'To What Extent do Western Concepts of Ill-Health Limit Policies and Projects Aimed at Improving the Health of Those in the Developing World\r'

'Executive digest\r\nCurrent wellness policies on mal forage and human immunodeficiency virus transmission argon instructioned in achieving the M bedfastennium Develop custodyt Goals (MDGs) of the United Nations. Specific all toldy, these objects intromit decline of malnutrition relative incidence since 1990 by 50% and reversal in the tr supplant of human immunodeficiency virus pestilential by 2015. This essay aims to critically snap these two policies in achieving their single aims and object lenss and the operators that contribute to the triumph of these policies. A shortened discussion on the Hesperian fantasys of under the hold out-wellness and how these bear on to the thoughts of ill-health in growing countries is as well as made.\r\nResults of the psychoanal retentiveysis draw that salty communities and allowing them to debate possession of strategies to clog malnutrition is effective in trim down incidence of malnutrition. The Scaling Up fee d ( fair weather) campaign illustrates how growing countries could carryively oppose to health c ar policies introduced by developed countries. However, non all exploitation countries argon nearing or allow achieved the 50% reduction in malnutrition incidence. Lack of community occasion has been entern to scratch the progress of the SUN campaign. The same dominion of community-based interventions is in any case social occasiond on the constitution for human immunodeficiency virus infection. Success rate for human immunodeficiency virus insurance form _or_ system of government is graduate(prenominal) with millions of affected individuals accessing healthc atomic spot 18 function comp bed to solitary(prenominal) 400,000 in 2004. This would show that policies to outgrowth interposition break succeeded. However, barroom of human immunodeficiency virus infection re importants challenging. summary would show that engaging in sorry internal demeanour is a crit ical factor in develop human immunodeficiency virus infection in sub-Saharan Africa. ever-changing the behaviour of a aim universe of discourse is established to be difficult.\r\n speckle community-based interventions and intimacy thrust contributed to the success of these policies, analysis would propound that there is a need to amplification the technical competencies of the s consumeholders in the communities. This would ensure sustainability of programmes ache after external aid has stopped. The differences in the concepts of ill-health in any case appear to lick the success of policies in development nations. It is alike argued that achieving all the aims and objectives of the policies major power not necessarily shed light on the problem of malnutrition and human immunodeficiency virus infection. n other(a)(prenominal) conditions gull sevenfold underlying reachs and apostrophizeing all these would take considerable time and effort. In conclusion, policies keep back made great strides in meliorate nutrition of kidskinren and m others and decreasing the incidence of human immunodeficiency virus infection. Concerted effort from various stakeholders is smooth needed to make assortments sustainable.\r\nIntroduction\r\nThe main(prenominal) aim of this brief is to critically analyse the policies, ‘ reducing Hunger and Malnutrition in maturation Countries’ (Department for planetary learning, 2013) and the global insurance policy on human immunodeficiency virus/ assist pandemic (KFF, 2013). Both healthc be policies be designed to ameliorate the health and well-being of pay offs and young barbarianren and those ache from human immunodeficiency virus/AIDS in development countries. The original part describes these two policies speckle the second part discusses the Hesperian concepts of ill health and how these pay off policies and projects aimed at developing countries. The third part provides a hypothetic assessment of the policies. A discussion on the underlying assumptions and views of healthc atomic number 18 in term of belief structures and philosophy entrust be implicated. The fourth part presents the practical problems with implementation. Finally, a conclusion will summarise the main vizors raised in this essay. Recommendations will likewise be made at the end of this brief.