Template Paper

Global Healthcare Issue

Measles

Description

Currently, there is a vaccine that is available world-wide that is cost-effective and safe, preventing the risk of infection from the measles virus. However, even with the availability of the vaccine, there are still 110,000 measles related deaths reported as of 2017. Majority of these cases were reported to be children (key facts, 2018)

Country

United States

Israel

Describe the policy in each country related to the identified healthcare issue

The Pan American Health Organization in conjunction with the North American continent teamed up to implement a measles prevention campaign in 1994. As of 2000, the United States declared victory over the measles virus, bringing with it an end to an endemic. However, even with numerous interventions in play, the risk of a measles endemic is still high given that it can be imported from other countries. There are no national vaccination laws in the United States, with each state having its own laws (Gastanaduy et al., 2018). In states with less strict vaccination laws, such as Ohio, the number of measles cases reported are higher than in states like Mississippi, where vaccination laws are strict. The common requirement in all 50 states is that children receive the MMR, IPV, Varicella, and DTap vaccine before enrolling for school. However, in 47 of these states, there are religious considerations while 17 states permit personal beliefs as an exemption from vaccines (exemptions, 2018).

Between March 2018-February 2019, Israel reported 3,590 measles related cases. Over half of these cases, an approximated 2,110 of these cases were discovered to be within the district of Jerusalem. The Israeli Health Ministry took strict measures aimed at increasing the rate of vaccines in hopes of reducing their infection rates. The nation does not have any vaccination laws in place, meaning that children can go to schools unvaccinated. It is important to note that their vaccination laws are not restricted by their religious beliefs like the Orthodox Jews. In fact, the Knesset (WHAT DOES THIS MEAN) recently submitted a bill to address childhood vaccinations. The Ministry of Health only necessitates that in case of a disease outbreak, all unvaccinated children should not be in school and quarantine themselves in their homes.

What are the strengths of this policy?

The minimum requirement in all states is that all children receive the Varicella, IPV, DTap, and MMR vaccines before enrolling for school (exemptions, 2018).

Any suspected cases of measles should be reported to the State Department of Health and report the case to the CDC within 24 hours. The CDC and the Department of Health conduct contact tracing and thorough investigations from information given from confirmed measles cases.

The groups of people who have been exposed to the virus or are suspected to have contracted the virus are quarantined until health experts are confident that they are free of measles (Gastanaduy et al., 2018).

In response to the last reported measles outbreak in 2018, the Israeli government was swift to contain the spread of the virus by setting up mobile vaccination stations in villages across the nation.

The government also set up a vaccination advisory committee where the Orthodox Jews community was also recruited to be a part of (McNeil, 2019).

The Ministry of Health also mandated that all routine vaccines given at schools and in health clinics are free of charge (Ministry of Health, n.d.).

What are the weaknesses of this policy?

One of the weaknesses of this policy is that states are allowed to set their own vaccination laws, despite the large number of U.S. citizens who travel to different states at different times of the year.

This factor is also a risk as the U.S allows entry to unvaccinated foreigners to their countries.

Those 17 states who believe that a vaccine should be a personal choice also pose a threat to the policy.

There are currently no vaccination policies in this country, posing a threat to millions, especially children, who attend social gatherings such as weddings and risk getting sick as they interact with infected individuals.

Explain how the social determinants of health may impact the specified global health issue. (Be specific and provide examples)

Societal beliefs and cultural play a big role in determining vaccination administration in the U.S. A portion of the American society believes that vaccines against Mumps, Rubella, and Measles increase the risk factors of autism even after confirmation from the WHO that there is no relation between the vaccine and the condition. There is an increased number of parents who do not vaccinate their children because they believe that these diseases do not exist, given the limited number of reported cases in recent years (Horton, 2016).

