NURS 6050: Global Healthcare Comparison Matrix and Narrative StatementPart 1: Global Healthcare Comp

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NURS 6050: Global Healthcare Comparison Matrix and Narrative Statement

Part 1: Global Healthcare Comparison Matrix Sample

Global Healthcare IssueHealthcare access to all citizens (universal healthcare coverage)DescriptionThe World Health Organization (WHO) global agenda focused on equitable healthcare to all people regardless of their economic status. Various countries have responded to this global health issue by formulating specific policies to ensure accessible health care to all citizens. This matrix compares the US policy and Kenyan Policies that relate to universal coverage.CountryUnited StatesKenya Describe the policy in each country related to the identified healthcare issueThe Affordable Care Act: This policy was initially called The Patient Protection and Affordable Care Act. It is informally referred to as ‘Obamacare.’ This policy aimed at improving healthcare insurance among Americans to promote the affordability of healthcare (Isola & Reddivari, 2020).Universal Healthcare Coverage (UHC)In Kenya, a UHC policy was enacted recently with the objectives of providing affordable and essential care to all citizens. The policy had three pillars: service delivery, governance, and health financing (Barasa et al., 2018).What are the strengths of this policy?This policy has increased health insurance for Americans. The number of uninsured citizens has significantly dropped. The policy allows for insurance of minors and youths below 26 years to remain under the parents’ health insurance.  It promoted minors’ insurance with preexisting conditions by baring insurance companies from declining cover for such age groups (McIntyre & Song, 2019).The policy has increased the utilization of public hospitals by the patients. The cost of insurance is catered for by the government. The government partially covers expensive imaging and surgical procedures, subsidized in some cases. Therefore, citizens can participate fully in their healthcare delivery through supportive and early detection of diseases (Okech & Lelegwe, 2015).What are the weaknesses of this policy?The policy faces challenges from legal and private sector practices. The citizens end up subscribing to insurance policies that they do not ‘need.’The policy created overcrowding in hospitals. The patients seek medical attention for every condition at the same time to utilize their free insurance. The policy is also expensive on government expenditure. The national coverage is yet to be established.Explain how the social determinants of health may impact the specified global health issue. (Be specific and provide examples)The expertise qualification to register and enroll the participant in Obamacare was not sufficient. The number of unexpectedly sick citizens would overwhelm the insurers in the program. The human resources to enroll and stratify citizens into who needed to take insurance cover for their health urgently and who did not need this service could overwhelm the human resource (McIntyre & Song, 2019).The number of employed doctors by the government in the public sector is low. According to the Voice of Africa News, the current ratio of doctor to patient ratio in Kenya is 1:16000. This means that one doctor is to serve 16000 Kenyans. With the introduction of government sponsored UHC, citizens have shifted to public healthcare (Okech & Lelegwe, 2015). The doctors are likely to be overwhelmed.How has each country’s government addressed cost, quality, and access to the selected global health issue?The US federal government has not solved unequal Medicaid expansion due to its inability to cover fully for middle- and a low-income class of citizens. There is no available documented evidence on Obamacare’s impact on the quality of healthcare (Isola & Reddivari, 2020).The Kenyan program is yet to cover all 47 counties of the country. The insurance policy is being piloted in four counties. Due to cost issues, there is a need to ensure, only those who need free health cover are catered for by the policy (Barasa et al., 2018). The issue of quality of healthcare is yet to be solved.How has the identified health policy impacted the health of the global population? (Be specific and provide examples)Obamacare had a tremendous positive impact on the health of noninsured Americans. The need for insurance had made access to quality healthcare possible and cheaper than the fee for service methods (Manchikanti et al., 2017). Unfortunately, six million had lost their insurance by 2017 while 20 million had gained health insurance. Therefore, not all the population was positively impacted by the policy.The agenda has impacted the health of the nation. The county dwellers with the pilot program have had affordable access to many conditions that they would not rather see a doctor for if they fell ill. This has led neighbouring county residents seeking residence in the counties with this novel health care program. The policy has conformed with the universal health care coverage agenda advocated for by the WHO, but yet to serve the whole nation’s population (Barasa et al., 2018).Describe the potential impact of the identified health policy on the role of the nurse in each country.This policy enabled the nurse to incorporate primary care to a larger population, and in the process, preventive care was enacted for several citizens through patient education. With many health care seekers, the nurse had a duty to do broadly follow up with patients.With this policy, the nurses have to work over time, round the clock to ensure the increasing number of patients is served adequately. There has been a need to offer patient education to many patients seeking care with different unrelated conditions (Barasa et al., 2018).Explain how global health issues impact local healthcare organizations and policies in both countries. (Be specific and provide examples)The private health care providers have declined due to their lower ability to follow the new policies financially. The pressure has gone to Medicaid to expand its services to several states. The change of regime gas caused legal implications with some states such as Texas declaring the policy unconstitutional.The policy has put more pressure on other counties that do not have the policy. The Healthcare government in Kenya is managed by the federal government and the county governments at different levels. The need to conform to the global standards entirely has caused discontent among patients. Kenya is a third world country and cannot fully abide by the global healthcare standards propositions without economic constraints. The general impact is the decline in the quality of care offered by public institutions.General Notes/CommentsThe policy worked well until the change in political regime and need to conform fully with constitutional requirements.To create accessible health care, the policy has led to a decline in health care quality and has resulted increased waiting time to access healthcare services.

