Critical Evaluation Of Health Determinants, Health Inequalities, Health Promotion, Public Health In Nepal - Essay.

The Evolution and Role of Public Health and Health Promotion

In the form of a core activity of public health, the aspect regarding health promotion provides support to the communities, regulatory bodies and the individuals to address and develop coping with the challenges of health. This can be met through the development regarding public health policies, the development of supportive surroundings and ensuring strength regarding the activities and skills of the community. The concept of public health evolved in the middle of the 19th century with the movement that is oriented with central reformation to provide sanitaria to the tuberculosis affected patients (Keefe and Lane 2018). The main aim of this reflective assignment is to critically evaluate health determinants, health inequalities, health promotion and public health in the national as well as global context. To perform so, Kolb’s reflective model is to be used throughout the Reflective paper. 

Kolb’s learning cycle consists of reflective observation, concrete experience, abstract conceptualisation and active experimentation (Chiu 2019).

Before the performance of this task, I was having the concrete experience that the concept of health is the state of accomplished social, physical and mental wellbeing and not just the absence of a particular disease. Before the commencement of this task, I used to understand that the basic concept of health implies an absence of disease. That is, if an individual is free from any kind of disease, then that person can be taken into account as a healthy person. I also knew that the health determinants are the vital factors which provide an impact on the health status of a person or a group of people. At each and every phase of life, the determination of health by the complicated connection between the financial and social factors, the individual behaviour as well as physical environment. The determinants of health illustrate the adverse health effect that are connected with the for profit actors and the associated activities (Lee et al., 2022). Also, I understood prior to doing this task that health inequalities can be termed unfair as well as unavoidable differences in health status between population groups or communities. 

Before this task, I had only general information regarding the mentioned health related concepts. After doing this reflection, I can realise the health concept, health determinant and the inequalities of health in a definite basis in the context of Cameroon. I realised that I have HIV/AIDS. I found that in Cameroon, this specific disease is mainly spread widely among the women. The prevalence of Malaria is there throughout Cameroon. Cameroon, similar to other countries which are less developed, faces a high burden of cancer with the rate of mortality as 66.7% (Abenwie et al., 2021). I found that there is a prevalence of dysentery and pulmonary issues in certain regions of Cameroon. There are events regarding schistosoma and leprosy, sleeping sickness as well as syphilis. I analysed that demographic transformations are the major drivers regarding the epidemic chronic disease that are being prevalent in Cameroon. Social mobility and urbanisation has led to financial development of the region, but has contributed to the enhancement in hypertension, diabetes and obesity affected people in Cameroon. I found that the people of Cameroon who are residing in the urban regions, are suffering from increased abdominal adiposity, increased obesity, because they are not doing adequate physical movement as is done by Cameroonians in rural counterparts.

Kolb's Reflective Model: A Framework for Critical Evaluation

I examined that there are health inequalities in the accessibility regarding health workforces in Cameroon. The circumstance of task and employment provides shape to the health determinants and can accumulate throughout the population group over a span of duration that can provide an impact on health inequalities (Ahonen et al. 2018). There is a relation between the social determinants to non-communicable as well as communicable disease. Therefore, status of health must be chief concern to the creators of policy in each and every department, not vitally those included in the health policy. In order to provide a response regarding this to the worldwide issue, a Commission regarding social determinants of health is introduced by the World Health Organisation (Marmot, 2005). Racism can be termed as a major health determinant of racial inequalities in health through the disciplines (Neblett Jr 2019). This will monitor the proof, increase the debate regarding society and provide suggestions of policies with the objective of advancing health regarding the globe’s most vulnerable individuals. It is the vital thrust that the Commission is developing to turn regarding the knowledge of public health into political activities (Marmot, 2005). To realise the social health determinants, the way the operations can be done and the manner it can be transformed to make the advancement regarding health and make the decrease of health inequalities (Marmot, 2005). I realised that the things that are going well in Cameroon is its development, however the things that are not going well are its ability to address the health needs of people. The examination regarding the Covid-19 inequalities associated with the social disease as well as social health determinants, the people are facing a syndemic pandemic (Bambra et al. 2020). The things which have gone well in the experiment is that I could understand health concepts, determinants and health inequalities in Cameroon. However, the thing that did not go well is that because of Covid-19, I have to rely only on online sources of data to find health related data and I could not visit the concerned place to gain further insights. 

