Policy related to new mothers living in a women’s crisis centre in the UK Essay Example

Food Hygiene and Nutrition

Policy related to New Mothers Living in a Women’s Crisis Center

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Policy related to New Mothers Living in a Women’s Crisis Centre

Approaches to enhance the global population face a revisiting of poverty and inequality discourses. A central role has been ascribed to the social determinants of health. Despite the concept of social determination of health being defined differently across literature, there is a consensus that while illness has biological causes, it is the social causes that can explain the illness distribution within a population. The social causes illustrate why certain people have higher risks of getting a disease and explain why the consequences of a higher impact on the lives of those individuals who are vulnerable. In spite of having various health promotion‘s traditional preoccupation with lifestyle, various countries formulate various health policies to ensure that the citizens remain healthy with reduced chances of injuries (Birn, Pillay, & Holtz, 2009). The health policies play important roles in ensuring effective health behaviour options and lifestyle of individuals. The purpose of this essay is to highlight the policy that is related to new mothers living in crisis centres in a global context. Particularly, this essay will appraise the social determinants of health in relation to health, equity & inequality within the context of a global environment. Further, this essay will evaluate the approaches to the needs assessment based approaches to health and sustainability in a global context. Lastly, this essay will evaluate the selected country’s public health policy. To achieve these objectives, this essay will focus on the new mothers living in mental facilities. Moreover, the policy discussed is the Obesity and Healthy Eating policy.

Social determinants and potential and health inequalities

The social determinant of health is the concept that focuses attention to the social factors that shape the health of the people within a country or region. Health and wellbeing of the society is sensitive to the conditions in which people are born, grow, live, work and age. These conditions are known as the social determinants of health and wellbeing. The social determinants of health include social structure, social position, social/material environment, illness and injury, and their social consequences.

Social position is an individual’s local in the social hierarchy around which her society is build. Therefore, social position includes dimensions such as socioeconomic position, ethnicity, and gender. According to Bartholomew et al. (2006) social position incorporates other structures of inequality including inequality regarding sexuality and nationality that have a great impact on how an individual lives her life. As Green & Kreuter (2005) posit, social position is a point at which the societal-level resources enters and impacts on the lives of individuals. Such resources may include education, employment opportunities, as well as material resources like property and income. In turn, social position shapes and is exposed to a set of intermediate factors that encompasses social and material environments of homes, workplace, and neighbourhood which provides resources for health as well as risks for health. The intermediate factors also include behavioural and physiological factors which can either protect and enhance, or damage the health of an individual. The intermediary factors are shaped by the social position to which they are linked, hence influencing the vulnerability of the people to illness and injury. Lastly, these conditions have repercussions for social position such restricting educational and qualifications opportunities, and earnings and pensions from reaching the people.

Health inequalities

Health inequalities re-count the transformation in health state or status of entities or groups. The variances can be measured in terms of socio economic groups, men and women, geographical communities and ethnic groups. The health inequalities may be partially biological in origin but may also be as a consequence of human activity. According to Epstein (2007) heath inequality is an unnecessary, avoidable, unfair, and unjust difference between health or health care individuals and the population experience in comparison to others.

Social factors, such as education, employment status, ethnicity, and gender determine the health of a person. In all countries globally, whether low, middle, or high, there are wide differences in the status of health of different social groups. When an individual is at a lower a socio-economic position it is likely that individual have the greater chances of poor health (Graham, 2000). Health inequalities have a substantial difference in the health status of different populations. Also, the inequalities have significant impact on the economic and social costs as well as to the individual or societies.

There are certain population of women population subgroups that are at a higher risk of severe mental disorder during childbirth because of their exposure and vulnerability to unfavourable social, economic, and environment conditions. Labonter & Torgerson (2005) also argue that social inequalities are relates to the increase of common risks of mental disorders among new mother who undergo abusive relationship or with health history of depression and anxiety. The inequality starts before birth and accumulates throughout the life of an individual. Currently, a reputable body of work exists to emphasize the need for a life course approach to acknowledge and tackle the mental and physical health inequalities. Efforts that assist in the prevention of mental disorders and promote mental health are significant part in improving the world population’s health and reduce health inequalities.

