International Health NUR 410 Community Focused Nursing Catherine T. Horat.
Transcript of International Health NUR 410 Community Focused Nursing Catherine T. Horat.
Community health nursing need for knowledge
• interactions with new immigrants
• client exposure to potential health hazards
• identification of potential risks
• awareness of health concerns worldwide has impact on health
State of World Health
• Life expectancy worldwide average 65 years
• Decrease in death rates
• Decrease in infant mortality
Comparison
• Developing Countries– Life expectancy
• 1950 40 years• 1995 64 years
– Infant mortality• 1950 287/1000 live
births by time reached age 5 years
• 1995 90/1000
• More Developed Countries– Life Expectancy
• 1950 67 years• 1995 77 years
– Infant Mortality• Varies with countries
Comparison
• Hong Kong 2.97• Germany 4.2 • Canada 4.82 • Greece 5.63 • Korea, South 7.18 • Canada 4.82
India 57.92 • China 25.28 • Mexico 21.69• Jamaica 12.81• KoreaNorth24.84 • Haiti 74.38
Overview of international health
• Health for All by year 2000– first proclaimed 1977 at World Health
Assembly
– reinforced 1978 at International Conference on Primary Health Care• where Alma Alta Kazakhstan• sponsored by WHO, UNICEF
– major components• health education• environmental sanitation• training village health workers• maternal/infant immunization & family
planning• local preventive programs• accessible, affordable tx• medication availability• nutrition programs• acceptance of traditional medicine
Global Designations
• Developed country– stable economy– industrial – Technology
• Lesser developed country– unstable economy– little industry or technology
Major international health organizations
• Private/voluntary
• Philanthropic
• Professional and technological
• Private and commercial
• Governmental
• Intergovernmental
International health and economic development
• Divert financial resources to advance country’s market economy or develop technology
• Divert resources to develop underlying infrastructures
• Dependence on importation of drugs, vaccines, other health products
• Divert monies to military• Improvements in over all health status
contributes to its economic growth
Health care systems
• Who can utilize
• What kind of coverage
• Who provides
• Where is health care provided
• Who controls
Burden of Sickness and Disability
• Mortality figures do not capture effect
• Result from diseases that do not cause death– Loss of ability to work– Keep out of school– Slow economic and social development
The Global Burden of Disease (GBD)
• Losses from premature death
plus
• Loss of healthy lives due to disability
• Nearly 9/10s occur in developing countries where only 1/10 of global health expenditures occur
Disability-Adjusted Life YearDALY
• Combine losses from– Premature death
• (difference between the actual age of death and life expectancy at that age in a low mortality population)
– Healthy life that results from disability– Disproportionate burden on children
• Half of all DALYs worldwide
Key Elements of DALY
• Age at which disease or disability occurs
• How long effects linger
• Impact on quality of life
Effects on DALY By
• Single most important cause of ill health globally– Communicable diseases (44%)– Top 7/10 causes from communicable
diseases• Leading causes
– Lower respiratory diseases– Diarrheal
Causes of DALYs Compared with Causes of Death
• DALYs1. Lower Respiratory Diseases2. Perinatal conditions3. HIV/AIDS4. Unipolar depressive
disorders5. Diarrheal Diseases6. Ischemic heart diseases7. Cerebrovascular diseases8. Road Traffic accidents9. Malaria10. Tuberculosis
• Causes of Death1. Ischemic heart diseases2. Cerebrovascular diseases3. Lower Respiratory Diseases4. HIV/AIDS5. Chronic Obstructive Lung
Disease6. Perinatal conditions7. Diarrheal Diseases8. Tuberculosis9. Road Traffic accidents10. Trachea, bronchus, and lung
cancer
World Health Report 2001
Health Problems of Children Lesser Developed Countries
• Diarrheal disease– leading cause of death/illness children 5 and
under worldwide 2 million in developing countries – causes: nutritional deficits, viruses, bacteria,
environmental toxins and parasites, contaminated food
– Correct management save 90%
Health Problems of Children Lesser Developed Countries
• Nutrition – associated with poverty– leading nutrient deficiencies: protein, iron,
Vit. A, calcium– women and children mostly affected– Malnutrition accounted for 6.6 million
deaths of the 12.2 million deaths under-five years
– Growth stunted, poor cognitive development, neurological deficits
Adults in Developing Countries
• Diarrheal diseases
• Tuberculosis
• Malaria
• Venereal Diseases
• Respiratory Infections
• Maternal and Perinatal illness
Maternal and Perinatal Health
• Maternal and women’s health– deaths remain high– family planning– good nutrition– prenatal care– safe birthing practices
Health Problems of Affluence
• Result from chronic non-communicable diseases
• Related to lifestyle– Arthritis– Cancer– Cardiovascular disease– Diabetes– Hypertension