The analysis regarding the health inequality in Cameroon is performed by me utilising the Lorenz Curve and Gini coefficients.  Lorenz curve is implemented to characterise the health personnel distribution and reveals the cumulative share regarding health employees against the cumulative people when the varied locations are ranked from lowest to highest gradings of health employees. I used the Gini index to identify inequality levels with values ranging from zero to one, when increased value highlights increased inequality level. The position regarding socio-economy can be termed as a dimension associated with the social health determinant that is featured in the World Health Organisation (WHO) Commission on Social Determinants of Health (SDH) framework (Northwood et al. 2018).

Having analysed the experience, I can understand the inequality and health determinants that are being faced by people of Cameroon, can be reduced, if effective contribution can be made by the public health workforce by developing integration regarding health equity aspects into programs and policies with the help of which equities can be addressed. The health workforce should get engaged with the communities of Cameroon so that their health inequities get addressed, thereby helping to lessen the health inequities and helping Cameroonians to lead a healthy life. The potential relevance that is associated with the differential effect to recognise the health inequalities and the policies which are essential to deal with them, is raised prior many years (Marmot, 2005). This is highlighted by the World Health Organisation (WHO) in the task on social health determinants (Diderichsen, Hallqvist and Whitehead 2019). The conditions in which the individuals work and survive, are crucial for the non-communicable and communicable disease (Marmot, 2005). The conditions of society develop a powerful impact regarding the response and onset of treatment regarding the vital infectious issues which kill. However, to critically analyse, it can be stated that uncovering the social health determinants and developing address of them is critical to develop improvement regarding the health population. It is because these are the factors which impact the health of individuals and the possibility of developing chronic issues in later life stages. The start to address social requirements can be done with an efficient strategy to address those requirements.

Understanding Health Determinants and Inequalities in Nepal

On the other hand, to critically analyse the concept of health inequality, it goes against the practice associated with social justice, as they are avoidable. The occurrence of them does not take place on a random basis or by chance. The social determination of them occurs by conditions which are highly beyond the control of an individual. These are conditions which are disadvantageous towards the individuals and imposes limitations on them to live a long as well as healthy life.  I, being a healthcare worker, would definitely contribute by going to Cameroon and helping people drive out of their health conditions and help them to access all healthcare facilities. 

The feelings that I used to have before doing this reflective experimentation is just having knowledge regarding the health of the public and the basic idea about health promotion. The health aspects of the public and the way people can be driven away from disease, can be accounted as public health. I used to think the disease of the public can be prevented by application of health promotion models. Health promotion drives to develop elimination regarding the inequalities of health in case the meaning of inequality implies the failure to term and make treatment “like but different” people and groups just as they are valued on an equal basis. The awareness which is associated with health inequalities, in recent days, culminated in the community of global health promotion behind the tasks which are performed by the Commission on Social Determinants of Health (CSDH) (Dixey et al. 2012).

I found that the underlying principles that are associated with public health of Cameroon as a national context and also in the global context, are equity, participation, social justice, effectiveness, acceptability and affordability. Also, the basic public health values comprised an obligation to prevent the occurrence of harm, thereby protecting the health of people. There must be transparency, privacy,trust and justice in the healthcare provisions in national and global context. The conference, which was performed in London in 2008, made the arrangement regarding the first vital global event to make the development regarding a global agenda that is required to address the problems. The major features that are performed by the healthcare system is to provide focus on health promotion and the prevention of disease (Watt et al. 2019). The objective of the conference is “Closing the Gap” in a particular generation and the optimistic works regarding the conversion of the CSDH framework into practical activities (Dixey et al. 2012). The CSDH calls for an involvement regarding political leadership at the greatest standard to commit to the global equity of health as a whole. Information regarding inequalities associated with health abound, whether it occurs in the UK that is a rich country, between the countries that are richer, like Japan and the USA, or in the countries that are poorer and are present in the global South regions (Dixey et al. 2012). The increasing prevalence of health problems are occurring mainly in the middle and low income countries (Peres et al. 2019). An undeniable argument regarding the health inequalities within the countries are illustrated by the wealth inequality, society inequality. The global focus regarding health policy at the level of individuals, is reflected in the High-level Meeting on NonCommunicable Diseases that took place in the United Nations at the General Conference (Dixey et al. 2012). The security of food and under nutrition would be required to provide a strategic intervention to deal with the reason associated with poverty and would need the policy developers and politicians at the national and global level to conduct actions. The history associated with health promotion generally starts in 1974 with the publication regarding the Lalonde report that took place in Canada and the development of Ottawa Charter (Dixey et al. 2012). I found that the measurement is done by the WHO that children and women bear the vital burden that is associated with health inequalities on a global basis. 

