This document describes a study abroad program in Central America designed to help nursing students understand social determinants of health. The program included visits to hospitals, rural clinics, and communities in Nicaragua, Honduras, El Salvador, and Costa Rica. Students participated in pre-travel assignments, journaling, and a post-travel assignment analyzing what they learned about healthcare systems and health access. Surveys found that students' perceptions of social injustice, indigenous culture, and the role of nurse practitioners significantly increased after participating in the program. The program enhanced students' understanding of how social and economic factors influence health outcomes.
Results from student-facilitated roundtable discussions at PACE Great Streets townhall meeting in Memphis, TN. This project represents an experiential learning activity at The University of Memphis, Health Promotion concentration in the Department of Health and Sport Sciences.
Michael Loevinsohn of the Institute of Development Studies presents findings of an innovative re-review of a systematic review of WASH interventions. Presented at 'Synthesising across health and development' a joint event of LSHTM, LIDC and IDS held at Woburn House on 19 September 2012.
Ethical Issues With an Aging PopulationAccording to the CDC, in t.docxmodi11
Ethical Issues With an Aging Population
According to the CDC, “in the United States, the proportion of the population aged
>
65 years is projected to increase from 12.4% in 2000 to 19.6% in 2030,” (CDC, 2003, para. 2). Caring for this aging population is going to be one of the greatest challenges facing the health care industry. Not only will the number of individuals requiring care rise, but so will the cost. As poignantly stated by Crippen and Barnato, “unless we change the practice of medicine and reduce future costs, and explicitly address the ethical dilemmas we face, there may come a time when our kids simply cannot afford us” (2011, p. 128).
In this Discussion, you will examine the ethical issues that the United States and other nations must address when faced with the health care challenges of an aging population.
To prepare:
Consider the ethical aspects of health care and health policy for an aging population.
Review the Hayutin, Dietz, and Mitchell report presented in the Learning Resources. The authors pose the question, “What are the economic consequences, now and for future generations of taxpayers if we fail to adapt our policies to the changing reality of an older population?” (p. 21). Consider how you would respond to this question. In addition, reflect on the ethical decisions that arise when dispersing limited funds.
Contemplate the impact of failing to adjust policy in accordance with the changing reality of an older population.
Reflect on the ethical dilemmas that arise when determining expenditures on end-of-life health care.
Post by Day 3
an explanation of the ethical standards you believe should be used in determining how resources should be allocated for an aging population and end-of-life care. Then, provide an analysis of the ethical challenges related to the preparation for the provision of such health care.
References:
Crippen, D., & Barnato, A. E. (2011). The ethical implications of health spending: Death and other expensive conditions
. Journal of Law, Medicine & Ethics, 39
(2), 121–129. doi:10.1111/j.1748-720X.2011.00582.x
Public health and aging: Trends in aging—United States and worldwide
. Retrieved from:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5206a2.htm
Readings
Milstead, J. A. (2013).
Health policy and politics: A nurse's guide
(Laureate Education, Inc., custom ed.). Sudbury, MA: Jones and Bartlett Publishers.
Chapter 7, “Program Evaluation” (pp. 137–159)
In this chapter, the focus is on how nurses can participate in public policy or program evaluation. It includes a summary of the methodologies that can be used in evaluation and how to best communicate the results
Craig, H. D. (2010). Caring enough to provide healthcare: An organizational framework for the ethical delivery of healthcare among aging patients.
International Journal for Human Caring
,
14
(4), 27–30.
Retrieved from the Walden Library databases.
The author of this text investigates the ethical discussions surrounding health car ...
Building Capacity to Improve Population Health using a Social Determinants of...Practical Playbook
The Practical Playbook
National Meeting 2016
www.practicalplaybook.org
Bringing Public Health and Primary Care Together: The Practical Playbook National Meeting was at the Hyatt Regency in Bethesda, MD, May 22 - 24, 2016. The meeting was a milestone event towards advancing robust collaborations that improve population health. Key stakeholders from across sectors – representing professional associations, community organizations, government agencies and academic institutions – and across the country came together at the National Meeting to help catalyze a national movement, accelerate collaborations by fostering skill development, and connect with like-minded individuals and organizations to facilitate the exchange of ideas to drive population health improvement.
The National Meeting was also a significant source of tools and resources to advance collaboration. These tools and resources are available below and include:
Session presentations and materials
Poster session content
Photos from the National Meeting
The conversation started at the National Meeting is continuing in a LinkedIn Group "Working Together for Population Health" and Twitter. Use #PPBMeeting to provide feedback on the National Meeting.
