Evaluation of Healthcare Delivery

The world has made incredible progress in securing the health of communities. More hospitals are being opened and life expectancy has registered an overall increase. There has been an encouraging decline in infant mortality and improvements in immunization as a result of the effort that the world has committed to improving healthcare delivery (Hixon & Maskarinec, 2008). However, as Allen Hixon and Gregory Maskarinec point out in their commentary on the state of global health, the world still lags behind in numerous health issues. They call on practitioners in family health to do more to address the issues that the world continues to grapple with (Hixon & Maskarinec, 2008). The United States is among the countries that have made the greatest contributions to enhancing health for its citizens and the larger global community. However, there are still many failures and inefficiencies that hinder effective healthcare delivery. Compared to other developed nations that have invested heavily in healthcare delivery, the US performs poorly and urgent improvement is needed.

The impact of conflicts and violence 

The academic community has attempted to determine the impact that violent conflicts have on health outcomes. It has been established that these conflicts adversely affect human health (Devkota & Van Teijingen, 2010). Violent conflict often results in a breakdown of the public health delivery system. This makes it nearly impossible for healthcare professionals to deliver care to the victims of violence. The violent conflicts also cause deaths, injuries and leave victims traumatized. The United States has performed well in ensuring the security of its people. However, there are violent conflicts that have tested the readiness and stability of the country’s healthcare system. For example, in 2013, Boston suffered a bombing attack which led to the deaths of three people and left dozens injured. This attack revealed how prepared the US is to respond to violence and conflicts. The hospitals which received the injured were praised for their speedy and effective response (Gawande, 2013). Thanks to this response, the number of fatalities was limited. In the years leading up to the bombing and following the 9/11 attacks, hospitals in the US invested heavily in emergency preparedness(Gawande, 2013). Medical practitioners recognized the need to develop proper procedures for attending to those wounded in violent attacks. The response to the Boston bombing underscores America’s preparedness to address the health issues resulting from violent conflicts that occur domestically.

The US’s effort to minimize the adverse impacts of violence and conflicts that occur within its borders is indeed commendable. It is unfortunate that the rest of the world has failed to commit sufficient effort to protect communities against violence and conflicts. Today, different parts of the world are witnessing violent conflicts that are responsible for death, injury and suffering. For example, Syria has been gripped by a civil war that has claimed the lives of hundreds of thousands of civilians (Carey, 2017). The US is among the players that have been involved in this war. It has partnered with its allies in an effort to drive out terrorist groups and cripple the Syrian government. It is unfortunate that the US involvement in this conflict has had the effect of compounding the challenges that the civilians face. The US has faced accusations of bombing civilian populations (Dearden, 2017). These accusations point to the damage that violent conflicts have on the health of populations. The medical community has strived to deliver assistance to civilians who are trapped and facing devastation. Instead of receiving support from concerned stakeholders, this community has been subjected to violence. For example, there have been reports that hospitals are being targeted in bombing raids (Shaheen, 2017). Instead of serving as refuges, hospitals in Syria have become graveyards and war zones. Medical personnel have also been killed while others have sustained serious injuries. The situation in Syria is clear indication that the US has failed in its mandate to insulate vulnerable communities against the adverse impacts of violence and conflict. The international community is equally to blame for the suffering that communities facing violence are enduring.

While Syria is one of the countries that have suffered as a result of war, it certainly is not the only one. Yemen is yet another victim of violent conflict. The country is also in the grips of a civil war that has left thousands dead. This war has also led to the collapse of the country’s healthcare system. The outbreak of cholera is perhaps the most urgent crisis that has resulted from the violent conflict in Yemen. It is estimated that as many as one million people have contracted this disease (Westall, 2017). Thousands have already died. The situation in Yemen points to the fact that violent conflicts set the stage for the collapse of public health infrastructure and the outbreak of dangerous illnesses.

