Relevance and Applicability of Health Promotion Skills - Research Paper Example

Exploring and critiquing the relevance and applicability of health promotion skills Introduction Health promotion skills are important aspects of healthcare delivery. They can make an important difference in the recovery or the deterioration of the patient’s health. These skills play an important role in promoting the health of a community or a population. One skill should not be improved or deteriorated in favour of another because taken collectively, all these skills are needed to achieve good health for the population. This paper shall explore a particular health promotion skill, and for this paper – the needs assessment skill will be discussed. The core elements of the skill shall also be described in this paper. The salient characteristics of the context – values, context of the setting, characteristics of the community or population being served as well as health issues prevalent in the population shall also be discussed. Finally, this paper shall justify why the needs assessment skill was chosen as the most appropriate; the most relevant and applicable skill for health promotion. Rationale for Needs Assessment Skill This skill was chosen because it is the basic foundation and basis for diagnosis and subsequent treatment that any patient will receive in the hands of the health care team. This skill was chosen because this is where health care begins. Possessing the right technique and skill in assessing the needs of the population is important because it will direct the health care team in its development of a health care plan. Wrong and improper needs assessment may lead to wrong goals and improper allocation of limited resources. It is vital for health care professionals and concerned authorities to possess the skills needed to conduct a thorough and accurate assessment of the population. Needs assessment accurately and comprehensively done can reveal details about the population and their environment. And these details may impact on their welfare and on the delivery of their health services. I believe that needs assessment is relevant because sometimes health professionals do not enhance or develop this skill as much as the other skills in health promotion. This often leads to improper and inadequate needs assessment. By assessing the needs of the population, we can determine the kind of life the community has already lived and later on use this information to determine which health needs should be prioritized. Elements of Needs Assessment Skill The central elements of the need assessment skill are the following: obtaining data on health needs of clients/communities/populations; identifying behaviours that promote or compromise the health of clients; analyse needs assessment data; and determining priorities for health promotion. Needs assessment is based on the concept of cost-containment. Based on healthcare’s limited budget and resources, not all needs of the community can be supplied. In order to ensure fair and equitable distribution of resources, the population’s needs have to be assessed (MacDowall, et.al., 2006, p. 22). In effect, the allocation of resources shall be based on the most important needs of the population which shall be prioritized over other needs. The needs assessment of the population includes appraisal of service options in order to meet the needs of the population; specification of the pattern for service provision; choosing between providers and contracts compatible with the area’s limited resources; and controlling expenditure (Stevens, 2004, p. 3). The planning process that will follow the needs assessment aspect in health promotion will depend on the characteristics of the population and on the area’s limited resources. Different approaches can be applied to needs assessment. National, regional, local, and individual/ general practice assessment may be utilized in order to assess the needs of the population. The national needs assessment strategy is utilized in order to effect legislative change; regional needs assessment is done to assess spatial equity, specific service planning, and target efficiency in a particular region or area in the population; local assessment involves service specification for individual clinical insights using potentially fertile practice register data available at individual practitioner level (Stevens, 2004, pp. 7-8). Finally, the individual needs assessment strategy involves service specification for the most common diseases, and the primary care services available (Stevens, 2004, p. 8). The intended outcome or goal of needs assessment is to identify the services and other related activities which interrupt health care; also, to improve the distribution of already limited resources; to accurately target the resources of those in actual need; to gather general intelligence on the population; and finally to engage the interest of the population and those involved in the health promotion