- Nutrition as a Risk and Protective Factor:
Dietary imbalances, the excess and deficiencies shown in poor diets are a contributing factor to many diseases, some of which are the major causes of morbidity and mortality in Australia. Over 60% of deaths in Australia are diet related, and mostly preventable if nutrition status could be improved.
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A risk factor is said to be any factor which represents a greater risk or influences getting a disease or condition.
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Protective factors are factors which assist in guarding against a disease.
Malnutrition is the lack of the right kind of foods e.g. osteoporosis, anaemia
Under nutrition is inadequate consumption of food e.g. anorexia, bulimia
Over nutrition is over consumption of foods, e.g. obesity, CVD, diabetes.
The seven diet related diseases are:
- Cardiovascular Disease
- Type 2 Diabetes
- Colorectal Cancer
- Obesity
- Osteoporosis
- Anaemia
- Dental Decay
Cardiovascular disease includes all diseases involving the heart and blood vessels. It includes; coronary heart disease, stroke, heart failure, peripheral vascular disease, angina, arthrosclerosis. The condition of cardiovascular disease has been decreasing since the 1960’s, however in 1998, CVD accounted for 40% of all deaths in Australia. Risk factor associated with CVD include: high blood pressure, overweight, a diet high in saturated fats and salt and low in fibre, poor levels of physical activity, smoking, and a family history. It is preventable, because the majority of the risk factors for CVD are lifestyle related disease.
Overweight and Obesity is where the body stores too much fat. If the energy intake from food is greater than the energy expended, then the excess is converted to fat. The health risks associated with being overweight or obese are diabetes, gall bladder disease and cardio-vascular disease. Colorectal cancer and breast cancer can also occur as a result of being overweight. The rates of overweight and obesity have been rising with the increased consumption of processed foods. Factors influencing overweight and obesity include: gender, age, hormonal factors, and genetics including body type, eating patterns, lack of physical activity, more sedentary lifestyles, increase in convenience foods, and increase in technology.
Colorectal Cancer includes cancers of the two main sections of the large bowel, the colon and the rectum. It develops from polyps that form on the lining of the bowel. The main risk factors for colorectal cancer are: family history, age, diet high in saturated fat and low in fibre and lack of exercise.
Diabetes Mellitus is when there is too much glucose in the blood. It is a condition where the pancreas produces inadequate or ineffective insulin. This means that the body is unable to produce carbohydrates normally. There are 3 main types of diabetes. These are: Type I, Type II and gestational diabetes. Type 2 diabetes is the only diet related type. This is where the body may produce enough insulin; however the action is blocked by fat around the cells. The body compensates for this by producing excess insulin. The main risk factors for type 2 diabetes is age, obesity, gestational diabetes, and a high fat, low fibre diet.
Anaemia refers to an inadequate level of red blood cells or an inadequate haemoglobin level in the body. Anaemia occurs when the bloodstream is unable to transport oxygen to the body cells. It can cause sever fatigue, pale skin, headaches and dizziness. Risk factors for anaemia include: gender, pregnancy, infants when being weaned, and diet, if it is low in folate and iron.
Dental Decay is the destruction of the enamel of a tooth. Plaque builds up on the tooth’s surface and decay results from the bacteria that live in the plaque. Over time, the plaque can also cause loosening teeth and gum disease. Risk factors for dental decay include: diet; a diet high in sugar increases risk of cavities, and also if the diet is low in calcium, water and fluoride. Regular brushing and flossing reduces the plaque build up.
Osteoporosis involves thinning of the bones. The structure of the bones becomes weaker due to the loss of both mineral and bone matrix. Over time, the bones have less available calcium and become more brittle, fragile and tend to break. This means it increases the risk of fractures. The risk factors for osteoporosis include: diet; especially inadequate consumption of calcium in early life, gender; women have a much higher rate of developing osteoporosis, hormone production also influences this condition as women with low oestrogen levels have a higher risk.