Violent conflict remains of the greatest challenges that the US and the global healthcare system face. To address these challenges, a number of improvements are needed. First, it is important for the US and the world to commit to build peace. The violent conflicts are the result of disagreement and lack of unity. The world needs to come together and condemn the targeting of civilians. Secondly, the US and the world should invest in healthcare infrastructure. This will allow for the treatment of victims of violence and conflict. These are achievable objectives that can be realized within ten years.

Food and nutrition 

In 2016, a study established that the world has more obese people than those who are underweight (“More Obese People”, 2016). This revelation is indeed frightening and highlights the need for more effort to combat unhealthy eating habits. The United States is among the nations where obesity is a serious public health concern. According to the Centers for Disease Control and Prevention (CDC), the rate of obesity among American adults stands at 39.8% (CDC, 2017). 18.5% of American youth are obese. These figures are clear indication that obesity is a serious challenge in the country. To understand why the US has such high rates of obesity, it is important to examine the food and nutrition trends in the country. It has been noted with concern that Americans consume more food. Americans particularly consume huge amounts of meat and this has been identified as among the factors responsible for the high rates of obesity (“Obesity in America”, n.d). Inactivity has also received blame for the high obesity rates. Many Americans have adopted sedentary lifestyles, thereby exposing themselves to the risk of becoming overweight and obese.

It is true that the American people have failed to invest in their wellbeing given the high rates of obesity. This is not to say that no action has been taken to promote healthier food and nutrition habits. Under the Obama administration, the Let’s Move campaign was launched in an effort to tackle obesity. The program seeks to encourage schools to offer their students healthier foods (Federal Government Takes Bigger”, 2010). This program also challenges the public and private health sectors to do more to combat obesity. Another initiative that the nation has launched involves healthcare reform. The government set aside $500 million which was ear-marked for obesity prevention initiatives(Federal Government Takes Bigger”, 2010).

The US is not the only country that faces problems with food and nutrition. Obesity is a global problem. The World Health Organization shared data on the state of obesity in the world. According to the data, 1.9 billion adults are obese (WHO, 2017). This figure paints a worrying picture as it suggests that billions of people are at risk of developing conditions that stem from obesity. Through the WHO, the global community has made tackling obesity a priority. A number of programs have been developed to prevent obesity. These programs include legislation aimed at regulating diets and promotion of physical activity.

Obesity is undoubtedly one of the greatest threats to public health. Malnutrition and underweight are other problems that the US and the world face. Barbara Bush and Hugh Welsh authored an article that focuses on malnutrition in the US. In the article, they observe that millions of Americans do not receive adequate amounts of vital nutrients (Bush & Welsh, 2015). This observation goes against the common belief that Americans are adequately nourished. Compared to developing nations, the US performs better as regards malnutrition. In developing countries, malnutrition is a serious problem that negatively impacts the health of populations. Women and children are the biggest victims of malnutrition. Such challenges as conflict and poverty are the main factors responsible for the high levels of malnutrition in the developing countries. Overall, the US and the world at large have failed to adequate address the problems of food and nutrition. The rates of obesity and malnutrition are unacceptably high.

It is clear that the US and the world have failed to fully address the problems of obesity and malnutrition. Improvements are needed if these problems are to be solved. In the next ten years, there are a number of measures that can be instituted to tackle these problems. Sensitizing the public on the importance of healthy eating habits is among these measures. The government, health practitioners and communities should join forces to educate the public on the need for healthy eating habits. Most of those who are malnourished are poor and lack the funds needed to secure healthy food. To promote the wellbeing of these people, governments need to invest in poverty eradication programs. These programs will go a long way in tackling malnutrition.

