Free Essay On Health Promotion For Hepatitis Prevention
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The famous saying, “prevention is better than cure” holds absolutely true for present day diseases because of the suffering they bring in the lives of patients, as well as significant increases in health costs all over the world. This report, therefore seeks to discuss and analyze health promotion for prevention hepatitis. The report also discusses the Tannahill model of prevention of Hepatitis B in nursing along with the roles of community nurses in every step of the prevention process. The report also notes preventive policies in Oman and the UK and compares them for better understanding.
Prevention of hepatitis
The report will examine health promotion for prevention hepatitis. This particular disease attracts expansive reporting and research due to its increased prevalence. Hepatitis is one of the most infectious yet more underestimated diseases on earth. It happens to be the eighth leading cause of death across the world taking toll of about 145 million people, which is the same mortality rate as AIDS/HIV (World Health Organization, 2010). This is the reason behind choosing this topic for the report.
Eastern European nations, Asian countries, South America and Africa are the countries having greater prevalence of the disease. African countries have 8% prevalence rate for hepatitis B while 10% for hepatitis C (World Health Organization, 2010). On the contrary, American nations have 2-8% prevalence rate for hepatitis B and about 90% rate of hepatitis C among injecting drug abusers (World Health Organization, 2010). Eastern Mediterranean has 2-10% rate for chronic viral hepatitis and in this region about 75% liver cancer or hepatocellular carcinoma and liver cirrhosis are due to hepatitis B and C (WHO, 2012). Egypt has the highest prevalence rate of 25% in some of its areas (CDC, 2012). Liver cancer is significantly rising in European states, attributing the prevalence to hepatitis B and C. Hepatitis A and E also poses serious concerns as 12 million hepatitis E cases occurring Europe and adds too much to half the global burden (WHO, 2012).
Western pacific region accounts for about 40% mortality related to hepatitis B and C along with liver cirrhosis and hepatocellular carcinoma. About 890 deaths occur daily in this region and about 60% of all the chronic cases of hepatitis B can be seen here with the exception of Japan, New Zealand and Australia (Lazarus, 2014). Hepatitis B has become a global disease. Also, liver cancer is on the rise worldwide and it involves high fatality rates (WHO, 2009). 90% children across the world are infected by Hepatitis C.Viral hepatitis affects the young population in their 20s and 30s, considerably destabilizing the much required young and energetic workforce for the development of a nation (Lavanchy, 2011).
Also, only about 38% of the total world countries have got a well prepared national day for combating hepatitis by implementing appropriate health promotion and prevention strategies, this shows how under-prepared the world is, with this global epidemic (El-Serag, 2012). In reference to Ministry of Health-Oman Annual Health Report (2009) Oman has approximately 2 to 7% of its population suffering from chronic HBV infection. In the endeavor to reduce the problem, Oman introduced the universal Hepatitis B vaccination in 1990. The vaccination strategy and the reported coverage were reviewed in 2005 (Ministry of Health-Oman Annual Health Report, 2009). The subsequent vaccinations have reduced the number of infection.
Epidemiology of Hepatitis
Epidemiology can be defined as the study of incidence and frequency of a disease in a large population Korsman et al., 2012). The study also extends to detection of the causal organisms, as well as, the cause of endemics of any infectious disease (Korsman et. al., 2012). Incidence is the number of fresh cases of disease in one year where as prevalence is the total number of infected cases in a population in a given time. Hepatitis is a global public health problem as declared by World Health Organization (WHO). According to a report by WHO (2012), it is estimated that about 240 million people worldwide are hepatitis B virus carriers and out of them, roughly six hundred thousand die in a year from hepatitis based liver disease such as liver cirrhosis or liver cancer (Griffiths, Tang and Yeoh, 2014). Many countries have implemented several comprehensive immunization programs resulting in a considerable decrease in rates of incidence for hepatitis in the world (MohdHanafiah et al., 2013). Still, the disease remains a leading cause of morbidity and mortality of a significant proportion of the world population. Hepatitis infection is cyclic in nature as it tends to repeat itself (MohdHanafiah et al., 2013).
In reference to Anderson et al. (2005) all adults must be screened for hepatitis though special effort should focus on groups with increased preferences via community outreach and fast testing. In addition, government, payers, and industry must combine effort to assure full success in availing health services and antiviral drugs for ever person infected. Arguably, access to new regimens should not be compromised by the escalating prices or capricious payer restriction. Anderson et al. (2005) states that partnership must be forged between the health care givers and the programs that serve people who administer illicit drugs. As such, health care provider, more so the primary care practitioners require sufficient education and training in treating hepatitis and taking care of the substance using populations.
Gust & Feinstone, (1988), Hepatitis A until 2004 was the most commonly reported especially in the United States. During this time, there were no vaccines and so only hygienic measures and protection were used to prevent it. In the US, Hepatitis A vaccines were licensed in the year 1995 to 1996. The vaccines are useful in the sense that they prevent and protect persons against acquiring Hepatitis A. with more vaccinations being done on the virus; the rate of it spreading is minimal.
There are large number of studies conducted by the scientists and researchers all over the world to formulate and assess new and effective promotional and prevention strategies and plans to fight the spread of hepatitis (MohdHanafiah et al., 2013). According to a study conducted by Jacobsen and Wiersma (2010), raising awareness and advocacy of preventive measures by community nurses helps in the reduction of the hepatitis infection in a community by 20%. However, effective and safe immunization techniques present greater chances of protection of populations from hepatitis infection (23%) (Jacobsen & Wiersma, 2010; Mast et al., 2005).
