Public health nurse educators’ Conceptualisation of public health as a strategy to reduce health inequalities: A qualitative study
Authors
Mabhala, Mzwandile A.Affiliation
University of ChesterPublication Date
2015-02-03
Metadata
Show full item recordAbstract
Background Nurses have long been identified as key contributors to strategies to reduce health inequalities. However, health inequalities are increasing in the UK despite policy measures put in place to reduce them. This raises questions about: convergence between policy makers’ and nurses’ understanding of how inequalities in health are created and sustained and educational preparation for the role as contributors in reducing health inequalities. Aim The aim of this qualitative research project is to determine public health nurse educators’ understanding of public health as a strategy to reduce health inequalities. Method 26 semi-structured interviews were conducted with higher education institution-based public health nurse educators. Findings Public health nurse educators described health inequalities as the foundation on which a public health framework should be built. Two distinct views emerged of how health inequalities should be tackled: some proposed a population approach focusing on upstream preventive strategies, whilst others proposed behavioural approaches focusing on empowering vulnerable individuals to improve their own health. Conclusion Despite upstream interventions to reduce inequalities in health being proved to have more leverage than individual behavioural interventions in tackling the fundamental causes of health inequalities, some nurses have a better understanding of individual interventions than take population approaches.Citation
Mabhala, M. A. (2015). Public health nurse educators’ Conceptualisation of public health as a strategy to reduce health inequalities: A qualitative study. International Journal for Equity in Health, 14, 14. DOI: 10.1186/s12939-015-0146-2Publisher
BioMed CentralType
ArticleLanguage
enEISSN
1475-9276ae974a485f413a2113503eed53cd6c53
10.1186/s12939-015-0146-2
Scopus Count
Collections
The following license files are associated with this item:
Related items
Showing items related by title, author, creator and subject.
-
National Health Service interventions in England to improve care to Armed Forces veteransBacon, Andrew; Martin, E; Swarbrick, R; Treadgold, A (BMJ Publishing Group, 2021-03-19)Armed Forces veterans (AFVs) are first and foremost citizens of the UK and are therefore—like all UK residents—entitled to universal healthcare, free at the point of need. This means that AFVs have nearly all their healthcare needs met by the NHS, which provides access to a full range of generic services. However, since 2013 there has been an Armed Forces team that can also support veterans. This review is an assessment of the work of this group over the last eight years. The health needs of AFVs have been investigated and are not significantly different from those of their demographically matched peers. However, due to their demographics, selection at recruitment and their roles, AFVs compared with the general population are more likely to be male, white and old and have fewer pre-existing or hereditary conditions. However, they do suffer from higher rates of musculoskeletal injury, different patterns of mental health illness and have historically been higher users—and abusers—of alcohol and tobacco. In addition to supporting mainstream services used by AFVs, the NHS in England commissions a bespoke range-specific ‘Priority’ NHS services such as those for mental health or for rehabilitation of veterans using prostheses. New interventions are continuing to be developed to improve AFVs’ healthcare and are aligned to the NHS Long Term Plan and the restoration and recovery plans after the COVID-19 pandemic.
-
Workplace Health and Well-BeingMassey, Alan; University of Chester (Springer Nature, 2019-10-01)The problems related to the process of industrialisation such as biodiversity depletion, climate change and a worsening of health and living conditions, especially but not only in developing countries, intensify. This chapter looks at the role of workplaces in the drive for global sustainability through the World Health Organisations healthy workplace framework
-
A Retrospective Cross Sectional Study of the Effectiveness of a Project in Improving Infant Health in Bwindi, South Western Uganda.Kamugisha, S. Robert; Dobson, Andrew E.; Stewart, Alex G.; Haven, Nahabwe; Mutahunga, Birungi; Wilkinson, Ewan (2018-10-12)Introduction: Low-cost community-based interventions to improve infant health potentially offer an exciting means of progressing toward the Sustainable Development Goals (SDGs). However, the feasibility of such interventions in low-income settings remains unclear. Bwindi Community Hospital (BCH), Uganda implemented a 3-year nurse-led community project to address child-health issues. Nurses supported Community Health Volunteers (CHVs) and visited mothers pre- and/or postnatally to assess and educate mothers and infants. CHVs gathered data and gave basic advice on health and hygiene to mothers. We hypothesized that increased interventions by nurses and CHVs and increased contact with households, would improve health and reduce infant mortality. Methods: This was a retrospective cohort study analyzing routine data of all children born between January 2015 and December 2016. There were three interventions: antenatal nurse visit, postnatal nurse visit and CHV participation. Children received different numbers of interventions. We defined four diverse outcomes: facility-based delivery, immunization completeness, nutritional status, and infant mortality. Odds ratios, adjusted odds ratios, and multivariate logistic regression were used to assess associations between interventions and outcomes. Results: Of the 4,442 children born in 2015 and 2016, 91% were visited by a nurse (81% antenatally and 10% postnatally); 7% lived in villages with a high participating CHV. Households receiving a postnatal visit were more likely to complete immunization (aOR: 1.55, p = 0.016) and have the infant survive (aOR: 1.90, p = 0.05). Children from a hard-to-reach village (no road access) were less likely to be delivered in a health facility (aOR: 0.55, p < 0.001) and less likely to survive in their first year (aOR: 0.69, p = 0.03). Having two or more interventions was associated with a child having all four positive outcomes (aOR 0.78, p = 0.03). Lack of baseline data, a control area, or integrated assessment data limited more detailed evaluation. Conclusion: Visits to mothers after birth, by a nurse to educate and identify child illness, were associated with lower infant mortality and improved infant health as measured by completion of immunizations. Community health interventions could potentially have a greater impact if focused on hard-to-reach areas. Building evaluation into all project designs, whether local or internationally funded, would enable greater learning, and hence better use of resources.