Positive Social Change in Community and the World Order Instructions: Share some of your ideas on how you can use the knowledge and insights gained in this course to promote positive social change in your community and the world.
 Final Project (7–10 pages), not including the cover and the references: |
Positive Social Change in Community and the World Sample Answer
Promoting positive social change in your community and the world
Reducing health inequities has the potential to bring about substantial gains in terms of improving health outcomes and increasing the life expectancy of disadvantaged groups. This paper looks into the social determinants of health for Botswana, a landlocked African nation located in the southern part of the continent. The possible public issues that I may encounter in health literacy and cultural awareness of Botswana are described exhaustively. The current efforts in Botswana to reduce health inequities are described, and an explanation is provided on how I might develop a health policy so that it gets the support for Botswana.
Positive Social Change in Community and the World and The choice of Botswana
Botswana was selected owing to the effort made by the government of Botswana to improve the health status of its people. Moreover, Botswana was selected because of the high prevalence of diseases particularly tuberculosis and HIV/AIDS in this country. It is of note that this southern African nation has been severely hit by the HIV/AIDS epidemic with 25% of the adult population – persons aged 15 years to 49 years – are infected and more than 90,000 children have lost either the mother or father (Clause et al., 2009). Owing to HIV/AIDS, life expectancy in Botswana dropped from 67 years in the year 1990 to 52 years in the year 2000. However, because of free universal antiretroviral treatment provided by the government since 2002, the life expectancy increased slightly to 54 years today (World Health Organization, 2013). The most prevalent diseases are respiratory such as tuberculosis and pneumonia, and intestinal such as digestive and diarrheal illnesses (Clause et al., 2009).
The Botswana government understands that people’s social development is integral to improving their health status. The government considers education as a foundation for life, thus is one of the main areas which has been targeted for reducing health inequities. This is true considering that the Ministry of Education has the biggest share of government financing. Additionally, 5 percent of health funding actually goes to education (Pleasant, 2013). Not-withstanding Botswana’s status as a middle-income nation, there are poor sections of society in which ⅓ of children have stunted growth and 1 out of 10 are underweight. In contrast, with the growing prosperity of lots of families, one out of 10 children is actually underweight (World Health Organization, 2013).
Positive Social Change in Community and the World and the Social determinants of health in Botswana
The conditions wherein people are born, live, grow, age and work, as well as the health system greatly determine the level of health that the people get to enjoy (CDC, 2014). These conditions are understood as the social determinants of health and include housing, socioeconomic status, access to services, transportation, environmental or social stressors, discrimination by the social group such as class, or gender. Others are education, culture, healthy child development, social support networks, as well as personal health practices and coping skills (CDC, 2014). It is of note that these social determinants are actually shaped by the distribution of power, resources, as well as wealth at local district and national levels. In turn, these are influenced by policy choices in the various sectors that are involved.
In Botswana today, there is a substantial homogeneity among various ethnic groups and the majority of them are quickly altering their lifestyles. Studies indicate that factors such as inadequate physical activity, cigarette smoking, substance abuse, unhealthy food habits, and alcohol abuse are common among adults in Botswana (Eyal et al., 2010). Even though the Botswana government is committed to alleviating the effects of climate changes, its impact is already clear. This could actually have a considerable impact on health, for instance, malaria prevalence is expected to rise as temperatures increase, and conditions are more favorable for mosquitoes to breed in rainy seasons. Moreover, the prevalence of cholera may rise in rainy seasons. With a decline in rainfall, production of food is expected to reduce and can result in malnutrition in the longer-term (Stover et al., 2008). I need to address these social determinants since they detract from or contribute significantly to the health of communities and health. Moreover, they influence the health of people in Botswana; hence, it is important to address them.
Possible public issues I may encounter in health literacy and cultural awareness in Botswana
Health literacy is understood as the ability of a person to get, process, and comprehend health information and services required to make suitable health decisions (Phaladze & Tlou, 2006). At present, I may encounter low health literacy in Botswana. Health facilities in Botswana are learning the significance of health literacy and they are developing health literacy programmes aimed at addressing the complexities that patients in this country have in getting and comprehending health information. In Botswana, health literacy depends on systemic and individual factors including the following: culture; context or demands of the situation; professional and lay knowledge of health topics; demands of the public health and health care systems; and communication skills of professionals and lay people (Pleasant, 2013).