Impact of COVID-19 on Health Inequalities in Nepal

The core concern that is associated with the difference between public health and health promotion. Health promotion ensures a contrasting approach from the public health in the mainstream basis. I can recommend that health promotion can be regarded as politics rather than a segment of the medical enterprise. The funding of public health practice must be done with the ethical review regarding protocols (Theobald et al. 2018). The alliance of this is much more on the social policy in comparison to the professional allied regarding medicine (Dixey et al. 2012). Though there can be arousal of disagreements between the aspect of health promotion and public health, these arguments cannot be termed as inevitable, therefore serving a political justification for the performance of this action. I found that the movement in the UK which is made by the localised coalition regulatory body, to develop location regarding health promotion and public health, and which are not present in the NHS, is essential to be welcomed. 

In the national level, the development regarding supportive surroundings is essential for the individuals who are surviving in hazardous working surroundings (Dixey et al. 2012). For this, the coordination of the inter-sectoral struggles is required to develop protection of health through the national boundaries. There is an increasing emergence of public health issues in the 21st century (World Health Organisation 2020). I found that the healthcare system in Cameroon is controlled by the Public health Ministry. It comprises different hospitals, including district healthcare centres and the provincial hospitals. I found that the vital issues in public health that are present in Cameroon  are due to the inequitable topographical location of health employees, mainly in the village areas of Cameroon, such as Sud, Adamas and many more. Also,  I found that health promotion is not adequately implemented in Cameroon, though a Ministerial incharge is present in health promotion context. The activities of health promotion in Cameroon are very much limited in terms of disease prevention, education provision to people regarding health and virtual ignorance is performed of social health determinants in Cameroon. The thing that is found to be going well in Cameroon is the fostering of primary health, though the other health related aspects are ignored. The thing that has gone well in terms of this experimentation is that I can understand the major health issues that people of Cameroon and worldwide are facing and can aim to develop actions to address those issues. However, the things which did not go well is some people were hesitant in Cameroon to share their health issues, that made it difficult for me to analyse their health related discrepancies. 

The application of the Health Belief Model should have been performed by me to gain deeper insights about public health and health promotion in national and global context. The utilisation of this theory has been performed for decades to help develop behaviour change interventions. This model is found to be very crucial for me to promote healthy behaviour among the people on a global basis and Cameroon to advance the prevention of disease and serve effective treatment to them. Since, this theory was not implemented by me to perform the experience, I could not understand the behavioural aspects of individuals in Cameroon for which they became hesitant to share their issues. 

In order to promote health,  I think that for health promotion, the development of a lead responsibility must be done by all the departments and the civil community to develop the expansion of health partnership and help international and national networks with the objective to promote health (Dixey et al. 2012). The healthcare departments throughout the world should be committed to health promotion as these are core to the agenda of global development. A basic responsibility that should be performed by all the regulatory bodies (Dixey et al. 2012). The healthcare employees need to be associated with good corporate practice. Cuba as well Sri Lanka are the effective examples regarding the countries which are attaining high health as an outcome of the national level policies which established availability regarding the fundamental social services (Dixey et al. 2012). Having analysed the experience, I would apply the Health Belief Model, playing the role of a healthcare practitioner and to promote health aspects, I would strengthen the actions of the community for health and develop reorientation regarding healthcare services. Also, I would develop supportive healthcare to promote health in national and global context.

It is experienced that there are various health issues that are facing the population in Cameroon and in the world. It can be seen that there is the absence of proper healthcare facilities and health promotion planning, for which these issues are faced. There are certain models and theories which are important to be applied so that these problems can be solved. 

The things which have gone well is I can understand health issues and inequalities that are encountered by people in Cameroon and worldwide. However, the thing that did not go well is that I failed to apply health promotion theories for which effective analysis regarding health conditions of the population could be done. 

I feel that it is of utmost importance to apply the Public Health Model to understand health situations globally and in the context of Cameroon. PMC model is termed as the epidemiological model which should be implemented to mitigate a specific illness or social issues in the people through the recognition of risk indicators. It can be analysed that better health results are attained by the healthcare systems when built on Primary Healthcare. The implementation of the PMC model can be termed as the action that is locally perfect through the array of social determinants (Marmot et al. 2008). Through the application of this model, development promotion and prevention are in equilibrium with the investments that are made in the performance of curative treatment. The engagement of the communities regarding health promotion is significant (Phantumvanit et al. 2018).Research regarding the social health determinants and the manner by which work will be done regarding public health and health promotion, will be dependent on the dedication of the practitioners and the adoption of new methods (Marmot et al. 2008). The function of public health provides emphasis on health promotion (World Health Organisation, 2018). The expansion regarding clearing houses and virtual networks must be done on the aspects of open access. The management of this can be done to gain availability for all regions in the low, high and middle income settings. The framework regarding social determinant across the programmatic and the policy activities which are connected with the Ministries of Health, must strengthen the approach of social determinant across the regulatory bodies. The integration regarding the SDT oriented interventions can be performed into the health policy (Ntoumanis et al. 2021). Also, implementation of the Public Health Promotion model should be performed by me. This model can help me to understand the manner by which the implementation of population health approach can be done via action on the entire range of health determinants through application of health promotion strategies.  

