Afghanistan is a country with one of the most impoverished health statuses. With a high mortality and morbidity rate, it requires focus from health agencies that promote global health. Nursing practice is one of the areas in which Afghanistan has fallen short over the years ( Madsen, 2012). With a majority of their problems relating to reproductive health and a high maternal and child mortality rate, nursing practice is essential to ensure that the goals of global health are achieved. Global health is focused on improvement of health, mitigation of disparities, and preventing global threats in the national borders. World Health Organization (WHO) plays an important role in global security and the health security of individual countries ( Madsen, 2012). The World Health Organization (WHO) advocates for new guidance that promotes cooperation between developed and developing nations on emerging health concerns (Rahmani&Brekke, 2013). This paper will focus on the global health priorities, strategies and initiatives, and the role of the global health nursing practices in mitigating the health care situation in Afghanistan.
Description of the Country
According to Madsen (2012), the geography of Afghanistan is made up of a rugged landscape that is mainly covered by mountains. The population of Afghanistan stands at 32 million with a GDP of $62.3 billion as asserted by Madsen (2012). The economic status of Afghanistan is stable with improvements marked on a yearly basis ( Madsen, 2012). The key contributors to the economy of the country include agriculture and the construction industry. Recently in 2016, it became a member of World Trade Organization. The country experiences political problems and security challenges on a frequent basis ( Madsen, 2012). The rule of law is yet to be fully realized in the country and the people have lost immense confidence in the government for failing to provide basic services. There is a wide systemic corruption in government institutions, courts, banks, among other sectors of the economy asserted by Madsen (2012). According to the World Health Organization profile, life expectancy of the country is at birth is 60 years and the fertility rate is at four births per woman (see: Appendix I). The rate of population growth is at 2.7% annually . The major ethnic groups include Tajik, Pashtun, and Hazara among others (World Health Organization)
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Global Health Priorities
Afghanistan is a country that has been at the helm of major political crises and severe droughts ( De Cock et al., 2013). These and many other factors have resulted in the deplorable health situation in the country, making it among the worst in the world. The WHO, with various health organization and authorities, has prioritized some of the health concerns that have since marred the country ( De Cock et al., 2013). The first priority in the country is to improve child health, infectious disease control, and immunization. Most premature deaths in the country are caused by diarrhea, pneumonia, measles, and tuberculosis, all which can be immunized against. It is vital to note that only 32% of the children in Afghanistan are immunized against these diseases ( De Cock et al., 2013). Therefore, to tackle the communicable diseases, health workers will be trained, integration and improvement will be made on the management of childhood diseases, lifesaving drugs will be provided, and child immunization levels will also be increased to maximum levels ( De Cock et al., 2013). The second priority in the country is to ensure that women can access reproductive healthcare. According to Madsen (2012), Afghanistan experiences one of the highest maternal mortality rates in the world with a whopping 17000 dying annually as a result of pregnancy-related complications. The health strategies that have been put forward will target obstetric care and strengthen other health care services such as the management of gynecological problems (Rahmani &Brekke, 2013). The focus will also be on educating the women when and where to pursue medical advice during pregnancy and childbirth. The third priority is to address the cases of malnutrition and malnutrition deficiencies in the country De Cock et al. estimates that almost half of the children in the country suffer from nutritionally related illnesses, including chronic malnutrition, which is a deadly disease ( 2013). The priority will focus on establishing surveillance mechanisms, referring those who are severely malnourished, and health education (Mayhew et al ., 2014).
Challenges Faced by the Country in Meeting the Health Priorities
The health sector in Afghanistan has faced years of neglect, an institutional vacuum, and under-funding (Rahmani & Brekke, M. 2013). The conflict experienced in the country has led to inadequate infrastructure, poor facilities that are unevenly distributed across the country, insecurity, and poor communication that have resulted in inaccessibility to health services. The country has also experienced a shortage in health care personnel especially women (Rahmani & Brekke, 2013).There is also a poor information system and weak implementation policy therefore approved national health guidelines cannot take effect as required (Rahmani & Brekke, 2013). The incidence of epidemic in the country is high and frequent including hemorrhage fever, cholera, meningitis, and measles among others thus jeopardizing the health system (’’Humanitarian Health Action’’).