The Practical Playbook was developed by the de Beaumont Foundation, the Duke University School of Medicine Department of Community and Family Medicine, the Centers for Disease Control and Prevention (CDC), and the Health Resources & Services Administration (HRSA).
Results from student-facilitated roundtable discussions at PACE Great Streets townhall meeting in Memphis, TN. This project represents an experiential learning activity at The University of Memphis, Health Promotion concentration in the Department of Health and Sport Sciences.
Michael Loevinsohn of the Institute of Development Studies presents findings of an innovative re-review of a systematic review of WASH interventions. Presented at 'Synthesising across health and development' a joint event of LSHTM, LIDC and IDS held at Woburn House on 19 September 2012.
Ethical Issues With an Aging PopulationAccording to the CDC, in t.docxmodi11
Ethical Issues With an Aging Population
According to the CDC, “in the United States, the proportion of the population aged
>
65 years is projected to increase from 12.4% in 2000 to 19.6% in 2030,” (CDC, 2003, para. 2). Caring for this aging population is going to be one of the greatest challenges facing the health care industry. Not only will the number of individuals requiring care rise, but so will the cost. As poignantly stated by Crippen and Barnato, “unless we change the practice of medicine and reduce future costs, and explicitly address the ethical dilemmas we face, there may come a time when our kids simply cannot afford us” (2011, p. 128).
In this Discussion, you will examine the ethical issues that the United States and other nations must address when faced with the health care challenges of an aging population.
To prepare:
Consider the ethical aspects of health care and health policy for an aging population.
Review the Hayutin, Dietz, and Mitchell report presented in the Learning Resources. The authors pose the question, “What are the economic consequences, now and for future generations of taxpayers if we fail to adapt our policies to the changing reality of an older population?” (p. 21). Consider how you would respond to this question. In addition, reflect on the ethical decisions that arise when dispersing limited funds.
Contemplate the impact of failing to adjust policy in accordance with the changing reality of an older population.
Reflect on the ethical dilemmas that arise when determining expenditures on end-of-life health care.
Post by Day 3
an explanation of the ethical standards you believe should be used in determining how resources should be allocated for an aging population and end-of-life care. Then, provide an analysis of the ethical challenges related to the preparation for the provision of such health care.
References:
Crippen, D., & Barnato, A. E. (2011). The ethical implications of health spending: Death and other expensive conditions
. Journal of Law, Medicine & Ethics, 39
(2), 121–129. doi:10.1111/j.1748-720X.2011.00582.x
Public health and aging: Trends in aging—United States and worldwide
. Retrieved from:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5206a2.htm
Readings
Milstead, J. A. (2013).
Health policy and politics: A nurse's guide
(Laureate Education, Inc., custom ed.). Sudbury, MA: Jones and Bartlett Publishers.
Chapter 7, “Program Evaluation” (pp. 137–159)
In this chapter, the focus is on how nurses can participate in public policy or program evaluation. It includes a summary of the methodologies that can be used in evaluation and how to best communicate the results
Craig, H. D. (2010). Caring enough to provide healthcare: An organizational framework for the ethical delivery of healthcare among aging patients.
International Journal for Human Caring
,
14
(4), 27–30.
Retrieved from the Walden Library databases.
The author of this text investigates the ethical discussions surrounding health car ...
Building Capacity to Improve Population Health using a Social Determinants of...Practical Playbook
The Practical Playbook
National Meeting 2016
www.practicalplaybook.org
Bringing Public Health and Primary Care Together: The Practical Playbook National Meeting was at the Hyatt Regency in Bethesda, MD, May 22 - 24, 2016. The meeting was a milestone event towards advancing robust collaborations that improve population health. Key stakeholders from across sectors – representing professional associations, community organizations, government agencies and academic institutions – and across the country came together at the National Meeting to help catalyze a national movement, accelerate collaborations by fostering skill development, and connect with like-minded individuals and organizations to facilitate the exchange of ideas to drive population health improvement.
The National Meeting was also a significant source of tools and resources to advance collaboration. These tools and resources are available below and include:
Session presentations and materials
Poster session content
Photos from the National Meeting
The conversation started at the National Meeting is continuing in a LinkedIn Group "Working Together for Population Health" and Twitter. Use #PPBMeeting to provide feedback on the National Meeting.
The Practical Playbook was developed by the de Beaumont Foundation, the Duke University School of Medicine Department of Community and Family Medicine, the Centers for Disease Control and Prevention (CDC), and the Health Resources & Services Administration (HRSA).
