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Global Healthcare Comparison Matrix and Narrative Statement

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Global Healthcare Comparison Matrix and Narrative Statement

Tuberculosis (TB) is a major global health concern due to its burdens that disproportionately weigh on low- and middle-income countries. With the occurrence of more than ten million cases annually, it is important to understand how countries address TB through a comparison of the role of policy, social determinants, and healthcare infrastructure that impacts this disease. This document discusses some TB-related policies in the United States and India, considering strengths, weaknesses, and impacts on the population: Global Healthcare Comparison Matrix and Narrative Statement.

These strategies, upon consideration by nurses and healthcare leaders, would support global views in local practices to address inequities in health disparities. The comparison matrix and accompanying narrative bring out the critical aspects of collaboration for achieving a global commitment to eradicating TB.

Part One: Global Healthcare Comparison Matrix

Global Healthcare Issue Tuberculosis
Description Tuberculosis is a highly infectious disease caused by the bacterium Mycobacterium tuberculosis. It primarily affects the lungs but can spread to other organs. TB is a major global health issue, particularly in low- and middle-income countries. The World Health Organization (WHO) End TB Strategy aims to reduce TB deaths by 90% and TB incidence by 80% by 2030 (World Health Organization, 2015).
Country United States India
Describe the policy in each country related to the identified healthcare issue The U.S. implements the National Tuberculosis Surveillance System (NTSS), managed by the CDC (CDC, 2024; ODPHP, 2021). It emphasizes monitoring, treatment adherence, and prevention through education, vaccination, and contact tracing. India implements the National Strategic Plan for Tuberculosis Elimination, which focuses on early detection, universal drug susceptibility testing, treatment adherence, and community engagement (Khanna et al., 2022; Malwe et al., 2023).
What are the strengths of this policy? High reliance on advanced diagnostic technologies and a robust surveillance system

Effective contact tracing, directly observed therapy (DOT), and federal funding ensure sustained support (CDC, 2024; ODPHP, 2021)

 Strong focus on community engagement, decentralized healthcare delivery, and free access to TB medications

Introduction of newer diagnostic tools and incentives for treatment adherence
What are the weaknesses of this policy? Weaknesses include high treatment costs for uninsured individuals, limited federal resources in rural and marginalized communities, and challenges with immigrant populations due to language and cultural barriers. Resource constraints in rural areas

Overcrowding in public healthcare facilities

Issues with treatment adherence due to a lack of awareness and stigma
Explain how the social determinants of health may impact the specified global health issue. (Be specific and provide examples) In the U.S., TB disproportionately affects immigrants, the homeless, and individuals in low-income communities due to limited access to healthcare, poor living conditions, and lack of insurance. For example, homeless shelters and correctional facilities often act as TB hotspots. In India, poverty, malnutrition, overcrowded living conditions, and lack of health literacy significantly contribute to TB prevalence (Khanna et al., 2022; Malwe et al., 2023). For instance, slum areas with poor ventilation and sanitation see high TB transmission rates.
How has each country’s government addressed cost, quality, and access to the selected global health issue? The U.S. offers federally funded TB treatment programs, ensuring free access to medications for diagnosed patients. Programs like Medicaid provide additional support, though access may vary by state. The CDC ensures quality care through regular updates to guidelines and provider training (CDC, 2024). India’s government provides free TB diagnosis and treatment under its Revised National TB Control Program (RNTCP), with initiatives like Nikshay Poshan Yojana offering nutritional support to patients (Malwe et al., 2023). Also, the government’s Ayushman Bharat scheme improves healthcare access for people living in poverty.
How has the identified health policy impacted the health of the global population? (Be specific and provide examples) The U.S. policy has contributed to a significant decline in TB incidence and mortality rates domestically, serving as a model for high-resource countries. CDC’s international collaborations, such as providing technical assistance to other nations, further global TB control efforts. India’s policy has improved TB detection and treatment rates. The introduction of community-based approaches and nutritional support programs has reduced default rates and mortality, particularly in rural areas.
Describe the potential impact of the identified health policy on the role of nurses in each country. In the U.S., nurses are integral to TB management, performing tasks such as administering DOT, conducting community education, and participating in contact tracing. Advanced practice nurses contribute to policy development and advocacy efforts. Nurses in India play a key role in community-based TB programs, providing patient education, supporting DOT, and addressing stigma. Their involvement in rural healthcare settings ensures last-mile delivery of services.
Explain how global health issues impact local healthcare organizations and policies in both countries. (Be specific and provide examples) In the U.S., global TB trends necessitate screening for immigrants and travelers from high-TB-burden countries, influencing policies on mandatory TB testing for visa applicants (ODPHP, 2021). Local healthcare organizations must adapt to rising multidrug-resistant TB (MDR-TB) cases, requiring advanced diagnostic and treatment protocols. India’s high TB burden drives healthcare policies to address social determinants of health, including poverty alleviation and nutrition programs. Local clinics often collaborate with global organizations like WHO to address MDR-TB challenges.
General Notes/Comments The U.S. focuses on technological advancements, robust surveillance, and federal funding to address TB. Efforts are needed to improve access in underserved communities and address cultural barriers. India prioritizes community-based approaches and universal access to TB care. Strengthening rural infrastructure and addressing stigma can enhance TB elimination efforts.

