Health practitioners and researchers worldwide are aware of the role played by culture in delivering healthcare. However, it is hard for healthcare providers to understand whether cultural differences between a provider and a patient add up to issues like disease severity, chronic disease management, treatment regimens, and health status. Arguably, cultural beliefs that encompass health and diseases, including those shared by small communities, contribute to how they view healthcare and how they can understand instructions from healthcare experts.
Cultural Influence on Health Issues
Healthcare experts in primary care settings are affected by cultural differences in their line of work, which may prevent effective or satisfactory health care. In this age of globalization, people of different cultures have intermingled and entered into the United States, and into the public health system. Mendoza (2000) agrees with the idea that cultural difference is becoming more crucial in the delivery of health care as well as the management of chronic illnesses each day; nonetheless, it still remains a thorny issue for both health care providers and patients. Cultural differences shape human behavior that encompasses the diet, lifestyle, and stress.
Notably, primary health care providers have to tackle the effects of cultural or language differences on patient compliance and disease outcomes each day. Cultural differences can be seen in beliefs regarding appropriate treatments, disease etiology, preventive treatment, proper self-care, suitable doctor and patient conduct, and human physiology. Furthermore, cultural differences influence the perception of emotion and symptoms states. For instance, cultural influences on the discernment of stress change as a health care expert encounters different communities.
According to research, African Americans usually make decision regarding chronic diseases based on culturally inclined experiences of the disease that consist of symptoms such as hallucinations, nosebleeds and headaches. Several medical domains have started to tackle the issue of cultural diversity in health care. Primary health care providers usually find themselves attempting to shape behaviors, lifestyles, and practices determined by culture. Health care that does not attempt to address the issue of cultural differences is related to more severe illness outcomes. An all-inclusive understanding of health must include such cultural issues into recommendations, interventions, and overall research.
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Culturally Appropriate Health Care
Many primary health care providers have called for adjusting care to suit the specific needs or beliefs of various cultural groups. Health care that is culturally competent has been raised as a way to minimize health disparities among many small ethnic groups. Schillinger & Chen (2004) stipulate that cultural competency should include programs to bring on board bicultural and bilingual health care providers, deployment of lay health advisors, use of interpreter services, as well as training of cultural competency for most primary health care providers.
However, the use of translators and interpreters does not guarantee the issuance of quality health care. They may limit the amount of information from the patient to the health care expert or the time a doctor spends with a patient. According to some research, there is a high level of patient satisfaction among ethnic group members that share an ethnic background or language with their physician or health care provider. Cultural differences also add to communication issues between providers and their patients. Furthermore, ethnic minority groups or low-income patients may face difficulty accessing appropriate information on their health.
Health education and campaigns that are culturally appropriate have brought success that comes with opportunities for extra research in the clinical field. Cultural barriers to the delivery of primary health care can include religious beliefs, language, gender norms, interactional styles, family ties, and misconception regarding Western medicines. Cultural beliefs that surround illness and health are an important part of a patient’s capacity to understand or act on the instructions given by a physician or doctor; therefore, efforts to enhance health literacy that do not consider all beliefs above will not fully address the needs of populations that are the most affected by cultural beliefs.
It has always been a challenge to provide primary health care to huge populations, and this is the case in India. India has a wide range of regions, languages, ethnicities and cultures. Definitely, this is a source of strength and richness; however, cultural influences have given rise to problems in the context of curing common illnesses. Thomas (2006) holds that the link between health and cultural factors has to be explored and critically looked into to improve patient outcome and hence achieve best practice. It is crucial to address the role played by belief and culture and how they affect the patient and general health care in India.
According to Bardhan (2008), moral values and belief systems are inborn to human life. For many people in India, culture and religion exert certain strong and positive influences on the way of life. Nonetheless, norms bound by belief and culture can be negative when it comes to the physical and mental wellbeing of patients. Syndromes bound by culture are common within health care in India. Many people in this country who fall sick believe that evil spirits have a hand in their predicament. Therefore, a family can decide to take their sick family members to traditional healers to drive the evil spirits away. Some combine herbal concoctions along with Western medication, which may have serious effects on the patients. While the role played by the family should never be undervalued, it is essential for health care givers to address this issue. Common illnesses that can be treatable need not to be explained by sorcery and other cultural beliefs. A lot of sensitization needs to be done to make communities understand that health care is the best option for them.