Global and national inequalities 

One of the resolutions made in the Declaration of the Alma Ata is that inequalities in the delivery of healthcare are unacceptable (Hixon & Maskarinec, 2008). The US appears to have disregarded this resolution. There exists glaring disparities in the distribution of healthcare services. Paula Braveman joined forces with other scholars to explore the socioeconomic disparities in healthcare in the US. They observed that “those with the lowest income and who were least educated were consistently least healthy” (Braveman et al., 2010). This observation is a scathing indictment of the US healthcare system. This system has failed to ensure that all Americans are able to access affordable and quality care regardless of their social and economic background. The poor and the less educated are not the only ones who have been denied proper access to quality healthcare. Ethnic and racial minorities also face challenges in their pursuit of quality healthcare. Furthermore, minorities endure a number of health problems that shorten their life expectancy. For example, in his examination of disparities in US healthcare, John Ayanian notes that the African American community loses many of its members to such illnesses as diabetes, cancer and heart disease (Ayanian, 2015). HIV, homicide and infant mortality are other challenges that the African American community grapples with. Poverty is among the realities that are to blame for the health disparities. The cost of healthcare in the US is prohibitively expensive (“Medical Waste”, 2016). This makes it difficult for poor and minority Americans to afford quality care.

To understand the poor state of American healthcare, a comparison with other countries is needed. The US lags behind its developed counterparts as regards the cost and quality of care (Rutkin, 2016). While other developed nations are able to deliver effective and affordable care to their people, the US struggles to ensure that its citizens are able to afford medical services. Inequalities in access and the distribution of healthcare are not confined to the United States. An examination of the state of global healthcare reveals that there are inequalities in the global context. Mauricio Barreto examined global health inequalities in an article that he authored. He notes that “health inequalities (are) a global problem which afflicts the populations of the poorest countries, but also those of the richest countries” (Barreto, 2017). Here, Barreto is acknowledging that inequalities are a problem in both developed and developing nations. To gain a full understanding of the inequalities, it is important to consider a developing country that struggles to deliver healthcare to its people. Malawi is one of these countries. Marte Ustrup and other researchers set out to investigate how effective the country’s healthcare system is in delivering care. They observed that there are a number of barriers that make it difficult for children to access care. These barriers include the huge amounts of time needed to visit healthcare facilities and the high costs of treatment (Ustrup et al., 2014). The problems in Malawi’s healthcare system do not end with high cost and difficulty accessing facilities. In addition to these challenges, the system also faces shortages of essential drugs (“Malawi Public Hospitals”, 2013). The challenges that Malawi grapples with highlight the inequalities in global healthcare. While the citizens of most developed nations enjoy access to quality and affordable care, the populations in poor countries encounter hurdles which make it difficult for them to access essential medical services.

That the world has made progress in addressing inequalities is not in doubt. However, these inequalities persist. The United States needs to lead the world in ensuring that all populations enjoy access to quality care. There are a number of initiatives that the country can implement towards this end. Sensitizing healthcare providers on disparities is among these initiatives (“Eliminating Racial/Ethnic”, 2008). For providers to respond to inequalities, they need to understand that they exist and have a detrimental impact on the health of communities. Another initiative that should be implemented involves providing health insurance to more people(“Eliminating Racial/Ethnic”, 2008). This measure promises to offer disadvantaged communities access to affordable care. Capacity building of facilities in underserved communities is yet another strategy that the US can employ to tackle inequalities(“Eliminating Racial/Ethnic”, 2008). The US government needs to work with minority communities to increase the number of healthcare facilities that serve these communities. To solve the global inequalities in healthcare, the world community needs to join forces and invest in developing countries. These countries lack the financial muscle needed to establish adequate health facilities. They need support from the rest of the world to improve the health outcomes of their people.

The Declaration of Alma Ata identifies a number of priorities that the world should focus on as it seeks to improve health outcomes. Encouraging progress has been made in meeting a number of these priorities. However, for the most part, the world has failed to deliver on the priorities. This becomes evident upon an exploration of the US and global healthcare sectors. In the US, millions lack adequate access to healthcare. The country also grapples with the problems of obesity and malnutrition. Disparities in health outcomes are yet another challenge that the US continues to face. The situation is replicated in other countries. Developing nations are particularly plagued by challenges that hinder healthcare delivery. Over the next ten years, the US needs to combine its resources with the rest of the world to combat the challenges that erode the progress that has been made. A global initiative holds the promise of improving healthcare for all.

References

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