objective (Stevens, 2004, pp. 6-7). Salient Characteristics of the Context My uppermost value in relation to the needs assessment context is about the equitable distribution of resources. My role is to ensure that the needs of the community are properly assessed by health authorities concerned. As a health care professional, my role would be focused on noting the health needs of the population and to make an accurate recommendation to concerned health officials. The chosen population for this paper is the aboriginal community of Australia. Australia has largely neglected its aboriginal population. The poor health of the aborigines is said to be a product of discrimination and dispossession inflicted upon them by the white Australians (Briskman, 2007, p. 200). The aboriginal infant mortality rate is 3 times greater than the rest of the White Australian population (Kennedy, 2009). Their life expectancy is also very low -- 50 years old, sometimes lower -- as compared to 69 years old for the White Australians; this is almost a 20 year gap in life expectancy (Creative Spirits, n.d). Their health problems are mostly based on their poverty, malnutrition, limited water supplies, and inadequate plumbing (Popline, 1983). Many health programs implemented by the government to help the aborigines have failed. Authors and other analysts claim that this failure is due to the government’s refusal to consider the beliefs and practices of the aborigines as part of health care planning and promotion (Popline, 1983). Needs Assessment and Health Promotion Outcomes The needs assessment skill is relevant, appropriate and applicable to the aborigines because cost-constraints in the health budget are affecting the delivery of health care services to the aborigines. Most of them now rely heavily on public health services. And these services are still insufficient in addressing the health needs of the aborigines. Due to limited budget, the government is now burdened with the responsibility of properly distributing resources based on what the aborigines need. Much like budgeting one’s limited salary to care for one’s family, needs assessment also involves the budgeting of limited resources for the aborigines. And before this process can be undertaken, the needs of the community have to be assessed. It is imperative that a proper and adequate assessment of health needs should be undertaken in order to avoid ineffective and inadequate delivery of health care services to the aborigines. Assessment is the key to understanding aboriginal health. And this assessment should be done in the aboriginal context, meaning, the culture, traditions, practices, and beliefs of the aborigines should be included in the assessment. They are different from the white and the Asian Australians, many of them still practice their traditions and practices in their daily lives (Royal Australian College of General Practitioners, 2007). Many of them also live below the poverty line; have limited access to water and plumbing services; and they have been historically dispossessed from their lands by the White Australians. There are specific characteristics about the lives and the condition of the aborigines which calls for needs assessment which is different from the rest of Australia. The needs assessment of aboriginal population should not therefore be likened or consolidated with the needs assessment of the white Australian population. Needs assessment of the aboriginal population is relevant because characteristics specific to the aborigines are relevant to their health and their health needs. It is important to note that more than 20,000 aborigines live in communities with inadequate water supplies (Government of Western Australia, n.d). It is also important to recognize that there has never been a formal agreement between the aborigines and the white Australians about aboriginal lands. And many concerned authorities have argued that “the absence of a treaty with Aboriginal peoples is causally associated with their poor health and social disadvantage” (Jackson & Ward, 1999). By not coming up with a definitive treaty to settle and protect the property rights of the aborigines, they are now deprived of the power to assert personal and legal rights to their lands and their territories. With proper assessment, we will be enlightened about Aboriginal health practices and beliefs – and they believe that illness is not just a physical illness; instead, it is also a symptom of other problems like the spiritual and emotional alienation from their land, their families, and their culture (Jackson & Ward, 1999). The aborigines have a deep and spiritual connection with their lands; they define their identity in relation to the land; and their health and well-being is very much affected by their spiritual connection to their lands. Without recognizing this initial assessment of the aborigines, we cannot ever truly come up with a solution or a healthcare plan which will address the health care needs of