5. The Roles Played by the Environment and Use of Technology in Primary Health Care
Arguably, environment greatly affects the delivery of health care to patients. Delivery models used in cities are different from the ones used in rural or remote areas. It is not easy to deliver health care to rural areas if the forms of transport and communication are still not developed. Generally, health outcomes are poorer in these remote areas when compared to metropolitan areas. It is also essential to note that communities and individuals living in remote areas face tremendous health disadvantage. According to research, illness level and mortality increase with distance from urban areas. Most rural communities are characterized by higher prevalence of illnesses and hospitalization rates. Therefore, new programs and models have to be launched with the aim to improve access to health care services.
According to Baker (2007), it is now recognized that attaining the best practice in primary health care requires the development of methods based on basic integration of information technologies and communications with clinical practice. This will have tremendous impacts on the pattern of domiciliary care, medical practice and patient outcomes. Many of the milestones achieved in the delivery of health care over the past decade have targeted improvements in the service quality, effectiveness in selecting the best methods for health care delivery, the management of resources, as well as production of services. For instance, the primary health sector in Australia is a sector that is of economic importance; it controls a health care system that accounts for approximately 8 percent of the country’s GDP.
The combination of this sector with other services using the correct IT based technologies will end in improved public health outcomes, as well as instrumental cost efficiencies. The outcomes of national IT implementation strategies in countries like Australia and the UK are likely to be immense and far reaching; still, the implementation of such policies has been unclear for some time now. The objectives of such initiatives are to offer IT based resources to enhance health care, promote health prevention techniques, offer continuity of information between hospital, community and primary health care services, as well as expound on practice management.
In the past, IT has been used as a tool for management of health care to support or enhanc the delivery of health care and practice of medicine. This has been a major setback in the use of technology to improve health outcomes. A number of medical practitioners keep on showing the same lack of enthusiasm that has immensely limited the introduction of IT over the last decade. Most computers used by practitioners go towards billing, accounting or simple office management work. Only a few use their IT systems for patient medical records or clinical purposes.
The provision of IT to the health care sector has been rather slow from a management perspective. Even in Australia, practice management systems have minimal integrated capabilities. Several factors continue to impede the delivery of IT systems and use of computers in the delivery of health care, for example the difficult nature of data entry and lack of standardization for classification and coding. Standardization affects countries like Australia because of its environmental factors. Many doctors and physicians have computers on their desks but few of them actually use it for data entry.
Nonetheless, three crucial elements of IT in general practice that have become increasingly important include computerized clinical measurements, decision support, and comprehensive patient education. Systems for data collection also benefit from IT functioning well in the health care sector. Taking accurate measurement is very essential in the decision making process. Use of sophisticated medical practice and clinical equipment has immensely contributed to the increasing influence and status of health care in many developed countries.
According to Willems, (1991), computer-based patient health care and education is becoming increasingly important in the general health care practice. It is essential for health care providers to record a summary of educational materials being offered to patients. Structured and clear patient education clearly improves patient satisfaction. Therefore, it is crucial that software be made available to all the computers being used in a hospital. The key to a successful use of IT in the delivery of health care is connectivity and integration. A practitioner should make choice as to what modules of software components to use in practice. Therefore, it is crucial that countries improve their network integration and connectivity between sites and health care systems to improve the use of IT in the delivery of health care. A communications network has to be installed so that telemedicine could have an immense impact on the general clinical practice. There are huge opportunities for the use of communications technology in primary health care. Medical workstations can be easily integrated and used in consultation and data interchange between specialists.
It is undeniable that IT plays a crucial role in the delivery of health care across many countries. Nonetheless, there is still a huge potential for IT to be realized in many other countries. The use of technology can have far-reaching effects, especially in rural areas where delivery of health care has proved to be hard. Technology makes work easier; health care experts can use it to connect with other health care givers and hence share vital information that can go towards building primary health care.
