UNIT 4: GLOBAL HEALTH

1. UNIT 4: GLOBAL HEALTH Unit 4 Outcome 1

2. 1.4 The influences on the health status of developing countries compared to Australia of income, gender equality, peace/political stability, education, access to health care, global marketing and physical enviroonment

3. Access to health care

4. Access to Healthcare • Access to healthcare involves many different areas: • Access to hospitals • Highly trained health professionals; such as nurses, doctors/physicians, midwivesand specialist areas eg. Maternal health nurses. • Immunisation services (immunisation can prevent against measles, tuberculosis, whooping cough and tetanus. • Ambulance services • Family planning services • Access to Medication (this could be for asthma, HIV/AIDS, malaria, anti-depressants…anything!!) • Preventative health care – such as early detection tests eg. Mammograms, Pap smears, prostate examinations. When you are discussing the impact of access to health care on health, health status or human development, make sure you choose a specific example above to discuss… otherwise your example will be too broad.

5. Access to healthcare IN DEVELOPING COUNTRIES • Developing countries often experience limited access to health care. This may be due to:

6. Healthcare and impact on health status • Access to immunisation is an example of health care that contributes to significant differences between Australia and many developed countries. How could the health status and human development of Australia and developing countries be different due to Australia having higher immunisation rates?

7. Low immunisationrates in developing countries would result in a higher incidence and prevalence (morbidity) of preventable conditions such as measles and tuberculosis compared to Australia. Developing countries would experience a significantly higher U5MR compared to Australia due to these preventable diseases not being treated, which would also result in a reduced life expectancy for developing countries compared to Australia. • Low immunisation rates in developing countries result in high rates of diseases such as whooping cough, tuberculosis, measles and tetanus. These diseases prevent many children from accessing education and they are unable to develop to their full potential, which affects human development levels.

10. Access to health care during pregnancy • Access to health care during pregnancy and childbirth is critical for the health of mothers and children. There are many complications that can arise during this period (obstetric fistula/obstructed labour, and haemorrhaging) and skilled health care workers can significantly decrease the rates of maternal and infant mortality. • Australia has relatively high rates of births attended by skilled health personnel.

11. OBSTETRIC FISTULA • An obstetric fistula is a hole between the vagina and rectum or bladder that is caused by prolonged obstructed labor, leaving a woman incontinent of urine or feces or both. • For women with obstructed labor, labor that goes unattended, the labor can last up to six or seven days. The labor produces contractions that push the baby’s head against the mother’s pelvic bone. The soft tissues between the baby’s head and the pelvic bone are compressed and do not receive adequate blood flow. The lack of blood flow causes this delicate tissue to die, and where it dies holes are created between the laboring mother’s bladder and vagina and/or between the rectum and vagina. This is what produces incontinence in a fistula patient. http://www.fistulafoundation.org/what-is-fistula/# http://www.fistulafoundation.org/what-is-fistula/learn-one-womans-story/ • Read the story of Fatimia, Halima and Hamida. Identify how their H and HD have been impacted upon and how health care could promote their H/HD if accessible. • Read booklet pages 78 and 79.

12. BIRTHING KITS • The Birthing Kit Foundation (Australia) is an organisation dedicated to improving the conditions for women who give birth at home in developing countries. • "Every 2 minutes, a woman dies of complications related to pregnancy and childbirth" • With an estimated 385,000 women dying annually in childbirth, many from infections acquired during childbirth, there is a great need for our clean birthing kits. • Most women we assist for reasons of isolation, cultural choice or poor transport have little or no assistance during childbirth. Many mothers and babies die from preventable infections. By providing a clean birthing kit and training in how to use it, these mothers will have the resources to reduce infection. • The Foundation is a not-for-profit non-government organisation (NGO) that provides birthing kits and education in clean birthing practices. We have no religious or political affiliations. • About our birthing kits • The birthing kit addresses the 7 cleans needed for a safe delivery. • The kits are basic with 6 items. A plastic sheet, soap, 2 gloves, sterile scalpel blade, 3 cords and 5 gauze squares. • These items are assembled into a small bag at an Assembly Day.

13. Family planning • Family planning allows people to attain their desired number of children and determine the spacing of pregnancies. It is achieved through use of contraceptive methods and the treatment of infertility. • An estimated 222 million women in developing countries would like to delay or stop childbearing but are not using any method of contraception. • Some family planning methods help prevent the transmission of HIV and other sexually transmitted infections. • Family planning reduces the need for unsafe abortion. • Family planning reinforces people’s rights to determine the number and spacing of their children.