the aborigines. Analysts and various health care authorities point out that in order to successfully implement a diverse and a holistic approach to aboriginal health, concerned authorities need to include the following aspects or needs in the aboriginal community: housing, education, employment, and social justice (Jackson & Ward, 1999). After considering these important aspects “we can then understand that physical and symptomatic relief of disease will not in itself redress the burden of Aboriginal ill-health” (Jackson & Ward, 1999). Needs assessment is very much relevant to health promotion because it will help decide the issue or the particular problem that a program is supposed to address. Through the process of collecting vital information about the population, it is possible to come up with a prioritization of needs for the community. It also helps health care authorities in coming up with decisions on how to start the health promotion process. By defining the health needs of the population, a possible target related to safe physical environment, good food, housing, and basic health information can be addressed in order to achieve physical, mental and social health for the community (Hawe, et.al., 1990, as quoted by Department of Health and Community Services, 2001). The needs assessment will usually reveal information that will later be shared with the community and with concerned health authorities in order to conceptualize a favourable plan of action for the population involved. Through needs assessment, awareness about community issues will now be improved and discussion about health issues will be initiated in the community and with health authorities. Information gathered through needs assessment will be used as baseline data for the population before any project will be started; and such data will be compared to information gathered after the project or program is implemented to the community. The needs assessment skills help to promote the health of the aborigines by identifying the behaviour that promotes or compromises their health. Studies undertaken on health-seeking behaviour among the aborigines reveal that aboriginal women seldom, if at all, seek early prenatal care (Cass, 2004, p. 597). Due to their delayed presentation for prenatal consultations, the birth weight of their babies is usually very low; the outcome of the pregnancy is sometimes adverse to the mother or the child because of prenatal and pregnancy complications. Surveys also reveal the “high prevalence of smoking, poor nutrition, lack of exercise, obesity and hazardous alcohol intake” (Australian Bureau of Statistics, 1999, as quoted by Cass, 2004, p. 597). The needs assessment will reveal that after analyzing the behaviour of the aborigines, it is possible to identify the primary health programs that will reduce or eliminate their smoking and alcoholic behaviour, their obesity, and their maternal and infant mortality and morbidity rates. Information gathered from the needs assessment will help the health authorities identify the actual health issues of the aboriginal population. Assessment of the general population reveals that the following diseases are prevalent among the aboriginal population: hypertension, diabetes, and chronic kidney disease (Colomeda &Wenzel, 2000). Many health critics and authorities often blame the aborigines themselves for the high incidence of these diseases in their community. They credit these high numbers to the aborigines’ smoking and drinking habits. However, an adequate and thorough assessment of the aboriginal population will reveal that there are different factors that affect their predilection for drinking and smoking. Socio-economic difficulties among the aboriginal communities drive many of them to alcohol, smoking, and drug abuse (Schizophrenia, Fellowship of NSW, 2008). Their miserable socio-economic conditions affect their mental health and cause many of them to turn to dangerous and habit-forming practices. Health researchers and analysts assessing the needs of the aboriginal population point out that inadequate contact and communication between aboriginal patients and health care professionals result to poor treatment outcomes (Charles Darwin University, n.d). These researchers firmly argue that aborigines are not receiving sufficient health services; and the health care givers are not paying enough attention to the specific needs of the aborigines. This is an unfortunate revelation because “in addressing [health] deficiencies, we must be sensitive to the attitudes of our indigenous peoples toward our health care systems. They will not otherwise experience acceptable, timely, responsive and high-quality health care services” (Schizophrenia Fellowship of NSW, 2008). Needs assessment of the aborigines will help focus more attention to their core health problems and issues. At the very centre of these health problems is their generally low socio-economic status. By adequately assessing the needs of the