1
Q
Define global health
A
The area study, research and practice that places a priority on improving health and achieving equity in health for all people worldwide
2
Q
Define global inequity
A
Is systematic produced by social norms, policies, and practices that tolerate or actually promote the unfair distribution of and access to power, wealth, and other necessary social resources
3
Q
Define structural violence
A
The social arrangements that put individuals and populations in harm’s way
These arrangements/barriers are structural because they are embedded in the political and economic organization of our social world; they are violent because they cause injury to people
4
Q
Define global nursing
A
Is the use of evidence-based nursing process to promote sustainable planetary health and equity for all people.
Global health nursing considers the social determinants of health, includes individual and population-level care, research, education, leadership, advocacy and policy initiatives.
5
Q
Describe the difference between global and planetary nursing
A
Global - nurses’ role in global health efforts with a focus on SDOH, respect for human dignity, and cultural diversity
Planetary - broader possibilities for engagement in planetary health initiatives
6
Q
What are five general responsibilities of global health nurses
A
- direct care delivery
- health promotion and prevention
- coordinating efforts and increasing interprofessional cooperation
- advocacy and policy development
- leadership
7
Q
List the five components of the global health approach
A
- priority on a population-based and preventative focus
- concentrations on poorer, vulnerable, and underserved populations
- multidisciplinary and interdisciplinary approaches
- emphasis on health as a public good
- stakeholder participation
8
Q
Define social justice
A
Social justice refers to the fair and equitable distribution of resources, opportunities, and privileges within a society.
It aims to address and correct systemic inequalities and injustices based on factors such as race, gender, class, sexual orientation, disability, and other identity markers. Social justice promotes the idea that everyone should have equal access, while also seeking to dismantle oppressive structures that perpetuate discrimination and marginalization.
9
Q
Define epidemiology
A
Study of the distribution and determinants of health-related states or events (including disease), and the application of this study to the control of diseases and other health problems
10
Q
What are the 4 key aspects of epidemiology?
A
- Health phenomena
- Population
- Distribution
- Determinants
11
Q
Define disability adjusted life years (DALYs)
A
Quantifies the burden of disease due to disability
The gap between current health status and an ideal health situation where the entire population lives to an advanced age, free of disease and disability
12
Q
What does one DALY equal?
A
One lost year of healthy life
13
Q
What are 3 critiques of DALYs?
A
- Lack a clear picture of global burden of diseases, leading to estimations
- DALYs are neoliberal - they focus on productivity and are created from a capitalist lens (western economic approach
- Measured from a distance - they are vague and don’t look at specifics within a country
14
Q
What is the purpose of DALYs?
A
Draw attention to diseases that cause morbidity but may not cause mortality
15
Q
Define the epidemiological transition
A
Accounts for the replacement of infectious diseases by chronic diseases over time due to expanded public health and sanitation
16
Q
What are the four assumptions of the epidemiological transition?
A
- Mortality is a fundamental factor in population dynamics, increases in populations are caused by declines in mortality rates, fertility rates are tied to previously experienced decreases in mortality
- The transitions cause a long-term shift in mortality patterns, with a decline in communicable disease and an increase of noncommunicable diseases
- The epidemiological transition appears first in health and disease patterns among children and women, but it does not alter the social class differential
- All countries and populations experience epidemiological transition
17
Q
What is the first phase of the epidemiological transition called?
A
The age of pestilence and famine
18
Q
What 3 things is the first phase of the epidemiological transition marked by
A
- Transformation of hunter-gather societies to agrarian societies
- Increase of infectious and zoonotic diseases
- Dietary deficiencies
19
Q
What 3 things is the first phase of the epidemiological transition characterized by
A
- High and fluctuating mortality rates - close living quarters, animal waste, contaminated water, sick livestock, and reliance on crops/animal sources may influence mortality rate
- Variable life expectancies, low average lifespan
- Periods of population growth that are not sustained - periods of robust food may result in more babies, but starvation may result in high mortality and low reproduction
20
Q
What countries currently exist in the first phase of the epidemiological transition?
A
Central Replubic of Africa
21
Q
What is the second phase of the epidemiological transition called?
A
Age of receding pandemics
22
Q
What 4 components is the second phase of the epidemiological transition marked by?
A
- Explanation of this transition are complex changes in the relationships in the classic matrix of agent, host, and environment; socioeconomic, political, and cultural changes
- Generally countries experience urbanization
- More advancements in medicine
- Improved living conditions, sanitary water sources, better food safety
23
Q
What 2 components is the second phase of the epidemiological transition characterized by?
A
- Declining mortality rates as a result of fewer epidemics - social changes result in less infectious diseases and more communicable diseases
- More sustained population growth
24
Q
What countries are currently in the second phase of epidemiological transition?
A
Latin America, Central Africa, and Central Asian
25
What is the third phase of the epidemiological transition called?
