GLOBAL HEALTH ISSUES AND IMPLICATIONS TO NONCOMMUNICABLE DISEASES Sustainable Development Goals (SDGs) → AIM: improve health outcomes,
pment Goals (SDGs) → AIM: improve health outcomes, promote equity, and
NURSING
Global Health
− improving people's health and achieving health
equity for all
GLOBAL HEALTH ISSUES TRANSCEND NATIONAL
BORDERS AND USUALLY HAVE A GLOBAL IMPACT ON
POLITICS AND ECONOMICS
− requires global cooperation in response, planning,
prevention, preparedness, and care that reflects
health equity issues among countries
Global health issues
− pose significant implications for nursing, as nurses
are at the forefront of healthcare delivery and play
a crucial role in addressing these challenges.
Issues (infectious diseases, pandemics, health
disparities, and humanitarian crises)
− require nurses to possess a global perspective,
cultural competence, and the ability to adapt and
respond effectively to diverse healthcare needs and
contexts
Global Burden of Disease Study 2016
− showed that deaths from:
• Noncommunicable diseases (NCDs) - 72.3%
• Communicable maternal, neonatal, and
nutritional diseases (CMNN) diseases – 19.3 %
Injury – 8.4 %
COMMUNICABLE DISEASES
− infectious or contagious diseases
− can be transmitted from one person to another,
typically through direct or indirect contact.
− caused by microorganisms such as bacteria, viruses,
parasites, and fungi.
− COVID-19, influenza, tuberculosis, HIV/AIDS, STIs
− EFFECTIVE PREVENTIVE MEASURES:
• vaccination, hygiene practices, and quarantine
− reductions in deaths caused by:
• HIV/AIDS--45.8% (1.91→1.03 million deaths
2016)
• Malaria--25.9%
o Leishmaniasis—54.1%
o Measles—72.5%
o Intestinal Infectious Diseases—14.7% (2006-
2016)
• Tuberculosis--20.9% (1.21 MILLION DEATHS)
• diarrheal disease--24.2% (1.66 million deaths)
• Dengue—only neglected tropical disease;
81.8% significant increase
− CVD = 17.6 million deaths (largest)
− Neoplasms = 8.93 million deaths
− Chronic Respiratory Diseases = 3.54 million deaths
− Lung Cancer and Breast Cancer = 1.71 million deaths
INJURIES
− 2016: total injury deaths 1.80 million deaths
• Falls: 678k deaths
• Drowning: 302k deaths
• Exposure to mechanical forces: 155k deaths
UNINTENTIONAL INJURIES
• Transport injuries: 1.44 million deaths
• Interpersonal violence: 1.21 million deaths
o physical violence = 41.2%
• Self-harm: 8.26%
GLOBAL HEALTHCARE TRENDS
− shifting, with more rapid declines in Communicable,
Maternal, Neonatal, and Nutritional (CMNN)
conditions compared to NCDs and injuries
Millennium Development Goals (MDGs)
− a set of 8 international development goals
established after the Millennium Summit of the
United Nations in 2000
− These goals had specific measurable targets and
deadlines aimed at improving the lives of the
world's poorest populations by the year 2015
Global health issues
− complex challenges influenced by poverty,
inequality, and social determinants of health
World Health Organization (WHO)
− social determinants of health as the conditions in
which people are born, grow, live, work, and age
Nursing as a profession
− ideal position to actively involve its members in
human rights advocacy and global health diplomacy
efforts, as highlighted by Breda in 2012
Nurses
− due to their frontline roles in healthcare and their
holistic approach to patient care→play a crucial role
in addressing these global health issues and
advocating for improved health outcomes on a
global scale
− set of 17 goals established by the United Nations to
address global challenges such as poverty,
inequality, and climate change
− 2015: United Nations General Assembly adopted
the SDGs, which aim “to ensure that all human
beings can fulfill their potential in dignity and
equality and in a healthy environment.”