- Population Groups in Australia:
Males & Females:
Socio-economic Status:
Rural and Remote:
Aboriginal & Torres Strait Islanders:
- Consequences of Dietary Imbalances for Individuals and the Community
Consequences of a condition can be measured in terms of:
- Direct costs
- Indirect costs
- Intangible costs
Direct costs are associated with providing health services to people, diagnosis and treatment. They include:
- Hospital fees
- Pharmaceutical costs
- Medical services
- Ambulance costs
- Nursing home costs
Indirect costs are those that are not always directly related to a disease, but are incurred as a result of a disease or illness. They include:
- Absenteeism
- Staff turnover
- Reduced productivity
- Loss of earnings as a result of premature death
- Costs of employing someone to look after an invalid
Intangible costs are difficult to identify, but can generally be described as the social and emotional costs. They include:
- Pain
- Suffering
- Anxiety
- Decrease in the quality of life, and in particular health.
Area of study 2: Promoting Health in Australia
- Changes in Approaches to Health Care:
The old health care system was called sanitary reform. The main aim of this was to address hygiene in the community, including garbage, sewage, antibacterial hospitals. This occurred in the years between the late 1700’s to around 1860.
From about 1860, came the development of the Biomedical Approach to health care, which included the dominance of medical science. During this time many technological advancements relating to health care occurred, including antibiotics, x-rays and vaccines. It was also on detecting illness as well as curing it. This approach was dominant until the 1970’s.
During the 1970’s, preventative health was the focus, which mainly looked at preventing people from getting illnesses.
The new public health approach was developed in the 1980’s, and it was called the Social Model of Health. This approach believed that social factors were the underlying cause of health, and that a change in the individual’s behavior could improve health. The Ottawa Charter was developed to reflect the Social Model of Health.
Social Model of Health: The Social Model of Health is a conceptual framework within which improvements in health and wellbeing are achieved by directing effort to addressing the social and environmental determinants of health. Some examples of these determinants include: shelter, food and water supply, employment, education, social connectedness, socioeconomic status, culture, gender, peace and conflict.
The social model of health is based on five principles. These are:
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Address the boarder determinants of health: health is determined by a broad range of social, environmental, and economic factors, not just biomedical risk factors. Differences in health status are linked to all these factors.
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Involves inter-social collaboration: The social and environmental determinants of health are not addressed by the health sector alone, and require collaboration at a government level as well as in the private sector.
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Acts to reduce social inequities: equity is a key principle for health care delivery. The social model of health acts to reduce the inequalities that are related to factors such as gender, culture, race, socioeconomic status, location and physical environment.
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Empowers individuals and communities: people have the right to participate in decisions regarding their own health and access to skills and resources they may need to change factors which influence their health.
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Acts to enable access to health care: health services should be affordable and available according to peoples needs. Health information should be available to all in accessible and appropriate formats.
The Ottawa Charter: The Ottawa Charter for health promotion was developed from the social model of health. The charter defines health promotion as “the process of enabling people to control over and improve their health”. Underlying the Ottawa Charter is a number of prerequisites for health, which are fundamental conditions and resources for health.
The five priority action areas identified by the Ottawa Charter are:
- Building healthy public policy
- Create supportive environments
- Strengthen community action
- Develop personal skills
- Reorient health services
- The Structure of the Australian Health Care System
Medicare: Medicare is Australia’s universal or National Health Insurance scheme, introduced in 1984. It is administered by the Federal Government, and it subsidizes the cost of medical care and the Pharmaceutical Benefits Scheme. Most Australians pay a Medicare levy of 1.5% of taxable income. High income earners who do not have private insurance pay an additional 1% levy. Low income earners do not pay a levy. 90% of their funding goes on curative care, the remaining going to prevention and health.
The principles of Medicare are:
- Universality – all Australians
- Equity – those who earn the most, pay the most
- Accessibility – priority according to need rather than income
- Efficiency – costs are kept low
- Simplicity – claiming is easy
- Affordability – cost should not be an issue
- Quality – good quality care
- Free choice – consumer chooses health care provider
- Health promotion – focus on preventative strategies where possible
The government encourages people to take out private health care insurance by:
- 30% rebate
- Lifetime cover
- Extra Levy
- The Values that underpin the Australian Health Care System
The four main values which underpin the Australian Health Care System are:
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Appropriateness: Health services that are culturally and gender appropriate
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Access and equity: services for the whole population including those from disadvantaged and vulnerable groups.