Age of degenerative and man-made disease
26
What 2 components is the third phase of the epidemiological transition marked by?
1. Associated with 19th and 20th century transition of today’s high-income countries
2. Western diets, lower activity levels, and addiction
27
What 4 components is the third phase of the epidemiological transition characterized by?
1. Fewer deaths from infectious diseases
2. More deaths attributed to chronic, noncommunicable diseases
3. Life expectancy increases to more than 50 years
4. Population growth depends more on birth than mortality but generally lower birth rates
28
What countries are currently in the third phase of epidemiological transition?
Eastern Europe, Middle East, North Africa, and Caribbean
29
What is the fourth phase of the epidemiological transition called?
age delayed degenerative diseases
30
What 2 components is the fourth phase of the epidemiological transition marked by?
1. Focus on health lifestyle - decline in CVD
2. Advanced medical care
31
What 4 components is the fourth phase of the epidemiological transition characterized by?
1. Prevention efforts delay onset of chronic disease
2. Treatment efforts prolongs survival
3. Increase in age related conditions (i.e., Alzheimer’s) - observed due to greater life expectancy
4. Life expectancy of over 75 years
32
What are the 3 critiques of the epidemiological transition?
1. Focus on the aggregate-level story of a country - looks at country statistics, rather than specifics within a country
2. Focus on mortality and not morbidity
3. Progress in countries may not result over time - Instead delayed transition can be argued to be caused by political neglect, economic exploitation, and resource withdrawal from LMIC
33
What are the five steps of nutritional transition?
1. Wild plants and animals
2. Cereals
3. Starchy, low variety
4. Increased fat, sugar, processed foods
5. Reduced fat, increased fruits and vegetables, and fibre
34
Describe the 4 changes in population growth
1. 4 billion live in Asia, with every other area having only 1 billion (America, Europe, Africa) - By 2100 population growth will slow to 11 billion, leaving 3 extra billion in Africa and 1 billion extra in Asia
2. At the peak of the industrial revolution, population growth made an incredibly fast incline - however, fast population growth will not continue and will plateau at 2100 with 11 billion
3. Mothers in 1800-1965 were having approx. 5 children. However, in 1965, it began to steadily decrease to 2.5 and lower by 2100
4. Fast growth will end in 50 years due to the age growth structure
35
When will fast growth of the population end?
2100 at approx. 11 billion people
36
Define globalization
the intensification of cross-national interactions that promote the establishment of trans-national structures and the global integration of cultural, economic, ecological, political, technological, and social processes on global, supra-national, national, regional, and local levels
37
What are two critiques of the following globalization definition?
"a constellation of processes by which nations, businesses, and people are becoming more connected and interdependent via increased economic integration and communication exchange, cultural diffusion and travel"
This definition implies that these processes are being integrated and shared equally - low-income countries will likely share the greatest burden of the negative impacts of globalization
38
What are 7 general characteristics of globalization?
1. Increased connectivity; Massive development and usage of the Internet
2. Advancements in scientific and technological innovation
3. Multi-cultural Societies
4. Westernization; Emergence of English as the working language of international relations.
5. Liberalisation- deregulation (free trade), privatization of public assets, elimination of social welfare programs, restrictions on immigration
6. Growth of Global Brands
7. Internationalization of criminal and terrorist activities
39
What are six positives of globalization?
1. Cheaper goods and services for consumers
2. More competition in consumer markets
3. Gains from specialization of factors or production
4. Transfer of ideas stimulates innovation
5. Gains from improved labour mobility
6. Reduction in extreme poverty rates
40
What are six negatives of globalization?
1. Trade imbalances
2. Dominations of transnational corporations
3. Reduced cultural diversity (westernization)
4. Corporate tax avoidance
5. Environmental impacts
6. Increased equity
41
Define the dual burden of disease
coexistence of communicable diseases and non-communicable diseases
This phenomenon is common in low- and middle-income countries, which continue to struggle with infectious diseases while also experiencing a growing prevalence of lifestyle-related diseases linked to factors like urbanization, sedentary lifestyles, and poor diets.
42
List 5 benefits and 5 negatives of globalization on health
Benefits:
1. New technologies
2. Improvements to sanitation
3. Integration of human rights
4. Improvements to healthcare
5. Improvements to food security
Negatives:
1. Emerging diseases
2. Microbial resistance
3. Climate change
4. Global travel of diseases and healthcare workers
5. Increased inequity
43
How does global trade affect health?
the increased transit of goods creates new opportunities for the transmission of diseases
44
How does global migration of health care workers affect health, specifically health of sub-Saharan Africa?
Globally, health workforce shortages continue to be greatest in sub-Saharan African countries that together bear 24% of the world’s disease burden today, but have only 3% of health workers and less than 1% of the world’s financial resources to respond to this burden
Ensuring that there are enough HCW will not necessarily result in improvements to health systems globally, they also need to be equitably distributed
45
How does global migration affect health?
