Table of Contents
The public health issue that has been identified in this paper relates to reproductive and sexual health. Providing access to the full range of reproductive health services is paramount to the overall well-being of the community, particularly for young adults and women. According to Healthy People 2020, reproductive and sexual health has been recognized as a key public health issue for improving the wellbeing of American citizens (Department of Health and Human Services, 2017).
Reproductive and sexual health encompasses a multitude of factors that impact on the emotional, mental and physical well-being related to sexuality and reproduction across the lifespan of an individual. Historically, the United States has considered reproductive health as a public health priority and thus provided vital opportunities for health-care professionals to refocus their efforts (CDC, 2013). According to the Healthy People 2020 statistics, more than 19 million new cases of Sexually Transmitted Diseases are diagnosed annually in America, with the majority being young people between ages 15-24. Additionally, of the 1.1 million American citizens living with Human Immunodeficiency Virus (HIV), 1 in every 5 living with the virus are unaware (Department of Health and Human Services, 2017). Therefore, high incidences and prevalence of reproductive and sexual health conditions underpins the urgency of developing community based prevention strategies.
Threat of Reproductive and Sexual Health in a Community
Among the threats that may arise from reproductive and sexual health as a public health issue include unplanned pregnancy and prevalence of HIV/AIDS infections. Particularly for young women and adolescent girls, untreated, STDs can lead to serious long-term health ramifications that include infertility, perinatal health challenges, transmission of HIV and cancer.
Unintended pregnancies, also, have serious consequences through imposing burdens on women, children and the society at large. Young women with unplanned pregnancies are at a higher risk of exposing the foetus to harmful substances like tobacco and alcohol, and are also less likely to seek timely prenatal care. Further, children born after an unplanned conception have been evidenced to be at a higher risk of dying during the early months and born at low birth weight (Ivankovich, Fenton & Douglas, 2013).
Another threat that may arise from issues related to reproductive and sexual health is on Sexually Transmitted Diseases (STDs). Undetected STDs may lead to life-threatening complications in a person that include infertility, cancer, stillbirth and even death. Unplanned pregnancies and sexually transmitted diseases like HIV infections may lead to adverse health and economic consequences for an individual, family and the community at large. As reported by the Centres for Disease Control and Prevention (CDC), STDs lead to severe human and economic burdens, where the US government approximately $16 billion every year on direct medical costs (CDC, 2013).
Current Interventions to address Reproductive and Sexual Health
Among the most pervasive interventions that has been undertaken by the government and other healthcare agencies has been to provide community based education and training to the general population. Such educational programs are essential in promoting abstinence in children, advocating the use of contraceptives, encouraging HIV/STI screening and promoting healthy relationships among adolescents. According to Tunnicliff et al. (2013), sexual health education, however, remains a controversial and sensitive topic despite its overall influence on physical and mental well-being of an individual.
The United States has also spearheaded the development of an evidence-based public health approach that promotes sexual health and enhances community health. This was particularly emphasized in the 2011 National Prevention Strategy that encourages health care professionals to collaborate in order to improve the quality of life of communities through focusing on prevention of sexual health (Department of Health and Human Services, 2012). This ensures that effective programs are implemented through using principles of scientific reasoning and the systematic use of data for effective service delivery.
Most government institutions have also initiated numerous sexual and reproductive public policy programs that target low-income and minority groups in order to reduce health inequalities (Yuen, 2013). One of the key policies that the government has established is the family planning program that is funded by the federal government. The program ensures that all women have access to contraceptive services regardless of her health insurance status or income. Furthermore, the government has also developed the Medicaid program which has increased the enrolment of pregnant women and improved prenatal care among poor families.
Potential interventions that could be implemented
A community-based intervention that health care professional can adopt is promoting awareness through increasing training and education. This is consistent with the epidemiology health nursing concept, which is the study of the distribution of health and diseases among populations (Tunnicliff et al., 2013). Therefore, integrating such concepts in community based health program research can be essential in equipping health professionals with critical knowledge to study and evaluate existing challenges for maximized nursing care delivery.
Further, healthcare delivery agencies can develop a community-wide integrated framework to promote reproductive and sexual health. Based on the significant impact and costs associated with reproductive and sexual health interventions, public health agencies can develop an integrated public health approach to advance sexual health. According to Ivankovich, Fenton and Douglas (2013), such an approach has the ability to develop a more unified health framework that focuses on the importance of health promotion and enhances existing efforts. The integrated framework has the ability to engage new and diverse partners that have common goals and the desire to address common determinants. Further, based on the stigma surrounding STIs, the authors recommend that such an integrated system has the ability to reduce discrimination and fear surrounding such conditions.