Part 2: Narrative Statement

Explain how you would advocate for incorporating a global perspective or lens into your local practice and role as a nurse leader.

From the information I have compared from the Kenyan and American situation, I would advocate for equitable enactment of the respective policies. Providing citizens with what they need, not what everyone should work with, should be the primary objective of any healthcare cover. Generalizations have made both citizens subscribe to what they may feel ‘unimportant’ at the time. The health policies should ensure prudent use and access to the healthcare they need at the time of application.

Explain how incorporating a global perspective or lens might impact your local practice and role as a nurse leader.

This incorporation would make the quality of nursing care more patient-centred and specific. My roles as a nurse would be relevant to the patients because the conditions for which they are treated would be appropriate. The one-size-fits-all approach would be unnecessary because the patients would be getting the care they need.

Explain how incorporating a global perspective or lens into your local practice as a nurse leader represents and contributes to social change. Be specific and provide examples.

Incorporating universal health care into my practice would significantly impact the social determinants of my patients’ health. By determining each patient’s social determinants, there would be a different social approach to patient-based care. For example, there would be a need to form a social collaboration between nurses to care for patients with related conditions. However, this bears the risks of resulting in a decline in the quality of work conditions due to a decline in nurse to patient ratio.

NURS 6050: Global Healthcare Comparison Matrix and Narrative Statement References

• Barasa, E., Nguhiu, P., & McIntyre, D. (2018). Measuring progress towards Sustainable Development Goal 3.8 on universal health coverage in Kenya. BMJ Global Health, 3(3), e000904. https://doi.org/10.1136/bmjgh-2018-000904
• Isola, S., & Reddivari, A. (2020). Affordable Care Act. Ncbi.nlm.nih.gov. Retrieved 1 November 2020, from https://www.ncbi.nlm.nih.gov/books/NBK549767/.
• Manchikanti, L., Helm Ii, S., Benyamin, R. M., & Hirsch, J. A. (2017). A Critical Analysis of Obamacare: Affordable Care or Insurance for Many and Coverage for Few?. Pain Physician, 20(3), 111–138. https://pubmed.ncbi.nlm.nih.gov/28339427/
• McIntyre, A., & Song, Z. (2019). The US Affordable Care Act: Reflections and directions at the close of a decade. PLOS Medicine, 16(2), e1002752. https://doi.org/10.1371/journal.pmed.1002752
• Okech, T., & Lelegwe, S. (2015). Analysis of Universal Health Coverage and Equity on Health Care in Kenya. Global Journal Of Health Science, 8(7), 218. https://doi.org/10.5539/gjhs.v8n7p218

NURS 6050: Global Healthcare Comparison Matrix And Plan For Social Change Instructions

To Prepare:

Review the World Health Organization’s (WHO) global health agenda and select one global health issue to focus on for this Assignment.

Select at least one additional country to compare to the U.S. for this Assignment.

