Discuss about the Public Health for Health Education and Continuity.
Community-based healthcare services are provided in a wide variety of settings such as community health centres, workplaces, child health centres, schools and family. These health care services are involved with health promotion, well-being maintenance, health education, continuity and coordination of health care within the community. Community nurses are among the community health service providers, among other roles as determined by the needs of the communities in which they work. A community nurse may also be employed to work as an occupational health nurse; school nurse; or women’s health nurse (Funnell, Koutoukidis & Lawrence, 2009).
As part of their service to the community, community nurses can help reduce risk factors for key populations by using health education to promote health literacy. This paper aims at providing the necessary information that could assist community nurses in achieving this task. It highlights the key populations and their reasons for being considered as key to HIV infection in relation to other community members, identifying the risk issues for the key populations, determining the health education strategies that the nurses could use, explaining how these strategies would be expected to promote health literacy for the key populations, and how these interventions would be expected to reduce risks for this population.
Health education is a means to strategically promote healthy and safe behaviours among the different groups in the population, the youth and children. It further aims to engage the education sector in advocating for change of the educational, economic, political and social conditions affecting health and wellbeing, (“Health education, as defined in World Health Organization technical report, is concerned with changes in knowledge, feelings and behavior of people,” (S.r.tiwari, 2014, pg 3). It is a process that helps people to identify their health needs and activate them for suitable behaviour. Health education is important as it helps to identify health problems and patterns within a given population and find the necessary solutions to these concerns. Its importance impacts on the whole community in such areas as creating awareness and prevention of chronic diseases; infant and maternal health; substance use and abuse, prevention of violence and injury; and obesity prevention.
Health literacy is used to describe the impacts of systems of health education, health care and mass communication. Health literacy is used to refer to the levels at which people have the ability to obtain, processing and understanding basic information and services of the health system and make appropriate health decisions.
“ The World Health Organization (WHO) expands the definition of health literacy to include personal action or use of information and states that health literacy represents the cognitive and social skills that determine the motivation and ability of individuals to gain access to, understand and use information in ways that promote and maintain good health”, (Parnell, 2014, pg. 7).
According to (Kopera-Frye, 2017), health literacy is important because it allows the public and all health personnel to find, understand, evaluate, communicate and use information. It also improves the ability of people to act on information for healthier living. Furthermore, it equips individuals with writing, speaking, listening, numeracy communication, interaction and critical analysis skills.
The key populations for this paper, as provided in the instructional part, are men who have sex with fellow men, people who inject drugs, people in prisons and other closed settings, sex workers and their clients, and transgender people. HIV has the potential to spread rapidly among People who inject drugs as a result of sharing of needles and syringes as well as through unprotected sexual intercourse between them and the non-injecting populations. Prisons and other closed settings also increase the risk of HIV infections for those living in them (Naidoo, & Willis, 2016). This is due to drug abuse and injection of substances that lead to sharing of needles and syringes as well as irresponsible sexual behaviours under these settings (Platt & World Bank, 2014). Commercial sex workers get into sexual contacts with multiple clients, some of whom are HIV positive. Due to unprotected sexual intercourse among these people, the risk of HIV infections is relatively high among the commercial sex workers and their clients.
The elevated prevalence rates of HIV among key populations create interest among the community nurse. The most common risk factors being commercial sex and injection drug use. Injection drug use involves sharing of needles and syringes (Bennette, 2014). By sharing these instruments, one can easily get infected by the disease. Additionally, more often than not, drugs alter the reasoning capacity of an individual. Impairing his or her capability of making informed decisions, thus they cannot reason for protected sexual intercourse. This further leads to more infections among the involved.
Commercial workers, in most cases, are after the payment they get for their services, in most instances they engage in unprotected sexual activities, considering a large number of clients that they engage with, the risk of HIV infections between commercial sex workers and their clients is very high.
Health education interventions refer to the means through which the community nurse could ensure that the aims and objectives of health education and health literacy are achieved. There are various interventions that could be applied to this case. Community nurses can use the following health education strategies to reduce infection rates among the key populations: creating supportive and enabling environments, re-orienting health services, strengthening community action, developing personal skills, raising public awareness and building healthy public policy (University of Pretoria, 2008).
This intervention program would target the whole community as a whole. It helps illustrate the importance of good behaviours that could promote healthy living. Even though the government initiates public health policies, the community nurses, through interacting with the key population helps promote these policies among the population (Callcot, Miller & Wilson-Gahan, 2015). From this health education policy intervention program, health literacy is gained by not only the key populations but also the whole community at large to make right healthy choices.
For intervention programs to be effective, there is need to involve the communities in which the interventions are being implemented. Community engagement and mobilization activities aim at creating a supportive environment that is enabling and empowering to HIV programs. By this, it would be possible to reach the key populations (Lomborg, 2012). Moreover, this will help reduce stigmatization and enable the target groups to come out freely and seek for HIV treatment and prevention programs. Through community mobilization, the key populations acquire the health literacy to seek treatments and accept their conditions. Furthermore, it enables those who are not yet infected to take preventive measures.
