In this week’s learning resources we reviewed how healthcare is provided in various countries impacting the international continuum of care. This international continuum of care has been a topic of interest for centuries, but really pick up momentum as individuals gained access to convenient and fast international travel. Bodenheimer & Grumback (2020) shared that there is no universal design for healthcare delivery. This discrepancy can be a barrier and opportunity for each country to tailor the delivery system to what their population of citizens. For example, social determinants of health are addressed differently in each country. Additionally, various nursing organizations are also focused on the international continuum of care. The International Council of Nursing (n.d.) is focused on several international nursing policies like socio-economic welfare. This is a demonstration of the role of an international organization in developing policy.
I am currently working in collaboration with a university in Rwanda creating curriculum content for a Nursing Leadership and Midwifery graduate level program. I am also an international nursing mentor and am working with students in Rwanda and Kenya on implementing quality improvement projects. The country that I am comparing to the U.S. is Rwanda.
A policy that Rwanda’s Ministry of Health (n.d.) is working on is related to how social determinants of health are addressed. Rwanda is currently rebounding from civil war in the mid 1990’s. In the past several decades they have made significant improvements in address it’s citizens social determinants of health. However, the country has an opportunity to optimize this effort due to persistent extreme poverty, overexploited land, and effects of climate change on housing and healthcare (Government of the Republic of Rwanda Ministry of Health, n.d.). The country’s nursing population is also largely midwives due to lack of providers in the country. Bazirete et. al. (2020) shared how social determinants of health impact maternal mortality and morbidity in rural Rwanda.
Social determinants of health is also a policy that is address in the U.S. The American Academy of Nursing has a policy from 2019 which prioritizes a focus on social determinants of health for nursing (Kuehnert et. al., 2022). We’ve incorporated social determinants of health into screening tools and electronic health records to provide targeted population health to support our existing healthcare system and reduce the burden on resources. Bedside nursing is incorporating social determinants of health into clinical practice by allowing the information to impact clinical decision making for improved health outcomes (Phillips et. al., 2020).
From the comparison between how Rwanda and the U.S. are creating policy around social determinants of health I’ve gained an understanding of how different the social needs of each country can be. Additionally, I’ve gained an understanding that it’s challenging to compare a third world and first world healthcare system. Each country is working with vastly different healthcare resources, infrastructure, and population health needs.
References
Bazirete, O., Nzayirambaho, M., Umubyeyi, A., Uwimana, M. C., & Evans, M. (2020). Influencing factors for prevention of postpartum hemorrhage and early detection of childbearing women at risk in Northern Province of Rwanda: beneficiary and health worker perspectives. BMC Pregnancy and Childbirth, 20(1), 678. https://doi.org/10.1186/s12884-020-03389-7
Bodenheimer, T., & Grumbach, K. (2020). Understanding health policy: A clinical approach (8th ed.). McGraw-Hill.
Government of the Republic of Rwanda Ministry of Health. (n.d.). Policies. https://www.moh.gov.rw/publications/policies
International Council of Nurses. (n.d.). https://www.icn.ch/nursing-policy
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