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Efficiency: relative costs and benefits and therefore whether the best value is being met.
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Effectiveness: of programs in preventing disease and reducing early mortality.
- The Development of the National Health Priority Areas
The National Health Priority Area is an Australian initiative in response to a global strategy to improve health. These strategies are the WHO’s commitment to achieving health for all and they outline the aims to achieve the highest possible health for all people. The National Health Priority Areas focus on factors that contribute the most morbidity and mortality of Australians. The particular diseases and conditions were selected because they were areas which significant gains in the health of Australians can be achieved. The seven priority areas identified are:
- Cardiovascular Health
- Cancer Control
- Injury Prevention and Control
- Mental Health
- Diabetes Mellitus
- Asthma
- Arthritis and Musculoskeletal Conditions
- Factors affecting the Provision, Selection and Purchase of food
The four factors which influence the provision, selection and purchase are:
- Behavioral
- Economic
- Environmental
- Social
Behavioral: Some behavioral factors include:
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Taste preference: could prefer sweet foods. People aren’t going to choose foods which they don’t like the taste of, or the smell, appearance and texture of the foods could also have an influence.
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Physiology: the way the body uses energy, hunger, appetite, and the body’s ability to store extra energy.
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State of Health: during depression or illness people can choose or not feel like eating. Taste and smell can be diminished.
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Stage of life: during old age, people’s taste buds become less sensitive to taste. Pregnant women may crave certain foods, and a lot of children don’t like eating veggies.
Economic: some economic factors include:
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Food systems and the food industry: Begins with food production, then the purchasers, then the distributors, such as supermarkets.
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Marketing food: food promoters and advertising. Confectionary is most marketed. Specials in supermarkets is also counted as marketing.
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Cost of food: food prices, production costs, product demand. Healthy foods are generally more expensive.
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Income: high incomes can afford fruit, veggies, low fat, and wholegrain varieties of food. Low income earners are not likely to get all the essential foods.
Environmental: some environmental factors include:
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Natural environment: Australia has low rainfall, and large arid areas, however we have quite fertile soils. Geographical remoteness is also a factor.
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Individual environment: access to affordable and appropriate foods, location and transport.
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Political environment: food law, food standards and policies
Social: some social factors include:
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Learning and experience: bad experiences could cause people to avoid that food in the future. Includes learning knowledge, beliefs, values, and attitudes.
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Family: Mothers influence, food as a reward, parent’s food and health knowledge, fussy eaters, and family lifestyle are all ways in which family influences food choices.
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Friends and peers: people who you are out with, going out for dinner, or going to the movies.
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Age: children get their food cooked for them as do elderly people in nursing homes.
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Gender: females generally have a better understanding and knowledge about foods, and are also usually the main cookers in a household
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Social trends: increase in people working especially women means a decrease in the amount of cooking time that they have. Healthy choices are becoming more popular.
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Body images: weight loss can lead to eating less which can lead to many illnesses.
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Education: knowledge about what foods to eat and how to cook.
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Ethnicity: religion, language, tradition, beliefs, lifestyle, access can all influence eating patterns.
- Role of Governments in Promoting Healthy Eating
The Commonwealth Government: the commonwealth government is responsible for policy making, funding for health promotion, and public health programs, nutrition education and research. Some examples of government funded programs and institutions are:
- Australian Institute of Health and Welfare
- National Health and Medical Research Council
- Dietary Guidelines for Australia
Many of Australia’s policies for public health are written into the National Health Priority Areas and the National Health Strategies.
The State Government: the main role of States and Territories in Public Health include: identification of public health issues, intervention, monitoring of outcomes, policy development, food safety, establishment of prevention and early detection programs including maternal and child health, health promotion for specific groups, an a range of other roles.
The Local Government: The responsibilities of local governments include the monitoring of food safety, which includes the work of environmental health officers, the provision of meals on wheels, and the work of community nutritionists. Some areas have developed local food and nutrition policies.
