Key Advancement in Global Public Health and How They Improved Maternal and Child Health Globally - Essay Example

Running head: THE ADVANCEMENT IN GLOBAL PUBLIC HEALTH The Advancement in Global Public Health Insert Insert Grade Insert 2 November 2011 The advancement in global public health Introduction Measles vaccine is one area of public health that has benefited from improved advancement in global public health. Increased vaccination and immunization are two advancement; today, WHO estimates that there has been reduction of 78% in measles worldwide as a result of advancement taking place (World Health Organization, 2011). In addition, maternal education, specifically among HIV pregnant mothers has increased; indeed currently, there is overall reduction in cases of mother to child transfusion during childbirth (Karlsen et al., 2011). Lastly, unlike earlier when traditional birth skills aggravated mortality cases, today, there has been advancement in skill attendance at birth, which is decreasing mortality rate as childbirth techniques improve and become prevalent among many people (World Health and Global Health Workforce Alliance, n.d). Therefore, the essence of this paper will be to look and analyze advancement that has taken place in these three key areas. Advancement in public health Measles WHO estimates that about one million measles-related deaths do occur every year and the most affected areas are Africa and Asia (Akramuzzaman et al., 2002). India it is perceived to have lost about 92,000 children in 2005 aged below five years (Anonymous, 2011; Akramuzzaman et al., 2002). On overall, the 2008 WHO estimates indicated that South-East Asia region has a prevalence rate of about 77% and the most affected country is India (Anonymous 2011). Advancement in measles vaccine in India can be compared to United Kingdom’s case. UK can be considered as a developed society as compared to India when human development aspects are evaluated. The prevalence of measles cases have been reducing in the country since the introduction of first vaccine in 1958. Before 1958, prevalence of measles-related deaths was high but from 1958, the trend tilted towards lower incident rate of measles (BBC News, 2009). Today, advancement in measles vaccine has resulted into better protection of younger children. Compared to India, England in 2007 recorded only 1348 cases of measles-infected children, which were regarded as the highest cases since 1995 (BBC News, 2009). What evidence shows is that, introduction of MMR vaccine in the country, coupled with government supportive efforts in enhancing and improving public health, prevalence of measles has continued to reduce in UK and today the country experience less cases as compared to India. India has had to improve its strategies on mitigating measles and this has led the country to initiate some proactive vaccination programs aimed at tackling the disease. MMR vaccine is now introduced in the country for infants being born (Yadav, Thukral, and Chakarvarti, 2003). Furthermore, MCV1 and MCV2 vaccines have been introduced under the ‘India Expanded Programme on Immunization’ (Anonymous, 2011). According to the program, children aged 9-12 months are supposed to be vaccinated. One issue that has acted as an obstacle to the progress of India’s vaccine initiative includes lack of government and key stakeholders’ involvement. As a result, there has been derailment and stagnation of the programme in some areas, especially those in rural areas. Moreover, lack of public education, wide awareness and little community involvement have all combined to work against the success of the vaccine initiative. Nevertheless, it is observed that the best way of solving this problem lies with government’s effort to own the programme and at same time, empower communities involved. Moreover, strong commitment should be shown in the program from all stakeholders, especially in providing financial, technical, and communication support to accelerate the pace of measles control (Anonymous, 2011). Maternal education, HIV/AIDS transmission, and breastfeeding Prevalence of HIV/AIDS in developed and developing nations differs and this can explain the variations that continue to be experienced. Women have been found to be susceptible to HIV/AIDS infection than men (Vieira, Harper, Shahani and Senna 2003; Department for International Development-UK 2010). It has been estimated that the probability of mother-child transmission (MTCT) of HIV/AIDS with absence of preventive measure ranges from 15 to 25% among developed countries and 25 to 35% among developing countries (Vieira, Harper, Shahani and Senna, 2003). India and UK again differs in terms MTCT, where India being developing society exhibit high levels of transmission as compared to UK’s low levels of transmission. Prevalence of MTCT in India can be associated to lack of awareness, limited services, and inaccessibility to available facilities (Pati 2003; Agarwal, Sethi, Srivastava, Prabhat and Baqui, 2010). At the same time, women in India face multiple social and cultural pressures that limit their ability and willingness to use safer methods of sex, hence leading to prevalence of transmission of the disease to children (Pati, 2003). Moreover, social stigma associated with women infected with HIV in India is still prevalent, a factor that discourages many women from seeking health opportunities and facilities when they are infected (Pati, 2003). In UK on the other hand, MTCT has been reduced largely due presence of better health facilities and easy access to such facilities. Furthermore, UK being a developed nation exhibits more programs, which are effective in nature. Such programs, which reduce cases of MTCT, include