NR 553 Week 5 Discussion, Cultural Norms and Healthcare Issues

Cultural Norms and Healthcare Issues NAME Chamberlain College of Nursing NR553: Global Health Policy DATE Search the World Health Organization website or Chamberlain online library for a social or cultural norm associated with behaviors leading to healthcare issues. Discuss the global healthcare issue and explain how cultural or social norms or practices play a role in perpetuating the behavior. Week 5: Cultural Norms and Healthcare Issues According to the World Health Organization (2018), Female genital mutilation (FGM) is one of the social-cultural norms which poses a considerable health risk to the affected. FGM refers to any intentional practice that involves the partial or total altering of the external female genitalia or other female genital parts for non-medical reasons. The practice is prevalent in about 30 countries in Africa, the Middle East as well as Asia and is carried out mainly to girls below the age of 15 years. Thus, over 200 million females alive today have undergone FGM. In barely all of the societies, it is practiced it is viewed as a cultural tradition. According to Cetorelli, Wilson, Batyra, and Coast (2016) many individuals and institutions consider it a significant public health as well as human rights issue. According to Powell and Mwangi-Powell (2014), FGM is a deeply rooted and ancient custom, and the factors that precipitate its continuation are many and diverse. Some of the primary reasons it is practiced include as a rite of passage and cultural obligation, limiting sexual desire and increasing chastity as well as to augment female marriageability prospects. The FGM problem is escalated by structural issues which have institutionalized the practice, and thus there is social pressure to conform to practice to be socially accepted. Local structures of power and authority including religious leaders, circumcisers, community leaders, as well as some medical professionals who uphold the practice also highly compound the situation (WHO, 2018). Some of the immediate health concerns it raises include severe bleeding, problems urinating, severe pain, genital swelling, fever, infections such as tetanus, shock, and wound healing problems. The long-term consequences include urinary issues, vagina problems, menstrual problems, sexual problems, increases the risk of childbirth complications and psychological issues among other major health concerns (WHO, 2018). References World Health Organization (WHO). (2018). Female genital mutilation. Retrieved from, Cetorelli, V., Wilson, B., Batyra, E., & Coast, E. (2016). Female genital mutilation/cutting in Mali and Mauritania. Retrieved from Powell, R. A., & Mwangi-Powell, F. N. (2017). Female genital mutilation and the Sustainable Development Goals: The importance of research. Health care for women international, 38(6), 521-526. PROFESSOR RESPONSE TO POST: Carole, Thanks for adding to the FGM discussion. Are there any nations, organizations, individuals who are making significant success in reducing this practice? We want to learn from them. RESPONSE TO PROFESSOR: Dr. Fildes, After doing my original research about FGM, I started to feel like there was no progress being made in eliminating this practice. However, after further research, I learned in Egypt a strategic plan was implemented to reduce FGM rate from 60 to 15 percent over 5 years. In Egypt, the United Nations Population Fund (UNFPA), in collaboration with the National Population Council and the Egyptian government played a crucial role in the work leading towards the 2016 amendment of the law prohibiting Female Genital Mutilation. The new amendment makes the practice of FGM a felony rather than a misdemeanor, increasing the penalty to range from 5-7 years, with a maximum sentence of up to 15 years, if the practice leads to death or permanent disability (UNFPA, 2018). Legal measures are important to make explicit the government’s disapproval of female genital mutilation, to support those who have abandoned the practice, and to act as a deterrent. Anti-FGM advertisements are aired on local TV stations in Egypt warning against the physical and psychological harm resulting from the practice, thus sparking a national debate on the issue. The “Enough FGM” media awareness campaign was launched in 2015 on all satellite Egyptian TV channels featuring testimonials from individuals and families abandoning the practice (UNDP/Egypt, n.d.). Media exposure can play a crucial role in disseminating correct information to households, informing people about positive social change that may be taking place in their community, and urging community leaders to denounce the practice. Since the ongoing efforts of the Egyptian Government in coordination with cooperation with Muslim and Christian clergymen, there has been a reduction of FGM in the girls’ age group of 15-17 years by more than 13 percent since 2008. Around 61 percent of the girls between ages 15 to 17 underwent FGM in 2014 compared to 74 percent in 2008 (UNDP/Egypt, n.d.). Reference United Nations Development Programme/Egypt. (n.d.). Abandonment of female genital mutilation and empowerment of families. Retrieved from United Nations Population Fund. (2018, February 7). FGM performed in clinics can make it dangerously attractive. Retrieved from PROFESSOR RESPONSE TO PEER POST: (Bullying) Diane, Thank you for identifying this very sad issue. I believe health policy nurses can make an impact on this issue. Any best practices that have produced good outcomes? RESPONSE TO PROFESSOR: Dr. Fildes and Diane, Although researchers have documented the success of some comprehensive programs in reducing bullying, we still have much to learn about which aspects of these programs are most important. In the Chamberlain library, I came across an article by Whitted & Dupper that discusses best practices for reducing bullying in schools. Whitted & Dupper acknowledge that recent studies have shown any “previous efforts of conflict resolution, peer mediation strategies, and group therapy to increase self-esteem are proven to be ineffective with bullies because bullying behavior results from a power imbalance rather than deficits in social skills” (2005). Power imbalances can be characterized by physical differences between children, such as age, size, and strength. According to Whitted & Dupper, “effective strategies to prevent or minimize bullying in schools must include school-level interventions designed to change the overall culture and climate of the school; classroom-level interventions targeting teachers and other adults in the school; and student-level interventions that target individual or small groups of victims and bullies” (2005). In order for specific bullying prevention or intervention practices, strategies, or programs to work efficiently and effectively schools must start with a school climate that is safe, equitable, and positive for staff and students alike. State and local lawmakers have taken action to prevent bullying and protect children. Through laws and model policies, each state addresses bullying differently. The United States federal government has put forth recommendations for best practices in bullying prevention and intervention (U.S. Department of Health and Human Services, 2017): 1. Commit to creating and sustaining a positive school environment in your school 2. Form or identify existing team to coordinate bullying prevention efforts 3. Regularly assess and monitor prevention efforts (e.g. climate survey and behavioral incident data) 4. Garner student, staff, parent, and community support and build partnerships 5. Establish or revise and enforce school policies and procedures related to best practices in bullying prevention and intervention 6. Increase active adult supervision in “hot spots” where bullying occurs 7. Intervene immediately, consistently, equitably, and appropriately when bullying behavior occurs 8. Dedicate class time to teaching and empowering students in bullying awareness and skills in prevention, appropriate intervention, and reporting 9. Utilize culturally responsive strategies, and skills that are inclusive and enhance communication and relationship building 10. Continue to implement, update, and monitor these efforts over time You can visit www.StopB for additional resources. References U.S. Department of Health and Human Services. (2017). Bullying Prevention and Response Training and Continuing Education Online Program. Retrieved from Whitted, K., & Dupper, D. (2005). Best practices for preventing or reducing bullying in schools. Children & Schools, 27(3), 167-175.