The role of nutrition in public health:
In Australia the role of nutrition in public health is extremely important and is given much focus by many organizations. Public health nutrition focuses on issues affecting the whole population rather than specific dietary needs of individuals, and is addressed in various ways by both government and non government organizations. It includes:
- Health promotion activities relating to food consumption
- Strategies related to recommendations for healthy eating, such and the Dietary Guidelines.
- Strategies and action plans that also focus on vulnerable population groups such as indigenous Australians, such as “Eat Well Australia”.
- Policy development, such as food standards and nutrition labeling.
Government food choice models: a food selection model is a representation of nutrition and food knowledge which can be used as a tool for education people about healthy eating. 60% of Australia’s burden of disease is made up from diet related diseases. If people are eating the rights amounts of foods and getting all the nutrients they require this risk of develp0ing diet related conditions is reduced.
National food and nutrition policy: this was introduced in 1992, and was developed to provide Australians with access to safe, nutritious and acceptable food, and its aim was to make healthy food choices easier, and reduce the diet related diseases in Australia. It is built on the 5 key principles of:
- Social justice
- Quality of the food supply
- Community participation
- Food/nutrition system and its wider interaction
- Ecologically sustainable development
This policy aims to:
- Improve the knowledge and skills necessary for Australians to choose a healthy diet.
- Incorporate food and nutrition objectives into a broad range of policy areas and sectors
- Support community based initiatives towards improving the diet of people with special needs.
- Regularly monitor the food and nutrition system
Eat Well Australia:
EWA was implemented by SIGNAL. It contains 2 national public health nutrition strategies. One focuses on the whole population, and another on Indigenous Australians. It was developed with people from government, non government and industry organizations. The 5 main priorities of EWA are:
- Preventing overweight and obesity
- Increasing the consumption of vegetables and fruit
- Promoting optimal nutrition for vulnerable groups including rural and isolated populations, low income groups and Indigenous Australians
- Addressing the structural barriers to safe and healthy food
Australian Dietary Guidelines:
These were developed by the NHMRC. The 3 groups targeted by the ADG are: Australian adults, children and adolescents, and older Australians.
Adults:
- Enjoy a wide range of nutritious foods
- Eat plenty of vegetables, legumes and fruit
- Eat plenty of cereals(including breads, rice, pasta and wholegrain noodles)
- Include lean meat, fish, poultry and/or alternatives
- Include milks, yoghurts, cheeses
- Drink plenty of water
And take care to:
- Limit saturated fat, moderate total fat intake
- Choose foods low in salt
- Limit alcohol intake
- Moderate amounts of sugars and foods containing sugars
- Prevent weight gain by being physically active
- Care for your food, prepare and store it safely
- Encourage and support breastfeeding
Children & Adolescents:
- Encourage and support breastfeeding
- Enjoy a wide range of nutritious foods
- Prepare and store food safely
Older Australians:
- Enjoy a wide variety of nutritious foods
- Keep active to maintain a healthy body weight and muscle strength
- Eat at least 3 meals per day
- Care for your food, store and prepare it correctly
- Eat plenty of fruits and veggies
- Eat plenty of cereals breads and pastas
- Eat a diet low in saturated fat
- Drink adequate amounts of water and other fluids
- If you drink alcohol, limit your intake
- Choose foods low in salt, and use salt sparingly
- Include foods high in calcium
- Use added sugars in moderation
The Australian Guide to Healthy Eating:
This was funded by the commonwealth government and was developed to meet one of the objectives of the National Food and Nutrition Policy, which is to help Australians develop the skills and knowledge necessary for choosing a healthy diet.
The guide is based on the scientific principles of the Australian Dietary Guidelines and the Recommended Dietary Intakes. Consumers and nutrition professionals were also involved.
The segments of the plate are designed to represent 5 food groups in the proportions necessary for a varied and nutritious diet. Healthy diet B is for people who prefer a more varied diet, whereas healthy diet A is for the breads, cereals, rice, and pasta and noodles groups.