Health literacy is founded on the notion that if individuals are more aware of the science behind their illness and the way their medicine works, then these people are more able to comprehend strategies for prevention, how they can decrease their infection risk, how the ARVs medications work, and the importance of adherence (Stover et al., 2008). The Botswana government has collaborated with the national nongovernmental organizations, the private sector and community-based organizations to address the epidemic of HIV/AIDS by increasing health literacy about this disease. The health literacy program was initially introduced in Botswana in 2007 (Bana, 2011).
Cultural awareness is an integral element of cultural competence. Cultural awareness is understood as being conscious, observant, and cognizant of differences and similarities between and amongst cultural groups (Eyal et al., 2010). Cultural sensitivity is of major importance to developing a policy that can be accepted by the government and people of Botswana. Working in the cultural context of Botswana could be both challenging and unique, and some experiences might be more difficult compared to other experiences. For instance, there is a stigma associated with HIV/AIDS since when someone dies of AIDS, many family members do not acknowledge it and rather claim that the person died of low blood pressure or another condition but not AIDS. Moreover, many men in Botswana are not receptive to the notion of having protected sex by using condoms and they claim that: one cannot taste a sweet with its wrapping on (Bana, 2011). Therefore, it is useful to understand such underlying ideologies to allow me to be culturally sensitive in my work. It is important to engage the people of Botswana in a discussion on condoms in order to dispel myths and offer correct information.
Relationship between health inequality/inequities and life expectancy for the population in Botswana
Inequities in health are unfair and avoidable systematic disparities in accessing and using health services between various social and economic groups. Ill-health and inequity are intertwined considering that unequal access to health services by gender, urban/rural location, and income groups leads to lower health outcomes for deprived groups (Clausen et al., 2009). Inequitable distribution of healthcare is a key challenge in Botswana given that the population is unevenly distributed and the country is large geographically. Attaining equitable universal health coverage calls for the delivery of necessary, accessible services for the whole population devoid of imposing an unaffordable burden on households or individuals.
In Botswana, Bana (2011) stated that socioeconomic status, urban-rural location, and insurance status are associated with access to health care, with people in the rural regions, the uninsured, and the poor experiencing greatest barriers to health care. Utilization of higher-level healthcare organizations in Botswana is greatest amongst the insured, urban and richer people. There are equality concerns since tertiary hospitals are mainly concentrated in the wealthier, urban regions of Francistown and Gaborone, and they are better specialized, equipped and resourced compared with the rural or district facilities (Bana, 2011).
Costs of accessing health care services could be very crippling for low-income and poor households. In essence, the poorest in Botswana bear a disproportionate cost of burden. The wealthy Botswanians and people living in cities and towns have ready access to high quality care whereas those who are poor, in rural areas lack access to quality health care and have limited access to care services since there are few and far between facilities in Botswana’s rural regions. Travel distance and costs of transportation are barriers to access to health care, particularly for rural, poor residents. This means that access barriers pertain to geographic inaccessibility of health facilities, especially in largely poorly resourced and rural districts (Phaladze & Tlou, 2006).
As a result of the inequities in health care, the life expectancy of people in Botswana at birth is 54.4 years – 60 years for females, and 48.8 for males. On average, the lifespan of poor people in the countryside with virtually no access to quality health care is 47.5 years whereas that of the wealthy Botswanians is 62.5 years (World Health Organization, 2013). The presence of inequalities because of differences in wealth means the need for a policy that will address the source of inequities between the poor and the rich.
Positive Social Change in Community and the World and Efforts in Botswana to reduce health inequities
Botswana strives to address the health inequities evident between and within districts in the state. The Botswana government has made several efforts aimed at reducing health inequities in the country and has adopted a multisectoral approach to health development and it acknowledges the concept of social determinants of health.
- Healthy places – healthy people
The place wherein citizens live has a considerable effect on their health and their odds of enjoying flourishing, prosperous lives. Neighborhoods and communities that are socially cohesive, which ensure access to essential goods, are protective of the natural environment, and which are designed to foster good psychological and physical well-being are integral for health equity (World Health Organization, 2013). The government of Botswana has taken into consideration several areas in order to make living areas healthy and improve the levels of health equity. Housing and shelter: the NDP 10 affirms that the dignity of the poor Botswanians would be reinstated, and the quality of basic shelter would be improved through civil society schemes, Self Help Housing Agency (SHHA), and the Destitute Shelter Programme (World Health Organization, 2013). There are several schemes that provide housing to people of Botswana. However, the SHHA is the main scheme that focuses on the low-income population. Environment: regarding the disposal of human waste, the Botswana government has established programmes that relate to latrines. For instance, there is a change from using pit latrines to the use of water-born systems in towns and cities, or encouraging more environmentally friendly – ventilated improved – pit latrines in the rural regions in order to avoid contamination of underground water as it has happened in some areas. Disposal of solid waste is increasingly better managed using landfills (World Health Organization, 2013). Water: this is a key determinant of health. Provision of water is a key element of rural development in Botswana. The government supplies portable water to every recognized village and settlement in an effort to address health inequities.