Additionally, at an individual level, community based health care nurses can also adopt information management systems or E-sexual health systems to improve access to sexual health services. By using internet-based health care delivery systems, community nurses can be effective in enhancing their patient’s sexual health since such systems facilitate confidentiality in communication (Minichiello et al., 2013). Since online based sexual health services can be offered anonymously and interactively, patients can be empowered to engage with various information systems and enhance relationships with various health care professionals. This is also vital in reducing costs associated with health-care provision, especially where majority of countries are facing the growing challenges of reducing costs related to healthcare.
Another individual-level intervention that has been identified as critical in advancing sexual health strategies is on men’s involvement in reproductive and sexual health. Ivankovich, Fenton and Douglas (2013) highlight that though majority of community based public health interventions are targeted at women and children, involving men in such interventions may encourage increased uptake of contraceptives and resist prevailing social norms.
Role of different disciplines in addressing the public health issue
In addition to the key roles that nurses play in promoting community based reproductive and sexual health, other professional disciplines that include physicians, pharmacists and researchers could also aid in promoting population health. Such public health professional could work together with multi-sectorial partners at local and national levels to implement a common reproductive and sexual health public health agenda.
Unlike other health professionals, pharmacists have an advantage based on their easier access to the public (Yuen, 2013). In the provision of pharmaceutical care, reproductive and sexual health care constitutes a large portion of their daily practice. Therefore, they also possess the social and professional responsibility to contribute to the treatment of STIs, unplanned pregnancies and abortions.
Additionally, clinicians can also play a critical role in promoting community based reproductive and sexual health through counselling and education, STI screening and the distribution of condoms. Counselling programs that are undertaken in clinics have been evidenced to have a clear scientific basis and effectively tailored to the patient. This is consistent with Ivankovich, Fenton and Douglas (2013) research which highlighted that extensive counselling from clinicians led to consistency in the use of condoms.
Researchers can also play a critical part in improving reproductive and sexual health. A well-functioning healthcare system requires the input of researchers to generate and analyse local data. Such researches provide fundamental, sustainable and cost-effective measure to advance health care delivery (Tunnicliff et al., 2013). Strengthening institutional and individual research capacities in reproductive health can lead to the development of sustainable research institutions. These huge research institutions are able to participate in international health research, and thus influencing the development of evidence-based polices that positively influence health outcomes.
Role of community, state and federal resources
For a successful implementation of reproductive and sexual health care delivery programs, numerous resources from the federal government can be essential in promoting population health. Among these resources include funding for sexual health programs and campaigns in order to increase awareness and access to reduce behavioural risks (Department of Health and Human Services, 2017). Additionally, the federal government can also undertake research and disseminate best practices to reduce risks of contracting STIs.
At a community level, the resources that can be utilized to advance reproductive and sexual health include using community elders, teachers and religious leaders to spearhead such programs. As highlighted by Yuen (2013), during the delivery of community-based programs, cultural considerations become critical in the successful execution of such programs. Therefore, engaging such groups ensures that cultural differences between the healthcare providers and the community are resolved for the successful implementation of advance reproductive and sexual health programs.
At a local level, state governments can also utilize social marketing tools and policies to offer counselling and other services to community members (Ivankovich, Fenton & Douglas, 2013). Furthermore, these governments can also utilize regional resources to implement mentoring services, especially among the youth in order to promote healthy lifestyles and ensure healthy populations.
- Centers for Disease Control and Prevention, CDC (2013). Incidence, Prevalence, and Cost of Sexually Transmitted Infections in the United States, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.
- Department of Health and Human Services (2012). Healthy people 2020: leading health indicators. [cited 2017 Jan 26]. Available from: URL: http://www.healthypeople.gov/2020/LHI/default.aspx.
- Ivankovich, M. B., Fenton, K. A., & Douglas Jr, J. M. (2013). Considerations for national public health leadership in advancing sexual health. Public Health Reports, 128(2l1), 102-110.
- Minichiello, V., Rahman, S., Dune, T., Scott, J., & Dowsett, G. (2013). E-health: potential benefits and challenges in providing and accessing sexual health services. BMC Public Health, 13(1), 790.
- Tunnicliff, S. A., Piercy, H., Bowman, C. A., Hughes, C., & Goyder, E. C. (2013). The contribution of the HIV specialist nurse to HIV care: a scoping review. Journal of clinical nursing, 22(23-24), 3349-3360.
- Yuen Loke, A. J. (2013). Editorial: Sexual health: an integral part of our health and quality of life. Journal of clinical nursing, 22(23-24), 3239-3239.