The segments shown on the plate are classified as:
- Breads, cereals, rice, pasta and noodles
- Vegetables and Legumes
- Fruit
- Milk, yoghurts and cheese
- Meat, fish, poultry, eggs and nuts.
- Water
- Extras
- Role of Non-Government Agencies in Promoting Healthy Eating
Non-government agencies are organizations or bodies that are not government controlled. Some however may be assisted with government funding, but they are usually non-profit organizations which rely on donations.
They provide and regulate food and nutrition information and services. They develop diet and non diet related initiatives to optimize health and development.
They promote healthy eating through:
- Policy development
- Education
- Advocacy
- Marketing
- Awareness
- Community development
Nutrition Australia:
This is the registered business name of the Australian Nutrition Foundation, and is a non-profit, community based organization. It encourages all Australians to achieve optimal health through food variety and physical activity.
Some of their main projects include the Healthy Eating Pyramid, and National Nutrition Week.
The Heart Foundation:
This is an independent non-profit organization, and its aim is to improve health for all Australians and to reduce disability and death.
The messages they convey are:
- Enjoy healthy eating
- Be active
- Be smoke free
- Have cardio risk status checked regularly
Their main initiative is the Tick program, which was developed in 1989 as part of a long term strategy to improve the eating behavior of all Australians.
Health and Human Development
Unit 4
Global Health and Development
Area of Study 1: Development across the Lifespan
- The interrelationships between health and development
Development: This is the orderly, sequential and predictable growth or change, which occurs across the lifespan, from conception to death, and incorporates physical, social, emotional and intellectual aspects.
Health and development affect each other. Physical changes may impact social changes, and these may impact emotional growth. Optimal health required optimal physical, social, emotional and intellectual development.
Physical development: The development of the physical body including change in weight and height, and changes in the complexity of body function. Motor development is included in physical development, and in concerned with the control of muscle groups. Physical development follows the cephalocaudal and proximodistal laws of development.
Social development: the developing capacities for relationships with others. It includes how we relate to other people, including in social groups such as school. An important aspect of social development is learning about the roles we play in society e.g. sister, daughter, employee, student, friend.
Emotional Development: this is the capacity to recognize and express feelings and emotions. It also includes awareness and control of emotions. Emotional development also includes self image (the picture you have about yourself) and self concept ( how you feel about yourself).
Intellectual development: The mental skills a person learns while learning to adapt to their environmental stimuli. Includes skills of attention, memory, knowledge, understanding, reasoning or problem solving and language.
Prenatal development:
Prenatal development begins at conception and ends at birth, and lasts approximately 9 months. Fertilization initiates prenatal development, and is where there is a fusion of sperm and ovum. Ovum is most receptive approx 10-15 hours after ovulation. Sperm has to be present 72 hours prior of 15 hours after ovulation. Sperm can survive 4-7 days in the reproductive tract. Fertilization takes place in the upper end of the fallopian tubes. Once the sperm reaches the ovum, they must penetrate the zona pellucida – a gelatinous tissue surrounding the ovum. There are 3 stages of prenatal development and they are:
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The germinal stage: from fertilization to 10 days
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The embryonic stage: implantation to 8 weeks
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The foetal stage: from 9 weeks to birth
The germinal stage:
Rapid cell division occurs through mitosis. Fertilized ovum, a single cell containing 46 chromosomes is called a zygote. It is then called a morula when divided into 8 or more cells. Blastocyst forms when morula continues to divide and hollows and fills with fluid. The fluid becomes the embryo, and the outer layer becomes the placenta. The blastocyst is swept along the fallopian tubes by the cilia and muscular contractions and eventually implants into the endometrium and then attaches to the uterine wall. When the blastocyst has fully implanted at approx 2 weeks it is called an embryo.
The embryonic stage:
Cell differentiation typifies this stage. The outer layer of the cells become the:
- Amniotic sac – fluid filled sack for shock absorption and temperature regulation
- Umbilical cord – links placenta to embryo, 2 arteries and 1 vein, transports nutrients to the embryo and takes away waste
- Yolk sac – produces blood cells until heart and circulatory system are established. Liver takes over at week 7.
