Compare your analysis of the case to your peers’ viewpoints. In places where you disagree, offer a competing understanding of where the priorities lie. In areas where you agree, add add

Heather Discussion:

Hello everyone!

In this scenario, the major health challenge is malnutrition. With this health challenge, women and children have other factors that they face. Women, especially during the reproductive stage of life, need a well-balanced diet to promote a healthy pregnancy for herself and the baby. According to Fatima, Nosheen, Afzaal, Islam, Noreen, Imran, and Ali, “proper nutrition and healthy eating habits are essential for survival…and overall health, whereas household food insecurity leads to poor physical and mental health, frequent hospitalizations, and premature deaths of infants” (2023). For Abrisham and her family, leaving home and having no access to healthcare will negatively affect their health and can lead to malnutrition if conditions aren’t met to alleviate the issue. When it comes to factors on preventing early pregnancies and reducing poor reproductive outcomes, policies have been in development since the early 2000s. According to Kim, Mansoor, Paya, Ludin, Ahrar, Mashal, and Todd, “a systematic review of evidence-based nutrition programmes taken to scale found that the following components improve birth outcomes and overall household nutrition: micronutrient supplementation, food fortification and supplements, nutrition education and counselling, and conditional cash transfers” (2020). One specific program that helped with maternal nutrition was the 2003 National Reproductive Health Strategy. This program aimed to “improve reproductive health through the safe motherhood initiative, specifically during ANC, PNC, and family counseling [and] focus on micronutrient supplementation and nutrition education at community and facility levels” (Kim, et al., 2020).

For children in this case, malnutrition can affect them from the beginning of their life, if not properly given the nutrition to help with development and growth. For Abrisham’s two siblings, malnutrition can cause major problems for their growth and could cause other major health concerns. According to the World Food Programmes, “3.2 million children under the age of five expected to suffer from acute malnutrition [and] 1 million of these children are at risk of dying due to severe acute malnutrition without immediate treatment” (2021). There are strategies that can be taken to reduce the cause of deaths and illnesses in children. According to Rahmat, Rafi, Nadeem, Salman, Nawaz, and Essar, “the Afghan government introduced a series of nutritional programs and agendas that centered around reconstructing the healthcare system [and] creating strong nutritional policies and regulatory bodies” (2022). With these programs and strategies, children’s health and development improved. With the Scaling Up Movement, “the number of children receiving treatment for severe acute malnutrition significantly increased in 2018” (Rahmat, et al., 2022). 

For the older adults in this case, this health challenge can affect them, but not in the same ways as the women and children. Farida and Yasif both have health concerns, with Farida having depression and Yasif having vision problems and early-onset dementia. Malnutrition can also affect the mental health of a person and her worrying about her children and grandchild can make that even worse. She also had problems with her latest pregnancy and preterm loss. According to Kim, Masoor, Paya, Ludin, Ahrar, Mashal, and Todd, “women’s nutritional status before, during, and after pregnancy affects their own well-being and mortality risk and their child’s health outcome” (2020). Yasif’s vision problem and dementia is defined by his older age. With these problems, his concern of not being able to provide for his family can cause malnutrition to spread. From a survey by the World Food Programme, ”95 percent of households in Afghanistan are not consuming enough food, adults are eating less and skipping meals so their children can eat more” (2021). 

References

Fatima, M., Nosheen, F., Afzaal, M., Islam, F., Noreen, R., Imran, A., & Ali, Y. A. (2023).  Nutritional and health status of Afghan refugee women living in Punjab: A cross-sectional study. Wiley Online Library. https://onlinelibrary.wiley.com/doi/full/10.1002/fsn3.3267

Half of Afghanistan’s children under five expected to suffer from acute malnutrition as hunger takes root for millions: World Food Programme. UN World Food Programme. (2021). https://www.wfp.org/news/half-afghanistans-children-under-five-expected-suffer-acute-malnutrition-hunger-takes-root 

Kim, C., Mansoor, G. F., Paya, P. M., Ludin, M. H., Mashal, M. O., & Todd, C. S. (2020).  Review of policies, data, and interventions to improve maternal nutrition in Afghanistan. Maternal & child nutrition. https://pubmed.ncbi.nlm.nih.gov/32293806/ 

Rahmat, Z. S., Rafi, H. M., Nadeem, A., Salman, Y., Nawaz, F. A., & Essar, M. Y. (2022).  Child malnutrition in Afghanistan amid a deepening humanitarian crisis. Oxford Academic. https://academic.oup.com/inthealth/article/15/4/353/6692347 

