A Health Needs Assessment in Southwark
Introduction
Health Needs Assessment (HNA) is defined as the technique of ascertaining the health inequalities and needs being faced by particular population groups and pinpointing their urgencies for service and professional development. The assessment aims at refining the health of the targeted individuals or population to minimize health disparities. The HNA helps identify the broader determinants of the target population health and appropriate interventions secured to meet the identified needs. The people to benefit from the planned interventions should be identified, and it should be cost-effective. Shah (2018) identified three conditions that are named the taxonomy needs (p2). Taxonomy needs include felt needs (what the people want), expressed needs (what individuals demanded), and normative needs, which entails both the unmet and met needs. In this assessment, the normative needs underpin the HNA for identifying both the unmet and met needs.
Swystun and Davey (2019) propose it is always essential for individuals to exercise autonomy and control their lives instead of being articulated what they should do (p6095). This self-control is an approach to handling health inequalities (Khan et al., 2019 p5). It is the priority of the national government that has enough resources allocated. Health Visitors (HV) should not rush when finding their preferences and priorities while working with the community to accomplish their objectives. This is one way of attaining health equality and building social capital. The social capital approach involves the system that HV work with fathers and mothers in improving community trust and relationships. This improvement has a positive and direct effect on enhancing breastfeeding extension until six months.
Research shows that peer training through laypersons is occasionally more significant than receiving information from professionals in power (Cramer et al., 2017 p258). Pennel et al (2016) provide a structure of tackling the broader social factor of health inequalities and health. The framework proposes to build persons’ confidence, resilience right, and self-esteem from the start and to old age with solid reliability for initial years. It is reinforced by the White Paper Liberation, providing the outline in ordering services that can impact the needy’s health, thereby assisting in minimizing health inequalities (Hall et al., 2016). All public members’ expectations have contributed to greater anxieties concerning the value of the services received from equity and access to effectiveness and appropriateness. These aspects have initiated health services reforms in both developing and developed countries.
Health Need Assessment has several benefits to both the community and government. According to the current research, there is an increase in the cost of health care. Over the last 25 years, spending on health care management has increased faster than the cost stated in other economic sectors. Health care is currently among the largest economic sectors in highly developed nations (Cramer et al., 2017). Medical, demographic changes, and advances continue increasing the pressure on costs (Jumbe et al., 2020 p6). Simultaneously the resources accessible for health management are limited. Numerous people have unfair access to sufficient health attention, and several governments are powerless to universally deliver such health care.
Furthermore, there is a significant variation in the use and availability of health care through the geographical range and provision point (Hagon, Dumont, and Junod, 2020 p24). Accessibility tries to be inversely correlated with the needs of the people served. An additional force for transformation is consumerism. Health authorities have greater chances to tailor domestic services to their people. The labor government commits itself to ensure there is enough treatment rendering to needs. The fundamental purposes of major care groups will be to monitor, plan, and commission native health services to achieve identified needs.
Discussion
Health inequality can be defined as providing the same health across diverse boundaries (Shin et al., 2019). According to Hall et al (2016) Southwark in the central London region is ranked 13th among the most disadvantaged London region and 42st most disadvantaged in England (p274). The pocket of dangerous deprivation is focused in the center of the area. Data from Phillips and Boyd (2016) reveal that Southwark people are amongst the most susceptible London areas, with 2 in 48 houses are in danger of being their homeless (p410). As stated in the 2010 census report, Southwark possesses a diverse multi-ethnic, multicultural, and multilingual population, and 52% of the community comes from the Britain minority ethnic group.
In Southwark, 4.2% compared to 3.2% in London households are rendered homeless, and 1 in four households are congested living in overcapacity homes, putting extra stress and pressure on family relatives (Khan et al., 2019 p15). However, the alliance government has recognized the overload on the household stock, and it is in the course of financing new home buildings across England (Khan et al., 2019 p15). This cannot control the housing state in its short term. The percentage of children facing poverty is 51.6 (29.7% London and 21.9% England average)
According to the report, the first time participant in youth justice is 4.50% in London and 6.13% in England and Homelessness is 3.14% in London and2.03% in England.
Also, 4’136 babies prompted breastfeeding immediately after birth, with 87.06% from London and 74.08% from England. Children breastfeed up to six to eight months compare include London 67.32% and 47.02% in England. At the point of delivery, the smoking status stands at 202 in London, with 6.02% and England with 13.19%. Girls conceiving while under 18 years are 679, London 38.1%, and England 40.9%. The infant mortality rate is 79, with 4.6% from England and 4.5% from London. Compared to London, 49% of the residents are of white British (Hagon, Dumont, and Junod, 2020 p24). The main marginalized racial groups are the Black Caribbean and Black African. Southwark is categorized as a new population. Generally, the Southwark population health profile is considered below. Children facing poverty, deprivation, crime, and teenage pregnancy rates are more in England (Jumbe et al., 2020 p5).
