Global health care has become a widely recognized concern for both governmental agencies and non-governmental organizations. Decreased barriers to transporting and exchanging information changed the lifestyles of people of many countries. For example, due to an increase in the import of high-sodium and high-fat fast food, low-income groups have started suffering from chronic diseases. In order to deal with international health care issues and coordinate worldwide health care activities, the World Health Organization was created as an intergovernmental agency. The purpose of this paper is to analyze characteristics of global healthcare policies and healthcare service delivery.

Historical Perspectives on Concern for Global Health Learning in Nursing

After the beginning of the globalization era, global health learning in nursing faced significant changes. At that time, educational programs were focused on biomedical and national health models. However, this period is characterized by a shift from a purely public health approach to cross-border studies, especially related to tropical diseases and travel medicine (Savage & Kub, 2009).

Nowadays, nursing has become an integral part of the definition of global health. In the era of globalization, diverse health concerns have appeared, including increased longevity, obesity, cardiovascular diseases and so on (Breda, 2012). Thus, because of these worldwide problems, nursing learning programs have become focused on integrating clinical topics and developing mechanisms for dealing with diseases that can be extended globally. Moreover, due to globalization, health learning in nursing has become directed at addressing issues related to cultural diversity necessitating the appearance of community nurses (Breda, 2012).

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The future perspectives of global health learning in nursing are based on addressing current international challenges. In order to improve the health of people worldwide, nursing specialists should follow a patient-centered approach in their health studies. New models of care can contribute to developing sustainable and quality primary care. Researchers agree that the future environment for nursing studies will face several challenges, such as the increased demand for care provided for the aging population and the complexity of medical therapy (Savage & Kub, 2009).

The Importance of Health Care Disparities

According to Holtz (2016), a health care disparity can be defined as a difference in access to health care services and their quality among diverse groups of the population. In the health care system of one country, disparities are related to socio-economic, racial or ethnic inequalities among its citizens. Moreover, they also depend on persons age, gender, sexual orientation, and factors. For instance, in global health care, disparities appear in the provision of life-saving HIV treatment or condoms to different groups of people (Holtz, 2016).

The existence of health care disparities results in the fact that some groups of people receive medical services and treatment of lower quality than others or experience more barriers to accessing care. Thus, individuals with a low income cannot get necessary help for treating diseases, which require significant financing (for example, cancer). Indeed, in some cases, people with non-traditional sexual orientation may experience challenges, while receiving health care services as compared to heterosexuals (Holtz, 2016). Therefore, the existence of health disparities does not only negatively affect specific groups of individuals, but also limits the overall improvement in health care quality worldwide.

Healthy People 2020 and Other Regulatory Guidelines

Healthy People 2020

Healthy People 2020 is a framework for regulating health care processes and improving them in the U.S. This program was developed in collaboration of the U.S. Department of Health and Human Services (HHS) with other federal agencies in 2010. The aim of Healthy People 2020 is to provide instruments for improving health care nationwide. This program also engages other economic sectors in the process of strengthening national health care policies and clinical practice. Healthy People 2020 outlines 26 health indicators divided into 12 topics (Office of Disease Prevention and Health Promotion, 2016). They are used as measures of the health of American citizens. For example, according to the Office of Disease Prevention and Health Promotion (2016), almost 81.6% of persons with public insurance have a usual primary care provider, while 60% of uninsured individuals do not have such. Thus, the statistical analysis of the data collected by Healthy People 2020 allows distinguishing key health care issues that appear in the U.S. and facilitate collaboration across sectors in order to improve the health of the Americans.

International Health Regulations

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The International Health Regulations were developed by the World Health Organization in 2005. These guidelines focus on preventing, protecting, controlling and providing a response to the spread of diseases among countries. While ensuring global health care safety, they concentrate on avoiding unnecessary interference with international traffic and trade (World Health Organization, 2005). The International Health Regulations help minimizing the negative impact of diverse diseases and ensure international reporting of events important for the global public health.

Moral Issues in Global Healthcare

According to the World Health Organization (2015a), there is a significant problem of limited access to health care in resource-poor countries. One of the key ethical issues related to it is specifying actions that wealthier nations should take in order to promote worldwide global health care equality. Further, a severe shortage of health care workers in poor countries also seems to increase its significance. Thus, the ethical consideration is how to stop brain drain from such nations without harming personal freedom to relocate and choose the country for professional activity (World Health Organization, 2015b). The next ethical challenge appears due to cultural differences among people worldwide. Finally, the global moral concern in health care is related to international research. For instance, there is an issue in choosing an appropriate level of care for patients comprising a control sample of a clinical trial, where traditional care standards are relatively low (World Health Organization, 2016b).

Holtz (2016) distinguishes several schools of thought that can be used in order to justify global healthcare initiatives. The first moral solution is to provide care for those who need it (humanitarianism). The second one is to maximize happiness for as many people as possible (utilitarianism). The last option is ensuring fair and equal distribution of healthcare services and supporting the research and development of new healthcare medications and technologies (Holtz, 2016).

Healthcare Productivity and Economic Costs

The global health care system has faced many inefficiencies and market failures. Some of them come from significant variations in health care spending across countries (Holtz, 2016). Such differences also appear on the territory of one country, for example, the United Stated. Moreover, achieving the maximum output while minimizing health care costs will allow improving healthcare productivity. However, an increase in the total government healthcare spending per capita is not always an indicator of reaching the best health outcomes (Lal, Moodie, Ashton, Siahpush, & Swinburn, 2012). Therefore, like any other economic activity, health care should focus on ensuring the maximum output (that is, the share of healthy people), spending the lowest amount of money on this activity.

The Availability of Healthcare Providers

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Increasing the demand for healthcare services is related to a rise in the aging and growing population and the development of the insurance coverage system for health care. As a result, the need for persons providing care is greater. Thus, advanced practice registered nurses (APRNs) play a significant role in the U.S. healthcare system. They represent one of the fastest growing segments of the professional workforce engaged in primary health care. For instance, 127 thousand of 154 thousand licensed nurse practitioners provided medical services to patients (Iglehart, 2014). Studies also show that the number of such graduates has been constantly growing (Iglehart, 2014). Researchers forecast that in the next years, such a trend will continue (Iglehart, 2014).

According to the World Health Organization (2015b), the density of physicians per 10,000 patients globally was 13.9 during 2007-2013, while the one of the nursing and midwifery personnel internationally was 28.6 per 10,000 people. On the regional level, differences in the availability of the healthcare workforce are significant. Thus, during 2007-2013, African and South-East Asia regions had only 2.7 and 5.9 physicians per 10,000 persons, while American and European communities had 21.5 and 31.2 healthcare providers per 10,000 patients respectively (World Health Organization, 2015b). Similar distribution appears in the number of the nursing and midwifery personnel, including registered nurses (World Health Organization, 2015b). Therefore, nowadays, despite of the growing total number of healthcare workers, their global distribution is still unequal in different regions.

Conclusion

The global health care system is characterized by many issues related to public health care provision. Nursing plays a key role in developing global health learning, which helps responding to international health care issues, such as providing care for individuals with a low income or creating barriers to disease spread across countries. Due to the existence of differences in an income level, race, nationality, gender, age, sexual orientation and other aspects, disparities in receiving health care services occur. However, researchers agree that the future of global health care will allow nursing to develop new patient-centered models, which will also help to deal with the existing challenges in the health care system.

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