National Health Authority Essay
National Health Authority Essay
As the illness progressed, he developed chest pains with the onset of haemoptysis. It was not until he was taken to the Civil Hospital that he was diagnosed with pneumonia and given some injections and oral medications. He developed haematuria and gradually progressed into a state of shock after being transferred to a sub-divisional hospital. Shortly after, several of the index case’s family members and relatives who had had contact with him and his wife during their incubation period were admitted to Postgraduate Institute of Medical Education and Research (PGIMER).
When four people from the same family residing in the same village as the index case were admitted to a tertiary care hospital on 12 February 2002 with similar respiratory symptoms, it was suspected to be a pneumonic plague outbreak .National Health Authority Essay. A standard case definition and treatment along with prophylaxis guidelines were prepared after which active surveillance was carried out and 30 cases identified.
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A day later the outbreak was diagnosed as highly communicable with a secondary attack rate of 75% and a relatively short incubation period ranging between 3 to 7 days. 43.3% of the 30 cases had a fever with a cough while fever, chest pain, and haemoptysis were prevalent in 30% of the case. Other symptoms were: fever with chills and chest pains and haemoptysis accompanied by episodes of vomiting. 5 of the 30 cases identified died, a case fatality rate of 16.6%.
Measures were taken to ensure public health and protection of medical teams. These included: use of protective gear and prescription of broad-spectrum antibiotics for all contacts (chemoprophylaxis). A guidance area was set up to give information to the general public to avoid any panic and take preventive measures such as chemoprophylaxis. The State Health Services carried put a house-to-house survey in the affected villages to detect any new cases among those who made contact with the index case, and his relatives.
The National Health Authority formally declared a plague outbreak on 20 February 2002. State health authorities quarantined the two affected hamlets and fumigated the affected houses. All educational institutions in the sub-division were closed until 22 February 2002. After the second wave of infection where cases had previously been admitted to the Emergency room of PGIMER, any suspected cases arriving at the Emergency Room were isolated and managed in the communicable diseases ward so as to break the transmission cycle of the disease.
An autopsy of a relative of the index case revealed bilateral pleural effusion and pericardial effusion. Lungs were robust and cumbersome with areas resembling abscess cavities. The liver and kidneys were enlarged, and the spleen was septicaemic. Five blood specimens of three patients three specimens from one patient and two from two patients grew non-lactose fermenting Gram-negative bacilli after overnight incubation. National Health Authority Essay.
To prevent future outbreaks, efforts should be made to identify known endemic foci early and gather essential information on the epidemiology and epizoology of the infection. Early identification of cases and the swift establishment of control measures, especially among close family members, relatives, and health care contacts coupled with the prescription of broad-spectrum antibiotics for all contacts (chemoprophylaxis) is crucial to containing outbreaks.
References
The source (Joshi et al., 2009) referenced the following seven sources:
Clem A, Galwankar S. (2005). Plague: a decade since the 1994 outbreaks in India. J Association Physicians India, 53:457-64.
Gani R., Leach S. (2004). Epidemiologic determinants of modelling pneumonic plague outbreaks. Emerg Infect Dis, 10:608-14.
John T. J. (1996). Emerging and re-emerging bacterial pathogens in India. Indian J Med Res, 103:4-18
Mittal V., Rana U.V., Jain S.K, Kumar K., Pal I.S., Arya R.C., Ichhpujani R.L., Lal S. (2004).Quick control of bubonic plague outbreaks in Uttal Kashi. India J Commun Dis, 36:3339.Seal S.C. (1949). Epidemiology of plague concerning the present Calcutta outbreak. Calcutta Med J, 46:167.
Sehgal S., Bhatia R. (1991). Plague in India. Delhi: National Institute of Communicable Diseases. National Health Authority Essay.
WHO (1999). Plague manual: epidemiology, distribution, surveillance and control. Geneva: World Health Organization, WHO/CSR/EDC/99.2.