Global travel and movement spreads infection/disease, which leads to greater mortality across countries
46
What are six challenges to global health governance?
1. Trade and investment
2. Agriculture - Differences in crops and available resources
3. Migration
4. Education
5. Environment
6. Security - May be threatened due to weapons of mass destruction and tension from politics
Have many different bodies that want to act on a global level, which creates tension
47
Define intellectual property
Refers to patents, copyrights, and trademarks that pharmaceuticals have and that increases control over medication and prices
48
What are three recommendations to reduce intellectual properties inequities?
1. Redistribution of vaccines
2. Increase manufacturing capacity of the global south
3. Pay greater attention to the human rights responsibilities of corporations
49
What are 3 governance challenges?
1. Sovereignty challenge - there is no government at the global level
2. Sectoral challenge - multi-sectoral influences on health (i.e., a health issue effects more than just health, it effects agriculture, environment, etc.)
3. Accountability challenge - who holds organizations accountable?
50
List 5 multilateral organizations
1. UN
2. WHO
3. World Bank
4. International Monetary Fund
5. World Trade Organization
51
Define multilateral organizations
A kind of alliance where multiple countries progress to any given goal - they obtain their funding from multiple governments and spend it on projects in various countries
52
Briefly describe the UN and its 7 objectives
Tasked to promote international co-operation and to create and maintain international order
Maintaining international peace and security, promoting human rights, fostering social and economic development, protecting the environment, and providing humanitarian aid in cases of famine, natural disaster, and armed conflict
53
List the 6 successes of the UN
Millennium Development Goals
Sustainable Development Goals
All countries part of the UN is mandated to work toward the 17 SDG
Material Assistance – World Food Program
Human Rights – Universal Declaration of Human Rights
Decolonization
Preventing conflict???
54
List the 6 critiques of the UN
a. Inability or ineffectiveness to enforce mandates or act within countries to ensure national sovereignty - i.e. Rwanda Genocide
b. Ineffectiveness in preventing conflicts between countries – i.e. Bosnian War, War in Ukraine
c. Security Council Inaction – role of elite counties - 5 permanent members of UN Security Council (China, France, Russia, UK, US) - all nuclear powers, all have veto power
d. Moral relativism - moral judgments are true or false only relative to some particular standpoint (Suggests that the UN will favor specific vales of certain countries over others)
e. Non-evidence-based policies
f. Western domination of UN institutions – European and American interests
55
Briefly describe the WHO
a. Governance takes place through the world health assembly, which is the supreme decision-making body
b. Serves as the world’s pre-eminent public health authority and as an intergovernmental platform for global health negotiations
56
How is the WHO funded?
Relies on donor funding, thus very under-funded
57
List the 5 successes of the WHO
a. Eradicating smallpox
b. Advancing the MDG & SDG
c. Standardizing medical nomenclature-International Classification of Diseases
d. Building a pandemic response network- International Health Regulations
e. Mobilizing a global fight against tobacco-Framework Convention on Tobacco Control
58
List 2 failures proposed of the WHO
a. 2014 Ebola outbreak in West Africa - Did not step in soon enough
b. Failed attempt to eradicate malaria - Began to attempt to eradicate malaria in 1940/50s, but discontinued the project
59
Describe how nurses can help SDG goal #6 – clean water and sanitation and its basic target
Providing education regarding water and sanitation
Supporting organizations such as water.org
Ensure Availability and Sustainable Management of Water and Sanitation for All
60
Describe how nurses can help SDG goal #7 – affordable and clean energy and its basic target
Nurses must learn to gather reliable information on sources of energy, identify how energy is being used in political agendas, and work with communities to ensure reliable energy sources
Educating clients on improved cook stoves and clean fuels to reduce household air pollution
Advocate for reliable energy sources for health facilities in LMIC
Ensure Access to Affordable Reliable, Sustainable, and Modern Energy for All
61
Describe how nurses can help SDG goal #8 – good jobs and economic growth and its basic target
Nurses must not only focus on the treatment of the health consequences of economic instability but work towards prevention (early identification of barriers to optimal health, community assessments)
Promote Sustained, Inclusive, and Sustainable Economic Growth, Full and Productive Employment, and Decent Work For All
62
Describe how nurses can help SDG goal #9 – industry, innovation, & infrastructure and its basic target
Nurses need to be innovative in enhancing the quality, efficiency and accessibility of care
Nurses must demonstrate the impact and outcomes of innovations in the health care system
Build Resilient Infrastructure, Promote Inclusive and Sustainable Industrialization, and Foster Innovation
63
Describe how nurses can help SDG goal #10 – reduce inequalities and its basic target
Nurses must advocate for all individuals to receive the same quality and access to health care
Must address our own experiences of inequity between health care professionals that keeps us from the policy table (we must learn to self-advocate, speak clearly and loudly about our practice, and clarify our role to the public, and celebrate the unique contribution nursing makes)
Reduce Inequities Within and Among Countries
64
Describe how nurses can help SDG goal #11 – sustainable cities and communities and its basic target
Nurses should utilize community development principles to guide communities through the urbanization process
Make Cities and Human Settlements Inclusive, Safe, Resilient and Sustainable
65
What 5 categories of municipal policy must nurses advocate for?