The study therefore is valid for every nation that is preparing itself to combat hepatitis infection by means of robust health policies and guidelines and by implementing and monitoring effective steps of vaccination and other preventive measures. Therefore, these studies can prove to be beneficial for developing health policy in Oman since the country is still looking for new preventive measures and policy makers, researchers and health workers can look upon these studies for finding new ways of improving older ways to fight and prevent hepatitis.
National Strategies/Policies in Oman
Oman has a well written national plan to combat hepatitis and the plan primarily focuses on prevention and control of hepatitis, preferably viral hepatitis. The program is monitored by the Oman Ministry of Health and contain the national plan contains the elements of disease surveillance, vaccination, hepatitis control and prevention, general as well as through injecting drug uses and prevention of hepatitis in hospitals and other health care settings. The plan includes hepatitis prevention and control and promotional activities for health care workers and waste handlers (Al Awaidy et al., 2013).
Evidence Based Policy
Prevention of Transmission
Hepatitis A vaccination lacks any national policy in Oman. Also, the government fails to establish the long term goal of eradicating hepatitis B. New born infants (98%) were given the first dose of hepatitis B vaccination within 24 hours of birth and one year old children (99%) received three doses of hepatitis B vaccination in 2011 (WHO, 2012). National policy entails mother to child hepatitis B transmission and prevention of hepatitis B and C in health care workers by recommending single use of syringes for therapeutic purposes and cannulas, syringes and needles are always made readily available in the laboratories. Government has formulated a well thought out national infection control agenda for all the blood banks in the country. Blood is screened for any infection of hepatitis B and C. On the contrary, there is no national policy that relates to the prevention and control of hepatitis infection in those who are involved in injecting drug abuse.
W.H.O. Recommendations on Hepatitis Screening
WHO has recommended that HCV serology testing to be done to individuals in a population with high prevalence of HCV or those with behaviors that expose to high risk of getting HVC. When confirming the diagnosis of the infection, WHO, suggests that nucleic acid testing (NAT) to be done to detect ribonucleic acid. It must be done
Screening, Care and Treatment
No clinical guidelines are available for management of co-infection of HIV/AIDS and HBV. No public funding is available for Hepatitis B or C treatment and management. Government has subsidized hepatitis B and C treating medicines such as pegylated interferon and lamivudine and interferon alpha and pegylated interfere on and ribavirin (WHO, 2011). As such, expansive health care promotion and prevention of Hepatitis must be done to get the endemic under control.
Tanhil approach for nurses in the promotion and prevention of Hepatitis
The nurses have a responsibility of helping patients who have acquired Hepatitis A,B and C and to conduct a civic education for others who are not yet infected as the disease is becoming prevalent in most countries. For instance, Hepatitis C inflammates the liver due to the hepatitis C virus that causes the disease. According to Campbell, (2011), it spreads through having sexual interaction with a person who is already infected; using objects to make tattoos, piercing and drug use or even personal objects for hygiene with someone who already has been infected thus, the nurses have the role in helping the patients who have been infected to lead better healthy lives by either improving their condition or prevention Koda-Kimble, (2009).
According to Sharma and Romas (2011) the three aspects of the Tannahill model include:
Health Education: It involves communicating to the public through various activities about the enhancement of well being, prevention of disease and illness positively by having a constructive influence on the knowledge, attitudes, beliefs and conducts of the community.
Community health nurses assess their patients for the quality and quantity of information they require regarding a disease and its prevention. Community nurse is responsible for conducting training and induction of several human resources that are related to health care services to enhance their skills and proficiency for delivering quality health care (Sharma & Romas, 2011). The nurses are providing the patients with education that will be useful to them. In keeping with Sharma and Romas (2011), this is done by elucidating the patients on the cause of Hepatitis, the expected progress and encourages them to constantly visit a doctor. The community nurses also have the role of encouraging the already infected persons with Hepatitis to attend clinical seminars. The nurses also provide accurate appropriate information to the patients though the assessment carried out on the patients. They teach them about the infection causes and side effects and inform them that regular check up is important for them
Health Protection: It refers to the guidelines and codes of practice that have the objective of prevention of bad health and constructively enhance the well being of an individual. The aspect of health protection is accountable for implementation and progression of policies, programs and legislation in comprehensive health related areas such as community care facilities, environmental health protection and emergency preparedness.
Community health nurse does the evaluation of the patients based on their physical and emotional requirements to understand their culture and perspectives of their own health and then provide adequate knowledge about a disease or a bad health condition. This is a major step towards prevention since, according to Sharma and Romas (2011) Hepatitis is infectious, and nurses should inform the infected persons on how the virus is spread. Sharma and Romas (2011) further indicate that the nurse guide and counsel the patient on what increases the risk of transmitting the disease to others.
Health Prevention: It deals with occurrence and recurrence of diseases and to the progress and final outcome of the disease and its management related actions.
Community nurse provides vaccination and other form of immunizations along with adequate knowledge and understanding to the people in community to stay protected against diseases (Sharma & Romas, 2011). The Community nurses provide the patients with education that will be useful to them. This can be done by explaining the cause of Hepatitis to the patients, the expected progress and encourage them to constantly visit a doctor. The community nurses also have the role of encouraging the already infected persons with Hepatitis to attend clinical seminars.
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