community, we will be able to establish that they need access to adequate water supplies in order to promote proper hygiene and cleanliness; they are also in dire need of plumbing facilities which will help prevent disease spread and infection in the community (Department of Health and Ageing, 2008). The needs assessment skill can lend a hand in analysing the behaviour and the health problems of the community, putting the spotlight on each health need and determining how each need affects the overall health of the population. After the needs of the community are now assessed, the health promotion process calls for a prioritization of these health needs. Studies on aboriginal health now reveal that mental health problems and addiction; chronic heart diseases and associated risk factors; and poor health of aboriginal children are some of the major issues among the aborigines (Victorian Aboriginal Health Services, 2008). Their associated health needs as indicated by the above health problems would therefore relate to mental health services and proper nutrition and diet for the aborigines. The aborigines need mental health services which are culturally sensitive to their needs and which are available in their communities. It is therefore important for some of the mental health workers to be aborigines (Australian College of Health Service Executives). Studies emphasize that there is a need “for mainstream services to work in partnership with Aboriginal Community Controlled Health organizations” (New South Wales Department of Health, 1997). Through needs assessment, the health promotion process for the mental health of the community will reveal that aborigines have a distinct and unique definition for mental health. They define it as more than just physical well-being, but also the social, emotional, and cultural well-being of the community (Bailey, 2005, pp. 2-3). Focusing on one individual who is ailing is not enough to address the health problems of the community; the emotional well-being of the entire community must also be taken into consideration in assessing and prioritizing the health needs of the aborigines. Their concept of health promotion therefore, must necessarily include the power to “reach a state of complete physical, mental, and social well-being, an individual or group must be able to identity and to realise aspirations, to satisfy needs, and to change or cope with the environment” (Bailey, 2005, p. 2). Through adequate needs assessment, the peculiar culture and practices of the aborigines are taken into account. If another population or group of people were involved, the needs assessed and the subsequent health promotion process would not be the same with the process applied to the aborigines. What may work for one group of people, may not necessarily work for another. And to the aboriginal people, health promotion “is not just the responsibility of the health sector, but goes beyond healthy lifestyles to well-being” (Bailey, 2005, p. 3). In order to adequately promote the health of the community the following needs have to be met: peace, shelter, education, food, income, stable ecosystem, social justice and equity (Bailey, 2005, 3). Due to the dispossession and rampant racial discrimination experienced by the aborigines from the white Australians, not one of the above needs have been met. And all these factors cause stress, drug-seeking behaviour, alcoholism, smoking, depression, and suicides (Australian College of Health Service Executives, n.d). Their drugged and alcoholic states often cause them to disrupt the peace within and outside their communities. It is a vicious cycle of ill health among the aborigines. Barriers to applying needs assessment skills usually take a long time to complete. “Collecting data and researching attitudes behind the numbers through focus or discussion groups can be a lengthy process” (Department of Transportation, 2001). Many of these groups can be uncooperative or generally unwilling to share vital information about their health needs. The language barrier can also interfere with adequate needs assessment of the aborigines (Charles Darwin University, n.d). The communication and exchange of information can be severely compromised because of this barrier. Failure to recognize the views of the indigenous community about mental health will also impact greatly on needs assessment (Schizophrenia Fellowship of NSW, 2008). If the health care givers will insist on addressing the mental health problems of the aborigines from the point of view of the white Australians, the health problems of the aborigines will never be solved. Another barrier in needs assessment is the use of non-indigenous cultural standards, tools and diagnostic criteria to assess the behaviour of the aborigines (Schizophrenia Fellowship of NSW, 2008). In assessing the needs of a population, our tools and manner of assessment must fit their standards and usual behaviour. They have a different language, different expressions, and