Asa Discussion:

Hello all,

      Maternal nutrition is vital for the positive outcomes of both mother and child. Maternal nutrition includes all nutritional needs of the mother during adolescents ,presconception ,anternatal and postnatal periods (Kim et al., 2019). Maternal malnutrition has both a direct and indirect effect on maternal morbidity . According to Kim et al. (2019), anemia  and calcium deficiencies are the greatest micronutrient deficiencies. Anemia increases the risk effects of hemorrhage and impaired clotting ,and calcium deficiency increased the risk of eclampsia (KIm et al., 2019). Abrishiam ,at fourteen years old ,has not had the time to fully develop and acquire the valuable micronutrient during adolescents and preconception. In addition ,Abrisham has not had maternal care ,related to the fighting in the area and the pressure to relocate to a tent city without access to healthcare (SNHU,2022). The country of Afghanistan faced decades of struggle ,including a broken healthacare system and a lack of participation in education for women and girls  (Sharma et al., 2021). Access to healthcare and education are two factors that could lead to the prevention of early pregnancy and the reduction of poor reproductive outcomes .

     Abrisham and her family are facing many different challenges at this time .Being forced out of their home ,they are now living in a tent city ,without access to healthcare ,proper sanitation,and access to vital resources . Abrisham and her younger brothers now lack access to vital nutrient responsible for adequate developement .Living in a tent city also limits the availability of nutrition -sensitivity approaches like WASH. WASH addresses water ,sanitation,and hygiene ,which are all great health concerns in low -middle income countries  (Kim et al., 2019). In order to reduce the cause od death and illness form children of Afghanistan ,it is important to address the causes ,such as non-communicable diseases,poverty,population growth ,urbanization and changing dietary patterns .Keeping all these factors in mind ,nutrition  programs can focus on the nutritional health needs of the children  (Sharma et al., 2021) .

     Similarly , to pregnant women and children ,nutrition is still a concerns for older adults .In addition to nutrition deficits ,older adults are faced with the challenges of ages -related conditions .Farida suffers from severe depression ,while Yasif suffers from vision loss and early-onset dementia (SNHU,2022). Al-Hajj et al. (2022), noted the high level of fraility  and the prevalence of comobid non-communicable diseases,the older aging population has an increased risk of injury ,such as fractures and traumatic brain injuries as a result of fall. Many injuries that result from fall require hospitalization or some extent of medical treatment ;in the current living situation of Abrisham and her family ,her parents may not receive the medical treatment that they need and could result in mortality .In addition ,mental health is a large issue in countries that are constantly faced with struggle, violence ,and war.Research conducted in Afghanistan over 12-months period ,identified that approximately 5% of participants experienced suicidal thoughts (during the 12-months period) , approximately 8% of participants had suicidal attempts ,and approximately  15% of participants had suicidal thoughts during their lifetime (Kovess-Masfety et al., 2021). Addressing mental health conditions is important in the overall health and safety of older adults in Aghanistan ; early diagnosis and treatment is key 

Al-Hajj, S ., Farran , S ., Sibai, A. M. Hamadeh, R. R., Rahimi-Movaghar, V., Al-Raddadi, R. M., Sadeghian, F., Ghodsi, Z., Alhajyaseen , W., Rameileh, N. M.A., & Mokdad, A.H.(2022). Injury burden in individuals aged 50 years or older in the Eastern Mediterranean region, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019. The Lancet Healthy Longevity, 3(4),  e253-262.  https://doi-org.ezproxy.edu/10.1016/S2666-7568(22)00038-1

 Kim , C., Masfety , V., Keyes, K., Karam, E., Sabawoon, A., & Sarwari , B. A. (2021). A national survey on depression and anxiety  disorders in Afghanistan : A highly traumatized population . BMC Psychiatry , 21 (1) , 1-12.     https://doi-org.ezproxy.edu/10.1186/s12888-021-03273-4

Sharma , J., Ludin, H., Chauhan,M., & Zodpey , S. (2021). Public health nutrition in Afghanistan -policies, strategies and capacity -  building : current scenario and initiatives .Eastern Mediterranean Health Journal , 27 (7), 728-737.     htts://doi-org.ezproxy.snhu.edu/10.26719/emhj.21.043

Southern New Hampshire University. (2022). Group Discussion: Health challenges across the lifepan. 4-1 Group Discussion: Health  Challenges Across the Lifepan -IHP-501-Q5506 Global Health and Diversity 22TW5 (snhu.edu) 

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