Complete the following document.

Global Health Comparison Grid Template

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

 

Global Healthcare Issue	Global Measles and Rubella Immunization Initiatives
Description	Immunization is one of the global health priorities (CDC, n.d). A vaccine is essential to prevent diseases and save many lives worldwide (CDC, n.d).  Centers for Disease Control and Prevention partnering with other worldwide organizations to protect people, especially children from these disabling and deadly diseases by eradicating them (CDC, n.d).  Centers for Disease Control and Prevention report shows, in 2018, over 9 million people were infected by measles, and 140,000 people lost their lives worldwide (CDC, n.d).  Rubella infection is also affecting many individuals globally (CDC, n.d).  It is also the main cause of preventable birth defects (CDC, n.d).  The Global Measles and Rubella Strategic Plan (MRSP) played a vital role in improving the health of children throughout the world by working on preventive measures (WHO, n.d).
Country	United States	Nigeria
Describe the policy in each country related to the identified healthcare issue
What are the strengths of this policy?
What are the weaknesses of this policy?
Explain how the social determinants of health may impact the specified global health issue. (Be specific and provide examples)
How has each country’ government addressed cost, quality, and access to the selected global health issue?
How has the identified health policy impacted the health of the global population? (Be specific and provide examples)
Describe the potential impact of the identified health policy on the role of nurse in each country.

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Solution

Introduction

Various clinical conditions have impacted public health adversely, thus becoming major global healthcare issues. Consequently, various initiatives have been introduced to resolve these healthcare concerns to improve people’s quality of life and well-being. This assignment presents global measles and rubella immunization initiatives as major programs for preventing rubella and measles outbreaks worldwide.

 