14. VCAA 2013, SECTION B, QUESTION 7 Consider the following information about health and health services in Australia and Swaziland. Using information from the table, explain how access to healthcare might account for the difference in life expectancy between Australia and Swaziland. (4 marks)

15. Impact on health and human development- how to answer sac/exam questions • Specific example: Lack of trained health professionals e.gMidwives • IMPACT ON HEALTH: • A lack of trained health professionals can result in many women in developing countries giving birth to their child without assistance. When complications occur women can experience prolonged labours (e.g three or more days) which often leads to a fistula(Physical health) developing between the bladder and vagina/rectum. Without adequate health care women have this fistula for life resulting in leaking of urine and faeces and causing a high level of morbidity. Women are isolated and excluded (Social health) from society as they smell and as a result experience poor self confidence (Mental Health) • IMPACT ON HUMAN DEVELOPMENT: • Being excluded and leaking urine/faeces does not allow one to participate in the life of the community. They are unable to live to their full potential or lead a productive/creative life as communities, families, husband abandon them and leave them unable to earn income, be a mother to their children, a wife etc.

16. THE next step…. • Can you discuss access to heath care in a positive way e.g How Australia experiences them? • Can you discuss multiple examples of the factor? Eg. Immunisation, hospitals, medication, trained midwives, etc.

17. EDUCATION

18. Education • Education promotes literacy (the ability to read and write, interpret, understand information) • Educated people are more likely to experience a higher SES. • Educated people are more likely to have a greater understanding of health promotion messages, such as using condoms to prevent the transmission of HIV/AIDS and to boil water before drinking it to prevent diarrhoeal disease. • Education allows individuals/families/countries to break the poverty cycle. • IN AUSTRALIA: • Education is compulsory between ages 6-16 • Many of the expenses are covered by the government • Literacy levels are high • Employment rates are high----leads to future generations experience sustainability. • IN DEVELOPING COUNTRIES: • Millions of children not enrolled in PRIMARY school • Millions of children (more than primary) are not enrolled in SECONDARY school

19. Education improves health and human development in many ways. • Access to knowledge is a key component of human development- with knowledge individuals are empowered and have greater opportunities. • Education allows individuals and families to break the poverty cycle. • Women are the most disadvantaged. • Educated women are more likely to have healthier children=healthier adults.

20. Compare school attendance rates between Developed and Developing countries:Secondary and primary, males and females.

22. Impact on health and human development- how to answer sac/exam questions • FACTOR: Education; • SPECIFIC EXAMPLE: Females not going to primary school due to poverty/children unable to attend school due to diarrhoea. • IMPACT ON HEALTH STATUS (YLL & YLD, MORTALITY, LE, U5MR): • IMPACT ON HUMAN DEVELOPMENT:

23. Peace and political stability

24. Peace • A peaceful environment is essential for promoting optimal health and human development. • On the other hand, when a country is in conflict/war, their level of human development or HDI is worse than many other countries. • Australia generally experiences PEACE but many developing countries are currently experiencing WAR or civil CONFLICT. • http://www.youtube.com/watch?v=KYEvA6B6ldI – Israel conflict • http://www.youtube.com/watch?v=IIJ2S6S2B2o – Israel air attack

25. conflict • Conflict is associated with: • Food shortages (as the physical environment can be destroyed) resulting in malnourishment/malnutrition (physical health). • The loss of lives – death. • Limited access to services and supplies as they may be destroyed by gun fire/bombs. • Water and sanitation facilities being destroyed, increasing the risk of coming into contact with contaminated water which can result in diarrhoeal diseases, such as typhoid, dysentery and cholera (physical health). • People become displaced from their homes as they may be destroyed or may have to flee because it is too dangerous (causing severe stress – mental health) • Increase in physical injuries and mental distress (physical and mental health) • Fewer children are able to attend school as the school may be destroyed or it may be too dangerous to leave the house (impacting on all aspects of health and HUMAN DEVELOPMENT)

26. conflict • When conflict ends things do not go back to normal, there are long lasting effects. Eg. presence of landmines, lack of infrastructure and families left without a male breadwinner and a female with very little education and/or skills for income. This may result in the female engaging in prostitution to earn an income for her family.

27. Political stability • When a country’s political system is stable, governments and individuals can work together to enhance economic development and living conditions. However, political instability removes the focus from the people as rival political groups struggle for power. • Decisions regarding the provision of adequate food, health care, and government infrastructure are usually not on the agenda when political instability is experienced. Rather political decisions focus on the deployment of troops and weapons of mass destruction.

28. Political instability Political instability is associated with: • Conflict and civil war (fight for power between different groups within the one country) • Trade restrictions between countries • Disruption to education – It may be too dangerous to leave the house • Lack of health care (the health system may have funding withheld meaning basic levels of health care are not available) • Human rights abuses (such as violence and rape) – activists may riot through the streets inflicting these behaviours on those opposed to the ruling party.