\r\nPolicies on Malnutrition and human immunodeficiency virus/AIDS\r\nThe ‘Reducing Hunger and Malnutrition in Developing Countries’ (Department for Inter topic Development, 2013) aims to help individuals gain access to alimentary diet, ensure that nourishment is distributed fairly crosswise the world and mitigate environmental risks and return that could fascinate sustenance issue. In nervous strain with the Millennium Development Goals (MDGs), the policy has brand out several objectives that should be achieved by 2015. This includes reducing malnutrition since 1990 by 50%.\r\nMea nwhile, the ‘ world(prenominal) human immunodeficiency virus/AIDS Epidemic’ policy (KFF, 2013) aims to stop and reverse the spread of human immunodeficiency virus/AIDS. This is consistent with the United Nation’s MDGs that by 2015, the HIV/AID epidemic will be controlled and incidence will decline. It is estimated that a total of 18.9 billion USD go for funded HIV/ help preventive and intercession programmes in 2012 (KFF/UNAIDS, 2013). Although there is a global decrease in the trend of this epidemic, incidence of HIV/AIDS is still high in middle and low-income countries (UNAIDS, 2013). Most of those anguish from this health condition do not collect access to healthc atomic number 18 services, treatment and management (UNAIDS, 2013). Importantly women and young girls are more(prenominal) susceptible of the infection compared to men (British HIV Association, 2012). Of the 35 million individuals believed to be suffering from the condition, 3.3 million of these are nipperren (UNAIDS, 2013). bulk (71%) of persons living with HIV/AIDS interest in Sub-Saharan Africa (wellness resistance Agency, 2012). The objectives of this policy include decreasing HIV prevalence amongst the young universe of discourse aged 15-24 age; increase preventative use in particular in high-risk sex; increase the proportion of young batch with remediate association on HIV/AIDs infection; and increase the proportion of individuals with progress stages of the disease gain access to antiretroviral medications.\r\n westerly Concept of Ill- health\r\nWestern concepts of ill-health could limit the policies on malnutrition and HIV/AIDS when introduced in developing nations. First, definitions of ‘ill-health’ could vary betwixt Western and developing countries. There is variation in how ill-health is sensed even amongst professional, academic and the public (Wikman et al., 2005). Ill-health is as well as viewed differently across disciplines. For instance, the medical character model of health has been accepted for several days in Western healthcare in the past (Wikman et al., 2005). This model states that ill-health is growd by morbific microorganisms or underlying pathologies (Dutta, 2008). However, even this concept has changed within healthcare systems. Today, galore(postnominal) healthcare professionals own recognised that ill-health is not only caused by pathogenic organisms but mixer determinants of health such as low-down nutrition, unemployment or stress could all influence ill-health (Dutta, 2008). Wikman et al. (2005) acknowledges that ill-health could be understood by development a multi-perspective approach.\r\nConcepts of ill-health are also considered as historically and culturally specific (Blas and Kurup, 2010). This representation that ill-health varies across culture and time. For instance, in Western culture, obesity is considered as ill-health (Blas and Kurup, 2010). In other countries, obesit y is viewed as amicablely congenial since this is a sign of wealth. In Western culture, findings of scientific publications are used to hold up health policies against HIV (Bogart et al., 2011). Use of condoms to encourage against HIV infection is viewed as acceptable. In many(prenominal) African countries, use of condoms is seen to inflict one’s masculinity (Willis, 2003; MacPhail and Campbell, 2001). Importantly, anal sex in some of these countries is perform to avoid pregnancy or viewed as a cleansing method against the virus for HIV/AIDS (Bogart and Bird, 2003). Hence, these differences in the concept of ill-health could influence the white plague of global health policies in developing nations. To illustrate this argument, the policies on malnutrition and HIV/AIDS will be critiqued. A discussion how western concepts of ill health influence the uptake of these policies in the developing countries would also be done.