colloquialisms which will ultimately affect the assessment of the needs of the population (OShea 1996, as quoted by Schizophrenia Fellowship of NSW, 2008). Conclusion The needs assessment skill is a relevant skill because it serves as the basic foundation for health promotion. Possessing adequate needs assessment skills enables the concerned health professional to accurately identify the needs of the community and consequently come up with a correct plan for the population. Needs assessment skills will help to budget and prioritize health resources in order to ensure that regardless of limited resources, the population will still receive services for their actual health needs. It is important for needs assessment skills to be properly applied to the aborigines of Australia because they have different health needs from the rest of the Australian population. They have a different culture, different practices, and beliefs that have to be taken into account in order to ensure that the health plan that will later be implemented to them will be successful. Needs assessment skills are important because it helps us promote the health of each citizen – as an individual, and as a part of the community. Works Cited Aboriginal and Torres Strait Islander People, 2008, Schizophrenia Fellowship of NSW Inc, viewed 16 June 2009 from http://www.sfnsw.org.au/Quality-of-Life/QoL-Indigenous/default.aspx Aboriginal health issues, 2008, Victorian Aboriginal Health Services, viewed 16 June 2009 from http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Aboriginal_health_issues?open Aboriginal life expectancy (n.d) Creative Spirits, viewed 16 June 2009 from http://www.creativespirits.info/aboriginalculture/health/aboriginal-life-expectancy.html Bailey, J. 2005, You’re not listening to me!! Aboriginal Mental health is different - Don’t you understand??, ABC.net., viewed 16 June 2009 from http://www.abc.net.au/rural/events/ruralhealth/2005/papers/8nrhcfinalpaper00495.pdf Briskman, L., 2007, Social Work with Indigenous Communities, New South Wales: Federation Press Cass, A. 14 September 2004, Health Outcomes in Aboriginal populations, Canadian Medical Journal, viewed 16 June 2009 from http://www.cmaj.ca/cgi/reprint/171/6/597.pdf Colomeda, L. & Wenzel, E., 26 April 2000, Medicine Keepers: Issues in Indigenous Health, Virtual Public Library, viewed 16 June 2009 from http://www.ldb.org/indheal.htm Community How To Guide On…Needs assessment & Strategic Planning, March 2001, Department of Transportation, viewed 16 June 2009 from http://www.nhtsa.dot.gov/people/injury/alcohol/Community%20Guides%20HTML/Book2_NeedsAssess.html#barriers Department of Health and Community Services, November 2001, Bush Book: Step 1: identify the issues or health problems in the community, Northern Territory Government, viewed 16 June 2009 from http://www.nt.gov.au/health/healthdev/health_promotion/bushbook/volume1/step1.html Indigenous communities deserve a sustainable health workforce, 27 June 2007, Royal Australian College of General Practitioners, viewed 16 June 2009 from http://www.racgp.org.au/aboriginalhealthunit/media/17314 Jackson, L. & Ward, J., 1999, Aboriginal health: why is reconciliation necessary?, Medical Journal of Australia, viewed 16 June 2009 from https://www.mja.com.au/public/issues/may3/jackson/jackson.html Kennedy, C., 17 June 2009, Indigenous Kids Still Faring Worse, Australian Doctor, viewed 17 June 2009 from http://www.australiandoctor.com.au/news/04/0c061b04.asp Macdowall, W., et.al., 2006, Health Promotion Practice, England: McGraw-Hill International NSW Aboriginal Mental Health Policy, 1997, New South Wales Department of Health, viewed 16 June 2009 from http://www.health.nsw.gov.au/policy/cmh/publications/Aboriginal%20Mental%20Health%20Policy.pdf Our role: Health of Aboriginal and Torres Strait Islander People (n.d) Government of Western Australia, viewed 16 June 2009 from http://www.aboriginal.health.wa.gov.au/role/index.cfm Report of the 6th National Conference: Working to Improve Water and Sewerage Provision in Discrete Aboriginal Communities in NSW : Murdi Paaki Region Case Study, 7 July 2008, Department of Health and Ageing, viewed 16 June 2009 from http://www.health.gov.au/internet/main/publishing.nsf/Content/natsieh-publicat.htm~natsienh-publicat-ch3.htm~natsienh-publicat-ch3-5.htm Stevens, A., 2004, Health care needs assessment, UK: Radcliffe Publishing. Summary of relevant literature on communication in Indigenous health care: extract from Sharing the True Stories Stage 1 Interim Project Report (n.d) Charles Darwin University, viewed 16 June 2009 from http://www.cdu.edu.au/centres/stts/resources/Summary%20of%20communication%20literature.doc The health of aborigines in Australia, February 1983, Popline, viewed 16 June 2009 from http://www.popline.org/docs/0559/265743.html The Health Status of Indigenous Australians (n.d) Australian College of Health Service Executives, viewed 16 June 2009 from http://www.achse.org.au/ruralhealth/indigenous.html Read More