The 2010 census report shows 5132 live births, which marked the highest London birth rates. Two hundred twenty-six of the live births were from mothers aged 18 years and below and linked with health inequalities and birth complication rates. The breastfeeding start rate was 74.0 percent in 2013, which is less than the percentage for 2012 (74.2 percent) and somewhat higher than in 2011 (73.5percent). The proportion of breastfeeding up to 6-8 weeks is 92% of young mothers in Southwark initiated by breastfeeding postnatal until 6 to 8 weeks (Jumbe et al., 2020 p10). A quarter of mothers breastfed children for six months. The other fraction, either relapse to exclusively formulae-feeding or mixed feeding, decrease by 65%.
Duration rates and initiation of some breastfeeding proportions are lowest in people from low socio-economic groups, increasing health disparities, and enduring the deprivation cycle’s execution. For some generations, birth fatality rates in the UK have been short and childbearing women, families, the public, and professionals have been open to the norm of formula feeding (Borba et al., 2016 p57). This norm explains why HVs and midwives should encourage mothers to continuously breastfeed their children for six months to about two years. Most mothers discontinue breastfeeding their babies after six to eight weeks reverting to formula feeding, classified as health inequalities. The fathers’ intervention is an essential motivator in assisting mothers in escalating breastfeeding rates until six months, thus preventing health inequalities.
The 2012 statistics in Southwark, England, and London on continuation and initiation of breastfeeding from three hours to eight for eight weeks postnatal identified a small improvement from 76% to 92% in 2013. After six weeks, the breastfeeding discontinuation is due to either mother feeling pain during breastfeeding, going back to work, or lacking family support. The involvement of fathers by health visitors and midwives from prenatal is a significant intervention to support partners in breastfeeding their babies up to six months postnatal (Khan et al., 2017 p12). The drive initiated on mothers by health visitors and midwives to continuously breastfeed is reinforced by local, International, and National policies.
The justification is to pinpoint fathers’ responsibility in promoting and motivating mothers to breastfeed infants as an initiative of public health, thereby minimizing health disparities for both infant and mother. Additionally, it will provide the health advantages of breastfeeding infants and mothers and babies’ health risks if high-class breastfeeding is stopped after 6 to 8 weeks postnatal. Evidence has revealed that breastfeeding infants up to six months dramatically reduces infancy obesity and avoid acquiring additional health complications as they grow up.
Increasing life expectancy, reducing smoking, and reducing childhood obesity is among the priorities of Southwark health (Nashilongo et al., 2017 p567). To reduce babyhood obesity, the study has revealed that mothers must be highly fortified to breastfeed their infants until six months fully. Fathers should bear the responsibility of encouraging mothers while breastfeeding (Phillips and Boyd, 2016 p418). Breastfeeding is considered among Southwark health priorities as it is an essential element in reducing child obesity. Increasing life expectancies and reducing smoking is mostly the way of reducing child obesity. Research has revealed that breastfeeding until six months are over is a significant intervention in reducing childhood obesity.
Implication
The determination that Health Visitors and Government placed on mothers to continuously and exclusively breastfeed their children up to six months postnatal is a useful and essential measure. This measure helps protect mothers and their infants’ health with specific motivations and contributions from infants’ biological fathers. Healthy Child Programmes (HCPs) proposes that fathers should be involved in encouraging breastfeeding mothers. However, the HCPs have contradictory evidence from the United Kingdom government, which openly recommends mixed feeding or formula can be started after 17 weeks. Nevertheless, mixed feeding and formula should be postponed up to six months (Cowley2020 p103). This situation gives contradictory information to the Health Visitors and mothers who follow the UNICEF UK guidelines.
Shah (2018) recommended that breastfeeding minimizes the danger of necrotizing enter colitis, diarrhea and chest infection, atopic asthma and dermatitis, obesity and diabetes I and II, childhood leukemia, and sudden infant deaths syndrome (p6). Also, breastfeeding confers advantages on mothers by regulating their fertility. Employment, income, and housing are primary factors of health inequalities and health. These determinants affect society, individuals, and families both indirectly or directly through broader economic and social factors such as child poverty, social isolation, and children’s educational achievement. London is debatably excessively affected by income, employment, and housing as factors of health because of the environment of its employment and housing markets.
Critical health care may reasonably meet the population needs as long as the conditions are well known. According to Berkley-Patton et al (2018) the WHO Europe regional office assembled a working team to inspect the impacts of the health needs assessment of the district population level for primary healthcare (p19). The team discussed useful models for civic-oriented primary care, which comprised the transfer of programs designed for community needs. The group measured health needs as the origin for distributing resources, selecting the community health needs programs, evaluating, and planning these programs. In the other area, the team emphasized developing additional models for the community-oriented evaluation and planning cycle (COPEC).