- Placenta – large flat organ connects uterus to embryo via the umbilical cord. Blood of the baby and the mother never mixes.
The inner layer also has cell differentiation. The nervous and circulatory system develops first. By week 8 all organs and external features have been established. This is the stage at which the embryo is most vulnerable to external hazards. During this stage, the embryo grows from 2mm to 4.5cm.
Foetal Stage:
During this stage, the child is known as a foetus, and this stage is dominated by growth. The foetus grows from about 4.5cm to about 50cm. The already formed organs mature and increase in complexity.
Adaptations after birth:
- Respiratory
- Circulatory
- Excretion
- Nutrition
- Temperature Control
- Role of inherited factors
Human growth and development are all influenced by inherited factors. Inherited factors include genes and hormones. Genes are the basic units of inheritance from our parents, and hormones control and regulate a number of body processes including growth and reproduction.
Hormones: Hormones are chemical substances that are produced by the body that act to control a wide range of bodily processes. The Endocrine System is the body’s glandular system, which consists of several glands which secrete hormones.
These 5 endocrine glands are:
- Pituitary Gland
- Thyroid Gland
- Adrenal Gland
- Ovaries
- Testes
Pituitary gland: This is the control centre, and it is found at the base of the brain. It secretes hormones which then have their own target sites.
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Growth hormone is targeting every cell in the body.
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Follicle Stimulating hormone goes to the ovaries and testes.
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Adrenocorticotrophic hormone goes to the adrenal gland.
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Thyroid stimulating hormone goes to the thyroid
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Lutenising hormone goes to the ovaries and testes.
Growth hormone goes to every cell in the body to increase it in size and number.
Follicle stimulating hormone goes to the ovaries and testes. In the ovaries it promotes the maturation of ovum and tells the ovaries to secrete oestrogen. In the testes is begins sperm production.
Adrenocorticotrophic hormone goes to the adrenal gland, and stimulates androgens, aldosterone and testosterone which promote male physical characteristics. Also secretes glucocorticoids, which help control the metabolism of energy nutrients, and mineralcorticoids which help control potassium and sodium/potassium fluid balance.
Thyroid stimulating hormone goes to the thyroid, which then secretes thyroxine, which controls metabolic processes.
Lutenising hormone goes to the ovaries which secrete progesterone for the regulation of the female reproductive cycle. Also goes to the testes, to secrete testosterone, responsible for male sex characteristics.
- Influence of environmental factors
The environment refers to anything around us that may have an influence on us. It can be any external factors that might influence our growth, development and health. Environmental influences can be divided into 4 broad categories. These are:
- Physical environment
- Social environment
- Lifestyle and behaviors
- Access to health care
Physical activity can have an important influence no health and development at all stages of the lifespan. Exercising regularly can be a key factor in reducing the risk for many diseases including heart disease, obesity and osteoporosis.
Family in the main social group, which has, the most influence on our development. They are our main socializing agent. It is where we learn most behavior and how to interact with others. Family will teach a child morals, values and attitudes from their family. One of the key roles of a family is to ensure all basic needs are met, such as the provision of food, shelter and clothing.
Culture is also generally passed on from the family. A persons culture related to the customs and traditions associated with the society in which a person lives. Cultural factors may influence development because of traditions, attitudes, beliefs and customs.
Socioeconomic status is sometimes referred to as social class. A number of elements contribute to socioeconomic status including education, occupation and income. People with a low socioeconomic status are at greater risk of poorer health and developmental problems.
Access to health care can influence health and development. Some population groups can experience lower levels of access to these services because they live outside urban areas.
- Importance of nutrition as an environmental factor
The diet of an individual plays an important role in their health and development. For a person to develop in an orderly predictable pattern and to ensure maintenance of good health they need to have an adequate uptake of nutrients including energy.
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Soft tissue: including skin, muscle, collagen, cell membranes, nerves, blood vessels.
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Hard tissue: includes bones, cartilage and teeth.
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Blood: includes red blood cells, white blood cells and platelets.
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Energy: includes physical activity, and basal metabolic rate.