Nurses should advocate for municipal public policy that
1. Addresses the SDOH
2. Creates physically active communities
3. Ensures effective zoning and land-use regulations
4. Engages civil society across the socioeconomic spectrum
5. Facilitates research regarding the effects of urbanization
66
Describe how nurses can help SDG goal #12 – responsible consumption and its basic target
Promote sustainable consumption in our own lives and at work
- Turn off unused lights and devices
- Promote the purchase of green equipment
- Avoid unnecessary laundering of linens
- Audit purchasing lists and reduce excessive inventory
- Opt for reusable products when safe and possible
- Reduce the number of products that are used in prepackaged sets
- Sort waste disposal and recycle when possible
Ensure Sustainable Consumption and Production Patterns
67
Describe how nurses can help SDG goal #13 – climate action and its basic target
Nurses are responsible for communicating the health risks associated with climate change, leading research efforts, and partnering with the communities they work with to design relevant health promotion plans
Take Urgent Action to Combat Climate Change and Its Impacts
68
Describe how nurses can help SDG goal #14 – life below water and its basic target
Support interventions that respect the relationship between human health and environmental health
Conserve and Sustainably Use the Oceans, Seas, and Marine Resources for Sustainable Development
69
Describe how nurses can help SDG goal #15 – life on land and its basic target
Support interventions that respect the relationship between human health and environmental health
Protect, Restore, and Promote Sustainable Use of Terrestrial Ecosystems, Sustainably Manage Forests, Combat Deforestation, and Halt and Reverse Land Degradation and Halt Biodiversity Loss
70
Describe how nurses can help SDG goal #16 – peace, justice, and strong institutions and its basic target
Nursing is all ready ethically bound to provide care to individuals and communities regardless of age, religious affiliation, gender, sexual orientation, race, ethnicity, socioeconomic status, education level, or disability
Nursing must openly address behaviours and circumstances that promote disrespect and incivility across contexts
Promote Peaceful and Inclusive Societies for Sustainable Development, Provide Access to Justice for All and Build Effective, Accountable, and Inclusive Institutions at All Levels
71
Describe the basic target of SDG goal #17 – partnerships for the goals
Strengthen the Means of Implementation and Revitalize the Global Partnership for Sustainable Development
72
List the 5 components of effective partnerships in SDGs
Clearly defined reasons for the partnership
Shared visions and goals
Clearly articulated roles and responsibilities
Recognition of the particular strengths and weaknesses of each partner
Accountability
73
What is the most common cause of malnutrition?
Infection
74
What is the underlying cause for half of child deaths worldwide?
Malnutrition
75
List 6 impacts of undernutrition
1. Impaired physical growth
2. Decreased cognitive function
3. Decreases employment opportunities
4. Decrease in the ability to participate in recreational activities
5. Effects on future pregnancies, small pelvic size, reduced uterine blood flow, undernourished fetus, rebound adiposity, diminished muscle gain
6. Increase in adult chronic diseases
76
Define rebound adiposity
As children are malnourished, the body stores fat around the organs to protect them - This leads to chronic illness later in life
77
What are four long-term health consequences of low birth weight?
rebound adiposity, hypertension, type II diabetes, and coronary heart disease
78
Define a policy
A broad goal or statement outlined by a facility, organization, program, or governing body that reflects certain directives or goals to be pursued.
79
Explain the difference between law and policy - how are they connected?
Laws - set out standards, procedures, and principles that must be followed
Policy - A policy outlines what organizations, governments, etc. hope to achieve and the methods and principles that it will use to achieve them
Laws are often the activation from policy
80
Define proactive, preactive, and reactive policy
Proactive: truly proactive policies are rare. Policy often needs urgency to move forward
Preactive: policy that respond to triggers that are recognized because we are scanning the environment and identifying potential issues
Reactive: policy responding to issues and factors that emerge, sometimes with little warning from the internal or external environments
81
What are the four steps of the policy cycle?
1. getting on the policy agenda
2. moving into action
3. implementation and change
4. policy evaluation and revision
82
Broadly define upstream interventions and provide an example
Policy Change, change to the structural environment
Make international trade regulations equitable (i.e., TRIPS, universal health care, primary health care)
83
In order to create a socially just and equitable world, what type of intervention is needed?
