This essay discusses the determinants of health in New Zealand with a focus on maternity care in rural areas. The main determinants of health in New Zealand are the social, cultural and economic factors such as genetics, income, education, poverty, culture, occupation and housing. The second part of this essay goes on to describe how objectives of the New Zealand Health Strategy (NZHS) can have a positive impact on health care in New Zealand.
Dew and Matheson (2008) state that the disciplines of epidemiology and social epidemiology have progressively given more descriptions of health inequalities. They also state that epidemiology mainly focuses on how and from where infectious diseases spread, whereas social epidemiology looks at the patterning of health outcomes involved with social characteristics such as gender, ethnicity and income in order to find the causes of differences between these groups. Key determinants of maternity care in rural areas are education, income, a sense of control over life circumstances and access to health care services (Ministry of Health [MoH], 2000).
Full maternity care comprises of prenatal care, early pregnancy care, antenatal care, postnatal care and also full obstetric care (Preston & Miller, 2012). Midwives are the main providers of maternity services in rural areas, who work as either Lead Maternity Carers (LMCs), who provide maternity care for women from early pregnancy up to six weeks postnatal, or are employed by rural maternity hospitals, providing maternity care when women are in the hospital (Kyle & Aileone, 2013). There is an increasing number of expectant mothers who experience difficulties in finding a suitable LMC, especially in rural areas, as there is a shortage of both midwi...
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Ministry of Health. (2014). Pregnancy services. Retrieved from http://www.health.govt.nz
National Health Committee. (2010). Rural health: Challenges of distance; opportunities for innovation. Wellington, New Zealand: Author.
Power, S. (2009, June 15). Maternity services a top priority. Manawatu Standard. Retrieved from http://www.stuff.co.nz
Preston, H., & Miller, D. (2012). Final year medical students’ perception of maternity care in general practice. New Zealand Medical Journal, 125(1352). Retrieved from http://journal.nzma.org.nz/journal/
P2: Assess own knowledge, skills, practice, values, beliefs and career aspirations at the start of the programme.
According to the World Health Organisation (2017) the social determinants of health are defined as the conditions where people are born, grown, work and live, which also includes the health system. The social determinants of health determined populations health’s outcomes and therefore linked with health inequalities (WHO, 2017)
Gavin Turrell, B. F. (1999). Socioeconomic Determinants of Health:Towards a National Research Program and a Policy and Intervention Agenda. Brisbane: Queensland University of Technology.
Essential to everyday life is the significant condition of our health. Our health can be affected by a number of elements, including our nutrition. In addition, health can also be affected by social determinants such as transportation, social economic status, early life, work, social support, food security and education. (Wilkinson, R.; Marmot, M. 2003) Case studies would be analysed and compare how the social determinants of health have been involved in the manifestation of the health complications. Also how these social determinants have affected the ability of the person access services and manage the health problems
In rural areas, 16% of people are illiterate compared to only 3% in urban areas. Only 57% of rural people complete secondary school, while 85% do in urban areas (PRB, 2015). These educational disparities contribute to many other inequalities. Women who are less educated are more likely to begin childbearing at younger ages and are less likely to use contraception. This is reflected in that 12% more women in rural areas begin childbearing before age 19 compared to their urban counterparts and only 45% of rural women use modern contraception compared to 55% in urban areas (PRB, 2015). These elements contribute to many health indicators including infant mortality and total fertility. The TFR is 3.5 in rural areas compared to 2.3 in urban areas and the differences in infant mortality were discussed previously. Education also contributes to active health seeking behaviors and higher economic status, which both support better
Irwin, A. & Scali, E. (2005). Action on the Social Determinants of Health: Learning from Previous Experiences - A background paper prepared for the Commission on Social Determinants of Health. Retrieved from: http://www.who.int/social_determinants/resources/action_sd.pdf
Finding a practitioner to care for you during your pregnancy and the birth of your child is a very important task. Most people go to their family doctor. Unless your pregnancy is high risk that may not be necessary. Midwives offer care that is “lower-tech, less invasive, and less inclined toward intervention without a clear medical need.” says Jamie Cruz, author of “Call the Midwife”. Many women are uneducated on the benefits to selecting care from a midwife. Many times when expecting mothers discuss their options with their family doctor, the discussion of midwives is often avoided or the doctor will discourage the expecting mother from choosing a midwife. Midwives and doctors should work as a team and embrace each other, however due to
They must assess the needs of the woman to determine and provide a care as instructed, this can be before conception and then throughout the antenatal and postnatal period. The focus when looking after women is to provide holistic care and making sure it's done with compassion and love. This includes respecting the women's individual choices and needs in a variety of different situations. According to NMC (2008) guidelines, midwives must treat people with care, compassion, dignity, respect and must be impartial. These competencies and proficiencies are assured through pre- and post-registration education. Being insightful when communicating and having an active listening skills provides the whole family with the feeling of being valued and considered. This includes being interested and being able to respond appropriately to establish productive and professional relationships with the women and their families. Midwives need to have the ability to be tactful, but also being able to exert influence through respect and credibility. Giving out clear and respectful messages that can be understood by women and also being able to recognise non-verbal cues and behaviours of family members is necessary (Mayes, 2011 and Nicholls L, Webb C. 2006). Midwives are also still accountable for their actions regardless of what happened, even when delegating tasks to other members of staff. The use of effective communication is
