The World Health Organization, or WHO, has the main objective of building a better future for every person. According to the organization, its main role is to coordinate and direct international health. It concentrates on several main areas that it works in including response, surveillance, health systems, preparedness, non-communicable diseases, promotion of health through the life-course, and communicable diseases. The Millennium Developmental goal (MDGs) are eight which are agreed on by the United Nations (UN). Their objective was to achieve the eight goals by the end of 2015. They MDGs are quantified and time-bound targets used in addressing severe poverty in its different dimensions like hunger, lack of acceptable shelter, disease, environmental sustainability, education, exclusion, and income poverty. This assignment aims at evaluating the MDG’s goal on decreasing the under-five mortality rate by two-thirds, Malawi’s progress on the goal and the health disparities. The paper also analyses the nursing roles plus any related strategies.
Global Health Goals
According to WHO, the main global health goals include eradicating severe hunger and poverty. The goal was to reduce the proportion of people suffering from hunger and improve the income of those who earn less than a dollar in a day by the year 2015 (Cohen, 2014) . The second goal was to decrease the under-five mortality rate by two-thirds by 2015. The third goal was to decrease the mortality rate ratio by two-thirds by 2015. The fourth goal was to eradicate all diseases especially malaria and HIV/AIDS by 2015. The next goal was to ensure that there was environmental sustainability by 2015 to ensure that they have access to basic sanitation and safe drinking water (WHO, 2018) . The last goal was to cultivate a global partnership aimed at the development to ensure that there is access to essential drugs in developing countries. One of the most important goals is decreasing the under-five mortality rate by two-thirds as it ensures the survival of children who are under the age of five so that they have the opportunity to fulfill their full potential.
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Malawi is considered to be one of the poorest nations in the African continent, and most of the international donors who provided the country with 40 percent of its budget abandoned the nation in the previous decade. The action was as a response to the late predicant Bingu wa Mutharika’s authoritative rule. Despite the challenges, the country has made great progress in reducing the under-five mortality rate. It is worth noting that in 1990, more than one hundred thousand children died each week in the country before reaching the age of five. It gave the densely populated nation one of the top under-five child mortality rates around the world. Despite the challenges that Malawi faces, it has managed to bring down the number to around 43,000. Most of the improvements are from 2000, and their pace of progress is accelerated.
Despite the success in the country, the current number shows that it is far from complete because the mortality rate is still high. The nation still has an under-five child mortality rate that is higher than the global average (Stephen, 2014) . However, the country is expected to see some improvement because it is among the 176 government that have dedicated themselves to improve child survival rate as part of their promise.
Nursing Role
Who strategy for dealing with under-five child mortality rate include the promotion of four main strategies that include infant and young Children feeding and promoting extended programmes on immunization. The other strategies include promoting integrated management of illnesses for under-five years’ children and suitable home care plus timely management of complications among newborns. These strategies can only be supported by interventions from nurses based on their roles. According to research done by Ustrup (2014), there are barriers that faces the country in trying to improve the health of under-five children. The barriers include socioeconomic inequality among people in Malawi. The research suggests for improved access of poor households to health knowledge and healthcare services. It also suggests for community-based interventions that would improve people’s healthcare-seeking patterns. Improved health communication efforts can improve the carer’s ability to determine the seriousness of an illness and develop the necessary response. Based on the research, the roles of nurses that support this MDG include the following;
Health promotion
Through health promotion, nurses get the opportunity to give patients the information needed to manage and eventually improve their health. The nursing role is vital in the country in terms of improving the under-five child mortality rate. A nurse’s work environment can make it easy for nurses to take advantage of the routine interaction with the patients to educate them of taking care of children to ensure their survival. Nurses can also partner with the local members of the community to provide the information in the remote areas of the country to ensure the success of the initiative.