Approaches to health and health sustainability

There are three basic approaches when conducting health needs assessments. These approaches include; comparative, corporate, and epidemiologically based approaches (Department of Health and Human Services, 2000). The comparative approach compares the level of service between different populations and takes into consideration the characteristics of local characteristics. The comparative approach is an effective tool to investigate health services especially those that requires capitation-based funding. Comparisons between costs and value of service may be appropriate depending on the local situations. However, with capitation funding of health care, gross departure require justification. While making comparisons between service provisions of different healthcare, it is vital to take the population characteristics must be taken into accounting. The use of mortality and morbidity data relies on the assumption that health care is a significant determinant of mortality and morbidity, which may lack justification. The corporate approach is based on the demands, wishes and perspectives of the interested parties. The corporate approached was initiated during the 1989 reforms with the local voices and the emphasis on collaboration (Ayo, 2003). It is significant if health policies formulated by the health department are sensitive to the local situations. Corporate approach allows a scope for managing supply and demand while at the same time, assessing the needs as affected by local circumstance. However, the disadvantage of this approach as that it covers the difference between demand and need and between vested interest and science. The epidemiologically based approach is based on the perspectives of the patient, the assessment of the effectiveness and possible intervention cost-effectiveness (Center for Disease Control and Prevention, 2001).The most commonly used approach is the epidemiologically based model of health care needs assessment. The Epidemiology based approach is used to understand the perinatal mental illness among expectants and new mothers living in crisis centres (Woodard & Gridina, 2000). The approach identifies current service provision and reviews the evidence and recommendation for effective management of mothers with perinatal mental illness.

Perinatal mental illness covers an extensive mental disorder that affects mother during the antenatal and parental period. New mothers with the perinatal mental illness do not know how to health with the illness and thereby require various needs. These illnesses occur during pregnancy and may include bipolar disorder or schizoaffective disorders. However, there are mothers who suffer from specific antenatal and postnatal and postnatal disorders such as antenatal depression. In most cases, depression and anxiety occurs together making it impossible to find an accurate occurrence of anxiety. A study conducted by Rahman et al. (2008) have shown that over 15% of women in the perinatal period are prone to suffer a combination of depressive and anxiety depressions . Also, among this number, 45% remain unidentified. This means that only half of the pregnant women develop depression during the primary health services each year.

For these women, professional help from the primary healthcare service would be appropriate. However, this may be impossible as almost 4% of these women give birth having moderate to almost sever depressions while 2% have to be taken to specialist mental health services (Surkan et al. 2011). Anxiety and depressions are the common mental health problem during the antenatal and postnatal periods. There are various risk factors that lead to perinatal mental illness among new mothers. These factors include exposure to violence such as domestic, sexual or gender based violence, childhood abuse, traumatic delivery, perinatal death, insufficient social support and being a single mother, and past history of mood and anxiety disorders.

Women’s mental health requires special consideration in the view that they have a higher possibility of suffering depression and anxiety disorders. Also, the mental health problems can impact on childbearing and childrearing. In most cases, when chronically mental ill women become new mothers (first pregnancy) they stop taking psychotropic medication due to the concern that the medication can harm the developing foetus, hence cause high chances of relapse of the woman during pregnancy (Barry, 2009). During pregnancy, new mothers living in crisis centres may be less likely to eat and sleep adequately, attend antenatal care, use harmful substance, and fail to seek help for the birth.

It is recommended that health professional’s advice new mothers in the crisis centres about their feelings, get support with practical tasks from friends and try to get some sleep and try to get some time away from their babies. However, this is still an issue among healthcare professionals. Motherhood comes with emotive expectation hence contributing to the fact that a huge number of perinatal mental illnesses among new mothers are not diagnosed. Mikulincer & Shaver (2012) argue that only approximately 20% of primary care trust have been developed and implemented the policy for perinatal mental health. The new mothers require specialist services including perinatal teams. Most importantly, crisis and home treatment team greatly impact the use of inpatient services rendered to the new mothers suffering from mental illness.

Activities and services offered to the mentally ill new mothers

The perinatal mental team comprises of consultants, a full time perinatal psychiatric nurse, a specialist registrar and a full time co-coordinator. The health professional may prefer any woman to the team. Currently, any woman who is pregnant or has been undergoing postpartum within a year with moderate to severe illness is referred to the team (Woodard & Gridina, 2000). Those who are under the care of community mental health team are given advice by the team but do not take over the care. Health centres within the country do not offer 24 hour cover for perinatal mental health. Therefore, it is difficult to identify and contact a consultant psychiatrist when required.