Application Access to Quality Health Care for Vulnerable Population.docxhirstcruz
Application: Access to Quality Health Care for Vulnerable Populations
Access to quality health care for disparate populations is a critical challenge for today's health care organizations and for the health care system as a whole. In this Application Assignment, you will describe the advantages and challenges facing the health care system in providing equal access to quality health care.
To prepare
for this Application Assignment, consider how health care is delivered to populations who are sometimes affected by the
Healthy People assigned focus area
you were previously assigned.
To complete
this Application Assignment,
write a
2- to 3-page paper
(essay style) that addresses the following:
What two obstacles confront vulnerable/underserved populations when they attempt to obtain quality health care
Healthy People assigned focus area
(e.g., a prevention program, screening program, diagnosis, treatment, and rehabilitation)? Be specific.
Name and describe
two
intervention programs that have addressed these obstacles (e.g., prevention, screening, diagnosis, treatment, and rehabilitation). You can find examples of these on the internet or by searching the library databases (CINAHL). Try searching with your Healthy People area (i.e. obestiy; heart disease) as a key term as well as the word "intervention" or "program"). You may also try looking at professional organizations that address that health issue. For example, the American Diabetes Association sponsors a program called "Project Power" which addresses diabetes type 2 among African Americans—specifically for church settings.
In your paper, summarize the programs by including the following:
The name of the program
The type of program (hospital based; for churches; online program, etc.)
Who has implemented the program (researchers, professional group, university, state, etc.) and where was it implemented:
For example, training programs are sometimes offered by commercial businesses and programs or activities are sometimes sponsored by federal government or professional organizations.
The types of services the program provides
How the program has addressed disparities
The achievements of the program
Does it address the issue of culture? How so?
Is there any evidence that it has been successful?
Your written assignments must follow APA guidelines (6th edition). Be sure to support your work with specific citations from this week's Learning Resources and additional scholarly sources as appropriate. Refer to the
Essential Guide to APA Style for Walden Students
to ensure that your in-text citations and reference list are correct. Also, since this is one of your only applications, you may want to submit this to a Walden Writing Center tutor first as well as run it through Turnitin.com prior to submission.
Learning Resources
Required Resources
Media
Video:
Laureate Education, Inc. (Executive Producer). (2009).
Behavioral and cultural issues in health care:
Health care disparities.
Baltimo.
Project PARTNER (Partnering with Adolescents to Ready The Newest Engaged Rese...YTH
The intersection of community engagement, research, and interactive technology is an innovative way for youth to develop leadership and 21st century skills. The California Adolescent Health Collaborative and community health clinic partners, Livingston Community Health and Asian Health Services, developed Project PARTNER, where youth in rural and urban communities learn critical thinking, problem solving, and collaborative processes through researching community health issues. \n\nYouth and adult allies from the health clinics were recruited to be members of a cross-generational and cross-regional community advisory board and were trained in research methodology. The online educational technology platform Kahoot!, and the mobile app Kahoot!, were utilized in training members on research fundamentals. The advisory boards then developed community surveys through Google Forms and utilized its mobile app feature to canvas neighborhoods to obtain community data. With data collected, they will develop research questions and participate in collaborative cross-site activities to support their research.
Most frameworks involving a “culture of safety” place patients at the center of the care delivery model (Sammer & James, 2011). In view of health policy, Ostrom (2007) stated that frameworks are meant to organize inquiry through identification of elements and potential relationship, but not intended to specifically test, explain, or predict behavioral outcomes or strengths of association as theory would test. In the healthcare setting patients occupy the center prominence of our safety efforts; however, we offer that care providers play an equally important role in optimizing patient safety and caregivers hold a position of equivalent actors in such frameworks. Furthermore, extrinsic factors such as government agencies are at times excluded in these discussions and some frameworks are structurally complex making it difficult for end users to retain, remember, and apply concepts consistently in practice.
Although a culture of safety is serious business (Denham, 2007a), it does not have to be implemented with a grim face. Joy and spirit of caregiving is also linked to patient safety. Joy comes from witnessing successful patient outcomes, and seeing the patient and family experiences of their healing journey (Hinz, 2011). Leape (2013) offers that joy and meaning will be created when the care providers feel valued, safe from harm, and being part of the solutions for change.