Preventive Care
As healthcare costs continuously increase, preventive care has become more valuable. Preventive care is especially valuable to develop countries such as Malawi that struggle to manage the current healthcare costs. The strategy of preventive care concentrated on helping patients to maintain their health as opposed to treating illnesses and diseases when they develop. It is a nurse role that can be useful in helping Malawi achieve its target MDG. It is a role that is in line with health promotion and has three levels. The first level is primary prevention that involves developing strategies aimed at preventing risk factors plus avoiding the development of unhealthy behaviors (Kemppainen, 2012) . Prevention strategies include immunization of children who are under five to protect them from getting preventable diseases. The next strategy includes identifying children who currently possess the risk factors such as those with malnutrition and lastly managing the diseases and illnesses identified to avoid more deterioration. At its core, preventive care for patients needs to be key, and the daily interactions between patients and nurses should provide the opportunity for education. When continuously practiced, preventive care can help in saving lives in the country.
Health Disparity and Findings
Health disparity is the difference between health care and health among populations. Health disparities have an impact on the underserved or vulnerable populations in terms of increasing the risk among these people to getting serious diseases. One group that experiences health disparity in Malawi include the poor. According to Zere (2007), there are pro-rich inequities in the country that keeps on increasing. The research further indicated that the non-poor population who are already experiencing low burden from diseases get more of the interventions. However, the poor who are at a higher risk of diseases, use less of the healthcare interventions. The research also indicates that publicly provided services for some of the country’s interventions benefit non-poor more than those who are poor. For example, with regards to child malnutrition in the country, there has been an increase in inequality from 1992 to 2004. Malawi is still under the category of serious stinting with a cutoff of ≥ 40%.
Nursing Strategies
Even with the disparity identified in the country, there are two main effective nursing strategies in improving the situation to make sure the achievement of the MDG targets among the poor segments of the community. The strategies include the following;
Access to care
The fact that those who are not poor get more benefit from publicly provided services is a concern. There is a need to concentrate on getting effective ways of leveling the scares resources. Initiatives that include designing essential healthcare package and implementing sector-wide approach (SWAp) are not equitable if they are not complemented with strategies and policies that uphold the idea of equity. Therefore, it is critical for the country to assess the initiative in terms of efficiency and also its accessibility to the vulnerable community.
Health education
Knowledge of the current problem and ways of improving the situation is critical for the government to implement the necessary steps needed to solve the disparities. Also, it is critical for the country to implement the strategy of educating the patients on the importance of accessing healthcare facilities to ensure that there is equity in the provision of healthcare. Healthcare practitioners can also partner with the local members of the community to provide the information in the remote areas of the country to ensure the success of the initiative.
Conclusion
From the analysis above, it is evident that one of the main global health goals is decreasing the under-five mortality rate by two-thirds as it ensures the survival of children who are under the age of five so that they have the opportunity to fulfill their full potential. Malawi has been able to make improvements towards reaching the goal. However, the nation still has an under-five child mortality rate that is higher than the global average. Nurses can assist in improving the situation by partnering with the local members of the community to provide the information in the remote areas of the country to ensure the success of the initiative. Some effective strategies, in this case, include making sure that every person has equal access to care and that there is the promotion of health education in society.
References
Cohen, R., L., Et. Al. (2014). Country progress towards the Millennium Development Goals: adjusting for socioeconomic factors reveals greater progress and new challenges. Global Health. 10: 67. , 1-5.
Kemppainen, V., Tossavainen, K., &., Turunen, H. (2012). Nurses' roles in health promotion practice: an integrative review. Health Promotion International , 490-501.
Stephen, N. (2014, 01 24). 21st Century Progress in Africa: Achieving MDG 4 in Liberia and Malaw . Retrieved from Bill & Melinda Gates Foundation: https://www.impatientoptimists.org/Posts/2014/01/21st-Century-Progress-in-Africa-Achieving-MDG-4-in-Liberia-and-Malawi#.XL54lrtR3Dc
Ustrup, M., Et. Al. (2014). Potential Barriers to Healthcare in Malawi for Under-five Children with Cough and Fever: A National Household Survey. Journal of Health, Population and Nutrition 32(1) , 68–78.
WHO. (2018, 04 21). Health-related Millennium Development Goals and Targets . Retrieved from WHO: https://www.who.int/gho/mdg/goals_targets/en/
Zere, E., Et. Al. (2007). Equity in health and healthcare in Malawi: analysis of trends. BMC Public Health. 7 (78) , 1-5.
