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This paper investigates the country India. Various student learning outcomes such as environmental health hazards, mortality and morbidity, and cost for healthcare were explored. Most of India’s population are living in impoverish conditions with limited access to healthcare. The population also have limited access to medication, running water, education, technology and financial resources. All these factors together lead to an increase in mortality rates due to an increase in the incidents in preventable diseases. This results in poor outcomes. Three nursing diagnoses are also formulated, and interventions implemented for each.
India is the seventh largest nation in the world and houses over a billion residents. The constitution guarantees free healthcare access to all its citizens; however, there is an urban and rural divide. Citizens living in the rural communities have limited access to healthcare and resources, while the urbanites have access to private hospitals. The lack of resources available to the citizens in the rural areas leads to an influx of preventable diseases such as HIV, diabetes, and hypertension; and waterborne diseases such as typhoid fever, dengue, cholera, and dysentery. The lack of immunizations leads many to suffer from polio and measles. The preventable disease could be reduced through education, and by providing basic resources such as vaccines.
Student Learning Outcomes
The biggest environmental hazards that plagues India is limited access to running water. India’s water supply mainly comes from rivers and streams. These reservoirs are polluted with waste matters from the community such as industrial effluents, chemical, fertilizers and pesticides. This affects the quality of the groundwater. Americans use running tap water that is chemically filtered; this decrease risk for individuals to be infected waterborne disease such cholera, typhoid, and dysentery. This is in comparison to these waterborne diseases plaguing India’s population due to the contaminated water supply.
There are many health factors hazards affecting the India’s citizens. These include HIV/AIDS cardiovascular disease, cancer, diabetes, and malnourishment. Approximately twenty two percent of the population in malnourished. There is a disparity in access to healthcare and equity of healthcare among the socioeconomic groups. Indian citizens pay for approximately 80% of their healthcare costs. This causes the people living in the rural area to be at a disadvantage. Access to the necessary treatment that is required is almost impossible as the bed to patient ratio in fifteen times lower in the rural area than in the urban areas. The United States of America is also plagued with some of these health hazards; however, there more access to healthcare and medications. There are also programs that are in place to health those who cannot burden the cost of hospital bill; these opportunities are not afforded to India’s citizens.
There has been a decrease in mortality in India leading to significant gains in life expectancy. Mortality in India is much more prominent in men than women. Many factors play into mortality such as location, access to healthcare, socioeconomic status, educational level on diseases prevention. “According to an article on morbidity in India, highly populated states like Punjab have a lower infant mortality rate and a better chance of living a longer life. The morbidity prevalence rates in these urban states are the highest rates in the country while the poorer states in the rural areas have a lower morbidity rate. According to the same article, one of the major cause of illnesses that occurs in children are acute in nature, while chronic illness affects the older population. The increase in incidents of chronic illnesses among the aged population will soon require special targeting and home health services (Ghosh, Arokiasamy 2010).
Healthcare in India is a state regulated body. It is not regulated solely by the government; therefore, care is dependent on the location of the residents and resources that are available. Many people in rural areas of India are subjected to poor health care regardless of their socioeconomic status; this is due to the location of healthcare facilities. Rural areas have limited access to primary care providers; they instead have something called “barefoot health workers”. Most doctors of these private health care facilities are under qualified.
Private health is not only costly, but the lack the knowledge and skills of trained personnel. When compared to the public sector(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4621381/2. Access to healthcare is one sided; residents residing in the urban areas have more access to quality health care while people living in the rural areas are double burdened with having a larger population, less access to quality care, more unhealthy residents. Even though India gained in over a half a century ago, access to quality healthcare is a luxury that can only be afforded by upper-class citizens. Poorer class citizens visit equally poor private health care providers and pays them beyond their capability; all while overlooking the public health unit that is available to them (Barik, Thorat 2015).
India has a high elderly population. Routine care clinics cannot keep up with the elderly population. There is great need for day-care centers, hospices, and in-home nursing care. There is also need for more training in healthcare for geriatric care “Indian elderly faces several social issues such as loneliness, elder abuse, neglect, lack of income security, and poor access to healthcare. They have a lack of polices and advance directive, palliative care, and end-of-life care (Adhikari, 2017)”.
According to UNICEF, India over two million children die every year from preventable diseases. Measles is the largest cause of death, which can be prevented by a vaccine. Over fifty three percent of children in India under 5 years old live without basic healthcare facilities. Poor children in India are three times more likely to die before their fiftieth birthday than children in other parts of the world. Indian girls are more likely to die before boys due to inequity of healthcare for females and males. Girls are often brought to health facilities in more advanced state of illness than boys and taken to less qualified doctors. As a result, girls are less likely to receive medicines and treatment they need (Sinha, 2008).