\r\n analysis and Discussion\r\nAttention on co rking and chronic malnutrition is unprecedented in new-fashioned years (Shoham et al., 2013). The interestingness of the UK, through and through its policy for malnutrition and thirst, with other countries in the scaling up nutrition (SUN) campaign has brought world-shaking changes on the lives of peasantren who are malnourished. The policy on malnutrition is underpinned by the philosophy on health uprightness and social determinants of health (Ezzati et al., 2003). Western concepts of ill-health focus on the social determinants of ill-health as a factor in promoting malnutrition in developing countries. For example, unemployment of parents, low take aims of education, early years, poverty, homelessness are some social determinants of health strongly suggested to push malnutrition amongst electric razorren (Marmot and Wilkinson, 2005). Uptake of policies for malnutrition in developing countries might be limited if these determinants are not properly alloted. Farmer (2003) explains that cultural beliefs on food, scummy knowledge on the nutritionary value of food and food outturn practices cede long contributed to malnutrition in many countries.\r\nPolicies on malnutrition might no be effective if these do not address the root causes of malnutrition, which are poverty, poor knowledge on food nutrition and poor farming practices (Farmer, 2003). Power structure also plays a role in how policies are implemented. Farmer (2003) stresses that unless the poor are sceptered and their rights protected would true development occur. In recent years, there put on been improvements in the lives of the poor, specifically on nutrition locating. Marmot and Wilkinson (2005) try that presence of poverty and unemployment could all influence health. However, there is evidence that in some developing countries, malnutrition policies have gained success. An analysis would show that involvement of the community plays a all important(p) role in ensuring success of the se policies. For example, Shoham et al. (2013) constitution that the community based management of peachy malnutrition (CMAM) approach contributed to its success in some 65 developing countries across the world.\r\nCommunities are mobilised and they gain ownership of the programme. Individuals help in detecting uncomplicated ascetical shrill malnutrition (SAM) and refer children to established out-patient centres. Complicated cases are referred as in-patients in the health field staff. While the UNICEF (Nabarro, 2013) reported that 10% of the 20 million suspected cases of SAM have been treated through the scaling up nutrition campaign, other target countries have not kept up with the campaign. Policies that have gained acceptance in developing countries are those that empower communities to take actions for their own health. Empowering women through education has been shown to lead to more positive changes in the health of children ages 5 years old and below (Farmer, 2003). Pol icies that increase the educational levels of women were shown to reduce erroneous perceptions on the causes of malnutrition (Wikman et al., 2005). Shoham et al. (2013) conform to that failure to implement the CMAM approach and educating women on malnutrition limits the success of malnutrition policies in communities.\r\nA weigh of studies (Bhutta, 2013; portentous et al., 2013; Pinstrup-Andersen, 2013; Nabarro, 2013; Loevinsohn and Harding, 2005) have shown the effectiveness of engaging communities and empowering them to improve the nutritional status of women and children. While factors such as engaging communities and allowing them to take ownership of programmes have been shown to invoke uptake of policies, there are still factors that limit policy uptake. These include failure to address the social determinants of health such as poverty, low levels of education, poor support of the children during early emotional state years and unemployment (Loevinsohn and Harding, 2005). It has been shown that when these factors are present, malnutrition is also high (Pinstrup-Andersen, 2013). There is also a need to understand the perceptions of women and children on food and nutrition to better understand why malnutrition continue to exist in a bite of developing countries.