Formal Carers in Health and Screening Programs - Assignment Example

Discussion Discussion Question One Formal carers in health are those professionals who are trained, qualified and licensed to provide the services (Nocon & Qureshi 1996). They are under contracts that specify their responsibilities, and their services are governed by organizations or the state in which they operate. They get paid and are entitled to working regulations and social rights, including scheduled time off duty. On the other hand, informal health care providers are mainly neighbors, close relatives, family members or friends of those seeking healthcare services (Nocon & Qureshi 1996). They are not trained professionals, are not under contract and perform wider scopes of tasks than their formal counterparts. Most are not paid but may receive contributions. This part will evaluate the implications for health if formal and informal carers work in partnership and the achievements to the society. Bringing together networks of informal and formal health service providers is crucial in supporting both the consumers of the services and the practitioners. One implication for health upon partnering will be improved accessibility of services by patients (Nocon & Qureshi 1996). Presently, formal providers are not making enough efforts to maintain and support the informal providers, even with the scope and goodwill available for them to work together. Informal providers have strong connections and well established roots in the communities they serve. They provide the vital care to low and middle income societies who, in some countries where formal, private and public practitioners are concentrated in urban cities, cannot afford access to formal services (Henderson 1991). Informal providers are a significant representation of the private health practitioners in the rural setting. In contrast to formal providers, they are well placed to reach the remote and rural communities. If this aspect is coordinated and managed by the formal sector, it can go a long way in expanding access and filling the gaps present in formal provision of healthcare. With their long running practices and personal affiliations with their societies, they are trusted by the people. This gives them the advantage of being able to persuade and encourage local folk to seek medical help when in need. Since they function in a complex and wide health market, they have also established ties with practitioners in the formal sector where they get medical updates and advice and, on their part, give referrals (Henderson 1991). These points indicate that if the formal and informal health carers work together, they will promote accessibility of the services to all, including remote communities and the poor. It, therefore, calls for recognizing, acknowledging and appreciating the efforts put in the endeavor by the two sectors. Basic training and guidance for the informal carers by the formal will improve quality of service. Another implication for health, when the two sectors partner, is safe delivery of services and dispensation of medicine. Making medical services accessible to citizens is not enough. The quality and safety of the environment under which they are delivered is also paramount (WHO 2005). After medical organizations and the state agree to work with informal carers, they should set standards for their operations to ensure they do not endanger the lives of those they are caring for. A survey conducted in Nigeria established that some informal health carers have some basic knowledge, through long experience and interactions with formal carers, of appropriate practice and standards (WHO 2005). However, without proper training, most of them are influenced by patients to give overdoses. For example, some even confirmed that they are vendors of patented malarial drugs, of which they themselves prescribe. But, the same study revealed, majority of the informal carers who lack familiarity of government policy on malarial drugs engage in unnecessary, wasteful and harmful medical practices (WHO 2005). These include giving unnecessary injections, administering multiple medications for a single incident, overprescribing medications and antibiotics and diagnosis before adequate tests are carried out. All these constitute dangerous and poor quality medical practice, in as much as the practitioners have vague ideas of the circumstances. Since the formal sector cannot overlook the fact that the informal sector is the first source of healthcare for the majority, if not entire, rural population in most of sub Saharan Africa, this dangerous practice can be reduced remarkably by partnering (WHO 2005). Rather than severing links, partnering will enable the formal sector to give guidelines on safety measures as well as monitor the quality of drugs and doses given. In some developing African countries, informal carers have a relatively formal level of organization because of the power of the formal associations of patented medical vendors who protect their own interests. These associations register and supervise members and offer periodic trainings via workshops. They realize that alienating the informal carers may cut their supply of patented drugs, which may lead them (the informal) to resort to other unsafe sources (WHO 2005). The ultimate beneficiary in such partnerships will be the patient who will receive the correct medication safely in an informal setup, hence promoting general health for all. Many communities or states may have enough formal carers, but their delivery of services is limited by factors like unfavorable state or federal policies and poor markets for their services. However, others simply do not have enough formal carers in certain medical fields although demand for their services is high (Henderson 1991). Partnering of formal and informal health carers will mitigate the shortage of professional practitioners prevalent in some communities or states. For example, cases of home nursing are on the rise in many western countries. Different categories of home nursing occur. There is an increasing number of the elderly who need carers most of the time. With a shortage of professional nurses, the informal sector steps in to ensure they are cared for. Although not all of them may be medical cases, professional services are necessary, given their delicate conditions. A partnership will see friends or family members receive advice on how best to care for their old. Another category is made up the sick that have been discharged from hospital but need home nursing in administering of medication, buying and preparing recommended diets and guidance in critical exercises (Henderson 1991). With growing numbers of such cases, the workload may overwhelm the limited available professionals to give care at home. Partnership will be the best way to ensure quality care is continuous. Therefore, any relevant actions taken to alleviate the shortage of professionals or improve the positive elements of the informal sector will improve health services provided at home (Nocon & Qureshi 1996). Question Two Screening may be defined as a health service where part of a defined population that does not necessarily recognize their vulnerability to risk, or