“In India, approximately eighty percent of all healthcare expenditures is out of pocket. This place a great number of families at risk for falling into poverty due to high health expenses (Vulnerable Children, 2017). According to an article on healthcare payment methods in India, a new social program has been announced. This program is called Rashtriya Swasthya Beema Yojna; it is designed to advocate for the poorer class citizen that cannot afford health care. This provides payment agreement between the residents and the health care provide for care provided. There are there methods of reimbursement for services; cost based, charged based, and prospective payment (Kumar & Sohal, 2008).
Nursing Diagnosis, STG, LTG, and Implementation
Nursing diagnosis: Risk for infection, related to limited healthcare access. The risk for infection increases due to the unavailability of resources that is available to the healthcare sector. The healthcare sector needs access that vaccines and other treatments to combat infestation with these preventable diseases.
Short Term Goal: have members of the community participate in programs pertaining to disease prevention within a three-month time frame. An intervention to expedite this goal would hosting forums in the community and provide information explaining why vaccinations and routine checkups are necessary in preventing and treating disease
Short Term Goal: To implement vaccination and wellness clinics for the residents. This could be achieved by collaborating with local organizations such as the Program for Appropriate Technology in Health (PATH) to initiate the vaccinations process and disease preventions. These goals will be achieved within 3 months; that is January 2019.
Long Term Goal: To expand health care clinics to the ninety percent of the vulnerable communities. This should be achieved within eighteen months. This goal could be achieved by obtaining financial assistant from the government. To achieve this goal, the community would be required to become involved in decision making and advocate for their right to healthcare. Evaluation of these goals will be dependent on the number of vaccines provided to the community and in the decline in the number of preventable diseases.
Nursing Diagnosis: Imbalanced nutrition, less than the body requires requirements related to lack of available food and water. Access to running water is one of the major problems of the Indian population. Lack of running water leads to waterborne diseases; this placed together with the unavailability of food leads to poor nutrition and depleted health status.
STG: To provide education on the importance of clean water sources in a one-month period. This goal can be achieved by having nurses along with health organizations provide education to the resident. This could be done in the form of community-based seminars.
STG: To establish reservoirs of clean water and to start a water purification system for the community. An intervention to achieve this goal would be to collaborate with the government and local organizations to help support a program for clean water. This goal could also be achieved within a one-moth time frame.
LTG: To implement resources to maintain clean water resources. This would involve having the government seek outside assistance from organizations such as the United States Agency for International Development (USAID) to provide information and assistance with maintaining clean water systems. This goal would be achieved within twelve-eighteen-month time frame. Evaluation of these goals would be based on the surge of clean water and the decline in waterborne diseases.
Nursing Diagnosis: Knowledge deficit, related to limited educational and technological resources. A vast number of citizens lacks the resources to improve the country’s infrastructure. These deficits make it difficult for the population to know what healthcare needs are necessary to prevent diseases.
STG: would be to have nurses start educational programs in the community to inform individuals on health risks and health promotions within a one-month time frame. This can be done by hosting community meetings with question and answer sessions.
STG: have resident verbalize their willingness to adopt what they learned to their daily lives in a bid to decrease the incident of illnesses. This can be achieved through resident participation in providing education to their communities. This goal can be achieved within a one-moth time frame.
LTG: To make healthcare promotions easier and expand on technological resources. This goal can be achieved by getting the government involved by providing easier access to technological resources within a fifteen month. These goals would be evaluated based on an increase of knowledge on disease prevention in the community and an actual decrease in the incident of these illnesses.
- Adhikari, P. (2017). Geriatric health care in India – Unmet needs and the way forward. Retrieved from http://www.amhsjournal.org/article.asp?issn=2321-4848;year=2017;volume=5;issue=1;spage=112;epage=114;aulast=Adhikari
- Barik, D., & Thorat, A. (2015). Issues of Unequal Access to Public Health in India. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4621381/
- CHILD Protection & Child Rights » Vulnerable Children » Children’s Issues » Child Health & Nutrition. (2017). Retrieved from http://www.childlineindia.org.in/child-health-and-nutrition-india.htm
- Ghosh, S., & Arokiasamy, P. (2010). Morbidity in India Trends, Patterns and Differentials. Improving Access and Efficiency in Public Health Services: Mid-term Evaluation of India’s National Rural Health Mission. Retrieved from 144-695. Retrieved September 24, 2018.
- Kumar, D., & Sohal, S. (2008). Overview of Health Care Expenditure & Healthcare Payment Methods in India. Retrieved from https://www.omicsonline.org/open-access/overview-of-health-care-expenditure–healthcare-payment-methods-in-india-2471-268X-1000154.pdf
- Sinha, K. (2008). 53% Indian kids under 5 lack healthcare. Retrieved from https://timesofindia.indiatimes.com/india/53-Indian-kids-under-5-lack-healthcare/articleshow/3019729.cms
- Statistics. (2013). Retrieved from https://www.unicef.org/infobycountry/india_statistics.html
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