bogle, V., 2007. Haringey Obesity Strategy 2007-2010 [Online]. p.12. Available at: http://www.haringey.nhs.uk/services/specialist/care_pathways_and_guidelines/obesity/obesity_strategy_adults.pdf [Accessed 26 July 2010]

Child Safety Week, 2010. The ‘Make time for safety’ theme [Online]. Available at: http://www.childsafetyweek.org.uk/child-safety-week/ [Accessed 26 July 2010]

Great Britain Department for Children, Schools and Families, 2010. Sure Start children’s centres: statutory guidance: response to the consultation [Online]. London: Great Britain. Department for Children, Schools and Families. Available at: http://www.scie-socialcareonline.org.uk/profile.asp?guid=5bcdbe7b-0d02-46f4-a984-33f856a7ef34 [Accessed 26 July 2010]

Greenhouse, P., n.d. The 4th Bandolier Conference: Chlamydia. Perspectives from the hospital [Online]. Available at: http://www.medicine.ox.ac.uk/bandolier/bandopubs/bandocon4/chlamyd.html#Heading4 [Accessed 26 July 2010]

Health Protection Agency, 2010. What the Health Protection Agency Does? [Online]. Available at: http://www.hpa.org.uk/AboutTheHPA/WhatTheHealthProtectionAgencyDoes/ [Accessed 25 July 2010]

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Stewart,S., Cutler, D. & Rosen, A., 2009. The New England Journal of Medicine. Forecasting the Effects of Obesity and Smoking on U.S. Life Expectancy [Online]. 361, p.2252-2260. Available at: http://www.nejm.org/doi/full/10.1056/NEJMsa0900459 [Accessed 26 July 2010]

Wild, S., Roglic, G., Green, A., Sicree, R. & King, H., 2004. Diabetes Care. Global prevalence of diabetes [Online]. 27 (5), p.1048. Available at: http://www.who.int/diabetes/facts/en/diabcare0504.pdf [Accessed 30 July 2010]

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