Approximately four women in various crisis centres need admissions to specialist unite during childbirth. However, there are limited health centres that are specialized in the treatment of antenatal and postnatal mental care illnesses. The new mothers are offered occupational therapies that include life skills such as cooking and shopping, health skills such as diet and physical activities, work skills and IT skills, and leisure skills such as photography and art. The new mothers are educated by the pregnancy support team. The pregnancy team assesses any risk that the new mother, her unborn child or infant is exposed to. Also, the team communicates effectively with other health agencies and identifies instances and areas that require actions to be taken to ensure that every child and the new mothers are safeguarded. The members that constitute the pregnancy support team include the family support team, midwifery manager, Lead midwife, and perinatal mental health nurse

It is worth noting that it is this group of women that have mild to moderate mental illness that often benefit from psychological treatment. However, there should be improvements made towards the services that target this group by including the services not offered to ensure that their health needs are adequately and effective met to ensure sustainability and health benefits.

Health policies

Obesity and Healthy Eating is one of the major health policies that are relevant to new mothers. In particular, obesity is an issue that has serious long-tern effects on the health and wellbeing of children as they grow. US policy makers have implements various policies and programs as a respond to the issue of obesity. The programs began in the 1990’s and heightened after the Surgeon General’s Call to Action in 2001. For instance, Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults drew on scientific literature to develop effective principles of safe and effective weight loss among those individual who are feared to be obese or might be obese. Relevant to the guidelines, regular and frequent physical activities is essential for a healthy life. Expectant mothers and other individuals who are physically inactive are more likely to develop coronary heart disease compared to those who engage in regular physical activities. because obesity has become epidemic in the country, the Obesity and Healthy Eating policy assists in the formulation of prevention efforts that focuses on helping different individuals to reduce their intake of calories and increase physical activities.

The Weight Control Information Network is another government program to address obesity. The program was established in 1994 as a service of the National Institute of Diabetes and Digestive and Kidney Diseases. The aim of the program is to provide information about obesity and weight control to the public and the media. Most importantly, the program provides information regarding effective child care. In respect to the child care, program advocates breastfeeding as the most effective strategy to reduce chances of children becoming overweight. For instance, by promoting breastfeeding among pregnant women and new mothers, and supporting their efforts to breastfeed, health organizations helps children to develop good eating habits while still infants. As argued by (Ayo, 2012) when physical activities and healthy eating is installed at infancy, they are maintained throughout life.

Other programs and policies move beyond the coalition and the provision of clinical information by using social marketing approaches to improve awareness in the society. Moreover, the policies motivate the population to change their diet and exercise habits the policies used the community based programs. These programs use different approaches to provide different people with the skills, knowledge, and attitude that are vital in a healthy diet and becoming physically active. By working with local organizations, the new mothers can be effectively recognized and addressed regarding the social, cultural, and physical environment that affects the community.
Other programs include Team Nutrition program which is an initiative developed by the US Department of Agriculture, hands-on educational programs that involves students practicing how to make healthy food choices and the difference between healthy and unhealthy foods.

How the obesity and healthy eating assist the new women in the women’s crisis centres to reduce their weight

The policy contains objectives that are directly related to nutrition and breastfeeding. It also related to physical activities. However, since to poor nutrition and physical inactivity results to increased chances of health problems, they have to be mentioned at all priority areas. Children and expectant mothers benefit from the interventions that are designed to improve their eating habits and increase their levels of activities. The intervention programs falls into three major categories; primary prevention, health promotion, and secondary prevention. The health promotion has an aim of establishing an active lifestyle and healthy eating habits during the children’s early lives by educating the new mothers on the importance of healthy eating. The key aim of the primary prevention is helping those individuals including mothers who have high risk factors for chronic diseases by establishing an active lifestyle and healthy eating habits. Lastly, the aim of secondary prevention is to assist those mothers that have chronic diseases to cope with their conditions and prevent other disabilities by increasing their physical activities.

Evaluations of US Health Policies

Fundamentally, the US have implemented to obesity prevention polices that has help, to an extent, in solving the problem of obesity among children and adults. These policies include imposing taxes on sugared drinks and putting up restrictions on marketing to children. The prima candidate for taxation to reduce obesity in the states is beverages wit added sugar. Consumption of beverages is associated with the likelihood of weight gain and other health conditions such as mellitus, diabetes and hypertension. Beverages constitute over 10% calories and have no or little nutritional value.

Various studies have evaluated the effect of increases prices of sugared beverages on consumption. A study conducted by
Green and Kreuter (2005) suggests that increase in price leads to decrease in the consumption and the higher the price of beverages increases, the greater the rate of consumption is reduced. Also, shows evidence that the increased prices of beverages encourages an increased consumption of more healthy foods such as milk and fruit juices. Other studies have also revealed that the higher prices may lead to a consideration weight reduction in the population.