− There are 17 goals and 169 target educators
SDG 3—GOOD HEALTH AND WELL-BEING
− Ensure healthy lives and promote well- being for all
at all ages
− covers the unfinished MDGs and newer challenges
such as NCDs, health security, tobacco and injuries
− SDG 3 is linked to around 50 health-related targets
across the SDGs. These SDGs include core health
targets, contribute to health and well- being and
commit to "leave no one behind.”
SDG 1 Extreme poverty/ Vulnerability to
economic, social & environmental shocks
and disasters
SDG 2 Malnutrition
SDG 5 Violence against women and girls/
Sexual reproductive health and rights
SDG 8 Safe and secure working environment
SDG 11 Housing and basic services/ Air quality,
waste management in cities
SDG 13 Climate-related hazards and natural
disasters.
Nurses play a crucial role in achieving these goals
through their diverse contributions in healthcare.
• promote health and well-being
• provide essential care and support to individuals
and communities
• advocate for equitable access to healthcare
contribute to research and policy-making for
sustainable healthcare systems.
Universal Health Coverage (UHC)
− 2030 Agenda for Sustainable Development: health
as a central component of development
− WHO' s view of (UHC) means that all individuals and
communities receive the health services they need
without suffering financial hardship.
− healthcare system where everyone has access to
essential quality health services without facing
financial hardship
reduce financial barriers to healthcare.
→ NURSES: a vital role in implementing UHC,
providing care, advocating for policy changes, and
addressing healthcare challenges
→ LEAD: better health, reduced disparities, and
financial stability for households, but challenges like
funding and infrastructure development need to be
addressed
HEALTH SERVICE COVERAGE AND FINANCIAL
PROTECTION
→ UHC progress is monitored using TWO INDICATORS:
1.Health service coverage—proportion of
population that can access essential quality health
services
2.Financial protection—… spends a large amount of
household income on health.
→ WHO (2019) uses 16 essential health services in 4
CATEGORIES as indicators of the level and equity of
coverage in countries:
1. Reproductive, maternal, newborn and child
health (RMNCH): family planning, antenatal and
delivery care, full child immunization and health-
seeking behavior for pneumonia
2. Infectious diseases: tuberculosis treatment, HIV
antiretroviral treatment, hepatitis treatment, use
of insecticide-treated bed nets for malaria
prevention and adequate sanitation
3. Noncommunicable diseases that include services
for prevention and treatment for raised blood
pressure and blood glucose, cervical cancer
screening and tobacco smoking
4. Service capacity and access to basic hospital and
health worker services, essential medicines and
health security
→ WHO (2019) FACTS ABOUT THE CURRENT GLOBAL
HEALTH SCENARIO:
1. At least half of the population still do not nave full
coverage of essential health services
2. About 100 million people are still being pushed
into extreme poverty because have to pay for
health care
3. Over 930 million people or around 12% of the
world's population spend at least 10% of their
household budgets to pay for health care.
→ Philippines: UHC and SDG Country Profile (WHO
2018) reports the following overall progress:
1. slightly below-average coverage for certain
essential services.
− stands out with high coverage for reproductive,
maternal, newborn, child health services, and
some communicable disease prevention
measures
2. Estimates of the financial burden for health
showed that 1.4% of the population incurred high
out-of-pocket health payments
3. Major challenges remain in infectious disease
prevention and control and in-service capacity
and access
STRENGTHENING HEALTH SYSTEMS
Kieny et al. (2017)
− health system strengthening as a significant and
purposeful effort to improve the system's
performance and should embody the intermediary
objectives of the national health policies, plans and
strategies which are quality, equity, efficiency,
accountability, resilience and sustainability
→ SIX BUILDING BLOCKS:
1. Leadership/Governance
2. Health Information Systems
3. Financing
4. Health workforce
5. Medical products and technologies
6. Service delivery
Primary Health Care (PHC)
− evolving approach to healthcare that originated
from the Alma-Ata Declaration in 1978.
