In response to two peers, address the following: Compare your analysis of the case to your peers’ viewpoints. In places where you disagree, offer a competing understandi

Rhoshae Discussion:

The major health challenges within this case related to reproduction and infants are low birth weight, premature birth/labor, and adequate sanitation, and nutrition. Low birth weight and premature birth are major health challenges related to infants. Premature birth is a cause for low birth rates; a low birth rates can cause a baby to have trouble eating, gaining weight, and may also cause them to have complications fighting off infections ( Low Birthweight, 2021). The current living conditions of Abrisham and her family can be very stressful since they are living in a tent city with no access to healthcare; the stressfulness of this situation could cause Abrisham to have a premature birth. Early pregnancies can be prevented by teenage and young adults receiving proper sexual education as well as learning about the important of abstinence. It is stated that sex education has led to a reduction in teen birth rates by over 3%. There are two types of sexual education; abstinence-only which is promoting only martial sex and comprehensive which is receiving scientific and medical information about reproductive health and safety (Mark & Wu, 2022).

The major health challenges that are faced by the children in this case are lack of proper healthcare, immunization challenges, and malnutrition. A strategy that can be taken to reduce the cause of death or illness would be micronutrient supplementation and food fortification. It is stated that food fortification can be a crucial part in decreasing the risk of malnutrition (Olson et al., 2021). Another strategy that can be taken by the family would be to travel outside of the tent city to seek care when needed and to receive proper care to live a healthy life. Although supplementation is a brief solution it is used to prevent micronutrient deficiencies which can lead to many other health conditions (Tam et al., 2020).

Farida and Yasif are the older adults in this case. The health concerns Yasif faces are worsening vision loss and early-onset dementia. Farida is suffering from severe depression from her recent pregnancy and loss as well the worry she has for her children and unborn grandchild. Strategies that can be taken to reduce these health concerns would be adequate rest and ensuring the family is receiving the proper amount of nutrients. The family may also have to travel further to obtain proper medical care. 

References:

Low birthweight. (2021). www.marchofdimes.org.  https://www.marchofdimes.org/find-support/topics/birth/low-birthweight

Mark, N. D. E., & Wu, L. L. (2022). More comprehensive sex education reduced teen births: Quasi-experimental evidence.  Proceedings of the National Academy of Sciences,  119(8).  https://doi.org/10.1073/pnas.2113144119

Olson, R., Gavin-Smith, B., Ferraboschi, C., & Kraemer, K. (2021). Food Fortification: The Advantages, Disadvantages and Lessons from Sight and Life Programs.  Nutrients,  13(4), 1118.  https://doi.org/10.3390/nu13041118

Tam, Keats, Rind, Das, & Bhutta. (2020). Micronutrient Supplementation and Fortification Interventions on Health and Development Outcomes among Children Under-Five in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis.  Nutrients,  12(2), 289.  https://doi.org/10.3390/nu12020289

Jaime Discussion:

There are several challenges related to reproduction and infants, I believe the most pressing and far reaching of these is malnutrition and micronutrient deficiencies. Looking specifically at Abrisham, micronutrient deficiencies such as iron and calcium can result in pregnancy and delivery related complications. A deficiency of calcium can result in complications like increased blood pressure, hypertension, known as preeclampsia which can ultimately result in eclampsia (Kim, et al., 2020). Eclampsia is marked by seizures that occur in pregnancy, precursors to the actual seizures include high blood pressure, blurred vision, and headaches (The Cleveland Clinic, 2023). The deficiency of iron, anemia, creates issues in delivery specifically related to hemorrhage (Kim, et al., 2020). As Abrisham is 400 km from medical care (300km to her hometown + 100km to her medical care) she is not receiving any pregnancy related care to supplement either micronutrient nor is she being watched for the increases in blood pressure that would mark preeclampsia and potential eclampsia. These nutrient deficiencies as well as the lack of healthcare are also harmful for the baby as children born to mothers suffering from malnutrition have an increased likelihood of being born at a low birth weight as to babies born to mothers with preeclampsia/ eclampsia (Kim, et al., 2020; The Cleveland Clinic, 2023)A method that could be employed to prevent early pregnancy would be to enact policies that keep adolescent girls in school longer – through late primary school and even secondary school, this should not just decrease early pregnancies but also decrease early marriages (Kim, et al., 2020).

               For the children in this case the major health challenges are around malnutrition, recovery from that malnutrition and the lasting effects. The immediate concerns surround development and capacity to learn as well as an increased chance of the children becoming ill (Soliman, et al., 2021). Soliman et al (2021) continue to outline progressive health issues including low energy, insulin resistance, and hypertension the chances of developing all of these increase the longer malnutrition persists. There are also health concerns as recovery from malnutrition is occurring as there is an increased risk of becoming obese if there is rapid weight gain after 2 years of malnutrition (Soliman, et al., 2021). As this family is currently living in a tent city, chances are most of their food is being provided through aid and relief donation therefore, one option for supplementing nutrients would be through fortified salt, flour, and oils (Kim, et al., 2020).

               The major concerns facing the older adults are the vision issues being experienced by the father, Yasif, as well as the depression being suffered by the mother, Farida. For Yasif, it is mentioned he has “worsening vision”, while it is not specifically mentioned if this is night vision or not, Kim et al (2020) indicate night blindness is a symptom of vitamin A deficiency. While it is not specified if the worsening vision is only at night, according to the World Health Organization (WHO, 2023) severe vitamin A deficiency can lead to blindness, not just night blindness, therefore I would suspect vitamin A deficiency in Yasif. As it relates to Farida, miscarriage has been associated with a higher rate of depression (Azad, et al., 2019). For the older adults fortified food products would be a good short-term solution (Kim, et al., 2020). Another option Kim et al offered was the use of greenhouses, as the family is staying a tent city, incorporating for all residents, nutrition education and growing food in a greenhouse would offer the most long-term solutions they can take with them when they are able to return home.

References

Azad, R., Fahmi, R., Shrestha, S., Joshi, H., Hasan, M., Khan, A. N., . . . Billah, S. M. (2019). Prevalence and risk factors of postpartum depression within one year after birth in urban slums of Dhaka, Bangladesh.  PLOS One.

Kim, C. M., Paya, P. M., Ludin, M. H., Ahrar, M. J., Mashal, M. O., & Todd, C. S. (2020). Review of Policies, Data, and Interventions to Improve Maternal Nutrition in Afghanistan.  Maternal & Child Nutrition.

Soliman, A., De Sanctis, V., Alaaraj, N., Ahmed, S., Alyafei, F., Hamed, N., & Soliman, N. (2021). Early And Long-Term Consequences Of Nutritional Stunting: From Childhood To Adulthood.  Acta Biomed, 92(1). doi:10.23750/abmv92i1.11346

The Cleveland Clinic. (2023).  Eclampsia. Retrieved from The Cleveland Clinic: https://my.clevelandclinic.org/health/diseases/24333-eclampsia#:~:text=Eclampsia%20is%20seizures%20that%20occur,the%20second%20half%20of%20pregnancy.

World Health Organization. (2023).  Nutrition Landscape Information System (NLiS). Retrieved from World Health Organization: https://www.who.int/data/nutrition/nlis/info/vitamin-a-deficiency#:~:text=What%20are%20the%20consequences%20and,damaging%20the%20retina%20and%20cornea.

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