Reducing the marketing of food and beverages to children have played a key role in effective child care. The policy has prioritized reducing the harmful effects of food and beverage marketing that targets the youths. The Children’s Food and Beverage Advertising Initiative (CFBA) commits companies to minimize or avoid marketing food to children below 12 years. The policy has not been entirely successful due to the unclear definition of the term ‘advertising primarily directed at children’ and ‘healthier foods’. Therefore, companies have continued to market unhealthy food products to children. There are pervasive practices of marketing to children despite having the pledges.

Conclusion

New mothers expect efficient prenatal and postpartum healthcare to ensure healthy pre-pregnancy, pregnancy, labor and delivery for the mother and baby. Prenatal care assists in reducing the risks that the new mothers are exposed to and increases their chances of having safe delivery. During the pregnancy, the new mother has to healthcare services. The policy of obesity and healthy leaving ensures that mothers and children get proper nutrition. Also, it is important to recognize that pregnant women and children should avoid high fat food and focus on nutritious meals, balanced with protein, carbohydrates, fruits and vegetables. The aim of this essay was to appraise the social determinants of health, identify and evaluate a health policy in the US, and critically evaluate the approaches to needs assessments. This essay focused on the new mothers in mental facilities who experience depressions and anxiety during pregnancy and childbirth. From the health inequalities discussed, a recommendation is made that action should be taken throughout the life stages to provide opportunities for improving world population’s mental health as well as reduce the risk of mental disorders.

References

Ayo N 2012, ‘Understanding health promotion in a neoliberal climate and the making of health conscious citizens.’ Crit Publ Health. 22:99–105.

Barry. MM 2009, ‘Addressing the Determinants of Positive Mental Health: concepts, evidence and practice.’ International Journal of Mental Health Promotion. 11(3):4-17

Bartholomew LK, Parcel GS, Kok G, & Gottlieb NH 2006 Planning health promotion programs: an intervention mapping approach. 2nd ed. San Francisco, CA: Jossey-Bass.

Birn AE, Pillay Y, & Holtz TH 2009, T’extbook of international health; global health in a dynamic world.’ 3rd ed. New York and Oxford: Oxford University Press.

Centres for Disease Control and Prevention 2001, ‘Increasing physical activity: a report on the recommendations of the Task Force on Community Preventive Services.’ MMWR
Recomm Rep 50(RR-18):1-14.

Department of Health and Human Services 2000, ‘Office on Women’s Health. HHS Blueprint for
Action on Breastfeeding, 2000.’ Available at www.cdc.gov/breastfeeding/00binaries/ bluprntbk2.pdf.

Epstein. S 2007, ‘Inclusion: the politics of difference in medical research’. Chicago and London: University of Chicago Press.

Graham. H 2000, U’nderstanding health inequalities.’ York, UK: Open University Press

Green LW, & Kreuter M 2005, ‘Health promotion planning: an educational and ecological approach.’ 4th ed. Boston, MA: McGrawHill.

Labonté R, & Torgerson R 2005, ‘Interrogation globalization, health and development: towards a comprehensive framework for research, policy and political action. Crit Publ Health. 15:157–79.

Mikulincer M & Shaver PR 2012, ‘An attachment perspective on psychopathology.’ World Psychiatry;11:11-5.

Rahman A, Patel V, Maselko J, & Kirkwood B 2008, ‘The neglected ‘m’ in MCH programmes—why mental health of mothers is important for child nutrition.’ TropMed Int Health. 2008;13(4):579-83.

2011;89(8):608-15.
Surkan PJ, Kennedy CE, Hurley KM, & Black MM 2011, ‘Maternal depression and early childhood growth in developing countries: systematic review and meta-analysis.’ Bull World Health Organ.

Woodard EH, Gridina N 2000, ‘Media in the Home2000: The Fifth Annual Survey of Parents and
Children’. The Annenberg Public Policy Center, (www.appcpenn.org/mediainhome/survey/survey7.pdf ).

Appendix

Increasing Number of Overweight Children around the World

Policy related to new mothers living in a women's crisis centre in the UK

Obesity and Sugar Intake by age groups

Policy related to new mothers living in a women's crisis centre in the UK 1

Statistics for Healthy Eating in the UK

Global Trend in Healthy Eating

Policy related to new mothers living in a women's crisis centre in the UK 2