Community nurses could also engage in strengthening community action plans tailored towards reducing the spread of HIV infections. Different communities will have various action plans towards fighting HIV, especially among the key populations. “Strengthening community actions would enable the community nurses to facilitate the process of developing health-promoting environments and community developments” (Slevin, Basford & Slevin, 2003. Pg 25). This would enable the key populations in the community to take actions to meet their health needs.
“Community nurses develop facilitatory approaches that empower individuals to maintain and sustain healthy lifestyles within health-promoting environments,” (Slevin, Basford & Slevin, 2003. Pg 30). One of the empowerment strategies to this would be through assisting the key populations to develop personal skills. Personal efficacy skills in corporation with health literacy are essential for making informed decisions with regards to healthy life choices.
Community health-based services can be re-oriented by the community nurses towards ensuring that the needs of the key populations are met. These health services re-oriented towards meeting the needs of the key population’s help in creating a health-promoting model through enabling these patients to engage with the health design, implementing and evaluating health information and services (Naidoo & Willis, 2016). Community nurses should ensure that they create a safe environment through which such people as commercial sex workers and gays can seek information relating to AIDs from or access preventive measures freely without fear of being identified or stigmatized.
Risk factors refer to the conditions that would increase the chances of one contracting the disease. By the use of such media platforms that are within reach of the concerned community and the specific key populations, community nurses could pass information about how these people can avoid contracting and spreading of the disease, (Linsley, Kane, & Owen, 2011). Moreover, pass any relevant information that could lead to making healthy choices for healthy living.
By community nurses’ health education interventions, they are able to seize the opportunity and attain health literacy over such factors as: fostering responsibility for HIV prevention in youth, who happen to be the most among people who inject drugs, within the community; examination of how economically empowering of vulnerable populations can change risky behaviors; ensuring that the young people can access HIV preventive services such as condoms; changing social norms that encourage risky behaviors among community members; encouraging scale-up of proven strategies targeting individual knowledge and behavior as well as attitudes, making more extensive use of HIV prevention of the platforms of communication and technologies that are used by the concerned populations and reviewing laws and law enforcements so as to better protect the rights of the vulnerable groups within the populations in relation to HIV infection (Funnell, Koutoukidis & Lawrence, 2009)..
Community nurses could encourage the integration of HIV related information in the community rehabilitation programs aimed at enabling drug users to make informed choices about their lives. By doing this, it also helps reduce the stigma associated with HIV/ AIDs and encourages the drug users to opt for safe practices that prevent the spread of HIV/ AIDS.
Most people often in their communities tend not to seek medical attention due to fears created by the community’s view about HIV/ AIDs (University of Pretoria, 2008). It is the work of the community nurse, through health education, to provide the right information about the disease and encourage everyone, not only those at high risk of getting infected, to know their HIV status and seek medical care, when found positive. Through this, healthy behaviours will be promoted across the larger community.
Conclusion
Health education is often seen to be activities focusing on certain issues. However, this is just one of the legitimate parts of health education. It also entails the principles that promote a series of strategies seeking to foster favourable conditions for making of both healthy choices and healthy living decisions among individuals and populations, (Linsley, Kane & Owen, 2011).
Community nurses are key stakeholders in designing health education towards health literacy among the most vulnerable populations to HIV infections. Through different strategies such as community mobilization, creating supportive environment, re-orientation of health services, creating public awareness on risk factors, promoting health policy among the target groups, they are able to gain a better understanding of the key populations’ needs and risk factors, therefore able to design HIV programs towards meeting these people’s needs thus promoting HIV responsiveness and awareness among the key populations.
References
Bennet, J. (2014). Mandell, Douglas and Bennett’s principles of infectious diseases-vol 1. Saunders.
Callcot, D., Miller, J. & Wilson-Gahan, S. (2015). Health and Physical Education: Preparing Educators for the Future. Cambridge University Press.
Funnell, R., Koutoukidis, G., & Lawrence, K. (2009). Tabbner’s nursing care: Theory and practice. Sydney: Elsevier Australia.
Kopera-Frye, K. (2017). Health literacy among older adults. Springer Publishing Company.
Linsley, P., Kane, R., & Owen, S. (2011). Public health and the nursing role: Contemporary principles and practice. Oxford: Oxford University Press.
Lomborg, B. (2012). Rethinking HIV priorities. Cambridge University Press.
Naidoo, J. & Willis, J. (2016). Foundations for health promotion. (4th edition). Elsevier Health Sciences.
Parnell, T. A. (2014). Health literacy in nursing: Providing person-centred care. Springer Publishing Company.
Platt, L., & World Bank. (2014). HIV epidemics in the European region: Vulnerability and response. (reprint). World Bank Publications.
S.r.tiwari, (2014). Health Education. APH Publishing.
Slevin, O., Basford, L. & Slevin, O. (2003). Theory and Practice of Nursing. London: Cengage Learning.
University of Pretoria, (2008). Compendium of key documents relating to human rights and HIV in Eastern and Southern Africe. Pretoria: Pretoria University Law Press.
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