HIV testing, prenatal, delivery and postnatal care, counseling and care services for pregnant mothers who have been diagnosed to have HIV-virus (Vieira, Harper, Shahani and Senna 2003). More so, in UK unlike in India, women have more access to antiretroviral drugs, delivery procedures and replacement of breastfeeding by alternative feeding methods, which are largely, used as key interventions strategies (Vieira, Harper, Shahani and Senna 2003). In other words, UK has continuously reduced risks associated with MTCT through adoption of effective and evidence-based interventions that are comprehensive in nature, which largely remain absent in India’s case. However, India has not lost hope of reducing MTCT cases in the country. For instance the country has initiated the ‘Safe Motherhood Initiative’ which is an education-based program aimed at promoting and advocating for safer interventions in MTCT cases (Vora et al. 2009). Many women in the country are being integrated in the program and the results of the program include comprehensive and extensive training and education for mothers infected with HIV/AIDS (Vieira, Harper, Shahani and Senna, 2003). Key areas of training include safer methods of delivery, child-care, mother care, how to obtain health care facilities, nutrition, and many more. Despite numerous efforts directed at the program, India has to address the issue of social and cultural pressure HIV/AIDS women face, the social stigma, and social backlash infected women face. Further, breastfeeding is still considered sign of care and responsibility in majority of rural India which makes it impossible for many women to avert to alternative feeding programs. Therefore, participation, awareness, education, cooperation and motivation constitute critical success factors to the program. Skill attendant at birth Developing societies share one aspect in common, majority of women give birth at home and in hands of unskilled birth attendants (International Development Committee-UK, 2011; Saravanan, Johnson, Turrell and Fraser, 2009). In most cases, crude methods of child births are employed which contribute to increased cases of maternal death in developing societies. In India, factors such as social, regional, cultural, and economical act as barrier to use of skilled birth attendant by many women in the country. In India, maternal deaths of about 65% are realized among women who give births in the hands of unskilled attendants and availability of poor health facilities (International Development Committee-UK, 2011). Majority of Indian midwife ‘experts’ lack efficient training, exposure and health care skills which can reduce the prevalence of maternal deaths. Furthermore, other factors have played to dilute the need and requisite for skilled birth attendants. Such factors include; social and cultural norms which largely limit political will and commitment to develop necessary human resource and systems necessary for skilled attendance (MacDonagh, 2005; Gupta, Thakur and Kumar, 2007). But this experience of India is different when one analyzes UK where skilled birth attendance is rated most effective. UK effort for a long time has been to reduce maternal deaths and to achieve this skilled birth attendance has been enhanced and improved over time. Investment in skilled births attendance has been given priority and this has led to professionalization of delivery care (MacDonagh 2005). Furthermore, there has been development of skilled attendants alongside emergency obstetric care delivery as complementary strategies for efficient results. Moreover, political, social, and legal action in UK have operated and instituted a viable environment for development of skilled attendance. To develop a strong institution of skilled birth attendance in India, there is need for sound political, social, and legal actions, which at same time should address women rights. Moreover, the strategies employed should address the key principles of participation, inclusion, and fulfillment of obligation. Moreover, at central should be improvement of skills and knowledge of birth attendants, even those considered traditional (Bale, Stoll, Lukas and Institute of Medicine-USA, 2003). Training manuals for birth attendants should develop curriculum in key areas of proficiency in basic techniques for a clean and safe delivery, recognition, and management of prolonged labor, infection, and hemorrhage (Gruenberg, 2008; World Bank and International Monetary Fund, 2004). Conclusion People from different parts of the world, especially in developing societies face different health problems, which can be addressed through various public health interventions. Global public health initiatives have evolved as mechanisms through which efforts to protect and improve the health of different communities take place. Key programs that the world bodies are involved include: promotion of public health education, promotion of healthy lifestyles, research and promotion of innovative and effective knowledge management, while at the same time enhancing technical exchanges and consensus building activities with aim of strengthening maternal health of the concerned society (Feldscher, 2011). It is believed that adoption of these programs and integrated in wider aspects of programs concerning measles; maternal education and skill attendant at birth possess great potential to enhance public health of many countries in the world. References Agararwal, S, Sethi, V, Srivastava, K, Prabhat, KJ & Baqui, AH 2010, ‘Birth preparedness and complication readiness among slum women in Indore City, India’, Journal of Health, Population and Nutrition, vol. 28, no. 4, p. 383. 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