Reflect on how the global health issue you selected is approached in the U.S. and in the additional country you selected.

Review and download the Global Health Comparison Matrix provided in the Resources.

The Assignment: (1- to 2-page Global Health Comparison Matrix; 1-page Plan for Social Change)

Part 1: Global Health Comparison Matrix

Focusing on the country you selected and the U.S., complete the Global Health Comparison Matrix. Be sure to address the following:

• Consider the U.S. national/federal health policies that have been adapted for the global health issue you selected from the WHO global health agenda. Compare these policies to the additional country you selected for study.
• Explain the strengths and weaknesses of each policy.
• Explain how the social determinants of health may impact the global health issue you selected. Be specific and provide examples.
• Using the WHO’s Organization’s global health agenda as well as the results of your own research, analyze how each country’s government addresses cost, quality, and access to the global health issue selected.
• Explain how the health policy you selected might impact the health of the global population. Be specific and provide examples.
• Explain how the health policy you selected might impact the role of the nurse in each country.
• Explain how global health issues impact local healthcare organizations and policies in both countries. Be specific and provide examples.

Part 2: A Plan for Social Change

Reflect on the global health policy comparison and analysis you conducted in Part 1 of the Assignment and the impact that global health issues may have on the world, the U.S., your community, as well as your practice as a nurse leader.

In a 1-page response, create a plan for social change that incorporates a global perspective or lens into your local practice and role as a nurse leader.

Explain how you would advocate for the incorporation of a global perspective or lens into your local practice and role as a nurse leader.

Explain how the incorporation of a global perspective or lens might impact your local practice and role as a nurse leader.

Explain how the incorporation of a global perspective or lens into your local practice as a nurse leader represents and contributes to social change. Be specific and provide examples.

Assignment document should include:

1. Title page
2. Introductory paragraph
3. Global health comparison matrix
4. Plan for social change
5. Conclusion
6. References

THE TWO COUNTRIES THAT I WANTED TO COMPARE WITH REGARD TO THE ISSUE ON HEALTH POLICY IS :

1.) Philippines – PHILHEALTH – Philippine Health Insurance Corporation (  PhilHealth ) 

2.) USA – MEDICAID 

Global health issue Universal health coverage is a matter of equity, rights, and justice.

NURS 6050: Global Healthcare Comparison Matrix And Plan For Social Change Example

Global Health Comparison Grid Template

Use this document to complete the Module 6 Assessment Global Healthcare Comparison Matrix and Narrative Statement.

Introduction

Universal health coverage (UHC) is a critical component of global health, aiming to ensure all individuals have access to the health services they need without suffering financial hardship. According to the World Health Organization (WHO), UHC is a matter of equity, rights, and justice, and it is essential for the well-being of citizens (WHO, 2024). The two countries selected for comparison in this paper are the United States and the Philippines. Medicaid is a federal and state program applied in the U. S. to cover health care for needy individuals (Medicaid, 2022). 

On the same note, the Philippines has PhilHealth as a nationalized health insurance program to pursue the goals of UHC. This comparison will determine the effectiveness of these policies, which policy has more advantages than disadvantages, the role of the social determinants of health and the possible outcomes, and the viewpoint of access to health care, its quality, and cost. By examining these aspects, we can gain insights into how different countries address UHC and the role of nurses in implementing these policies effectively.

