INTRODUCTION
Lack of access to health care systems is believed to be a major cause of the high mortality rates, within all age groups in the world today. The case is true for children as it is for adults. It is also very evident among the poor lot. Although each state has put in place policies to enhance easy access of health systems, some factors such as race, ethnicity, socioeconomic status and education cause a constraint to the access to this health care systems and facilities. Unaffordability of health insurance is also an obstacle that many people have to overcome in order to access the health facilities. This is a major problem especially for the poor natives in the United States, the immigrants, and for the developing countries. Poor access to medical facilities is therefore the prime cause of high mortality rates and this poor access to health care systems is caused by a number of reasons.
In the United States particularly, immigrants have extremely low insurance coverage and lack access to quality health care facilities. Less than half of all immigrants are insured. Lack of access to health facilities leads them to experience challenges economically and socially. It leads them to rely on every opportunity of reduced hospital rates such as use of county-owned facilities instead of private owned ones. Some even rely on religious affiliated facilities for affordable and sometimes free services. Unaffordable insurance coverage and other constrains which include ethnicity are therefore responsible for the existence of some of the most dangerous killer diseases such as malaria, HIV/AIDS and tuberculosis. The ageing adults are quite vulnerable when it comes to accessing health care systems. This is because some of them lack health insurance. Some of the health facilities don’t have the right equipment used for the people with disabilities. The adults get more chronic related diseases as they advance in age. .
FRAMEWORKS TO UNDERSTAND HEALTH
A couple of frameworks are involved in understanding the constraints experienced in accessing health systems. Public health frameworks which are organized by public health agencies stand a better position to provide firm policies to enhance better health facilities. This is because public agencies can link people to the services they could not reach, for instance through offering immunization and guaranteeing proficient health facilities which are effective, accessible, and of good quality. These frameworks are developed by researchers and policy makers who have put their concern in to the dealing with the discrepancies associated with the access of health facilities. This frameworks focus on both individual-based and community based factors to analyze how these factors influence the disparities in accessing health care facilities .
One of the most popular frameworks is the Behavioral model, which has been in use since 1968 to date. It is also commonly known as the socio-behavioral model. This framework was initiated by Ronald Andersen. In its use, the framework focuses on three major types of factors; predisposing factors, such as demographics and health values, permitting factors such as income and insurance, and illness level or need factors. This model has been used in different ways. These include distinguishing between measures of potential access and measures of realized access. The model also has involved environmental aspects, fitness performance and health results in its functioning. It focuses on attributes that enhance access to health facilities such as fairness, competence, effectiveness and overall fitness.
Another framework focuses on the obstacles hindering the majority from utilizing health care facilities. This framework was initiated by Roy Penchansky and William Thomas and has been in place since 1981 till present. It agrees with the fact that individual-based factors play a significant role in effecting access to health care facilities. It theorizes that accessibility of health care facilities depends especially on what it refers to as a ‘fit’ between the sick person and the health care facility. This ‘fit’ can be gaged by convenience, approachability, and affordability of health care service. The ability of the health facility is prepared to attend to the clients is also used to measure the ‘fit’. This framework also incorporates a wide range of providers such as nurse practitioners. However, it excludes public health roles
A third model is the access to personal services model which was started in 1993 and is still present. This was developed by the Institute of Medicine. This model was initiated in order to observe individual’s access to subjective health services. It focuses on physical, individual and economic constraints to access of health facilities and their use. It involves an analysis of services offered to an individual, their quality, their efficiency, and the credibility of the services. It is quite open as compared to other models and use and the health results act as a measure of the accessibility of health care. It however does not involve public health.
Other frameworks include age-group based frameworks which are set to assist the different age groups gain access to the health care services they need. For instance there is a framework for the adolescents. This framework involves which is set to promote health literacy among the adolescents. It has been designed by the Institute of Medicine. It explains how peers, media, parents and systems in their lives influence their knowledge, use and access of health information . Another framework concerns the ageing adults. It is a regulatory framework involving the understanding of the quality of health care and quality of life for residents in residential aged care. this framework’s target is enhance easy access of health care services to the aged and maintain the quality of these services especially within the residential home for the aged.
HEALTH INTERVENTIONS AND HEALTH SYSTEMS
Health interventions are efforts that are employed to facilitate access and may consists of international health departments and non-governmental organizations. They are generally activities involved in preventing certain harmful health behaviors hence improving health conditions. They organize outreach programs to promote proper health behavior, for instance the programs on washing of hands and discouraging heavy drinking or stopping the use of harmful drugs. Health care systems on the other hand consists groups of people in organizations or institutions whose main agenda is to convey health services to target groups. A health system will deliver the necessary health services at any time in any place where there are needy people. The setup of these systems may vary from country to country but in general all systems share certain characteristics. Health systems must have funding systems, highly skilled man-power, dependable information to base resolutions and rules on and appropriate facilities and logistics to enable the supply of valuable medications and machineries.
Health systems and health interventions work hand-in-hand. They provide services that help promote health worldwide. A health system works on a strategy to improve health conditions day by day. A health system will focus on the living conditions of its target group and start the process of improving health conditions by improving the living conditions, for instance by building water reservoirs offering clean water, constructing toilets in an area that lacks some and also providing free tests of breast cancer. These activities will go a long way to better the living conditions hence reduce the cases of diseases in the society.