The way by which I aim to conduct this particular experimentation in the future is that I would definitely apply Public health model and Promotion Health Promotion model. These models will help me to effectively understand public health issues, health determinants in the global and national aspect. I found that the health department is an effective place to begin establishing structures and support which motivates activities regarding the social determinants associated with health as well as health equity. I feel that this needs effective leadership that is to be provided by the Minister of Health by receiving help from WHO. While the social team representation via the representation of them through the agenda which are policy associated, decision and agenda development is important. The integration regarding health promotion into the general care of health is crucial (Tinanoff et al. 2019). This should be done to identify a comprehensive right set and make sure the occurrence of fair distribution regarding social goods and important materials amongst the population teams (Marmot et al. 2008). Empowerment can be served to their activities through grassroot and bottom up approaches. It provides the individuals with an increased sense of control regarding their future and lives. Community regarding the health inequities cannot be segregated from the state’s responsibility to provide guarantee to a comprehensive set associated with rights. The bottom up and top down approaches can be termed as important, equally (Marmot et al. 2008). The mentioned models will help me to develop health promotion and support me to reduce the overall health disparities. 

In an arguable manner, the concept regarding health promotion is optimally recognised in the form of expression and reflection associated with transforming viewpoints in healthcare. These transformations can be viewed to widen the curricula to provide training and education to healthcare professionals (Cribb and Duncan 2008). The emergencies regarding public health which are confronting the societies, develop particular contributions through which the resolution of a health crisis can be done (Zhang et al. 2020).

Health promotion can be termed as the promotion of health  (Cribb and Duncan 2008). I found the meaning of promoting something is to motivate or enhance it, therefore a certain thing which motivates health should be an example associated with health promotion. I think that the basic point that should be noted is that the care of health and the values that are connected with it emerge and transform over the span of time. The transforming institutions as well as the healthcare practises, not only develop representation regarding the change in techniques and processes, they also develop representation regarding value changes  (Cribb and Duncan 2008). In several manners, the legacy oriented hospice associated with healthcare, represents the value instead of their institutional form  (Cribb and Duncan 2008). 

The core discipline of public health comprises epidemiology, management, biostatistics, health policy, environmental health sciences as well as behavioural and social sciences. People attain competence regarding all the core disciplines via the course of public health  (Cribb and Duncan 2008).  To critically analyse, it can be stated that though there are various values that are associated with health promotion theory, there is the presence of criticism associated with it too. A wide assessment regarding the patterns of diet in the global basis, can recommend that the diet of food which are processed minimally, are predominantly connected with the health promotion aspects and contribute to prevent the occurrence of disease (Blesh et al. 2019). Another critique that is raised is that the political, environmental and financial factors are not segments associated with the health promotion theory. The policies that are regarding health promotion, require to focus on the wellbeing of individuals through the development of an effective culture associated with growth and learning (Mansfield, Daykin and Kay 2020). The focus of this theory is on the health behaviour of the individual. 

Health promotion is relatively a recent discipline which stems from public health, education, sociology, psychology, political science and many more. Health promotion is the procedure of enabling the individuals to enhance their control over and cause improvement regarding their health. Health promotion can be regarded as a critical and emerging domain associated with public health. Therefore, to understand the concepts regarding public health and health promotion, application of Public Health Model and Public Health Promotion Model would be definitely done by me so that I can attain a disciplinary base to understand regarding public health and health promotion. 

Conclusion 

It can be concluded that in this Reflective essay, critical evaluation is done regarding the understanding of mine about health inequalities, health determinants and the health concepts. The major concepts which are underlying the principles and values regarding the promotion of health on a global and national basis, are illustrated. The approaches, models and methods which are associated with the health promotion and public health concept is highlighted. The disciplinary base which is associated with the concerned concepts is mentioned. Overall, reflection is done regarding my basic understanding about health determinants and public health issues globally and in Cameroon. The implementation of Public health promotion model and Public health theories are essential to be done to promote the health of Cameroonians and globally.

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