Burden of Disease - Nature and magnitude - Nursing Assessment Answer

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Assignment Task

Identify a country that you are most familiar with and prepare a policy brief on one health problem from those listed below.

(1) HIV, Malaria, LRI or Diarrhea (if the country of your choice is classified as ‘low income’ or as a ‘lower-middle income’ country),

(2) Ischemic heart disease, stroke, COPD, drug use disorder, or breast cancer (if the country of your choice is classified as ‘high income’ or as an ‘upper-middle income country’).

Executive Summary

The Global Burden of Disease entails one of the most comprehensive efforts to measure the epidemiological levels, as well as the worldwide trends. According to statistics collected by the World Health Organization (WHO), Philippines is involved amongst the seven nations internationally where the number of people suffering from HIV has risen by a percentage exceeding 25 between 2001 and 2009. Currently, the infections have affected the populations that are high risks including individuals engaging in unprotected male-to-male sex, as well as those using drugs, and those engaging in transactional sex. The prevention of the HIV infection should be done to the adolescent since the infections happen at a young age mostly between 20 to 29 years (World Health Organization, 2010). The young people should be targeted as the abuse of drugs as well as sex engagement starts at the age of 14 and 19 years. The statistics show that only 5 per cent of the women who are infected with the virus are in a position to get the antiretroviral medicines which is needed to prevent infecting the unborn child. It is also reported that only a small portion of those at risk have taken the HIV test. Within the individuals who are at risk below the age of 18 no tests have been taken. As such, this paper discusses the nature of HIV in the Philippines.

Nature and magnitude

The state of HIV epidemic in the Philippines, as opposed to the surrounding countries has been established to be slow. However, in spite of the lesser cases reported in the country, the infection has been growing a high rate in the recent past. In the years between 2003 and 2008, the HIV epidemic hit harder, in the country, increasing three times the initial levels of infections. The diagnosis of HIV, has, however, decreased in the population between 36 and 29 years. The South East Asia is a region that has been experiencing evolving rates of HIV infections, but the rate is lower in the Philippines. The Philippines has been reported to have one of the lowest rates of condom use in Asia. Amongst the individuals with the risk of contracting HIV, the rates are between 20 to 30 per cent. As such, this is a factor that is alarming since reports show that infections in the country mostly are as a result of sexual contact. According to a survey, 63% of the respondents indicated that they had never used a condom (Farr, & Wilson, 2010).

The use of condoms in extramarital affairs is also reported to be very rare amongst the population. The people in the country believe that condoms are used to prevent pregnancies which are unplanned rather than the prevention of STIs. Further, the Catholic Church does not support the condoms use, and the government in the country has implemented policies that prevent supply of condoms against the unmarried people. These are some of the factors contributing to the failure of the use of condoms amongst the young people. Consequently, the spread of the HIV virus has increased amongst these individuals. In the mid of 2003, there were between 10 and 15 infections of HIV in the country, but this has risen to between to 30 and 50 every month (Farr, & Wilson, 2010). Between 2008 and 2009, there was a 58.1% increase in the infections being a number of between 528 and 835 (JUNP on HIV/AIDS, & WHO, 2014). The epidemic is now seen to be rising currently and if measures are not taken to combat the situation this could get worse in the future.

Affected Population

The HIV infection in the Philippines has been reported to be more common amongst the homosexual contact as compared to the heterosexual contact. Between the years 2003 and 2008, a rise of the infection amongst the homosexual contact was 328, whereas the heterosexual contact increased by 92 and 704 and 289 respectively. This represents an increase of 114% and 214% in 2003 and 2008 (Lewis, Lyons, & Setel, 2012). The epidemic, therefore, has is striking the men more as compared to the women. HIV infection in the country is also common amongst the individuals using the drugs mostly the injecting drug users. A report that was made in 2004 in the country indicated that 48% of the injecting drug users used injecting equipment that is sterile (World Health Organization, 2010). It was also established that large populations of these injecting drug users shared the injecting equipment. According to a report by The United Nations Programmes on HIV/AIDS infections shows that the sharing of injecting equipment is still high amongst the drug users. This; therefore, contributes to the high infections amongst these individuals. The injecting drug users, therefore, is a major group that leads to the rapid infection of the HIV/AIDS disease in the Philippines. Overseas Filipino workers are also another group which is affected by the HIV infection in the country. Over 7 million Filipinos are working in 170 countries over the globe. It is also established that over 2,000 Filipinos leave the country on a daily basis (HAIN (Philippines), & PNAIDS Council, 2010). The oversee Filipinos engage in casual sex, as well as other risky behaviors in the countries which have high prevalence of the HIV virus. These individuals, in turn, come back to the country and infect the rest of the population. Statistics show that the cases of HIV infections which are from the overseas workers range between 30 to 35% of the total cases in the country (World Health Organization, 2010). The populations between 14 and 19 are also a common section of infected individuals in the Philippines. This is because this is the age where the drug use and sexual contact is introduced. This is also common since this is the population engaging in casual unprotected sex.

Rick factors

HIV/AIDS infection in the Philippines is contributed by some factors. These are the risk factors and they include unprotected sex. Reports indicate that 63% of men who are sexually active have never used condoms in their lives (Boesten, & Poku, 2013). This is contributed to factors such as the perception towards condoms, as well as the policies implemented by the government in the country. As such, the spread of the virus has been seen to increase as many people who are sexually active do not use condoms during sex. It is also established that the most infections in the country are as a result of sexual contact. Homosexuality is also another factor that has contributed to spread of the HIV virus in the Philippines. It is established that the dominance of HIV virus in the country is greater amongst homosexual men as compared to the heterosexual infection. The use of injecting drugs is another factor that has led to the increase in infection of HIV virus in the nation. This is because these individuals are seen to share the injections used amongst themselves hence the spread of the disease. As such, this is a factor contributing to the rise in the HIV virus in the last few years.

Priority Action Steps

The government has identified the three areas which are most disadvantaged in the country. Consequently, the UNICEF HIV and AIDS programme, is involved in implementing preventive measures in these areas. UNICEF has been working with the local governments so as to ensure that there is efficiency in resource application for this purpose. Various steps have been taken to ensure the success of these programmes.

These steps include the removal the legal barriers which are present against the testing of HIV as well as counseling amongst the populations aged below 18 years. The adolescents, as well as the pregnant women have also been mapped out so as to strengthen them in HIV fighting techniques. The report systems on HIV have also been strengthened to ensure the provision of quality services. There has also been the implementation of development, as well as communication programmes which facilitate the transfer of messages, as well as strategies applied. These are supposed to ensure an increase in the awareness levels hence the reduction of stigma, while at the same time facilitating the usefulness, accessibility, as well as the affordability of the services provided. The capacity of the local providers of the social welfare is also improved so as to facilitate the understanding of the HIV epidemic amongst the adolescents. This will also ensure that there is understanding of all the risk factors, as well as the HIV awareness amongst these young people to help lower the rates of infections (Chin, 2011). There has also been the advocacy of more investment in local AIDS council so as to strengthen the advocates for the plans established on the local level. Further, the budget allocations for the young people who are at risk, as well as the mother-to-child allocations are being increased so as to prevent the transmission of HIV. As such, there has been models for interventions for the young people at risk, as well as prevention campaigns in high schools. Further, UNICEF has implemented a strategy which is meant to address STIs and HIV during pregnancy periods. Additionally, they have established a strategy framework which covers the children and young people.