In the world of midwifery, women in particular are the main focus of primary care. In addition, it is about being with the women, in partnership with the women and delivering women centered care. In the perspective of midwives, it is important that women view midwives as the supporters of their journey rather than midwives doing their jobs. (Carolan & Hodnett, 2007). Midwives are the primary providers of maternity care. They have the role and responsibility to deliver continual care throughout a women's naivety and ensures that the women receive optimal care and support. Over the time of pregnancy and beyond, women and midwives have the time to create trust and develop a sense of bonding with one another. Antepartum, intrapartum, and postpartum
Aboriginal and Torres Strait Islanders have some of the worst health outcomes in comparison to any other indigenous community in the world (AIHW, 2011). According to United Nations official Anand Grover, Aboriginal health conditions are even worse than some Third World countries (Arup & Sharp, 2009), which is astonishing, considering Australia is one of the worlds wealthiest countries. Thoroughly identifying the causes and analysing every aspect behind poor health of indigenous Australians, and Australian health in general, is near impossible due to the complexity and abundant layers of this issue. Even within the category of social determinants, it is hard to distinguish just one factor, due to so many which interrelate and correspond with each other. The aim of this essay is to firstly identify and analyse components of the social determinants of health that impact the wellbeing of Aboriginals and Torres Strait Islanders, and demonstrate how they overlap with each other. By analysing the inequalities in health of Aboriginal and non-indigenous Australians, positive health interventions will then be addressed. Racism and the consequences it has on Indigenous health and wellbeing will be discussed, followed by an analysis of how and why social class and status is considered a determining factor when studying the health of the Aboriginal population. The issue relating ...
Living in a remote area has always been thought to have negative influences on the individual. There are 35 % of the total population in Australia living in rural area(Phillips, 2009).Rural areas in Australia and all over the world are not geographically isolated and disadvantaged only but also culturally and economically deprived which has great consequences on the health status of the population. The main two factors that have a major effect on rural health are socioeconomic status and cultural issues(Beard, Tomaska, Earnest, Summerhayes, & Morgan, 2009).
Statistics New Zealand. (2005, June). Focusing on women 2005. (Catalogue No. 16.001). Retrieved from http://www.stats.govt.nz/browse_for_stats/people_and_communities/Women/focusing-on-women.aspx
Throughout history mankind has come up with some wonderful inventions and innovations, but out of all the creations by far the most beautiful and precious is human birth. I first developed an interest in nursing and in particular midwifery years ago. I believe it is a great service within the health profession because of the privileged position to assist in human childbirth. The word midwife means with woman. Centuries before obstetricians delivered babies, midwifes assisted women in having at home births. But it was only formally established as a profession in the early 1900’s. A nurse-midwife is a registered nurse that specializes in midwifery. The job of midwife is to assist in family planning and birth control advice, provide general gynecological services (such as pap smears and breast exams), aid women in childbirth, and help women by providing prenatal and postpartum care. Nurse-midwives are required to have a Master’s of Science in Nursing (MSN) degree and pass the American College of Nurse Midwifery (ACNM) board examination to obtain certification.
I initially considered midwifery when I attended an antenatal scan with my auntie and heard the heartbeat of the unborn baby for the first time. Listening to discussions regarding health concerns and family support highlighted the importance of the midwife and mother relationship. Two years ago I was given the opportunity to be my mum’s birthing partner alongside my dad. I saw how the midwives interacted and were supportive through the birthing and decision making process. It was found that the baby was breach and the safe option was a caesarean section, and with the complications discussed mum was able to make the right decision. I attended pre and postnatal appointments and listened to the midwives offering advice and guidance, develop a birthing plan as well as check and monitor the health and wellbeing of mum. These first hand experiences have given me a deeper understanding of the role of a midwife and how communication and building trusting relationships is key during these emotional and vulnerable times for a woman, and inspired me to become a midwife.
Social determinants of health has been a large topic for many years and can have a positive and negative effect on individuals, families and communities. (World Health Organisation, 2009) The social determinants of health are the conditions in which people are born, grow, live, work and age, including the health system. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels, which are themselves influenced by policy choices. Social determinants have many factors and in this essay education will be the main social determinant of health discussed and how this could have an impact on the physical and mental sides of health.