Upstream
84
Broadly define midstream interventions, provide an example, and the level of equity it may bring
Community development, capacity building, community programming
Asset based community interventions, such as community gardens, comprehensive approaches to TB etc.
Improved health and living conditions but may not increase equity between countries
85
Broadly define downstream interventions, provide an example, and the level of equity it may bring
Individual Health Education
Individual Counselling
Education on preventable diseases, healthy living, healthy childhood development
Potential impact on the individual but may not change living conditions or increase equity between countries
86
List 4 global actions that promote health equity
1. debt cancellation
2. democratic governance
3. profit centred to people centred
4. environmental protectionism
87
What is the predominant downfall of the classic health coverage model in LMIC?
The largest portion of the population is uncovered and forced to pay out of pocket for health services, although the lowest quintile is covered and wealthiest quintile is covered by private insurance or can afford to pay out of pocket
88
What is the predominant downfall of the incremental strategy based health care model?
A larger portion of the lowest quintile and wealthiest quintile groups are covered, however, it still leaves a large portion (1/3) of the population uncovered
89
What are the 3 core concepts of universal health care?
Everybody is included, according to need, and health financing contributions according to one’s ability to pay (healthy wealthy subsidizing the poor and sick)
90
What 3 actions can help us move toward a more effective health system?
1. commitment to PHC and its 5 values
2. appropriate work force - task shifting from more skilled to less skilled providers
3. accessibility of medicines
91
What is ever greening?
Practice used by pharmaceutical companies; when they patent a medication it is good for about 20 years, and it prevents other companies from making generic versions for 20 years
These companies will make a very slight change to the medication and request another patent to be able to get another 20 years where companies cannot make generic versions
92
List the 11 characteristics of effective partnerships at a global scale
1. clearly defined reasons for the partnership
2. trust
3. shared vision
4. shared goals
5. clearly articulated roles and responsibilities
6. in-country leadership
7. joint planning
8. equity
9. shared evaluation process
10. recognition of the particular strengths and weaknesses of each partner
11. sustainability as a key value for all parties
93
What are the 5 impacts of effective partnerships
1. Knowledge creation
2. Interdisciplinary collaboration
3. Capacity development
4. Access to resources
5. Policy influence
94
Define interdisciplinary and what term is interchangeable
- Planned interdependent collaboration among team members
- Common goal; common decision-making process
- Believed to be the most evolved approach
- Reflective of a model of shared leadership
Term interprofessional is used interchangeably
95
Define multidisciplinary
- Interactions are limited or transient
- Several professionals work on same project independently or in parallel
- Bringing together members of the community to create initiative
96
Define transdisciplinary
The inclusion of non-academic stakeholders in the process of knowledge production
97
_____ are responsible for articulating a preferred future
Leaders
98
What two actions can RNs take to articulate a preferred future?
1. RNs need to take a stance that changes their focus from just doing their job to having a larger purpose
2. RNs need an idea of societal trends and awareness of the social, political, economic, technological and organizational forces that create, influence, or are influenced by those trends
99
What are the 5 means of advocacy within nursing?
1. Legalistic - the nurse as a protector of rights
2. values-driven - nurse as a preserver of client autonomy
3. moralistic - advocacy as a moral act of shared humanity - focused on human rights not just legal rights
4. social justice driven - focuses on advocacy for the marginalized in society and conditions that create inequities in matters of health>>political action
5. subversive - advocacy “under the radar”
100
Much of our knowledge about advocacy is rooted at which level?
Individual
101
Carper’s ways of knowing would fall into which level of advocacy?
Individual
102
How is professional level advocacy achieved in nursing? Provide a broad explanation
The nurse puts on a wider lens, looks at the root cause of the problem, as well as resources, stakeholders, and possible allies in action for change within the context
103
List 6 challenges to policy advocacy in nursing
1. Disconnect, feel “removed” from their scope of influence
2. Nursing education doesn’t provide sufficient preparation
3. Internal division
4. Working conditions breed apathy
5. Lack of knowledge about process
6. Lack of autonomy (perceived or actual)
104
Define interpersonal ethics
How you interact with others, morality, principles that guide practice
105
Define institutional ethics
Ethics that guide AHS, UofL, etc. related to our roles and responsibilities
106
Define international ethics
Humanitarian aid, humanitarian crises and the ethics surrounding them
107
Define structural ethics
Macro-economic conditions, world financial institutions (good or bad?), do no harm, high interest loans ethics
108
Define the ethical principle of autonomy
Right to self-determination, free from controlling influences of limitations
Often concerned with an individual's capacity to make informed decisions
109
What is ethics of affluence and how is it limited in specific areas of the world that are constrained?
places great importance on personal autonomy and individual rights
Ethics of affluence may not be transferable to resource constrained settings where family survival is tied to the joint efforts of each family member
Barriers to informed consent in resource constrained areas.