- Universal health care, and early childhood development and education
Health care systems are an important determinant of health. The National Development Plan seeks to ensure that Botswana’s population is within 5 kilometers of a health facility. The public sector is the key healthcare services provider, and provides roughly 80 percent of all health services via public healthcare organizations and facilities (World Health Organization, 2013). Health care services in Botswana are offered by a network of clinics in towns and villages throughout Botswana, and by referral to big state hospitals in Francistown and Gaborone. Basic health care in this country is available for a small cost in facilities that are state-run. Educational accomplishment is associated with improved health outcomes, to a certain extent, through its effect on adult income, living conditions, and employment. Botswana government’s 10th National Development Plan encompasses the period from April 2009 until March of 2016. Chapter 7 of the NDP 10 – An Educated and Informed Nation – asserts that the objective of this particular plan is to provide a sufficient supply of competitive, productive, and qualified human resources. Moreover, it stresses that the sectors which contribute directly to this goal include youth, public service, education, health, finance and labor (World Health Organization, 2013).
How I might develop a health policy so that it gets support for Botswana
I might develop a health policy so that it gets the support of the people of Botswana by involving every important stakeholder in the development. These stakeholders comprise the government, nongovernmental organizations, and the citizens of this country. Their input will be of major importance in developing a health policy that will not only be relevant to Botswanians, but also one that all Botswanians can be receptive of. I will take into account the culture and beliefs of the people of Botswana in formulating the health policy so that they can find it applicable and improve their health outcomes.
Positive Social Change in Community and the World Conclusion
In conclusion, the country selected is Botswana, and it was selected owing to the high prevalence of HIV/AIDS and tuberculosis here. The most prevalent illnesses are respiratory such as tuberculosis and pneumonia, and intestinal such as digestive and diarrheal illnesses. Social determinants of health in Botswana include housing, socioeconomic status, access to services, transportation, and environmental or social stressors, and I will address them since they influence the health of people in Botswana. Presently, I may encounter low health literacy in Botswana. There are health equality concerns as tertiary hospitals are mainly concentrated in the wealthier, urban regions of Francistown and Gaborone, and they are better specialized, equipped and resourced compared with the rural or district facilities. The government strives to reduce health inequities by providing universal health care considering that HIV/AIDS medication are provided free of charge. It also seeks to provide adequate housing to all Botswanians and high-quality education. I will develop a health policy so that it gets support from the people of Botswana by taking into account the culture and beliefs of the people of Botswana, and involving all key stakeholders.
Positive Social Change in Community and the World References
Bana, R. (2011). The Importance of Cultural Awareness in Global Health – Experiences from Botswana. UBCMJ, 2(2).
CDC. (2014). Social Determinants of Health Maps. Available at http://www.cdc.gov/dhdsp/maps/social_determinants_maps.htm (Accessed October 6, 2014).
Clausen, T., Romoren, T. I., Ferreira, M., Ingstad, B., & Holmboe-Ottesen, G. (2009). Chronic Diseases and Health Inequalities in Older Persons in Botswana (Southern Africa): A National Survey. J Nutr Health Aging, 9(6): 455-61
Eyal, N., Hurst, S. A., Iorheim, O. F., & Wikler, D. (2010). Inequalities in Health: Concepts, Measures, and Ethics. Oxford, England: Oxford University Press.
Phaladze, N., & Tlou, S. (2006). Gender and HIV/AIDS in Botswana: A Focus on Inequities and Discrimination. Gender and Development, 14(1):23-35
Pleasant, A. (2013). Health Literacy: Improving Health, Health Systems, and Health Policy Around the World: Workshop Summary. Tucson, AZ: National Academies Press.
Stover, J., Fidzani, B., Molomo, B.C., Moeti, T., & Musuka, G. (2008). Estimated HIV trends and program effects in Botswana. PLoS ONE. 11/14;3(11):e3729.
World Health Organization. (2013). Integrating Social Determinants of Health in all Public Policies: The Case of Health Development in Botswana. World Health Organization. Regional Office for Africa.