Global Healthcare Issue Universal Health CoverageDescriptionAccording to the World Health Organization (2023), UHC is defined as the ability of all people to obtain the required healthcare services without putting excessive physical, financial, or social pressure on them. It refers to the different services offered in the management of the condition, such as preventive, curative, restorative, and end-of-life care. Achieving UHC requires strong health systems, adequate funding, and equitable distribution of resources to ensure that everyone, regardless of socio-economic status, can access quality.CountryUnited StatesPhilippines: PhilHealthDescribe the policy in each country related to the identified healthcare issue.Medicaid provides health coverage to low-income individuals, families, children, pregnant women, the elderly, and people with disabilities. It is funded jointly by state and federal governments (Medicaid, 2022). PhilHealth aims to ensure that all Filipinos have access to affordable health services (PhilHealth, 2023). Member contributions, government subsidies, and sin tax revenues fund it.What are the strengths of this policy?It covers various health services, including hospital and outpatient care, nursing home care, and home health care. It reduces the financial burden for low-income families.Covers a comprehensive range of health services. Has a no-balance billing policy for indigent and sponsored members in public hospitals.              What are the weaknesses of this policy?Varies significantly between states in terms of coverage and eligibility (Jackson et al., 2021). Administrative complexity can be a barrier to access.  Funding constraints and inefficiencies. Limited coverage for certain high-cost treatments and specialized care.Explain how the social determinants of health may impact the specified global health issue. (Be specific and provide examples)Income, education, and geographical location impact access to Medicaid services. For instance, rural areas may have fewer healthcare providers accepting Medicaid.Poverty, education, and urban-rural disparities influence access to PhilHealth services. Many rural areas lack healthcare facilities, affecting access to covered services.  How has each country’s government addressed cost, quality, and access to the selected global health issue?The federal government sets broad guidelines, but states have flexibility in implementing Medicaid, leading to variation in quality and access. Efforts to expand Medicaid under the Affordable Care Act aimed at improving access.   The Philippine government has increased funding through the sin tax law. It aims to improve quality and access through the Universal Health Care Act, which integrates local health systems and aims for comprehensive service delivery.            How has the identified health policy impacted the health of the global population? (Be specific and provide examples)Medicaid expansion under the ACA significantly increased insured rates and access to healthcare services among low-income populations.    PhilHealth has improved access to health services for many Filipinos, particularly the poor and vulnerable, but challenges remain in ensuring consistent quality of care.Describe the potential impact of the identified health policy on the role of nurses in each country.Nurses in the U.S. often play a critical role in managing care for Medicaid patients, including care coordination and preventive services.   Filipino nurses are essential in delivering PhilHealth-covered services, particularly in public hospitals and rural health units, which often face challenges due to resource constraints.Explain how global health issues impact local healthcare organizations and policies in both countries. (Be specific and provide examples)Global health issues such as pandemics highlight the need for robust Medicaid policies to ensure vulnerable populations receive care. Local healthcare organizations may face increased demand and financial strain.    

 

 

 

Similar global health challenges emphasize the need for PhilHealth to provide comprehensive coverage. Local healthcare facilities often struggle with funding and resource allocation to meet the demands.General Notes/CommentsMedicaid in the United States has played a vital role in addressing the health needs of the less privileged in society by removing monetary obstacles to accessing healthcare. However, due to the differences in the scope of coverage and the conditions that make one eligible for the insurance, the quality and accessibility of healthcare are affected across the different states. It also has the disadvantage of having so many stiff procedures that act as a barrier to the beneficiaries. As for the improvement of Medicaid, it is necessary to have the states’ policies as similar as possible and work on the simplification of the administrative moments. Furthermore, their targets incorporate social determinants of health as a way of reaching out, especially to the rural and other underprivileged settings, in order to benefit from the program.Currently, PhilHealth has achieved substantial improvement in affecting the percentage of Filipinos who can access health services, especially for the needy groups. Another strength of the program is its balanced billing policy and the attempts to link the local health systems through the Universal Health Care Act. However, an acute problem in the funding also remains a critical factor that affects the overall effectiveness of health care services. If more coherence to facilities is to be achieved, then it is vital to seek better funding sources for PhilHealth to improve its administrative structure further. Equitable access to healthcare services within rural and urban areas will also be achieved by addressing other social determinants of health, which include poverty and education.

Plan for Social Change

Incorporating a global perspective into local nursing practice necessitates advocacy for policy reforms and initiatives that address the social determinants of health and promote universal health coverage. Community engagement, exercises, and health campaigns are core strategies for ensuring that members of the public are made aware of the role of UHC and where they may access it (World Health Organization, 2023). Such campaigns comprise meetings, seminars, distribution of handouts, and any other form of education that seeks to make the public change their attitude towards a particular issue.