The government plays a big role in encouraging the performance of these health systems. The support offered to health systems by the government at even the county and municipal levels is of great importance in the improvement of the government’s health conditions. The governments therefore need to embrace the activities of health care systems and ensure that the benefits out of these systems are fairly distributed within the states. This has been recognized as one of the effective ways to eradicate poverty in poor countries hence better health conditions in general. The governments need to recognize the constraints of its people towards access of health care services, since apart from poverty others may lack infrastructure such as roads to access health facilities or even lack the necessary equipment to administer health services
Health interventions are particularly very vital for young people and adolescents. These age groups go through a lot due to peer pressure and urge to experiment. They are vulnerable to mishandling of drugs and sexual exploits. They need such interventions to control their consumption of drugs and to advice on use of contraceptives since there are a lot of teenage pregnancies for instance this will also reduce on te rate of deaths among these age groups. Interventions are known to narrow down disparities such as poverty, discrimination and other factors affecting the youth today. They are also known to encourage learning among these age groups in schools. Good health is a key factor in performance . CASE STUDY: MALARIA
Malaria is one of the most dangerous diseases in the world creating a great menace. It is believed to affect mainly the countries in the tropics which constitute of Africa, Asia and Latin America. In the United States there are quite few cases; the people travelling to malaria infested areas may catch it though. Malaria is treatable and the treatment is even more effective while in its initial stages, but when advanced it is likely to lead to death if not handled fast enough. Malaria is a disease caused by the bite of an Anopheles mosquito. Not all mosquitoes cause malaria. Yearly, over a million deaths are experienced due to malaria. Malaria is most dangerous to children under the age of five because their body systems are not strong enough to fight malaria. At this age the resistance is still weak. Cases of children dying of malaria are especially most in Africa .
One of the reasons why malaria causes a lot of death in the tropics is because of the economic status of most of these countries. The people need to purchase drugs and the hospitals need the right equipment to diagnose and treat malaria, yet these needs cannot be met without money. Another reason is ignorance. The people lack proper information on the prevention measures such as the use of treated mosquito nets. Most countries lack malaria prevention vaccines and efforts to develop such technologies are quite poor. Research is however encouraged in the efforts to eradicate malaria. Some countries, especially in the United States have successfully eradicated malaria .
The multiple life cycles of the mosquito parasite, the plasmodium, allows the parasite causing malaria to easily adapt to the drugs used in treating malaria hence making it difficult to eradicate malaria. Spreading insecticides is one of the ways that the united states have used to eradicate malaria. These chemicals are however believed to have detrimental impacts on the environment hence are only advisable under extreme circumstances such as epidemics. Another preventive measure is educating the people concerning safety measures. They include use of mosquito nets and the clearing of swamps and shrubs neighbouring their households which hold stagnant water and become breeding sites for mosquitoes. Governments are engaging in efforts to source for both anti-malaria and curative drugs to provide the people with a solution. Malaria is not only a problem to the human body but also to the economy as a whole since the more people are infected the less the work days spent making income.
GLOBAL INTERVENTIONS AGAINST MALARIA
Malaria is not only preventable but also curable. In the efforts to fight and possibly eradicate malaria, interventions have been involved. These interventions include supply of insect-treated mosquito nets, creation of awareness among the ignorant communities, indoor residual spraying, and efforts to provide curative drugs and preventive vaccines especially to children of the ages under five. New drugs are being produced time to time to counter the problem of the parasite mosquito gaining resistance. The several interventions that are available are mainly costly. It calls for health systems especially non-governmental institutions to invest in these interventions. Most of the existent interventions are enacted in African countries and especially to the poor since they need access to the cure .
Some bodies have taken an initiative to fund the organizations that conduct these interventions in poverty-stricken countries. These include the President’s Malaria Initiative (based on US Global Health Initiative); Global Fund to Fight AIDS, Tuberculosis and Malaria; and the World Bank Booster Program for Malaria Control in Africa. In order to achieve effectiveness since it is difficult to fund all countries at a go, a selection of countries in which malaria is most severe is done . The organizations that have dedicated themselves to fight malaria in Africa include the Africa Fighting Malaria (AFM), the united nations as a whole( they have incorporated it in their millennium goals, World Health Organizations (WHO), united nations children’s funds (UNICEF), Centers for Disease Control and Prevention ( CDC), Malaria intervention project (MALIP), Roll Back Malaria (RBM) and the Global Malaria Action Plan.
Most of these organizations are much progress in the eradication of malaria. The united states are a success story of eradication of malaria. This gives hope to eradication Africa, though this will take time due to the poverty in African countries. The WHO has since 2010 been working on a five year strategy against malaria. This far, they’ve succeeded in delivering enough insect-treated mosquito nets in Africa, hence saving around 580 million people. Due to WHO’s efforts and other supportive partners, around eleven African countries have cut out malaria cases by half. UNICEF has also largely progressed in the reduction of malaria cases. Since 2000, they’ve greatly distributed insect-treated mosquito nets across sub-Saharan Africa. They target at increasing their coverage for their interventions since this will consequentially reduce the malaria coverage in Africa. .
CONCLUSION
It is evident that poor access to health care systems is a major cause of deaths in the world is a leading cause of high morbidity and mortality rates. This is caused by a number of reasons but the prime reason is poverty. In most cases the people cannot afford health insurances, drugs or even in some cases the hospitals lack the necessary equipment for treating certain diseases. Interventions are therefore made by both governmental and non-government institutions and organizations to bridge the problem of poor access to health care systems.
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