110
Define beneficence
Refers to a moral obligation to act for the good of others to help further their interests, often by preventing or removing harms
111
What are some arguments posed regarding beneficence?
Some argue that is too demanding to be morally obligated to benefit others, even if we are able to do so
Tend to be more concerned with helping those who are proximal and the same as we are
Some argue that we do have a moral obligation to help everyone in need if we can
Others argue that beneficence is often equated with charity
112
Define nonmaleficence
Refers to our moral obligation to not inflict harm on others.
Do no harm
113
Intellectual property rights of pharmaceutical companies may be an example of not upholding which ethical principal?
Nonmaleficence
114
How is social justice achieved?
achieved through the recognition and acknowledgment of social oppression and inequity and nurses’ caring actions toward social reform
Must involve a shift from a focus on individual care to a global approach to health equity
115
What concept is the foundational rationale for action at the population level?
Social justice
116
What 3 ways may human rights declaration contribute to health equity?
1. Right to health is seen as normative and legally binding
2. Potential to empower rights-holders
3. Accountability mechanisms
117
What is moral imagination?
Moral imagination is the humility to accept things as they are and the audacity to see things as they could be.
Moral Imagination is the ethical premise for human engagement that has been employed in creating healthy and respectful cross-cultural collaborations
Aims to improve the quality of life for all human beings
118
List 6 assumptions of moral imagination
1. A shared humanity
2. Human dignity is a priority and ethical standpoint
3. Holistic perspective of health
4. Call for consciousness of cultural and interpersonal humility
5. Acceptance of another’s lived experience and circumstances as they are
6. A commitment to change
119
What is cultural humility?
A lifelong commitment to self-evaluation and self-critique
120
What are 6 key aspects of implementing culturally safe care?
1. Knowledge of cultures
2. Being humble
3. Education and training in culturally competent care
4. Recognizing the dynamics of power and privilege
5. Critical reflection
6. Patient advocacy and empowerment
121
What are 5 attributes of cultural humility?
openness, self-awareness, egoless, supportive interaction (challenge power differentials in working relationships), and self-reflection & critique
122
What are the 5 outcomes of cultural humility?
mutual empowerment, respect, partnerships, optimal care, and lifelong learning
123
List the 7 critiques of the WHO
1. Inefficiency, bureaucracy, passivity (Not the global health police)
2. Inability to deal with problems within countries
3. Delays in declaring public health emergencies
4. Introduction of DALYs (No sound methodology when creating DALYs)
5. Recommendations do not always align with best available evidence
6. Statistics have been challenged by other organizations (i.e. Gates foundation)
7. Totalitarian approach to public health (One size fits all approach to health (i.e, what may work with Canada may not work for Kenya))
124
Briefly describe the Bretton Woods Conference
addressed what were considered the two main causes of the pre-war economic downturn and obstacles to future global prosperity—the lack of stable financial markets around the world that had led to the war and the destruction caused by the war itself.
Wanted to establish financial order post-war
125
What two intergovernmental pillars did the Bretton Woods Conference result in?
The world bank
The international monetary fund
126
Briefly describe the World Bank
focuses on poverty reduction and the improvement of living standards worldwide by providing low-interest loans, interest-free credit, and grants to developing countries for education, health, infrastructure, and communications, among other things
127
Does the world bank implement the MDG and SDGs?
Yes
128
List the 10 critiques of the world bank
1. Governance – influence of USA
2. Run by a small number of economically strong countries – President is always from the USA
3. Structural loans and debts - Extremely high interest – countries can only afford to pay their interest and never pay the loan
4. Conditionality (policy conditionality)
5. Imposing western Capitalism
6. Washington Consensus leading to liberalization, privatization, downscaling of governments (fiscal discipline)
7.Increasing inequities
8. Environmental neglect
9. Poor countries are under-represented in decision-making processes
10. Lack of transparency and accountability
129
Briefly describe the International Monetary Fund
promotes monetary cooperation internationally and offers advice and assistance to facilitate building and maintaining a country’s economy.
Provides loans and help countries develop policy programs that solve balance of payment problems if a country cannot obtain financing sufficient to meet its international obligations.