state of being affected by diseases and their complications, are tested to identify the ones who may be assisted rather than be harmed by more tests (Jones & Sidell 1997). Most screenings are usually defined and categorized by age. Screening is critical for some diseases. For example, some cancers occur in various forms and differ in potential of spreading and developing rate. However, they may all seem the same without appropriate screening to identify them. Studies (Jones & Sidell 1997) have shown that screening programmes have both positive and negative contributions to health, and this part will assess these contributions to a population’s health. The general perception of prevention being better than cure adds to the significance of the ability of screening to detect diseases and conditions early enough for their effective prevention, cure or management. This, in effect, results in a generally healthier population (Rose 1992). Positive contributions of population screening programs can be carried out geared towards the direct gain of screened people. It is necessary to determine the program’s purpose when assessing its worth. Most community based interventions like checking blood pressure during health fairs, aim at helping people. They may also involve screening for cancer, tuberculosis or diabetes with the intention of detecting and curing at the early stages before the onset of irreversible complications. Screening is also intended to protect others through routine tests done on samples of blood from donors to curb transmission of agents of infection. It may also simply be performed to collect elementary information on populations or individuals. Although early diagnosis should be coupled with better results, screening procedures may not be possible for all conditions in a target group (Rose 1992). For example, programs in postnatal screening for metabolic disorders can only identify limited anomalies in the population. However, some in their midst are preventable, severe neurologic cases. A positive contribution of screening is also displayed by the manner in which it selects target groups based on age. The groups are selected because there is sufficiently strong scientific proof that they are the most exposed to risk of having or getting certain diseases, and they will benefit the most from screening. Such an example of targeted population is found among women of ages ranging from 50 to 69 years. They are considered to be at a higher risk of developing breast cancer and screening has gain to them. For instance, in Australia, women are encouraged to attend free screening for breast cancer through a program known as BreastScreen Australia. Those found to exhibit signs of cancer are encouraged to go for further tests. This practice has the potential of having a healthy population within that age group if their conditions are managed properly after the screening. Such programs, designed and harmonized with the purpose of providing the utmost health benefits to the community, are a manifestation of the positive contributions screening gives to a population. They are also regularly assessed to ensure they remain safe, relevant and effective. The target groups are encouraged to attend screening with a clear message that there is a probability of treatment being effective for most conditions exposed early. Some programs also help in preventing cancer from developing when the changes are discovered ahead of their becoming cancerous. Relevant examples are bowel and cervical cancers. Screening can detect the changes responsible for the two, and treating the changes is a key step towards stopping them from developing into cancer (Rose 1992). On the other hand, even with the common knowledge that prediction and prevention outweighs diagnosis and cure, screening still has its downfalls on the way it psychologically affects populations (Jones & Sidell 1997). This circumstance is created by the fact that no screening program is 100 percent efficient, and that screening is conducted on seemingly healthy people, rather than those with clinical situations. Furthermore, screening results only categorize individuals into lower or higher risk groups (Jones & Sidell 1997). They do not go the extra step of offering diagnosis. Screening can give rise to numerous harms, and especially to a population that do not have and may never have the conditions or diseases being addressed but will, however, be screened as having them (Jones & Sidell 1997). This will most probably call for both unnecessary follow up tests and treatments, with the potential of inflicting long lasting psychological and physical harm. Sometimes, in remote though significant cases of the harms of screening, the results do not make things better. There are some conditions whereby nothing can be done to the exposed condition. In such situations, people live with the knowledge of the condition for a longer period and may plunge into depression (Jones & Sidell 1997). This psychological trauma easily spreads to those close to them in society. Nevertheless, even with the few problems associated with screening, well arranged programs in population screening are designed to deliver the benefits without being overridden by the negatives. Prior to a screening program being initiated, appropriate evidence in relation to the incidence of the condition in the target group is collected. The organizers work under laid criteria so as to decide whether to offer certain programs and to what target population (WHO 2005). In conclusion, screening ensures the health of future generations too. Screening programs conducted annually on infants reveal that 29 conditions are prevalent among them (Rose 1992). The most common are primary congenital hypothyroidism, hearing loss, cystic fibrosis and sickle cell disease. With timely and proper screening of newborns, followed by treatment, disability and death from these conditions can be prevented (Rose 1992). For instance, out of the examples above observed in newborns, congenital hypothyroidism is found in one out of every 2000 infants. If screened and treated on time, intellectual disability can be prevented (Rose 1992). Another more serious condition is congenital hearing loss, which occurs in three out of 1000 newborns. Annually, hearing screening of newborns exposes hearing loss in more than 5,000 of them. Evidently, in the absence of screening, the children would be faced with delayed acquisition of language, low attainment of education, higher rates of behavior problems, reduced adaptive skills and poor psychosocial wellness. These are all clear contributions that screening contributes more positive than negative attributes to the health of a population. References Henderson, V 1991, The nature of nursing: reflections after 25 years, National League for Nursing Press, New York. Jones, L & Sidell, M 1997, The challenge of promoting health, Macmillan, London. Nocon, A & Qureshi, U 1996, Outcomes of community care for users and carers: a social services perspective, Open University Press, Buckingham. Rose, G 1992, The strategy of preventive medicine, Oxford Medical Publications, Oxford. World Health Organization (WHO) 2005, Traditional medicine strategy, WHO, Geneva. Read More