How then do we approach a complex system framework, such as patient safety, with a program that is meaningful, sustainable, and consistently recognizable, if not marketable, to the bedside caregivers? We have found that correlation of thoughts plays a significant role in retention and recognition of information for our multicultural staff. Gigerenzer (2007) posited that the strength of recognition surpasses that of simple recall in humans. When recall memory is impaired, recognition memory often remains (Gigerenzer, 2007, p. 111).
One way to strengthen recognition and information recall is through the use of mnemonics (Bakken & Simpson, 2011). Mnemonics encode complex information in which unfamiliar information to be learned is linked with known information, pictures, or symbols (Bakken & Simpson, 2011). Visual cues and auditory reminders enhance meaningfulness of new information and promote overall strength of association between novel learning and known or familiar patterns (Mastropieri, 1988).
Competency 2 AssessmentInstructions This Competency AssessmChantellPantoja184
Competency 2 Assessment
Instructions:
This Competency Assessment will allow you to apply concepts of population-based practice and community as partners.
For this course Competency Assessment, you will need to conduct a community assessment using assessment and evaluation tools, identify principles of community-based participatory research, and describe data sources using mixed methods for evaluation in a particular community context.
Many of you have traveled and participated in international/global immersion experiences, or a local practice where you may be an outsider (not a member of the community for whom you are caring). Others of you may aspire to practice in international settings. Also, in this unit, you have been introduced to the idea of genetics/genomic risks.
For this assignment, submit your assignment in which you do the following:
1. State two issues that may be of concern among vulnerable populations and possible solutions to combat such issues.
Please Note!
My 2 Vulnerable Populations are:
a.
Children of low-income families
b.
The Mentally disabled
Emphasis should be focused on the following topics:
·
Increase school dropout.
·
Use of Drugs.
·
Low quality of health/Poor health outcomes/Inadequate healthcare/ poor healthcare
·
Increase risk of chronic health conditions such as diabetes.
·
Increase mental health needs
2. Succinctly describe the relationship between health literacy and population health outcomes.
3. What has been your experiences understanding 1) and 2).
4. As you process some of the ethical issues and concerns about ethical engagement highlighted in the readings and media offerings for this unit
Please identify how you will ensure your engagement is helpful rather than well intended but ineffective (or worse).
· Submit your reflection by the last day of this unit.
(min. 5 pages- not including cover page or references)
Studies of parenting find that low family income and maternal hardship hamper children’s cognitive and social competence. 14 Moreover, parents in poor living environments have difficulty nurturing and protecting their children, increasing the likelihood that children will gravitate into activities and peer associations leading to school dropout, premature sexual experience, use of drugs, and other deviant behavior. 15 Family deprivations also increase the probability of abuse and neglect of children, who then seek to escape the household early, associate with inappropriate peers, form tenuous sexual partnerships, have early pregnancies, and often replicate the pattern of inadequate parenting they experienced as children. 16
Recommendation
Payments to health plans and providers should promote quality health care and improved health and functional status for all patients, including vulnerable populations. Adjusting payments for differences in health or functional status is especially important for Medicare, Medicaid, and other payers that have significant ...
Discussion Ethical Issues With an Aging PopulationAccording to th.docxmickietanger
Discussion: Ethical Issues With an Aging Population
According to the CDC, “in the United States, the proportion of the population aged
>
65 years is projected to increase from 12.4% in 2000 to 19.6% in 2030,” (CDC, 2003, para. 2). Caring for this aging population is going to be one of the greatest challenges facing the health care industry. Not only will the number of individuals requiring care rise, but so will the cost. As poignantly stated by Crippen and Barnato, “unless we change the practice of medicine and reduce future costs, and explicitly address the ethical dilemmas we face, there may come a time when our kids simply cannot afford us” (2011, p. 128).
In this Discussion, you will examine the ethical issues that the United States and other nations must address when faced with the health care challenges of an aging population.
To prepare:
Consider the ethical aspects of health care and health policy for an aging population.
Review the Hayutin, Dietz, and Mitchell report presented in the Learning Resources. The authors pose the question, “What are the economic consequences, now and for future generations of taxpayers if we fail to adapt our policies to the changing reality of an older population?” (p. 21). Consider how you would respond to this question. In addition, reflect on the ethical decisions that arise when dispersing limited funds.
Contemplate the impact of failing to adjust policy in accordance with the changing reality of an older population.
Reflect on the ethical dilemmas that arise when determining expenditures on end-of-life health care.
By Day 3
Post
an explanation of the ethical standards you believe should be used in determining how resources should be allocated for an aging population and end-of-life care. Then, provide an analysis of the ethical challenges related to the preparation for the provision of such health care.
Milstead, J. A. (2013).