Assists more with the guidance of finances when compared to the world bank
130
List the 5 critiques of the International Monetary Fund
1. Imposing western Capitalism
2. Washington Consensus leading to liberalization, privatization, downscaling of governments
3. High-interest rate loans, loaded with conditions
4. Lack of transparency and involvement (Do not have power over how countries spend their money)
5. Supporting military dictatorships
131
Briefly describe the World Trade Organization
Governs rules of trade between countries
Goal is to ensure trade flows smoothly, predictable and freely as possible (liberalization), to resolve trade disputes, and to help developing countries benefit from trade
132
List the 8 critiques of the WTO
1. Free trade benefits developed countries more than developing countries (Developed countries often have more than one good to export, whereas developing countries often only have one export to benefit from)
2. Most favored nation principle (Nations trade with discrimination)
3. Failure to reduce tariffs on agriculture (High tariffs on agriculture effect developing countries, as agriculture is often their only export)
4. Diversification
5. Environment
6. Free trade ignores cultural and social factors
7. Undemocratic
8. Slow progress
133
What is TRIPS? Explain it
Trade related intellectual property rights which forbids countries from breaking pharmaceutical patents
134
Briefly describe positives of transnational corporations to health/SDOH
Can support gains in public health through investment in host countries which contributes to improvements in employment opportunity, working conditions, education, infrastructure or health service provision
135
Briefly describe negatives of transnational corporations to health/SDOH
creating conditions suitable to the spread of infectious diseases, food insecurity, prevents economic growth in LIC
136
List 5 of the anti-globalization movements
Debt relief, Movement to change international trade rules and barriers, Anticorruption movement,
Fair trade movement,
Torbin tax (Proposed tax on short-term currency transactions)
137
Describe how bilateral organizations receive funding and how they use it
receive funding from the government in their home countries and use the funding to aid developing countries
138
How much of income does the UN expect HIC to spend on developmental assistance?
0.7%
139
List the 6 actions of Global Affairs Canada and what type of organization it is
It is a bilateral organization
1. Advance Canada’s interests in a complex global environment.
2. Manage diplomatic relations
3. Promote international trade
4. Provide consular assistance
5. Lead international development, humanitarian, and peace and security assistance efforts.
6. Contribute to national security and the development of international law
140
Define a nonprofit organization and list 3 examples
A nonprofit organization that is independent of governments and international governmental organizations.
Doctors Without Borders
International Red Cross
Bill and Melinda Gates Foundation
141
List the 3 different types of NGOs
PINGO – public interest NGO
BINGO – business interest NGO
GONGO – government organized NGO
142
Briefly describe the ICN
International council of nurses
representing the more than 16 million nurses worldwide - Goal is to ensure quality nursing care for all and sound health policies globally
143
Nurses are called to be _______
Transformational leaders
144
What are the 4 components of emotional intelligence?
Self-awareness
Social awareness
Self-management
Social skills
145
Describe self-awareness’ role in emotional intelligence
The ability to recognize and understand your moods, and emotions, and drives, as well as their effect on others
Awareness/recognition
146
Describe social awareness’ role in emotional intelligence
The ability to understand the emotional makeup of other people, skill in treating people according to their emotional reactions
147
Describe self-managements’ role in emotional intelligence
The ability to control or redirect disruptive impulses and moods, the propensity to suspend judgement – to think before acting
Regulation
148
Describe social skills’ role in emotional intelligence
Proficiency in managing relationships and building networks, an ability to find common ground and build rapport
149
Briefly describe the millennium development goals, who created them, and in what year
Developed by the UN in 2000 with a 15-year span of when they wanted them to be completed
Set 8 total goals and quantified targets for health
Only three specifically related to health
150
Briefly describe the sustainable development goals, who created them, and in what year
Developed by the UN in 2015
Set 17-time bound goals with 169 targets to be achieved by 2030
151
What are four reasons why SDGs are important?
1. Create social mobilization – points the whole community in the same direction
2. It puts pressure on national governments – drives policy
3. Engages epistemic communities – drives the research/academic community
4. Mobilizes stakeholders
152
List 5 critiques of the MDGs
1. Based on aggregate data - Looks at the country as a whole, not individual areas within a country
2. No mention of NTDs (tropical diseases)
3. Fragmented the health system through vertical programs - Silo resources, rather than collaborating with the interdisciplinary team
4. Segmented by age group, instead of adopting a life course perspective - No focus on the elderly or adults suffering from chronic disease
5. Measure mortality but not morbidity
153
What are the 4 key principles of SDGs?
Economic prosperity
Social inclusion
Environmental sustainability
Good governance
154
What 4 things cause the SDGs to differ from the MDGs?
1. Disaggregate data
2. Address all the major determinants of health
3. Take a life course approach
4. Include universal healthcare, NCDs, and sexual/reproductive health
155
What are 2 critiques of SDGs?
The principles will eventually conflict i.e., in order for a country to gain economic prosperity, it may result in environmental degradation
The goals do not call for restructuring international global governance and financial structures to reduce inequities between and within countries
156
Describe how nures can help SDG goal #1 – no poverty and its basic target
Nurses need to have all the information (Who are the poor, where do they live, where is poverty rooted the deepest?)