Global Health Strategy
The government in the country has rolled on a program to ensure that the citizens are covered under medical insurance at low cost (Zainullah et al., 2014).This is a program which was recently launched by the governments and it still three months young and hence facing heel of challenges. The program will ensure that citizens have insurance covers at low cost to ensure that each citizen receive healthcare whether they are poor or rich. The purpose of this strategy is as follows: first, it will ensure that healthcare is evenly distributed to all population as this has been a problem I the country due to conflict as asserted by Zainullah et al . (2014). It will also ensure that the healthcare facilities are well funded by the insurance companies and hence staffing and facilities may not be a problem anymore. It is also aimed at enhancing primary care facilities, this inclusive of productive care, martial care and many others (Rahmani & Brekke, 2013).This will reduce the rate of mortality and morbidity within the country which has been prevalent for many years. This project has been supported by many organization inclusive USAID, donors and much more.
Global Health Nurses’ Role
As Global nurse, and with the developing expectations of the population and the cost containment strategies, I have pivotal role to play in global health. Zainullah et al. (2014) asserts that in meeting the demands of their clients, I have a role to play in implementing a care model that is patient centered. Therefore for perfect global nurse, my roles have to be redefined in the healthcare system so that they can be a central position between the doctors and the community. Also as a global nurse, I must show a high level of collaboration, cultural sensitivity, and must be aware and knowledgeable of diseases that have no borders such as cancer, diabetes, obesity, and other infectious diseases. I have to depict competency in community health to be successful in supporting global health work (Diana Austin, 2013). In a global health setting, my role goes beyond just providing healthcare to the patients. According to De Cock et al . (2013), they are an integral part in creating policies that define how care should be given and also giving best solutions that can mitigate a health condition facing a country.
In addressing reproductive health concerns in Afghanistan, My preferred role would be on enlightening the masses through education on the dangers that may lead to maternal death. This I believe is the only solution to address the health concerns in the country. I would ensure that the women are educated on the importance of prenatal and antenatal tests and other screening tests that help mothers have healthy pregnancies. I would try and collaborate with other bodies such as the media to ensure that I reach many people or many women and educate them on issues pertaining maternal health. I will also ensure that I meet most of the mothers in the village or reach them through media to encourage participating in follow-up activities that help in monitoring the pregnancy. I will also ensure that within this period, I play a role in reducing child mortality rates; with this in mind, I will ensure that I educate the community on the importance of immunization during and after pregnancy (Rahmani & Brekke, 2013).
Conclusion
In conclusion, analyzing the aspect of global health has proven to be important because through it I have learned various new pieces of information such as the major health concerns in Afghanistan, how international health organizations have since intervened, and the roles of nurses in global health issues. What I have come to understand in this case is that mores skills need to be in place to ensure that healthcare promotion especially maternal care sensitization is being achieved in a country. I have learned that as a global nurse, it is very paramount to have collaborative skills too in addition to the nursing skills due to the fact that in meeting some global challenges, partnership and collaboration is very necessary.
References
World Health Organization. (n.d.). Humanitarian health action . Retrieved From
http://www.who.int/hac/donorinfo/afg/en/index1.html
De Cock, K. M., Simone, P. M., Davison, V., &Slutsker, L. (2013).The new global health. Emerging infectious diseases , 19 (8), 1192.
Diana Austin, (2013), ‘’Envisioning the Future of Global health Nursing’’ https://scienceofcaring.ucsf.edu/global-health/envisioning-future-global-health-nursing
Madsen, E. L. (2012). Afghanistan, against the odds: A demographic surprise. Environmental Change and Security Program Report , 14 (1), 0_1.
Mayhew, M., Ickx, P., Stanekzai, H., Mashal, T., &Newbrander, W. (2014).Improving nutrition in Afghanistan through a community-based growth monitoring and promotion programme: A pre–post evaluation in five districts. Global Public Health , 9 S58-75. doi:10.1080/17441692.2014.917194
Rahmani, Z., &Brekke, M. (2013).Antenatal and obstetric care in Afghanistan - a qualitative study among health care receivers and health care providers. BMC Health Services Research , 13 (1), 166.Doi: 10.1186/1472-6963-13-166
Zainullah, P., Ansari, N., Yari, K., Azimi, M., Turkmani, S., Azfar, P., & ... Bartlett, L. (2014).Establishing midwifery in low-resource settings: Guidance from a mixed-methods evaluation of the Afghanistan midwifery education program. Midwifery , 30 (10), 1056-1062. doi:10.1016/j.midw.2013.10.026 https://libguides.tru.ca/c.php?g=194005&p=1418555