It is, therefore, crucial to work to enhance funding for public health services, including in underprivileged regions. This involves active participation in lobbying the policymakers and other related stakeholders in order to explain the advantages of implementing UHC and also in the provision of sufficient funds to enhance the supply of health care facilities. Hence, by advocating for policies that will help to eliminate issues of health disparities, rehabilitation can be done to make health outcomes more fair and bias-free, making the health industry more fair in the future (Ang & Fernandez, 2024).

Another source of evidence is cooperation with other global health institutions and countries that may provide examples of the best practices and successes in UHC implementation. Such a sharing of information and techniques can be useful and help introduce certain strategies that might not have been thought of before but can be easily incorporated into local environments. Thus, it can be relevant to study how the Philippines has been integrating the country’s regional health systems under the umbrella of PhilHealth to make the Philippines experience more comparable to the U.S. one (PhilHealth, 2021).

It is crucial to incorporate culture and sensitivity training into both curricula for nursing and practice with regard to population requirements. This has a bearing on ensuring that nurses are well placed to handle issues to do with the specifics of different communities’ health. Reducing patient abuse, harassment, and mistreatment improves patients’ loyalty, compliance with treatment, and overall well-being, hence advocating for a social change in the delivery of services; policies such as the Affordable Care Act aimed at improving Medicare & Medicaid services for the citizens (Centers for Medicare & Medicaid Services, 2021). 

A worldwide approach enhances the local practice in the delivery of healthcare to the people. It supports social transformation as it plays a role in eradicating social determinants of health, including poverty, education, and health. Thus, the promotion of health and prevention of the incidence of diseases, offering equal chances to lead a healthy life to every person regardless of their economic status, are the major WHO objectives (World Health Organization, 2023). 

Promoting changes in local, state, and national policies that focus on global health will help in the formulation of guidelines that encompass the needs of various groups of people in society. Of course, practicing community relations as well as collaborating with organizations that work in the sphere of global health can be helpful in offering the support needed to apply these changes. In effect, my responsibilities as a nurse leader would entail constant acquisition of knowledge, lobbying, and cooperation with other stakeholders in a bid to bring practice on UHC principles in healthcare systems.

Conclusion

Comparing universal health coverage policies in the United States and the Philippines reveals strengths and areas for improvement. Medicaid and PhilHealth each have unique approaches to providing healthcare access, with varying degrees of success in cost, quality, and access. Addressing the social determinants of health and ensuring adequate funding are essential to achieving universal health coverage. Incorporating a global perspective in the local nursing practice creates social change by influencing the nursing practice through the values, beliefs, knowledge, and attitudes of the nurse leaders, which, in turn, increases their efficiency in enhancing the health status of the community. This not only supports the concept of equality and fairness but also strengthens the capacities and relevance of health systems for everyone.

References

Centers for Medicare & Medicaid Services. (2021). Centers for Medicare & Medicaid Services. Cms.gov. Accessed July 29, 2024, from https://doi.org/99908

Jackson, M., Agbai, C. & Rauscher, E. (2021). The effects of state-level Medicaid coverage on family wealth. RSF: The Russell Sage Foundation Journal of the Social Sciences, 7(3), 216. https://doi.org/10.7758/rsf.2021.7.3.10

Medicaid. (2022). Medicaid eligibility. Medicaid.gov. Accessed July 29, 2024, from https://www.medicaid.gov/medicaid/eligibility/index.html

PhilHealth. (2021). Philippine health insurance corporation. Www.philhealth.gov.ph. Accessed July 29, 2024 from https://www.philhealth.gov.ph/

PhilHealth. (2023). Phil Health, your partner in health. Accessed July 29, 2024, from https://www.philhealth.gov.ph/about_us/transparency/PhilHealthStratplan2021-23.pdf

Ang, B. W., & Fernandez, L. (2024). A prospective study on direct out-of-pocket expenses of hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease in a Philippine tertiary care center. BMC Pulmonary Medicine, 24(1). https://doi.org/10.1186/s12890-024-03011-y

World Health Organization. (2023, October 5). Universal health coverage (UHC). World Health Organization. Accessed July 29, 2024, from https://www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(UHC)

World Health Organization. (2024). Health equity. World Health Organization. Accessed July 29, 2024, from https://www.who.int/health-topics/health-equity#tab=tab_1

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