− WHO (2019): approach to health and well-being
centered on the needs and circumstances of
individuals families and communities and addresses
comprehensive and interrelated physical, mental
social health and well-being
− Initially criticized, it has adapted to address various
health challenges.
→ FOCUSES: holistic well-being of individuals, families,
and communities, emphasizing comprehensive care
and addressing broader health determinants.
− empowers people to advocate for health policies,
participate in healthcare development, and take
responsibility for their well-being.
− This approach seeks to integrate healthcare
services, considering social and environmental
factors, to achieve health for all.
→ THREE COMPONENTS:
1. Ensuring people's health problems are addressed
through comprehensive promotive, protective,
preventive, curative, rehabilitative and palliative
face
2. Systematically addressing the broader
determinants of health (including social, economic,
environmental as well as people’s characteristics.
3. Empowering individuals, families, and communities
to optimize their health
International organizations
− play a significant role in achieving sustainable
development goals by coordinating global efforts,
mobilizing resources, and fostering collaborations
among member states.
− They engage in advocacy, policy development, and
implementation of programs and initiatives that
address the various dimensions of the SDGs, such
as poverty eradication, education, healthcare,
environmental conservation, and gender equality,
with the aim of promoting sustainable development
worldwide.
GLOBAL HEALTH PLAYERS
Global Action Plan (WHO, 2019)
− builds on existing mechanisms, including country
platforms for achieving the SDGs and the ongoing
process of reform in the United Development
System
→ COMMITMENTS:
1. Engage with countries better to identify priorities
and plan and implement together
2. Accelerate progress in countries unrough joint
actions under 7 accelerator themes set out in the
Plan, and through an overarching commitment to
advance gender equality and support the delivery of
global public goods
3. Align by harmonizing operational and financial
strategies and policies in support of countries where
this increases our efficiency and reduces the burden
on countries
4. Account by reviewing progress and learning
together to enhance shared accountability
1. UNICEF—United Nations Children’s Fund
− lifecycle based approach in all work, recognizing the
particular importance of early childhood
development and adolescence
2. UNILAID
− a global development agency engaged in finding
innovative solution in global health, including new
ways to prevent, diagnose and treat diseases more
quickly, cheaply, and effectively, in low- and middle-
income countries
3. UN Woman—United Nations Entry for Gender
Equality and the Empowerment of Woman
− A global champion for women and girls, UN Women
was established to accelerate progress on meeting
their needs worldwide
4. World Bank Group
− supports countries ' efforts to achieve universal
health coverage and provide quality, affordable
health services to everyone- regardless of their
ability to pay-reducing the financial risks associated
with ill health and increasing equity
5. WFP—World Food Programme
− leading humanitarian organization saving lives and
changing lives, delivering food assistance in
emergencies, and working with communities to
improve nutrition and build resilience.
− As the international community has committed to
end hunger, achieve food security and improved
nutrition by 2030, 1 in 9 people worldwide still do
not have enough to eat
6. WHO—World Health Organization
− Founded in 1948
− promote health, keep the world safe and serve the
vulnerable.
− GOAL: to ensure that, by 2023, a billion more people
have universal health coverage; a billion more
people are protected from health emergencies; and
a further billion people achieve better health and
wellbeing.
− WHO hosts the Global Action Plan Secretariat
7. Gavi, The Vaccine Alliance
− public private partnership committed to saving
children's lives and protecting people's health by
increasing equitable use of vaccines in lower
income countries
8. The Global Financing Facility (GFF) for Women,
Children and Adolescents
− multi-stakeholder partnership that supports efforts
to tackle the greatest health and nutrition issues
affecting women, children and adolescents in low
and lower middle-income countries around the
world
9. The Global Fund to Fight AIDS, TB and Malaria
− partnership designed to accelerate the end of AIDS,
tuberculosis, and malaria as epidemics.