Area of Study 2: Promoting Health and Development Globally
- Developing countries in the WHO regions
Industrialised countries: These countries have high living standards, and are technologically developed. They generally enjoy a healthy economy based on trade. The majority of people have access to adequate food, health care, housing and education, and have a relatively long life expectancy. These countries may hide a small proportion of people living in poverty, with out access to basic food and medical care. Generally, they have a high participation in education and have high literacy levels. Most health problems are related to poor lifestyle practices. Some of these countries include: Australia, United States, New Zealand, Japan, Britain, and most of Europe.
Developing Countries: These tend to be the poorest countries in the world. Industry and technology are less developed. Their infrastructure is poorly developed, and their business and finance sectors are weak. These countries have less access to technology, poor industry and limited trade agreements. These countries are characterized by high rates of poverty caused by debt, colonization and international trade agreements. They can also be further impoverished by effects of war, conflict or natural disaster. The majority of people living in developed countries have low incomes, low levels of health care and poor participation in education. Literacy rates are generally low, especially for females. These countries may have a small number of people living in high standards with plenty of money. Some countries attributable to this description include: Africa, Asia, Latin America, and a few European nations.
World Health Organization Regions: the WHO was established in 1948, and is an agency of the United Nations. The objective of WHO is to attain the highest level of health for all people. The WHO organizes its operations globally into 6 regions. These are:
- African Region
- Americas Region
- Eastern Mediterranean Region
- European Region
- South East Asian Region
- Western Pacific Region
- The burdens of disease comparison between developing counties and Australia
- Factors contributing to health status and developmental outcomes in developing countries
Cultural factors: When working in developing countries, international agencies need to pay attention to culture. They need to be aware about the culture and belief about health issues they are dealing with. They need to be respectful of local ways of working with people, respect local customs, acknowledge local experience and promote actions that are relevant to the population.
Women are usually at a disadvantage because of cultural factors, due to things such as less food, less medical treatment, greater responsibility for child rearing, labor in rural areas, fewer education opportunities and early marriage.
Poverty: Poverty can be defined as not having access to sufficient income to provide basic human needs, opportunities and choices. Poverty is the most significant cause of ill health and suffering in the world. According to UNICEF, about 1.3 billion people in the world live in complete poverty. Patterns which follow poverty include malnutrition, disease, lack of energy, despair, lack of education and a lowered capacity to work. Poor countries often lack the resources to provide public health care infrastructure, including safe water and sanitation, health programs and health care, education, and social security benefits.
Conflict: Since 1990, 2 million children have been killed, and 6 million seriously injured due to war and conflict. Millions have been displaced from their homes, and forced to live in refugee camps, mostly without adequate health and educational resources. Conflict can occur due to race, culture, nationality, religion, social groups or political opinion. In some cases conflict can turn to war. This results in disruption of lives, destruction of homes and human suffering. It has a disastrous effect on income, living conditions, food and medical supplies, opportunities and freedom. War and conflict are two factors which contribute to poverty.
Education and Literacy: About one quarter of the world’s population is illiterate, and nearly 2/3 of these are women. Many children in developing countries do not attend school. Many children are sent out to work at a young age. Not being able to read and write can lead to significant reduction in health status, particularly for women. For people who are illiterate, employment is limited to labor intensive work for long hours every day.
Lack of access to primary health care: Access to health care is an important basic requirement for all people. In developing countries, the ratio of qualified medical practitioners is so low that access for many people is restricted. Lack of medical attention accounts for a high number of infant deaths at birth, many of which are easily preventable.
Globalisation is the interconnectedness of the world through the transfer of goods, services, capital, people and information. Globalisation is growing through media, politics, technology, trade, sport and education.
- Strategies by WHO and the UN, as well as NGO’s to optimize health and development
The major causes if morbidity and mortality in developing countries in children are:
- Malnutrition
- Diarrhoea
- Pneumonia
- Measles
- Malaria
Some strategies which have been introduced into developing countries in an attempt to optimize health and development are:
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Breastfeeding: breast milk is the best source of nutrition for babies, and can even help protect them from illness as it helps to build up their immune system.
