NR 443 Week 1 DQ 2 Determinants of Health Recent

NR 443 Week 1 DQ 2 Determinants of Health Recent

NR 443 Week 1 DQ 2 Determinants of Health Recent

Determinants of Health (Graded)

Healthy People 2020 identified four Foundation Health Measures (FHM) that reflect the major health concerns in the United States. The third FHM is Determinants of Health. The description of Determinants of Health is:

“A range of personal, social, economic, and environmental factors that influence health status are known as determinants of health. Determinants of health include such things as biology, genetics, individual behavior, access to health services, and the environment in which people are born, live, learn, play, work, and age” (U.S. Department of Health and Human Services, n.d., About Determinants of Health section, para. 1).

Go to the “Learn More About Determinants of Health” (http://www.healthypeople.gov/2020/about/DOHAbout.aspx ) and choose one of the five Determinants of Health that you feel is most important for community health. In your posting, share the determinant of health and the rationale for your choice. Remember to cite any references used for developing your rationale.

Social determinants of health are factors within one’s environment that affect their health. Factors such as education and employment status influence the population’s access and utilization of the available healthcare services. Disparities in healthcare are evident across countries depending on their level of socioeconomic development. For example, low- and middle-income countries have significant health disparities because of immense effect of social determinants of health (Kiplagat et al., 2019). Healthcare providers, including nurses are well positioned to influence the adoption of policies that bridge the gap in access to healthcare services in the population. Therefore, the purpose of this paper is to examine the issue of HIV/AIDS in Kenya. It develops an infographic representing equity, health equity, equality, justice, inequality, gender equity, and inequality to be presented to the minister of health. It also offers the background of the issue and need for interventions to address it.

Infographic

            Kenya is a country in East Africa, Africa. It is a lower-middle income country, with the largest as well as most developed economy in east and central Africa. HIV/AIDs are one of the health issues facing Kenya. The country’s prevalence rate of HIV/AIDs in 2017 was 4.9%, with highest prevalence being seen among women (5.2%) as compared to men (4.5%) (MOH, 2018). The following infographic provides a true picture of HIV/AIDS in the country.

Equity	Health Equity	Equality	Justice	Inequality	Gender Equity	Gender Equality
Use of antiretrovirals among those with HIV/AIDS was 42.5% in 2012. Lack of ART use due to rural residence, age (15-24 years), nondisclosure of HIV status, and recreational drug use (Moyo et al., 2018).	Challenges such as visits to multiple healthcare providers, inadequate quality facilities, and poor provider-patient communication contribute to disparities in accessing HIV/AIDs care (Kiplagat et al., 2019)	Kenya has expanded access to HIV testing and treatment to level 2 hospitals (Lane et al., 2021).	The constitution protects fundamental freedoms and human rights of people with HIV/AIDs on an equal basis with others. This extends to access to and use of resources (Lane et al., 2021).	The ART guidelines in Kenya called adherence counseling for postexposure prophylaxis for adults but failed to consider special populations, including children, adolescent girls and women (Lane et al., 2021).	Women have high rate and risk of HIV infections (5.2%) compared to men (4.5%) (Mahy et al., 2019).	Gender inequality in Kenya predisposes women to HIV/AIDS than men. Culture and socialization cause gender inequality, with men having more opportunities than women (Vrana-Diaz et al., 2021).

Health Issue

            The selected health issue in Kenya is HIV/AIDS. According to data by the Ministry of Health, the HIV prevalence among adults in 2017 was 4.9%. Women had the highest prevalence of 5.2% followed by men with 4.5%. The annual new infections in the same year were estimated to be 52800 for all ages, 44800 in adults aged 15 years and above, and 8000 among children aged below 15 years. Despite the country’s rates of infection decline over the years, its rate remains high as compared to countries within East and Central Africa. The annual mortality rates in Kenya have also been declining. In 2010, the annual mortality rate in the country was 53900, dropping to 28200 in 2017 (Mahy et al., 2019). The improvement in mortality rate is attributable to factors such as the increased access to antiretroviral treatment in the country.

            HIV/AIDS in Kenya is attributed to several causes. One of them is cultural and social factors. Cultural practices in some communities such as wife inheritance and polygamy contribute to the high rates of HIV in Kenya (Lokken et al., 2020). Social factors such as poverty, unemployment, and low educational level also play a role. Poverty and unemployment predispose the population to risky behaviors such as prostitution, which elevates the potential of contracting the virus. In addition, low educational attainment affects the utilization of HIV prevention and treatment services by the population (Nall et al., 2019).

Stigma associated with HIV/AIDS also plays a role in high rates of HIV and its associated mortalities. Stigma hinder the utilization of HIV services such as testing and initiation of early treatments. It also lowers the utilization of preventive services such as access to condoms for safe sex practices among those at risk (Lokken et al., 2020). The other factor contributing to HIV/AIDs in Kenya is substance abuse. Statistics show that the lifetime prevalence of substance abuse in Kenya is up to 69.8% among the college students. This population represents the majority of those increasingly at risk of contracting HIV/AIDS. Substance abuse practices such as sharing needles and reckless sexual behaviors increase the spread of HIV/AIDs in the population (Mutiso et al., 2022). Therefore, interventions addressing these factors should be adopted.