7. Effects on Major Diseases and Fractured Health Care Systems on Communities
Major diseases around the globe, such as HIV/AIDS and cancer, have significantly affected the socio-economic status and level of productivity in the community all over the globe. These diseases have made it difficult for individuals to work because of their weak immune system . The World Health Organization (2005) asserts that major diseases and fractured health care systems have been instrumental in weakening individuals hence making it difficult for them to work normally. It weakens them to the extent that they are not able to continue with their normal rate of working and generating income for their families. This has extreme effects especially in cases when an individual suffering from some major disease is a key provider within a family. Diseases weaken the rate at which an individual can work properly within society and provide the required resources within the family as usual. Therefore, major diseases, such as cancer and HIV/AIDS, lead to individuals keeping off their usual activities hence leading to the reduction of income supply to their families. This implies that the family will have to suffer the consequences by having to lead a poor and difficult life as their bread winner is bed ridden and not able to work.
Fractured health care systems and major diseases within society lead to increased medical care expenditure among families hence gradually draining the key resources owned by the family. Major diseases and fractured health care systems within the country could affect individuals socio-economically to the extent that they have to spend massive resources on their suffering hence straining the entire resources of the family. Individuals affected by major diseases, such as cancer, need frequent medical care, and this involves a high level of expenditure among their families. Some families go to the extent of selling some of the most significant resources to ensure that the affected individual accesses the required level of care and treatment for major diseases such as loans. The high levels of expenditure affect the socio-economic status of the family as all resources are spent on the individual. This increases the level of poverty within the entire community. Most families have been forced to live in poverty after straining their resources trying to cure major diseases in their members. More so, fractured health care within communities necessitates excessive expenditure among families as they seek better healthcare facilities in neighboring countries. It is worth noting that all the resources spent in accessing improved healthcare in other countries contribute to increased poverty within society as family resources are strained.
It is also worth noting that major diseases and fractured health care systems lead to increased mortality rates hence affecting the socio-economic status of the community. Major diseases, such as HIV/AIDS and cancer, have reportedly contributed to many deaths to the extent of depopulating some areas. This robs communities of labor resources hence reducing overall productivity. Most individuals who die from these diseases are instrumental in the supply of key resources within their families and their death emanating from major diseases and poor health service provision leads to increased poverty and reduced population within communities. This is a negative aspect as the socio-economic status of the entire community is affected. The community will be left in a state where it has many dependants in terms of widows and orphans. This is unfortunate because it hinders development within the community as most individuals cannot access necessities. Therefore, the entire generation faces poor socio-economic status as it may involve a vicious cycle.
Micro-credit schemes and other initiatives to empower women will significantly improve health care access and quality of life among both rural and urban communities in developing countries. Notably, micro-credit institutions and other initiatives to empower women will be instrumental in improving health care access and the quality of life as they advance cheaper loans to women. These institutions ensure that women are economically empowered through accessing cheaper loans, which they use for starting different types of businesses. The businesses and other projects put in place play a vital role in boosting the economic status of these women hence ensuring they are able to take care of their families’ needs and their own needs. They can access effective medical care using the benefits earned from their businesses, which comes into place because of support from micro-credit organizations and other initiatives. More so, they earn more benefits from these businesses and community projects hence ensuring improved quality of lives among them.
Additionally, micro-credit and other initiatives launched to support women and improve their access to medical care have improved conditions living among individuals in developing countries because of the education they offer. Notably, micro-credit and other initiatives play an instrumental role in enhancing health care awareness among their members. Beigbeder (1991) affirms that they offer vital education hence ensuring women can take into consideration the significance of health care for their families and themselves. Micro-credit and other initiatives are vital in ensuring women have adequate education that would enable them understand the significance of medical care in society improvement. Thus, they are able to utilize the loans given to them to invest wisely in areas that would lead to profit generation and improve their economic power. Empowering women empowers the entire society and improves the level of medical care access among individuals. More so, the education gained from such institutions ensures women can provide for their families and take care of other significant needs. This leads to improved living standards in the entire community within developing countries.