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Baby friendly hospital initiative: This initiative was launched by UNICEF and WHO in 1990, as a campaign to counter the worldwide trend towards bottle feeding. Their goal was to have thousands of hospitals around the world designated as baby friendly. The aim of BHFI is to ensure that all maternity facilities provide accurate information to empower women and support mothers in making the best choice for their child. BHFI follows the 10 steps to successful breastfeeding.
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Oral rehydration therapy (ORT): diarrhea is a major cause of childhood death, attributable to malnutrition and lack of safe water and sanitation. This strategy involves adding sugar and salt to water, to hydrate up to 25 times quicker.
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Immunization: vaccine preventable diseases kill approximately 3.5million children each year, and are a major contributor to malnutrition. WHO and UNICEF worked together in an attempt to immunize up to 80% of the worlds children by 1990.
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Child growth monitoring: This is a strategy used to monitor the physical development of infants and children. A healthy baby gains weight each month, so if a child is not gaining weight, this can alert health workers before malnutrition sets in.
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Family planning: family planning programs are an essential part of an approach to improve child survival, safe mother hood and reproductive health. These strategies encourage women to understand that if they space their children and reduce their family size they will have more money, food and time to allocate to the children they do have. Smaller families mean fewer mouths to feed, less work in food preparation, and money can be spent on education and other resources.
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Safe motherhood: the safe motherhood initiative was launched in 1987. The initiative is working to protect the health and lives of women, especially during pregnancy and childbirth.
- Australia’s aid contribution
AusAid: The Australian Agency for International Development was established in 1974. They give $1.894billion.
The aims of AusAid include:
- Improve economic and financial management in governments and strengthen their democracy
- Help maximize the benefits from trade and new technology
- Support government stability by improving vital serviced such as education, health care, water and sanitation.
- Strengthen regional security by helping governments to prevent conflict, manage issues such as disease.
- Promote sustainable approaches to environmental management and the use of resources
AusAid works with other governments, the UN, Australian companies and other NGO’s.
CARE Australia: provides humanitarian assistance around the world, founded in 1987. It has a focus of:
- Water and sanitation
- Maternal and child health
- HIV/AIDS prevention and care.
- Key elements of sustainable primary health care
Sustainable Primary Health Care: is a comprehensive approach to meeting health needs for all people based on the social model of health care. It meets the needs of people today with out reducing the options available for the development of future generations.
For something to be sustainable, it needs to:
- Involve the community
- Focus on women
- Ensure the correct type of aid
- Focus on education
- Focus on water and sanitation.
The key components of a sustainable primary health care strategy are:
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Safe water and sanitation: This is ensuring that everyone has access to safe water and sanitation. It is required to prevent water-borne diseases, such as diarrhoea, which is a major cause of death to children under 5. Water is also an essential part of life, needed for all bodily processes, so an inadequate supply could greatly inhibit health and development.
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Food and nutrition: This is ensuring an adequate supply of food and a balanced diet for everyone. An adequate supply of food is required to help prevent malnutrition, and an adequate well balanced diet provides people with the nutrient that they need to grow, develop, and have the energy to carry out everyday tasks.
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Immunization/Disease control: this is ensuring that everyone is vaccinated against major diseases. It is very important for preventing many childhood diseases, and other diseases such as malaria, polio, typhoid etc.
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Maternal and child health: This is ensuring trained birth attendants are available at all births. It also includes the promotion of family planning and child growth monitoring. It is important that the mothers are safe during child birth so they can look after the child once it is born and the children need to be monitored after birth to ensure they are developing correctly.
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Curative care: this is giving countries the knowledge and resources for treating common diseases and injuries. It is a very important aspect for maintaining a countries basic health status
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Health education: This is educating parents about the causes of ill health, and ways to promote good health. If people in a country know what is bad for them, and how to stay free from disease, it can prevent them from getting many conditions.
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Essential Drugs: this is enabling people to have access to basic drugs and medication. If they are supplied at an affordable price, it can help treat many people and conditions.
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Traditional medicine: this is important in a community as it is what they are used to using, and they feel comfortable with it. This means they can treat people, even those who are reluctant to get involved in an introduced health care system.