Must advocate for equity in health care services
End poverty in all its forms everywhere
157
Describe how nures can help SDG goal #2 – zero hunger and its basic target
Nurses must become more adept at identifying food insecurity and making appropriate referrals
Nurses should support and advocate for organizations that have a hand in realizing SDG 2
End Hunger, Achieve Food Security, Improve Nutrition, and Promote Sustainable Agriculture
158
Describe how nures can help SDG goal #3 – good health and wellbeing and its basic target
Advocating for the thoughtful and appropriate deployment of and support for health human resources to ensure Universal Health Care
Supporting public engagement to create people-centered health systems
Ensure Healthy Lives and Promote Well-being for all at all ages
159
Describe how nures can help SDG goal #4 – quality education and its basic target
Advocate for educational parity across genders, ages, and socioeconomic strata
Informing policy makers about the link between education and health outcomes
Increasing the quality of nurse education globally
Ensure Inclusive and Equitable Quality Education and Promote Lifelong Learning Opportunities for All
160
Describe how nures can help SDG goal #5 – gender equality and its basic target
Universal screening for gender-based violence and intimate partner violence at all client contacts
Ensuring that sexual violence protocols are in place, that staff is trained, that there is access to a clean, safe, and private treatment room, that there is availability of a wide range of treatment options, including abortion services
Achieve Gender Equality and Empower All Women and Girls
161
In Kurth’s reading, what does the author say about global urbanization and its effect on health?
Humans are more and more living in cities and urban centres, predominantly slums through population growth and migration
Global urbanization trends suggest growth in social and health inequalities
162
In Kurth’s reading, what does the author say about cities and the global burden of disease in LMIC?
Cities are the main drivers of climate change, but also the recipients of deleterious climate impacts
The global burden of disease is vastly and disproportionately borne by LMIC
163
What does author Kurth say about climate change and its ‘time lagged’ nature?
The author states that temperature rise and some of its unstoppable consequences are already ‘baked in’ to our system and future
Meaning, the harmful things that occurred in 2016 will not have noticeable effect until 2030
164
In the Kurth reading, what does the author say in regard to current health of the global population and sustaining these health trends?
The organizing premise of planetary health is that, while the global human population is healthier than ever before, the ecological cost to attain this standard has required an unprecedented and unsustainable exploitation of the planet.
On our current un-sustainable trajectory, we could see a reversal of health progress made as well as destabilized governments due to resource scarcity and inequities.
165
In the Kurth reading, the author discusses global conflicts and water scarcity. Discuss this.
Increasingly, global conflicts are not based on religious differences, but on water scarcity: a study on the impact of heat and drought on human behavior, inclusive of economic productivity as well as violence, found that for each standard deviation in temperature and rainfall, there was a 14% increase in violence between groups, and a 4% increase in violence between individuals
166
How do climate change issues disproportionately affect LMIC and how do HIC contribute to the problem? (Kurth reading)
These changes will have a disproportionate impact on the poorest individuals, amplifying health inequities. It has been estimated that 88% of persons facing health consequences due to environmental threats reside in LMICs, though HICs contribute to the problem to a much larger extent.
167
What does the author, Kurth, state about nurses, resilient health systems, and planetary health as a solution to current issues?
Nurses help plan and build resilient health systems, but in order to develop health beyond health care, nurses must move into expanded roles, working with other sectors and individuals, to support the development of resilient communities.
Nurses are key to achieving the sustainable development goals that, like the planetary health framework, focus on environmental sustain- ability and human well-being. Nurses contribute to resilient health systems, as trusted leaders and providers of health care, and as advocates and change makers impacting the world.
168
In the CNA position statement on planetary health, what are the three primary calls for action for nursing?
1. Education and research
2. Advocacy and policy
3. Practice and leadership
169
Within the CNA position statement, what do they state in regards to Indigenous groups and biodiversity protection?
Indigenous Peoples are acknowledged as key to protecting nature, with 80% of the world’s remaining biodiversity within their care, even though they constitute only 5%
of the global population
170
What does the CNA position statement suggest about the triple threats and equity/human rights?
The triple threats are not just
health concerns but also issues of justice and human rights as those most affected have the
least resources to counter impacts or to adapt to accelerating changes
171
According to the CNA position statement, which groups will/are most impacted by the triple threats?
Populations that have least contributed to these problems and have the fewest resources to
adapt are historically subject to the worst impacts of the triple threats. In Canada, this is
particularly the case with First Nations, Inuit and Métis populations due to ongoing
inequities, poverty, discrimination, marginalization and the close relationships many have
with local ecosystems
172
What does Ferguson state regarding mental health trends and SDOH in LMIC?
This issue disproportionately affects lower-income populations, with more than 80% of people with mental disorders residing in low- and middle-income countries. Climate catastrophes exacerbate social determinants that have already created massive mental health burdens around the globe
173
According to Ferguson, who are the first to witness climate change effects on health? Why?
Nurses - because as public health leaders and climate first responders, nurses are often the first to witness the impact of climate change on people’s health.
In addition, nurses and nursing leaders are at the intersection of health and climate
Global Health
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