Module Code – MID 314
Assignment - A 3000 word essay identifying two public health issues pertinent to clinical placement area; analyse these with reference to appropriate literature and research and discuss the public health role of the midwife.
Word Count = 3210
Health is a broad concept, which can embody a huge range of meanings, from the narrowly technical to the all-embracing moral or philosophical. A definition of health is a state of well-being, interpreted by the World Health Organisation (WHO) in it’s constitution as ‘a state of complete physical, mental and social well-being, not merely the absence of disease or infirmity’ (WHO, 1946). This definition was established at the International Health Conference, New York, 1946; and entered into force on 7 April 1948. This definition has not truly been modified since 1948. Only a handful of publications have focused specifically on the definition of health and its evolution in the first 6 decades. According to WHO, the main determinants of health include the social and economic environment, the physical environment and the person's individual characteristics and behaviours. The way in which an individual lives plays an important role on his / her life quality and health status. The social and economic environment is a key factor in determining the health status of individuals (WHO, 2010).
The role of the midwife according to O’Luanaigh et al (2005) in promoting better public health is an integral part of the midwives’ work. Midwives serve all communities and visit and deal with women from a variety of social backgrounds including those at the sharp end of social inequalities, thus increasing the already justified concerns about the ever increasing inequalities in health and the impact it has on communities and individuals. There is, however, considerable scope for developing the midwifery contribution to public health. This could be achieved by enhancing the extent of midwives’ involvement in assessing the health needs of local populations through needs assessment and community profiling. Likewise by Identifying groups that have particular needs, or are missing out on maternity care – such as women who are refugees, or homeless, or misusing drugs, or from minority ethnic communities or vulnerable teenagers who find themselves pregnant – and developing services that are appropriate, acceptable and accessible to them. Furthermore by designing, managing and evaluating maternity services with the clear aim of improving health outcomes and reducing health inequalities. The Acheson Report (1998) found that inequalities in health range across geographical areas, social class, gender and ethnicity. The report recommended that the needs of pregnant women, young families and infants should be high priority for efforts to reduce inequalities and develop a healthier nation. The report did have limitations, in that there were no specifics and therefore made implementation difficult. Despite this the Acheson Report has been fundamental in developing widespread recognition of health inequalities and the determinants of health and has been a stepping stone to prompt new policies. The government White Paper (1999) was an action plan to tackle the poor health and set out how the government planned to implement issues brought to light in the Acheson Report. It had two key aims: to increase the length of life free from illness and to increase the health of those living in poverty. The four main priority areas set out in this report do not look at maternity care, this is due to outcomes in pregnancy and childbirth being good and the mortality and morbidity rate being relatively low. Maternity services were recognised as having some importance in the public health role. Links were made to the importance of breastfeeding as a measure to decrease the risk of occurrence in later life of the two of the four main areas mentioned in the government’s strategy: Cancer and...
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