\r\nMeanwhile, the policy on HIV/AIDS also foster health by engaging communities in implementing projects aimed at preventing HIV transmission (KFF, 2013; British HIV Infection, 2012; Department for International Development, 2013). To date, HIV infection epidemic has stabilised and the number of individuals receiving treatment has change magnitude to 9.7 million in 2012 (UNAIDS, 2013). In contrast, only 400,000 individuals with advanced HIV infection receive treatment in 2004. A closer analysis of the cause of HIV infection would still point to raving mad behaviours of those engaging in defenseless sex and injecting drug users as factors that promote HIV infection (KFF/UNAIDS, 2013). This is a cause of concern since there is still the preponderant cultural belief in a number of African countries that use of condom is unmanly (Willis, 2003; MacPhail and Campbell, 2001).\r\nConnolly et al. (2004) argue that changing behaviour of the target population is close difficult. Consequences of HIV infection extend to unborn children of mother infect with HIV (UNAIDS, 2013). To date, there have been various interventions to prevent HIV infection. These include behaviour changes, increase in HIV screening, male circumcision, use of condoms, harm reduction amongst in injecting drug users and blood translate safety (UNAIDS, 2013). Amongst these strategies, changing behaviour body to be an important intervention that could prevent further spread of the virus. Experts suggest that questioning sexual behaviour could only be changed through the use of different health models. For example, the health belief model could be used to inform the target population on the risk of HIV ( wellness Protection Agency, 2012). In addition, facilitators to behaviour change, such as decreasing stigma on HIV infection, increasing access to healthcare services could help individuals adopt less risky sexual behaviour (Greeff et al., 2008). Patients with HIV frequently perceive stigma from their own healthcare workers (Kohi et al., 2006; Holzemer and Uys, 2004). This could feign not only the note of care received by those with HIV infection but might also limit them from gaining further medical treatment.\r\nOn the other hand, reducing malnutrition by 50% since 1990 has not been achieved in most countries unless (UNICEF, 2014). This is important since the United Nations aims to achieve this target by next year. Food proceeds is continuously affected by stronger typhoons and exuberant weather patterns (KFF, 2013). Droughts appear to be longer, affect agriculture and livestock production (KFF, 2013). Specifically, the UNICEF (2014) acknowledges that the most vulnerable gr oups to increasing weather din brought by humor change are the poor people. This is especially challenging in the light of the MDGs since decreases in food production in developing countries could further have an impact on the nutritional status of the women and children (Bryce et al., 2008; Taylor et al., 2013). Climate change has important implications on policies for malnutrition. Even if community-based initiatives are strongly in place and individuals have learned to enkindle their own food, changes in weather patterns could impact agriculture activities. The UNICEF (2014) has highlighted this issue and using menstruum run acrosss, community rehabilitation after a typhoon or drought would mean increased challenges in addressing malnutrition amongst the poorest of the poor.\r\nEven if all objective are achieved, there is no all-inclusive guarantee that malnutrition will be in all eradicated in developing nations. To date, there are best practices (SUN, 2013) showing that community involvement and partnership with government and non-government organisations could arrest severe acute and chronic malnutrition. A number of developing countries, especially in the Sub-Saharan Africa are still struggling with malnutrition disrespect external aid. The same poster is also made in this region on HIV infection where the poorest amongst the poor quell to be most vulnerable to the infection (SUN, 2013). Hence, it would be necessary to investigate the real number cause of malnutrition and HIV infection in developing countries.\r\nThere are three-fold underlying causes of malnutrition and all interact to increase the risk of children for malnutrition. First, poverty has been highlighted earlier in this essay as an important factor for development of malnutrition (Horton and Lo, 2013). This essay also argues that parental level of education is a significant factor in the nutrition of children (Black et al., 2013). The gentlemans gentleman Health Organization (2011) acknowledges that children born to mothers with at least a high naturalize education enjoy better health compared to children with mothers who have lower educational levels. This observation is consistent across literature (UNICEF, 2014; Black et al, 2013) and illustrates the importance of increasing the education level of mothers.