8. Role of World Health Organization and UNICEF
The World Health Care Organization (WHO) and the United Nations International Children’s Emergency Fund (UNICEF) have played an instrumental role in the health care sector around the globe. WHO plays the role of providing effective technical advice and guidance to health care institutions in different countries. More so, it plans, implements, and evaluates measures which promote effective health care among all individuals around the globe. Beigbeder, Nashat, Orsini, & Tiercy (1998) reiterate that the World Health Organization provides technical advice to countries on the standards of required health care and the manner in which they are supposed to ensure all individuals get access to medical care. In line with this, WHO develops significant plans that would be helpful in improving the quality of care around the world. These plans always come in the form of key instructions on the terms and conditions meant to assist countries adopt proper medical care initiatives that would assist their citizens.
UNICEF plays the role of setting health care standards that would promote the survival of children from the antenatal level to growth until they mature. UNICEF is always concerned with the needs of children and it has always aimed at ensuring these needs are satisfied by health care systems within different countries. Therefore, it sets standards that would enable countries adopt immunization projects and disease alleviation projects. The latter plays the role of preventing malaria spread in children hence reducing mortality rates among children around the globe. The promotion of proper health care among children is vital as it ensures the future generation is well protected within society. All societies will have hope for the future if children are able to survive from their earlier ages. UNICEF ensures countries cater for children health care by educating mothers on the effective ways of taking care of children from pregnancy up to the time they are deemed independent.
Other significant current non-UN groups involved in the formulation of health care policies around the globe include the American Medical Resources Foundation (AMREF), Africare, the International Federation of Red Cross and Red Crescent Societies, and the International Medical Corps (IMC). The American Medical Resources Foundation (AMREF) is currently one of the key players in the formulation of health care policies. It ensures that standards relating to effective medical equipment in hospitals and clinics are met adequately. In line with this, it donates the necessary equipment to developing countries around the globe. This ensures that the standards are met as required. More so, it sets policies relating to increased medical care accessibility among individuals. It is geared at ensuring people’s access to required medical care any time they are in need. The International Federation of Red Cross and Red Crescent Societies is also an instrumental player in the determination of policies currently. Merson, Black, & Mills (2008) opine that Red Cross and Red Crescent Societies set medical care policies relating to humanitarian assistance and assurance of medical care assistance among these individuals. It donates vital medical resources to individuals in camps and those displaced in other areas hence ensuring they can access effective medical care. The organization also plays an instrumental role in guiding governments to support all individuals that are in need of medical care within the country. Concerning this, the Red Cross and Red Crescent Societies ensure all individuals in need get access to medical care facilities and resources by setting up temporary medical facilities especially in refugee camps. International Medical Corps (IMC) is dedicated to saving lives by ensuring effective health care standards are upheld by all governments and health care institutions within the country. It provides guidelines relating to proper medical care among all individuals and set policies, which have to be adhered to by governments in the protection of lives. Africare is mainly concerned with African countries. It sets policies that are vital in promoting the prevention of malaria among African children. More so, Africare has been vital in promoting policies for effective health care standards among all individuals of the African continent. It directs governments on some of the measures and policies that should be implemented in order to uphold proper health care within a particular country.
Globalization has also been instrumental in affecting primary care around the world. Globalization has led to free movement of medical practitioners to different parts of the world. Notably, globalization has significantly affected primary care by promoting free mobility of medical practitioners, especially to developing countries. Medical practitioners have been able to move from developed countries, such as the US and the UK, to deliver effective medical care standards to developing countries in the world. This has promoted efficiency of medical care delivery around the globe. More so, globalization has led to worldwide spread of medical care technology. Technology used in primary care has spread at a faster rate thanks to globalization. Developed countries can now access and utilize the current equipment and means of delivering medical care in their countries. According to Cockerham & Cockerham (2010), increased transfer of medical care technology has also boosted the innovativeness of different individuals around the globe hence promoting proper medical care in many countries .
In addition, globalization has made it easier for patients to move from one country to another with the aim of accessing effective and quality health care. Patients are not restricted to medical care facilities provided within their countries as globalization has opened opportunities for them to seek medical care from other countries, which they deem effective in medical care provision. This has revolutionized medical care because different countries have accepted to attend to people from other countries hence promoting global health. Lastly, globalization has facilitated easier manufacture and supply of medicine around the world. Crooks & Andrews (2009) affirm that countries have been able to manufacture and supply assistive medicine to individuals around the world hence promoting the health status of people globally . Medical supply around the world has revolutionized primary care by ensuring sufficient medical resources among all individuals.