Global Healthcare Issue	Global Measles and Rubella Immunization Initiatives
Description	Immunization is one of the global health priorities (CDC, n.d). A vaccine is essential to preventing diseases and saving many lives worldwide (CDC, n.d).  Centers for Disease Control and Prevention partner with other worldwide organizations to protect people, especially children, from these disabling and deadly diseases by eradicating them (CDC, n.d).  Centers for Disease Control and Prevention report shows, in 2018, measles infected over 9 million people, and 140,000 people lost their lives worldwide (CDC, n.d).  Rubella infection is also affecting many individuals globally (CDC, n.d).  It is also the leading cause of preventable congenital disability (CDC, n.d).  The Global Measles and Rubella Strategic Plan (MRSP) played a vital role in improving children’s health throughout the world by working on preventive measures (WHO, n.d).
Country	United States	Nigeria
Describe the policy in each country related to the identified healthcare issue	Measles, Mumps & Rubella Vaccine (MMR) vaccination was introduced in the United States to protect various people, including children, teenagers, adults, elderly, and healthcare personnel, against measles, mumps, and rubella. Children are given two doses of MMR vaccine. The first dosage is administered between 12 and 15 months, while the second is given between 4 and 6 years of age. Additionally, teens and adults should ensure that their MMR vaccination is up to date to minimize the risk of contracting measles, mumps, or rubella.	Nigeria is using vaccination coverage improvement as a policy for eliminating measles in the country. Measles vaccination was included in the routine immunization program in 1978. The first dose of measles routine immunization targeted children aged nine months, while the second dosage was administered within the child’s second year (Baptiste et al., 2021). The immunization program was initially introduced in areas with a high incidence of measles and was later launched in areas with a low risk of measles. Additionally, the government introduced an SIA program that involves periodic mass vaccination undertaken countrywide. This program was launched to facilitate the immunization of children who were not vaccinated during the routine immunization exercise. The SIAs focus on all children within the target age bracket without considering if they had been immunized. Therefore, this program ensures that subpopulations who do not access routine vaccination are immunized (Masresha et al., 2018).
What are the strengths of this policy?	This policy reduces the risk of contracting measles, mumps, or rubella in various age brackets, including children, teenagers, adults, and older. Secondly, a single dose of the MMR vaccine is effective for adults without presumptive evidence of immunity. In other words, the second dosage of MMR is only required by adults who are at a high risk of contracting measles, mumps, or rubella, such as healthcare personnel and international travelers.	Improving vaccination coverage policy is associated with various strengths. First, the program includes two doses to enhance its effectiveness in preventing measles. The first dosage is administered at nine months, while the second dose is given within the child’s second year. The policy includes an SIA program that involves periodic mass vaccination of all children within the targeted age to ensure special populations that had not accessed the vaccine are immunized. Consequently, vaccination programs have reduced measles-related deaths in Nigeria (Masresha et al., 2018).
What are the weaknesses of this policy?	However, this policy is associated with some shortcomings since it is unfavorable for some groups of people. First, the MMR vaccine should not be given to individuals with known severe allergies since the vaccine might trigger a life-threatening allergy. Secondly, the MMR vaccine is unsafe for pregnant mothers, and one should wait until when no longer pregnant to be immunized. Additionally, women are advised to refrain from getting pregnant for a minimum of 1 month after receiving the MMR vaccine. Lastly, this vaccine is unsafe for individuals with a weakened immune system, such as HIV/AIDs or cancer, or under medical treatments, including radiation or chemotherapy.	On the contrary, the vaccination improvement policy implemented in Nigeria to reduce the high rate of measles-related deaths is associated with some weaknesses. First, the national government did not implement the policy entirely. As of 2015, the measles immunization coverage was approximately 32% (Baptiste et al., 2021). Furthermore, the immunization coverage was relatively low 13 years later. Data collected by the Demographic and Health Survey (DHS) indicated that the measles vaccine had been given to about 54% of children aged between 12 and 23 months (Baptiste et al., 2021). Consequently, all 36 Nigeria states were impacted by measles outbreaks between January and May 2019.  Additionally, over 28,000 and 89 measles cases and deaths, respectively, were reported in the country in May 2019. Borno State recorded the highest number of suspected measles cases (15,000) and measles-related deaths (89) (Baptiste et al., 2021).
Explain how the social determinants of health may impact the specified global health issue. (Be specific and provide examples)	Racism and discrimination are social determinants of health that impact MMR vaccination in the U.S. In most cases, the minority groups lack access to the vaccine due to discrimination in the healthcare system, which increases their risk of contracting measles, mumps, or rubella.	The social determinants of health (SDH) affect measles vaccination in Nigeria. Poor housing, physical environment, and lack of basic amenities are the most significant SDH that contributes to measles in Nigeria. Being an infectious disease, measles in the country is relatively high in highly-populated and congested areas. According to Baptiste et al. (2021), about 75 measles-related deaths were reported in 37 IDP camps in Nigeria. Additionally, IDP camps had previously reported relatively high measles-related deaths. For this reason, measles is considered the primary cause of child mortality in humanitarian emergencies.
How has each country’s government addressed cost, quality, and access to the selected global health issue?	The U.S government has addressed cost, quality, and access to MMR vaccination in the country. Federal, state, and local governments have set aside some funds to facilitate MMR vaccination. Various clinical trials have been conducted to ensure that the vaccine effectively prevents measles, mumps, or rubella infections. The government has enhanced accessibility by ensuring that the vaccine is available in various healthcare organizations countrywide.	The Nigeria government has addressed measles vaccine cost, quality, and accessibility. The cost issue has been resolved by asking for financial aid from international organizations to fund the vaccination exercise. The quality is assured by conducting clinical trials to ensure that the vaccine effectively protects individuals against measles. Finally, accessibility is enhanced by training over 1,000 health workers to give the vaccine in various parts of the country, especially in highly-risk areas.
How has the identified health policy impacted the health of the global population? (Be specific and provide examples)	The MMR vaccination has lowered the risk of contracting measles, mumps, or rubella among Americans. Hence, the introduction of the MMR vaccination initiative has reduced the rate of measles and mumps among Americans. Additionally, the introduction of this vaccine resulted in eliminating rubella in the U.S. since 2004, preventing rubella-related complications and deaths. According to NCIRD (2020), approximately 11,000 expectant mothers infected with rubella during the last major rubella outbreak in the U.S lost their babies. Additionally, 2,100 newborns died while 20,000 babies were diagnosed with congenital rubella syndrome (CRS) at birth.	The introduction of vaccination improvement initiatives has improved the health of the global population, particularly the Nigerians. According to Masresha et al. (2018), the implementation of measles vaccination programs in Nigeria resulted in an 85% decline in measles-related deaths by 2015 compared to 2000.
Describe the potential impact of the identified health policy on the role of a nurse in each country.	The MMR vaccine impacts nurses’ role in the U.S. Nurses are mandated to give at least one dose of MMR vaccine to children within the first year of their lifetime. Similarly, nurses are responsible for administering a single MMR dose to adults who are not at a high risk of contracting the three infectious diseases. Furthermore, they are mandated to administer the two doses of the MMR vaccine to children between 4 and 6 years and adults whose risk of contracting the three diseases is relatively high.	The introduction of vaccination improvement programs has changed the role of nurses in Nigeria. Nurse practitioners are actively involved in giving the two doses of measles vaccine to children at nine months and within the second year of their lifetime. Additionally, nurses are involved in periodic mass vaccination that targets a special population who did not access the recommended measles vaccines.
Explain how global health issues impact local healthcare organizations and policies in both countries. (Be specific and provide examples)	The MMR vaccination has impacted U.S. healthcare organizations. The vaccine has reduced measles, mumps, and rubella cases in the U.S, thus lowering the high cost associated with treating these conditions.	Global measles and rubella immunization initiatives affect Nigerian’s local healthcare organizations and policies. Healthcare organizations incur an additional cost in hiring and training nurse practitioners involved in immunizing the two doses of the measles vaccine. For instance, nurses immunize children during the clinical visit at nine months and 1.5 years. Additionally, local medical facilities are expected to develop policies that support the immunization process. For instance, healthcare organizations should introduce a policy that ensures all children are given the two doses of the measles vaccine by two years.
General Notes/Comments	The MMR vaccine is a practical initiative for preventing or eliminating measles, mumps, and rubella cases in the U.S.	Immunization is an effective strategy for reducing measles-related deaths in Nigeria. Thus, the government, healthcare providers, and parents/guardians should ensure that all children are given the two doses of measles vaccine within the first two years of their lifetime.