Part Two: A Plan for Social Change

Advocacy for a Global Perspective in Local Practice

Making global strategies of TB control part of local policies is significant in addressing tuberculosis issues both locally and globally. Accordingly, advocacy for a global perspective in local practice may encompass the promotion of culturally sensitive education and training programs for reducing stigma or promoting early diagnosis. Working closely with international institutions such as the WHO would enhance a bottom-up approach of new approaches to community DOT.

Impact on Local Practice and Role as a Nurse Leader

A global health perspective will, therefore, further equip health professionals in responding to these health disparities. Nurse leaders can be at the forefront of proposing culturally and socially appropriate interventions for at-risk populations and implementing TB transmission strategies. For instance, education campaigns in many languages would improve awareness and adherence in immigrant groups. Nursing leaders also have to provide an interprofessional practice, undertake research into trends of the disease, like multidrug-resistant TB (MDR-TB), and advocate for more funds for the prevention and treatment of the disease.

Contribution to Social Change

The alignment of local practices to global TB strategies is an evident step toward social equity in health care. Developing multilingual TB education materials can help bridge the gap in communication and improve health outcomes for marginalized populations. Besides, the adoption of global strategies, such as India’s Nikshay Poshan Yojana, which provides nutritional support to TB patients, will go a long way in addressing the root social determinants of health, like malnutrition. It helps integrate these practices into letting local healthcare systems play their role in the greater global vision of eliminating TB and, eventually, reducing the disease burden toward better global health.

Conclusion

The policies on tuberculosis control in the United States and India reflect the different strategies needed to address global health issues. The U.S. relies on technological advances and a system of surveillance, while India relies on community involvement and access to treatment for all. A global perspective can enrich local practices, enabling nurses to implement culturally sensitive interventions and advocate for systemic changes.

In addition, such global efforts go conjointly with local strategies that would strengthen health equity and counter the causes of TB, and these include nutritional support and multilingual education. Health professionals can contribute to lowering the burden of TB globally and improving outcomes through interprofessional collaboration.

References

CDC. (2024, December 10). National TB Surveillance System Data Request Form. Tuberculosis Data. https://www.cdc.gov/tb-data/ntss-request-form/index.html

Khanna, A., Saha, R., & Ahmad, N. (2022). National TB elimination programme – What has changed. Indian Journal of Medical Microbiology, 42(42). https://doi.org/10.1016/j.ijmmb.2022.10.008

Malwe, S., Bawiskar, D., & Wagh, V. (2023). Tuberculosis and the effectiveness of the revised national tuberculosis control program (RNTCP) to control tuberculosis: A narrative review. Cureus, 15(12). https://doi.org/10.7759/cureus.51418

ODPHP. (2021). Reduce tuberculosis cases — Data – Healthy People 2030 | odphp.health.gov. Health.gov. https://odphp.health.gov/healthypeople/objectives-and-data/browse-objectives/infectious-disease/reduce-tuberculosis-cases-iid-17/data

World Health Organization. (2015, August 16). The End TB Strategy. WHO. https://www.who.int/teams/global-tuberculosis-programme/the-end-tb-strategy

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Question

Note: This Assignment (both Parts 1 & 2) is due on Day 5 of Week 11.

If you talk about a possible poor health outcome, do you believe that outcome will occur? Do you believe eye contact and personal contact should be avoided?

You would have a difficult time practicing as a nurse if you believed these to be true. But they are very real beliefs in some cultures.

Differences in cultural beliefs, subcultures, religion, ethnic customs, dietary customs, language, and a host of other factors contribute to the complex environment that surrounds global healthcare issues. Failure to understand and account for these differences can create a gulf between practitioners and the public they serve.

In this Assignment, you will examine a global health issue and consider the approach to this issue by the United States and by one other country.

Be sure to review the Learning Resources before completing this activity.

WEEKLY RESOURCES

To Prepare:

The Assignment: (1- to 2-page Global Health Comparison Matrix; 1-page Plan for Social Change)

Part 1: Global Health Comparison Matrix

Focusing on the country you selected and the U.S., complete the Global Health Comparison Matrix. Be sure to address the following:

Part 2: A Plan for Social Change

Global Healthcare Comparison Matrix and Narrative Statement

Global Healthcare Comparison Matrix and Narrative Statement

Reflect on the global health policy comparison and analysis you conducted in Part 1 of the Assignment and the impact that global health issues may have on the world, the U.S., your community, as well as your practice as a nurse leader.

In a 1-page response, create a plan for social change that incorporates a global perspective or lens into your local practice and role as a nurse leader.

Assignment document should include:

  1. Title page
  2. Introductory paragraph
  3. Global health comparison matrix
  4. Plan for social change
  5. Conclusion
  6. References

By Day 5 of Week 11

Submit both Part 1 and Part 2 of your Assignment.

submission information

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