The issue of HIV/AIDs in Kenya should be addressed. It acts as a cause of significant disease burden to the affected and their significant others. HIV/AIDs also contribute to premature mortalities. It increases government’s spending on its management, affecting the overall social and economic development (Moyo et al., 2018). HIV/AIDS act as a burden to the families of the affected. The fact that most of the people in Kenya live below the poverty line implies that a diagnosis of HIV/AIDs worsens the challenges that families undergo (Vrana-Diaz et al., 2021).

Social and economic inequalities affect the manner in which HIV/AIDs is addressed in Kenya. Social factors such as poverty, gender inequality, and culture affect access to and utilization of healthcare systems (Vrana-Diaz et al., 2021). The Kenyan healthcare system is still underdeveloped in most parts of the country. For example, access to specialized treatment for HIV/AIDs may be a challenge, affecting its outcomes in the population. Economic issues such as the high rate of unemployment in the country also affects HIV/AIDs rates and its management. The unemployed populations are increasingly predisposed to risk factors for HIV such as substance abuse and prostitution (Lokken et al., 2020). Therefore, Kenyan government should adopt responsive measures to address the needs of the population, as an approach to reducing rates and severity of HIV/AIDs in the country.

Conclusion

             HIV/AIDS is among the crucial public health concerns in Kenya. Issues such as health, social and economic inequalities play an important role in the rise and addressing HIV/AIDs issues in Kenya. The factors attributed to HIV/AIDs in Kenya are varied. They include cultural, social, economic, and substance abuse factors. Therefore, the government should adopt responsive interventions to address the factors contributing to the high rate of infections in the country.

References

Kiplagat, J., Mwangi, A., Chasela, C., & Huschke, S. (2019). Challenges with seeking HIV care services: Perspectives of older adults infected with HIV in western Kenya. BMC Public Health, 19(1), 929. https://doi.org/10.1186/s12889-019-7283-2

Lane, J., Brezak, A., Patel, P., Verani, A. R., Benech, I., & Katz, A. (2021). Policy considerations for scaling up access to HIV pre-exposure prophylaxis for adolescent girls and young women: Examples from Kenya, South Africa, and Uganda. The International Journal of Health Planning and Management, 36(5), 1789–1808. https://doi.org/10.1002/hpm.3252

Lokken, E. M., Wanje, G., Richardson, B. A., Mutunga, E., Wilson, K. S., Jaoko, W., Kinuthia, J., & McClelland, R. S. (2020). Incidence and correlates of pregnancy in HIV-positive Kenyan sex workers. Journal of Acquired Immune Deficiency Syndromes (1999), 85(1), 11.

Mahy, M., Marsh, K., Sabin, K., Wanyeki, I., Daher, J., & Ghys, P. D. (2019). HIV estimates through 2018: Data for decision-making. AIDS (London, England), 33(Suppl 3), S203.

MOH. (2018). Kenya HIV Estimates: Report 2018. https://nacc.or.ke/wp-content/uploads/2018/11/HIV-estimates-report-Kenya-20182.pdf

Moyo, S., Young, P. W., Gouws, E., Naidoo, I., Wamicwe, J., Mukui, I., Marsh, K., Igumbor, E. U., Kim, A. A., & Rehle, T. (2018). Equity of antiretroviral treatment use in high HIV burden countries: Analyses of data from nationally-representative surveys in Kenya and South Africa. PloS One, 13(8), e0201899.

Mutiso, V. N., Ndetei, D. M., N.Muia, E., Musyimi, C., Osborn, T. L., Kasike, R., Onsinyo, L., Mbijjiwe, J., Karambu, P., Sounders, A., Weisz, J. R., Swahn, M. H., & Mamah, D. (2022). Prevalence and perception of substance abuse and associated economic indicators and mental health disorders in a large cohort of Kenyan students: Towards integrated public health approach and clinical management. BMC Psychiatry, 22(1), 191. https://doi.org/10.1186/s12888-022-03817-2

Nall, A., Chenneville, T., Rodriguez, L. M., & O’Brien, J. L. (2019). Factors affecting HIV testing among youth in Kenya. International Journal of Environmental Research and Public Health, 16(8), 1450.

Vrana-Diaz, C. J., Korte, J. E., Gebregziabher, M., Richey, L., Selassie, A., Sweat, M., & Gichangi, A. (2021). Social and Demographic Predictors of Gender Inequality Among Heterosexual Couples Expecting a Child in Central Kenya. Global Social Welfare, 8(1), 71–79. https://doi.org/10.1007/s40609-019-00138-3

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