Health policy and politics: A nurse’s guide
(Laureate Education, Inc., custom ed.). Sudbury, MA: Jones and Bartlett Publishers.
Chapter 7, “Program Evaluation” (pp. 137–159)
In this chapter, the focus is on how nurses can participate in public policy or program evaluation. It includes a summary of the methodologies that can be used in evaluation and how to best communicate the results
Craig, H. D. (2010). Caring enough to provide healthcare: An organizational framework for the ethical delivery of healthcare among aging patients.
International Journal for Human Caring
,
14
(4), 27–30.
Retrieved from the Walden Library databases.
The author of this text investigates the ethical discussions surrounding health care resource allocation among aging patients. The article supplies an organizational decision-making model for health care resource allocation among the aging.
Crippen, D., & Barnato, A. E. (2011). The ethical implications of health spending: Death and other expensive conditions.
Journal of Law, Medicine & Ethics
,
39
(2), 121–129.
Retrieved from the Walden Librar.
Public Health Program Development to Complement Occupational Therapy Practice
SDH Presentation San Antonio
1. Changing Nursing Graduate
Students’ Understanding of
Social Determinants of Health
Costa Rica
Nicaragua
Panama
Honduras
El Salvador
Dr. April Folgert
Concordia University Wisconsin
Colombia
2. Objectives
Identify trends and approaches to reduce health
disparities across populations.
• Identify two curricular strategies to enhance
students’ knowledge of social injustice.
• Explain two lessons students learned about the
social determinants of health.
• Explain one or more challenges and strategies
for organizing a short-term study abroad course
designed to teach students about the social
determinants of health.
4. Within the Context of Culture
Image adapted from https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health
Neighborhood
and Built
Environment
Health and
Health Care
Social and
Community
Context
Education
Economic
Stability
SDOH
19. • Analyze the health care system
• Analyze levels of health care access
implications for health
• Develop plan to promote health
Written Assignment
20. • Health Care
• Culture
• Social Inequality
• Role for Nurse Practitioners
Image adapted from https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health
21. % rated perceptions mostly or
significantly increased
50
55
60
65
70
75
80
85
90
95
100
Arrival Hospital and
Caja
EBAIS and
Indg Cult
EBAIS &
Indig Culture
Free Time
Cult Comp
Soc Injustice
Healthcare
22. “I found it surprising
to take 8 hours to
receive care…”
“Immersing ourselves in another
culture is an important aspect of
learning to deliver culturally
congruent care to the patients
we serve.”
“As an NP, I need to
advocate for a better
system.”
“It was nice to hear the
perspectives of those
who use the system.”
24. References
Davis, S. L., & Chapa, D. W. (2015). Social determinants of health: Knowledge to effective action for
change. Journal for Nurse Practitioners, 11(4), 424-429. Retrieved from www.npjournal.org
Carryer, J., Halcomb, E., & Davidson, P. M. (2015). Nursing: The answer to the primary health care
dilemma. Collegian, 22(2), 151-152. doi: 10.1016/j.colegn.2015.05.001
Carryer, J., & Yarwood, J. (2015). The nurse practitioner role: Solution or servant in improving primary
health care service delivery. Collegian, 22(2), 169-174. doi: 10.1016/j.colegn.2015.02.004
Kidder, R. M. (2009). Overview: The ethics of right versus might. In R. M. Kidder (Ed.), How good people
make touch choices: Resolving the dilemmas of ethical living (pp. 12-29). Camden, MA: Institute for
Global Ethics.
Lanthrop, B. (2013). Nursing leadership in addressing the social determinants of health. Policy, Politics,
and Nursing Practice, 14(1), 41-47. doi: 10.1177/1527154413489887
Riner, M. E., Bai, J., & Larimer, S. (2015). Intercultural global health assessment and reflection framework
for teaching study abroad courses. Journal of Nursing Education and Practice, 5(5), 65-72.
doi:10.5430/jnep.v5n5p65
U. S. Department of Health and Human Services. Office of Disease Prevention and Health Promotion.
(2011). Social determinants of health. Healthy People 2020. Washington, DC. Retrieved from World
Health Organization. (2012a). Social determinants of health. Retrieved from http://www.who.int/
social_determinants/thecommission/finalreport/key_concepts/ en/index.html
Editor's Notes
Introduction
Studying abroad is one of the most unforgettable ways to learn about culture and the social determinants of health.
During the next 20 minutes I’m going to share with you a course I developed for nurse practitioner students that includes a short-term study abroad experience in Costa Rica.