Public healthcare in the United Kingdom is provided by the National Health Service where all citizens with permanent residence status have free access to healthcare. This program’s budget comes from the general taxation funds. The provisions of public healthcare differ from one territory of the United Kingdom to the other (Triggle, 2008). Healthcare programs throughout the United Kingdom have been created to aid citizens in taking care of their well-beings.
Importance of Public Health
Public health does not generally concern with the individual level, but with the population level. With basically everyone in a location as the market, it is not easy for governments to device systems that will cater to everyone and in all aspects. The Nuffield Council on Bioethics (2007) stated that the central issue in public health is whether it is acceptable for the state to establish policies that will affect national health or not.
Liberties of individuals to act on their own health care on their own preferences are considered. However, the Council (2007) notes that constraining liberties to some extent play an important role in assisting people to act autonomously in the first place, like in establishing primary and secondary education as compulsory acts.
States, including liberal states, have the responsibility to cater to people’s universal needs, whether individually or collectively. Thus, healthcare programs are created that aim to reduce illness and promote health among the people. National Health Authority Essay. These programs also aim to ensure that health care is easily available to anyone qualified for it (members of its nation).
Difficulties in Promoting Health
One reason the government has difficulties with promoting public health is that since the devolution of powers in the UK, the different nations implemented different healthcare systems amongst themselves. NHS Confederation boss Gill Morgan stated that the UK basically has four different systems albeit with the same set of values (Triggle, 2008).
England, Scotland, Wales, and Northern Ireland have the same or similar healthcare goals but execute their systems differently. For example, in England, hospitals and community centres compete with the private sector for patients, while in Scotland; the private sectors have limited involvement. In Wales, health agencies work well with their local governments, while in Northern Ireland; political issues hamper innovations in the system.
The problem with this diverse system is that patients from one nation compare services they receive from patients of other nations. Joyce Robins of a patient group called Patient Concern said that the differences were “breeding envy” (Triggle, 2008) from patients across the UK. Patients of one nation observe patients from other nations and wonder why they do not receive the same services as the other. This incites negative reactions towards nations’ healthcare systems.
Health agencies do attend to the issue of promoting health by facilitating promotional activities. But they usually focus on only one health determinant at a time.National Health Authority Essay. The World Health Organization (1998) as cited in Ziglio, et al. (2000) observed that changes from these promotions were minimal and did not produce any major impact on the determinants of health or the development of policies.
Health promotion then must be dynamic and relentless in order for it to produce visible and positive results. All patients cannot be pleased by a single healthcare system thus government agencies must take note on improvements suggested by citizens to further improve public healthcare in the UK.
References
Triggle, N., 2008. NHS ‘now four different systems.’ BBC News. Web.
Nuffield Council on Bioethics, 2007. Public health: ethical issues. London: Nuffield Council on Bioethics. Web.
Ziglio, E., Hagard, S. and Griffiths, J., 2000. Health promotion development in Europe: achievements and challenges. Great Britain: Oxford University Press. Web.
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However, a healthy lifestyle was seen to prevail among the rich population (Webster, 2002; Geoffrey, 2011). Later, findings from a series of reports including report from Royal commission on National Health Insurance in 1926; The Sankey Commission on Voluntary Hospitals in 1937; and reports from British Medical Association (BMA) in 1930 and 1938, all collectively indicated that inadequacy existed in the pattern of the services (Christopher, 2004; Webster, 2002). Evident were reports of conflicting care and duplication of work between the municipal and voluntary hospitals (Wheeler & Grice, 2000). National Health Authority Essay.Additionally, world war had a huge impact on the health services and the conditions in which hospitals, theatres, radiology and pathology department operated was very poor. Thus, no machinery existed that supported running of a coordinated healthcare system, hence a need for unified, simplified and cohesive system was felt (Smith, 2007). Furthermore, Royal Commission’s report suggested that funding for the health services might benefit from general taxation rather than its basis on insurance principle (Christopher, 2004). However, it was not until the Beveridge report in 1942, which provided a huge drive and momentum for a movement of change in the health services. And within subsequent years seen were the proposals for NHS drawn through the White Paper in 1944, then in 1946 the National Health Service Act and at last in 1948 the establishment of the NHS. National Health Authority Essay.