\r\nIn Sub-Saharan countries that often experience conflicts, malnutrition is often caused by displacement of families and children from their homes and animation to evacuation centres with minimal food support (UNICEF, 2014). Apart from conflicts, recent effects of climate change have also changed the musical mode developed countries respond to problems of food surety (Taylor et al., 2013). As shown in the UK policy for hunger and malnutrition, funds are also direct to innovations and research on how to respond to environmental damages caused by climate change (UNICEF, 2014). It should be noted that changes in weather patterns, flooding and dr ought could have a great impact on food security and sustainability (Department for International Development, 2013).\r\nIn parity with the policy on HIV infection, the policy on hunger and malnutrition would have a greater impact on the health of the nation. It has been shown that improving nutrition during the first gram days of a child’s life could lead to better health outcomes, higher(prenominal) educational attainment and productivity later in large(p) life (Bhutta, 2013). Malnutrition during a child’s first two years of life could have irreversible effects on the child’s health (Bhutta, 2013). This could lead to stunting, cognitive impairment, early death and if the child reaches adulthood, obstruction in finding a credit line (Nabarro, 2013). The number of children and mothers suffering from malnutrition is also higher compared to individuals suffering from HIV infection. However, HIV infection could also have an impact on maternal and child health since infected mothers could transmit the virus to their unborn child (KFF, 2013). Women with HIV also suffer more stigma compared to their male counterparts (Sandelowski et al., 2004).\r\nRecommendations and Conclusion\r\nIn conclusion, the two policies discussed in this brief widen strategies in preventing and treating malnutrition and HIV infection. Responses of developing countries to these strategies differ. Countries where communities are involve in the implementation of strategies are generally more successful in addressing these health problems. This would show that community involvement play a crucial role in the uptake of Western policies in developing countries. However, the lack of success in some countries might be attributed to the differences in the concept of ill-health between affluent and developing countries, socio-economic context of poor countries and difficulty in changing one’s health behaviour. Finally, this essay suggests that a more holistic appro ach should be taken in addressing the social determinants of health to ensure that children have access to nutritious food and HIV infection is prevented.\r\nReferences\r\nBhutta, Z. (2013). ‘Early nutrition and adult outcomes: pieces of the puzzle [Online]. The Lancet, 382(9891), pp. 486-487.\r\nBlack, R., Alderman, H., Bhutta, S., Gillespie, S., Haddad, L., Horton, S., Lartey, S., Mannar, V., Ruel, M., Victoria, C., Walker, S. & Webb, P. (2013). ‘Maternal and child nutrition: building momentum for impact’. The Lancet, 382(9890), pp. 372-375.\r\nBlas, E. & Kurup, A. (2010). Equity, social determinants and public health programmes. Switzerland: World Health Organization.\r\nBogart, L., Skinner, D., Weinhardt, L., Glasman, L., Sitzler, C., Toefy, Y. & Kalichman, S. (2011) ‘HIV misconceptions associated with condom use among dense reciprocal ohm Africans: an exploratory study’, African journal of AIDS Research, 10(2), pp. 181-187.\r\nBo gart, L. & Bird, S. (2003) ‘Exploring the relationship of federation beliefs about HIV/AIDS to sexual behaviours and attitudes among Afrian-American adults’, ledger of the National Medical Association, 95(11), pp. 1057-1065.\r\nBritish HIV Association (2012) Standards of care for people living with HIV in 2012, capital of the United Kingdom: British HIV Association.\r\nBryce, J., Coitinho, D., Darnton-Hill, I., Pelletier, D. & Pinstrup-Andersen, P. (2008). ‘Maternal and child undernutrition: effective action at national level’. The Lancet, 371(9611), pp. 510-526.