− As an International organization, the Global Fund
mobilizes and invests more than $4 billion a year to
support programs run by local experts in more than
100 countries
10. UNAIDS—The Joint United Nations Programme on
HIV/AIDS
− Leads and inspires the world to achieve a vision of
zero new HIV infections, zero discrimination and
zero AIDS-related deaths.
− UNAIDS works for an inclusive, multisectoral
response to HIV that is people-centered, integrated
in the 2030 Agenda and grounded in a respect for
human rights and gender equality.
− ensuring that people living with and affected by HIV
are meaningfully involved in the response
11. UNDP—The United Nations Development
Programme
− one of the world's largest multilateral development
agencies, present in over 170 countries and
territories and on the frontlines of anticipating,
understanding, and acting on today’s opportunities
and risks
12. UNFPA—The United Nations Population Fund
− United Nations agency working to deliver universal
access to sexual and reproductive health, including
voluntary family planning and safe motherhood,
and to advance the rights and opportunities of
young people
ROLE OF NURSES IN GLOBAL HEALTH International Council of Nurses: 3. All but one are correct statements about the SDG:
1. being at the forefront of health care delivery stem • Actively participated in drafting the WHO Global
are expected to help accelerate progress towards Strategy on Human Resources for Health: A. it has 17 goals and 139 targets
achieving these Workforce 2030 (White, 2016). B. It will be implemented from 2016 to 2030
2. must recognize and understand how social • The Global Strategy has the vision: "Accelerate C. It was launched by WHO to ensure quality of life
determinants impact on health of individuals and progress towards Universal Health Coverage and D. It aims to foster collaboration among member
populations the Sustainable Development Goals by ensuring states of the UN
3. advocate for addressing these social equitable access to skilled and motivated health
determinants of health and health inequities to workers within a performing health system. 4. UHC means that all individuals and communities
help individuals, families and communities • Nurses can contribute as leaders of change to help receive the health services they need without
achieve better health address global health issues, achieve the SDGs, suffering financial hardship. Such services include:
4. Nurses in the different levels of care across the implement universal health coverage and primary 1. Health Promotion
health system must know how to assess, health care 2. Disease Prevention
implement, and evaluate programs and policies • Nurses can contribute by becoming involved in 3. Rehabilitation
that would better address the local, national, and communities and professional nursing 4. Curative and Palliative Care
global health issues organizations, getting involved in policy making and
5. Nurses need to become human rights advocates, advocacy organizations, and active in their A. 1,2,3,4
political activists, engaged citizens and critical workplaces B. 1,3,4
artists for global health issues and acquiring these C. 1,2,3
roles requires that they have a sound REVIEW QUESTIONS D. 1 and 4
understanding of globalization and the political
economy of health, as well as a solid knowledge 1. The leading cause of death globally is which of the
base in human rights and global health diplomacy following?
(Breda, 2012)
A. Malnutrition 5. Which of the following roles can the nurse assume
− Nurses play a critical role in global health by B. NCDs to promote global health?
contributing to achieving the Sustainable C. Infectious Diseases
Development Goals (SDGs) through equitable D. Aging A. Human Rights Advocate
access to skilled healthcare B. Political Activist
− work across various settings, from academia to C. Community Organizer
clinical care, and serve as leaders, managers, direct D. All of the above
caregivers, researchers, and policy advocates.
− Nurses must address social determinants of health,
advocate for health equity, and engage in policy-
making to improve the health of individuals and 2. Common factors that influence global health issues
communities. include:
− crucial role in shifting the global burden of disease 1. Poverty
towards addressing non-communicable diseases 2. Inequality
and promoting well-being for all. 3. Environment
4. Socioeconomic conditions
Global Health Workforce Alliance & WHO (2015)
"Ensure availability, accessibility, acceptability and A. 1,2,3
asdf
quality of the health workforce through adequate B. 1 and 2
investments and the implementation of effective C. 3 and 4
policies at national, regional and global levels, for D. 1,2,3,4
ensuring healthy lives for all at all ages, and
promoting equitable socio-economic development
through decent employment opportunities.”