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Transcultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th EditionTranscultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Global Health and Nursing Care

Larry Purnell, Ph D, RN, FAAN



Effects of Globalization

Globalization has led to a growing interdependence of the world’s population.

Potential for infectious diseases to spread rapidly in a world with extensive travel.

Includes food, insects, animals, and other vectors.



Effects of Globalization Bioterrorism necessitates surveillance for

suspicious clusters of symptoms for populations at a global level.

Unhealthy populations can destabilize economies.

Shift in health conditions from an acute care focus to chronic care.



Global Context: No boundaries

Global context of health addresses circumstances that affect populations worldwide, such as quantity and nutritional value of food, air and water quality, exposure to infectious diseases and environmental toxins, access to essential medications, and gender inequalities.



International Context

International health perspective emphasizes exchanges between national governments.

International is border bound. We need both the International and Global

contexts



Definition of Global Health: Institute of Medicine

Health problems, issues and concerns that transcend national boundaries, may be influenced by circumstances or experiences in other countries, and are best addressed by cooperative actions and solutions



Alternate Definition of Global Health

Global health emphasizes transnational health issues, determinants, and solutions.

Involves multiple disciplines collaborating.



Global Nursing The adoption of a global health perspective by

nursing professionals interested in seeking collaborative and sustainable solutions to health problems irrespective of national boundaries.

Requires respect for differences in language, culture, customs, and health beliefs.



WHO Millennium Declaration Goals

Eradicate extreme hunger and poverty Achieve universal primary care Promote gender equality and empower

women Reduce child mortality



WHO Millennium Declaration Goals

Improve maternal health Combat HIV/AIDS, malaria, and other diseases Ensure environmental sustainability Develop a global partnership for development



Peace Corps

U.S. government agency that places volunteers in 139 countries to work on issues ranging from AIDS education to information technology and environmental preservation, and to foster cultural understanding.



ClickerCheck

The difference between a global and international context is that international

a. Is between two countries only.b.Is between low- and high-resource countries.c. Is between national governments.d.Emphasizes cultural differences.



Correct Answer

Correct answer: CInternational is between 2 or more national

governments of county perspectives.



U.S. Agency for International Development (USAID)

U.S. government agency that provides economic, development and humanitarian assistance to countries for reasons of poverty, conflict and natural disaster, and to support populations engaging in democratic reforms.



Food and Agricultural Organization

UN agency that provides international leadership for combating world hunger. FAO helps countries improve agriculture, forestry and fisheries practice to ensure good nutrition for all.



Pan American Health Organization

UN agency focused on improving the health of the countries of the Americas. Also serves as the Regional Office of the Americas for the World Health Organization.



United Nations Children’s Fund

UN agency that advocates for children in the areas of nutrition, environment, education, gender equity, health, and public policy.



United Nations High Commissionerfor Refugees (UNHCR)

UN partnership that strives to assure universal access to services for HIV prevention, treatment, care and support.



World Bank

UN-affiliated intergovernmental financial institution that provides low interest loans, interest free credits, and grants to developing countries to invest in areas such as education, health, infrastructure and resource management.



World Health Organization

UN-affiliated intergovernmental agency responsible for shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries, and monitoring and assessing health trends.



Care International

Relief and development organization that identifies underlying causes of global poverty. Operating in more than 70 countries, CARE responds to emergencies by delivering aid and helping people rebuild their lives.



Health Volunteers Overseas

A network of health care professionals who aim to increase health care access in low resource countries. They work to improve access through clinical training and education programs. HVO train, mentor and support health care providers in more than 25 countries.



Human Rights Watch

Investigates and exposes human rights violations and holds oppressors accountable for their crimes. Dedicated to upholding freedom and preventing discrimination.



International Medical Corps

Dedicated to relieving suffering through health care training, and through relief and development programs. Builds capacity in underserved communities.



International Red Cross Based primarily on the Geneva Conventions of 1864

& 1949, ensures humanitarian protection and assistance for victims of war and armed violence and other emergencies. The goal of ICRC’s Health Unit activities is to give people affected by conflict access to basic preventive and curative health care that meets universally recognized standards.



Médecins Sans Frontières Doctors Without Borders

Provides life-saving medical and technical assistance to people affected by natural or man-made disasters and armed conflict. Field staff deliver direct care in more than 60 countries, often in very difficult conditions.



Oxfam International

Group of 14 international organizations that work with other local organizations in 98 countries to fight poverty and injustice. Oxfam objectives are guided by the belief that respect for human rights is the key to lifting people from poverty.



Partners in Health

Strives to create solidarity in health by partnering with poor communities to combat disease and poverty by using a comprehensive and community based approach.

Projects are ongoing in 12 countries.



Project Hope

Since 1958, has delivered direct healthcare services and health education to people in more than 35 countries, with a goal of creating sustainable approaches.



World Vision

Christian humanitarian organization that serves close to 100 million people in over 100 countries. Support children, families and communities to help all people reach their full potential by fighting poverty and injustice.



The Gates Foundation

Philanthropic foundation created by Bill and Melinda Gates. Provides key resources to promote health and education in the United States and globally through innovative approaches to pressing problems.



The Rockefeller Foundation

First U.S. philanthropic foundation with global perspective, established by John Rockefeller in 1913. Funded the first global initiative to eradicate malaria and yellow fever in the 1940-1950s.



The Global Fund

U.S. government initiative to save the lives of those suffering from HIV/AIDS around the world. Provides the largest commitment by any nation to combat a single disease internationally.



ClickerCheck

What organization provides loans and grants to countries to improve health infrastructures

a. Pan American Health Organization.b.U.S. Agency on International Development.c. World Bank.d.World Health Organization.



Correct Answer

Correct answer: CThe World Bank provides low interest loans,

interest free credits, and grants to developing countries to invest in areas such as education, health, infrastructure and resource management.



Recommendations for the future U.S. nursing workforce

Promote targeted educational investment in foreign educated nurses in the United States.

Promote baccalaureate education for entry into practice in the United States.

Harmonize nursing curricula. Add global health as subject matter to

undergraduate and graduate nursing curricula.



Recommendations for the future U.S. nursing workforce

Establish a national system that monitors and tracks the inflow of foreign nurses, their countries of origin, the settings in which they work, and their education and licensure to ensure a proper skill mix for the U.S. nursing workforce.

Create an international body to coordinate and recommend national and international workforce policies.



Country Income & Health

No direct relationship between high-income countries and health.

US spends more than any other country on health but ranks in the bottom quartile in terms of life expectance.

Inefficiencies and cost control are concerns.



Risk Factors for Health across Countries are similar

HIV/AIDS, Alcohol, tobacco, obesity, lack of physical activity.

Very low income countries – adequate food, sanitation, safe drinking water, and vector-bourne diseases are primary concerns.



Health professionals

Shortage of health professionals. Push factors: low compensation, sociopolitical

instability, etc. Pull factors: increase income and quality of

life. Brain drain for some countries.

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