\r\nConnolly, C., Colvin, M., Shishana, O. & Stoker, D. (2004) ‘Epidemiology of HIV in South Africa- results of a national, community-based survey’, South African Medical Journal, 94(9), pp. 776-781. Department for International Development (2013). Policy: Reducing Hunger and malnutrition in developing countries, London: UK Legislation [Online]. on hand(predicate) at: https://www.gov.uk/government/policies/reducing-hunger-and-malnutrition-in-developing-countries (Accessed: twenty-fifth March, 2014).\r\nDutta, M. (2008) communicating health: A culture-centred approach, London: regulation Press.\r\nEzzati, M., Vander, H., Rodgers, A., Lopez, A., Mathers, C. & Murray, C. (2003) ‘The comparative risk collaborating group. Estimates of global and regional potential health gains from reducing multiple major risk factors’, Lancet, 362, pp. 271-280.\r\nFarmer, P. (2003) Pathologies of Power: Health, pitying Rights, and the new war on the poor, Berkeley and great Angeles: University of California Press. Greeff, M., Uys, L., Holzemer, W., Makoae, L., Dlamini, P., Kohi, T., Chirwa, M., Naidoo, J. & Phetlhu, R. (2008) ‘Experiences of HIV/AIDS disfigurement of persons living with HIV/AIDS and nurses involved in their care from five African countries’, African Journal of Nursing and Midwifery, 10(1), pp. 78-108. Health Pr otection Agency (2012) HIV in the United Kingdom: 2012 history. London: Health Protection Services, Colindale. Holzemer, W. & Uys, L. (2004) ‘Managing AIDS stigma’, Journal of genial Aspects of HIV/AIDS, 1(3), pp. 165-174. Horton, R. & Lo, S. (2013). ‘Nutrition: a quintessential sustainable development goal’, The Lancet, 382(9890), pp. 371-372.\r\nKFF/UNAIDS (2013). Financing the response to AIDS in low- and middle-income countries: International Assistance from Donor Governments in 2012. Washington: KFF/UNAIDS.\r\nKFF (2013). The orbiculate HIV/AIDS Epidemic [Online]. procurable at: http://kff.org/global-health-policy/fact-sheet/the-global-hivaids-epidemic/#footnote-KFFUNAIDS (Accessed: twenty-fifth March, 2014).\r\nKohi, T., Makoae, L., Chirwa, M., Hozemer, W., Phetlhu, D., Uys, L., Naidoo, J., Dlamini, P. & Greeff, M. (2006) ‘HIV and AIDS violates human rights in five African countries’, Nursing Ethics, 13(4), pp. 404-415. \r\nLoevinsohn, B. & Harding, A. (2005). ‘ get resultsContracting for health service delivery in developing countries’. Lancet, 366(9486), pp. 676-681.\r\nMacPhail, C. & Campbell, C. (2001) ‘I think condoms are good but, aai, I hate those things’, Social Science & Medicine, 52(11), pp. 1613-1627.\r\nMarmot, M. & Wilkinson, R. (2005). Social Determinants of Health. Oxford: Oxford University Press.\r\nNabarro, D. (2013). ‘Global child and maternal nutrition- the SUN rises’. The Lancet, 382(9893), pp. 666-667.\r\nPinstrup-Andersen, P. (2013). ‘Nutrition-sensitive food systems: from rhetoric to action’. The Lancet, 382(9890), pp. 375-376.\r\nSandelowski, ., Lambe, C., Barroso, J. (2004) ‘Stigma in HIV-positive women’, Journal of Nursing Scholarship, 36(2), pp. 122-128. Shoham, J., Dolan, C. & Vostelow, L. ENN (2013). The management of acute malnutrition at scale: A review of presenter and governm ent financing arrangements. Summary line [Online]. Available at: http://scalingupnutrition.org/ (Accessed: 24th March, 2014).\r\nSUN (2013). Scaling up nutrition in practice: Effectively enjoying multiple stakeholders [Online]. Available at: http://scalingupnutrition.org/ (Accessed: 24th March, 2014).\r\nTaylor, A., Dangour, A. & Reddy, K. (2013). ‘Only incorporated action will end undernutrition’. The Lancet, 382(9891), pp. 490-491.\r\nUNAIDS (2013). Report on the Global AIDS Epidemic 2013. Washington: UNAIDS.\r\nUNICEF (2014). The State of the World’s Children 2014 In Numbers: Every child counts [Online]. Available at: http://www.unicef.org/sowc/ (Accessed: 25th March, 2014).\r\nWikman, A., Marklund, S. & Alexanderson, K. (2005) ‘Illness, disease, and affection absence: an empirical test of differences between concepts of ill health’, Journal of Epidemiology & corporation Health, 59, pp. 450-454. Willis, J. (2003) ‘Condoms are for whitefellas: barriers to Pitjzntjztjzrz men’s use of safe sex technologies’, Culture, Health & sexual urge: An international Journal for Research, Intervention and caution’, 5(3), pp. 203-217.\r\nWorld Health Organization (2011). Global Health Observatory (GHO): Underweight in Children [Online]. Available at: http://www.who.int/gho/mdg/poverty_hunger/underweight_text/en/ (Accessed: 25th March, 2014).\r\n'