 

Part 2: A Plan for Social Change

            Social change movements change relationships, institutions, and cultural norms. In other words, social change involves the transformation of social and cultural institutions through human relationships and interactions over time, thus impacting society profoundly. Hence, a social change is required to eliminate rubella and measles infections worldwide. The desired change can be created by creating the Anti-Infectious Diseases Movement, which will focus on preventing exposure or transmission of rubella and measles worldwide. This social change will positively impact society by eliminating adverse effects associated with rubella and measles outbreaks, including the high cost of treating these conditions and the high related mortality rate.

Conclusions

            Overall, rubella and measles outbreaks are a primary global health care concern. These outbreak of the two infectious diseases is associated with adverse health outcomes such as miscarriages and giving birth to babies with congenital rubella syndrome (CRS). Additionally, rubella and measles outbreaks are attributed to a relatively high treatment cost. Consequently, the U.S. and Nigeria governments have adopted vaccination to prevent rubella and measles outbreaks in their respective country. This initiative has then lowered adverse effects associated with rubella and measles outbreak.

References

 Baptiste, A. E. J., Wagai, J., Luce, R., Masresha, B., Klinkenberg, D., Veldhuijzen, I., … & Hak, E. (2021). Measles outbreak in a complex emergency: estimating vaccine effectiveness and evaluation of the vaccination campaign in Borno State, Nigeria, 2019. BMC Public Health, 21(1), 1-10.

Center for Disease Control and Prevention. (n.d). Fast Facts on Global Measles, Rubella and Congenital Rubella Syndrome.

https://www.cdc.gov/globalhealth/measles/data/fast-facts-global-measles-rubella.html

Masresha, B., Braka, F., Onwu, N. U., Oteri, J., Erbeto, T., Oladele, S., … & Fall, A. (2018). Progress towards measles elimination in Nigeria: 2012–2016. Journal of immunological sciences, 135.

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.

National Center for Immunization and Respiratory Diseases (NCIRD). (2020). Rubella in the U.S. CDC. https://www.cdc.gov/rubella/about/in-the-us.html