The WHO blames the measles outbreak of 2018-2019 on a poor medical system and increased poverty. Religion does not affect vaccination measures in the country since the Orthodox Jews believe that the vaccines are a pro-life measure. With the current war with the pro-Russian separatists, there is a lot of distrust with the Israeli government. Additionally, Orthodox Jews are known to have large families with as many as 12 children in one household. The vaccination schedules become tedious as parents strain to manage (McNeil, 2019).

How has each country’ government addressed cost, quality, and access to the selected global health issue?

Most health insurance agencies in the United states cover vaccines at no extra cost to insured citizens. Covers such as Tricare offer active duty members and their families 100% cover for vaccines. Under Medicare part B and D, recipients are eligible for vaccinations for little to no costs. Additionally, Medicare also advocates for all vaccines recommended by the Department of health for infants, children, and adults. Children who do not have medical insurance are still eligible to get vaccines from the Vaccines for Children Program at no extra costs. United States residents also have the choice of getting vaccinated at a local clinic at no extra cost ("vaccine pay," 2018).

All children born in Israel are eligible to get the MMR vaccine at no extra cost. As of 2018, the country adopted the use of mobile vaccination clinics to increase access to those citizens who were in remote villages. Rabii Litzman, Israel’s Deputy Health Minister in 2018 approved an undisclosed sum of funds directed towards the vaccine campaign that was used in staffing for the benefit of the people (Hackett, 2018).

How has the identified health policy impacted the health of the global population? (Be specific and provide examples)

As of 2019, the United States had confirmed over 700 measles cases by Mat. In New York, health officials had no option but to close down two Orthodox Jewish schools because they did not comply with a directive given on unvaccinated children and school attendance. In the state of California, a number of college students and staff were forced into mandatory quarantine after exposure to the measles virus. Out of the total identified, 66 had to be hospitalized because of complications they developed after exposure. The measles outbreak has so far affected 22 states in America. However, there have been no reported deaths so far as a result of the outbreak. Over 100,000 children remain at risk of exposure to the virus because they are not vaccinates. The vaccine is noted to be effective in preventing the spread of measles among vaccinated individuals (McNeil Jr., 2019).

In Israel, the 2018-2019 outbreak was noted to have originated from Ukraine after a large number of Hasidic Orthodox Jews gathered to celebrate the New Year as per their Jewish calendar. The number of infected cases rose as the crowd returned from their pilgrimage. Even with the vaccine being free for all at no extra cost, 20% of the Israeli population remains unvaccinated. One unvaccinated child who contracted the virus from the United States caused the virus to spread to approximately 4000 people, leading to two deaths (Oster, 2019).

Describe the potential impact of the identified health policy on the role of nurse in each country.

The increased number of measles cases in the United States puts healthcare workers at increased risk of exposure. The signs and symptoms, as well as associated complications are not known to many nurses, necessitating the need to educate healthcare providers to ensure optimum care is maintained at all times. Nurses should also be given the necessary tools to educate the masses on the dangers of not vaccinating.

In Israel, awareness of vaccination programs in major cities, towns, and remote villages has increased comfortability for nurses to practice in the public health sphere. Nurses should be empowered to engage in increased community healthcare programs as they try help these large families keep up with their routine vaccination schedules.

Explain how global health issues impact local healthcare organizations and policies in both countries. (Be specific and provide examples)

There is a chain of reaction in measles related cases where individuals from Israel travel to the United States and carry the virus with them. Once they get to the United States, they interact with others from different parts of the country increasing the infection rate. Numbers in the state of New York for example were factored by the fact that Orthodox Jews had travelled from Israel during the outbreak, got infected unknowingly, and traveled back to the United States, interacting with others within their communities (McNeil Jr., 2019).

Annual pilgrimage in Ukraine for the Jewish New year is common, with over ten thousand people engaging in one place. Unvaccinated individuals expose themselves to the virus and return to Israel where the virus then spreads quietly among them within their communities.

General Notes/Comments

As a first world nation, much is expected in terms of policy formation where vaccines are concerned to conserve the lives of millions.

There should be mandatory screening to diagnose the condition in good time to prevent an outbreak that could endanger the lives of many.