The Objectives
The objectives for this session are listed in your handout and on the screen and relate to the conference objective of identifying trends and approaches to reduce health disparities across populations.
Nurse Practitioners
You may be surprised to learn that nurses and nurse practitioners are challenged by the complexity of health care issues related to community health, access, and social injustice.
My concern in teaching nurse practitioner students is the possibility that their primary care focus would take them further away from the broad yet very real issues related to the social determinants of health.
Social Determinants of Health in Cultural Context
So I began looking at the learning objectives and considering the strategies I could use for this course.
But I began to think about what I wanted students to gain from this experience. What would be so impactful that it would change how they practice currently as nurses and how they would advocate for patients locally and globally.
Challenges
From a personal perspective, I had some challenges. I wasn’t certain what types of experiences were available because I had never set foot there. I had never been to Costa Rica but this is where the students were expecting to go.
Where were my resources? Did they have hospitals? And when we get there, how do we behave? I had a lot to learn about Costa Rica before I could truly lead a group of 24 students there.
Lastly, yo hablo mui pochito Espanol. That means, I speak very little Spanish. Now don’t let the fool you. I learned that just to give those whom I was communicating with a “heads up.”
Strategies
Google was truly my friend. I learned a lot about Costa Rica, the culture, health care system, economic stability of the country, common health concerns.
I took a scouting trip so I could see, first-hand, what the resources were and where I wanted students to study. I was able to determine that it is possible to study the urban and rural areas of Costa Rica in a week’s time since the country is only about the size of West Virginia.
I hired a tour guide. These folks know the area and with medical tourism being a major component of income for the country, they had very good ideas and access to healthcare facilities.
I took time to learn the basics of the language, cultural norms, and ensured I had Google Translate on my phone. Trust me, it came in handy.
Curricular Strategies
Once I learned what was possible, I went to the drawing board to develop strategies that would prepare students for the experience, allow them to engage in meaningful experiences in Costa Rica, reflect upon the experiences, and transform their understanding of culture and the social determinants of health.
Pre-Travel Assignments
List of assigned readings
Online discussion questions
Cultural Self-Assessment
Experiences
CIMA –
Private
Technology
Customer Service
Hospital Nacional de Ninos
Care for children throughout country
Care for more than 1000 children in clinics each day
30-60 referrals each day outside San Jose
Antiquated (Consumer Product Safety Commission)
EBAIS
947 EBAIS across country. Each covers care for 3500-4000 patients across the lifespan.
1 physician, a nurse, medical records technician, and pharmacy technician
Indigenous Culture
Traditional medicine and practices
2% of population = 65,000 people
Nearly half are impoverished and live in mountains
Only 26% access to clean water
We learned about health care within the community context. We learned about how pre-Columbian cultures practiced and continue to use herbal medicine (traditional medicine) to protect and heal the body of illness. We also learned about access for those who still reside in the mountains.
Nearly half are Bribri and Guaymi, are impoverished, and have minimal access to healthcare because they live in secluded areas such as the mountains.
Social Security System
Working class support health care system
Uninsured include Nicaraguan population – 30% unemployed
Challenges with sustainability, growth, and equity
Covers medical, sick leave, maternity, and pension
Free Time
Allowed students to talk to locals
Describe activities and observations based on sensory experience. Describe your reactions such as feelings, desires, thoughts, and behaviors. Explain the insights you gained to develop cultural competence as a nurse practitioner.
Location
Students identified location as an issue related to access. While in Costa Rica, we travelled throughout the country. Students learned that people located in rural parts of the country didn’t have access to healthcare. The terrain is Costa Rica is beautiful and mountainous but makes it challenging for those who need care to access an EBAIS very easily. This was particularly noted about indigenous community members who reside in the mountains.
Availability
Each EBAIS has a physician, a nurse, a receptionist, pharmacist,
Insurance
Students learned about how health care costs are paid for in a universal health care system. Visiting a private and public hospital provided the opportunity to compare access to what students’ defined as quality of health care between the two. They talked about how socioeconomic status impacted residents’ access to quality of care, efficiency, and use of the most modern equipment.
For the students who enrolled in this course, studying abroad was unforgettable.
By being in our own element, become blinded to community health issues and social inequality. But when you step outside of your own environment, evaluate what is happening in other countries, and reflect upon what one’s own biases, we learn where we are and can then transform into what we want to be. My hope for these students is that they would be moved to advocate for patients both locally and globally after this experience.
It has been my pleasure to share this course with you.
Thank you.