The health needs assessment results were used in Southwark, where the statistics were conducted from local health preparation officers. The needs assessments varied from the district to the nearby driven. Approaches guaranteed local participation, but the procedure was slow and more difficult for the planners. There was the usefulness of the needs assessment. However, these would not be comprehensive for the more significant effect but should focus on possible modifications that could be reinforced by the health services (Hagon et al., 2020 p24). Like marginal analysis, other priority-setting methods would be adopted to define where it can be applied in determining where optimum health benefits are possible.
Several researchers pressure the significance of collecting qualitative and quantitative data from several sources for ensuring the health needs are scrutinized from different perspectives. The recommended framework is built on signs of health needs for all the dimensions. Sociologists, doctors, economists, and philosophers all differ in opinions on what health needs are (Miller et al., 2017 p38). In appreciation of the shortage of resources accessible to meet the health needs, needs are distinguished as needs, supply, and demands. In health care, needs are commonly defined by the capability to benefit.
Proper identification of the health needs allows available effective intervention to meet the needs and recover health. There might be no advantage of government interventions that are not active or in limited resources. General health practitioners play an essential role as caretakers in monitoring the health demand, and the waiting list becomes a substitute marker that influences the demand. The need for services from patients depends on the persistent or media attention in that facility. The type of health needs depends on politicians’ primary concern, the specialists’ welfares, and the sum of cash available. The relationship between the health need and the service provided is an important reflection when evaluating health needs (Hall et al., 2016 p273). Public health assesses the population’s need, a district, or a population section such as women aged 18 and above.
Conclusion
In practice, although health needs assessment denotes a combination of values, epidemiology, and economics, it should put into an applied tool. Making health needs assessment concrete may have some unfortunate effects. The device can be unhelpful to understand the result of health needs assessment as a file, the termination of chains of defined, restricted steps. Reasonably, health needs assessment sometimes acts as a messy, iterative process that can serve several political purposes. The needs assessment helps develop consent among clinicians, planners, and managers about priorities for facility development. The needs assessment is easily accessible as specialists of public health reserve several arcane. The technical abilities applied can be overstated. Common sense and basic numeracy are essential requirements.
The current tactics to needs assessment can be restricted by context and time. Much health needs assessment movement was inspired by an internal market’s arrival and doubts concerning the suitability of care and cost-effectiveness. For the first time in their duty as procurers, general practitioners and health authorities require comprehensive service requirements. However, with growing proof of several healthcare interventions’ vague efficacy, hindered endorsement of helpful health care, mysterious geographical deviations, and increasing costs. The anxiety with the capability to benefit in limited resources is doubted to diminish. The rhetoric changes, but the call for increasingly sophisticated approaches to the health needs assessment drive intensity.
Bibliography
Berkley-Patton, J., Thompson, C.B., Bradley-Ewing, A., Marcie, B., Booker, A., Catley, D., Goggin, K., Williams, E., Wainright, C., Petty, T. and Aduloju-Ajijola, N., 2018. Identifying health conditions, priorities, and relevant multilevel health promotion intervention strategies in African American churches: A faith community health needs assessment. Evaluation and program planning, 67, p.19.
Borba, C.P., Ng, L.C., Stevenson, A., Vesga-Lopez, O., Harris, B.L., Parnarouskis, L., Gray, D.A., Carney, J.R., Domínguez, S., Wang, E.K. and Boxill, R., 2016. Mental health needs assessment of children and adolescents in post-conflict Liberia: results from a quantitative key-informant survey. International journal of culture and mental health, 9(1), pp.56-70.
Cowley, S., 2020. Health needs assessment. Community Public Health in Policy and Practice E-Book: A Sourcebook, p.103.
Cramer, G.R., Singh, S.R., Flaherty, S., and Young, G.J., 2017. The progress of US hospitals in addressing community health needs. American journal of public health, 107(2), pp.255-261.
Hagon, O., Dumont, L., and Junod, J.D., 2020. Needs assessment. Field Hospitals: A Comprehensive Guide to Preparation and Operation, p.24.
Hall, J., Battarbee, G., Rossouw, C., Hanley, E., Hopper, A., and Ingram, C., 2016. Creation of a population-based early intervention falls prevention service in two areas of south London, UK (Southwark and Lambeth). Physiotherapy, 102, pp.e273-e274.
Jumbe, S., Milner, A., Clinch, M., Kennedy, J., Pinder, R.J., Sharpe, C.A., and Fenton, K., 2020. A qualitative evaluation of Southwark Council’s public health approach for mitigating the mental health impact of the 2017 London Bridge and Borough Market terror attack.
Khan, Z., Koehne, S., Haine, P., and Dorney-Smith, S., 2019. Improving outcomes for homeless inpatients in mental health. Housing, Care, and Support.
Miller, K., Yost, B., Abbott, C., Thompson, S., Dlugi, E., Adams, Z., Schulman, M., and Strauss, N., 2017. Health needs assessment of Plain populations in Lancaster County, Pennsylvania. Journal of community health, 42(1), pp.35-42.
Nashilongo, M.M., Singu, B., Kalemeera, F., Mubita, M., Naikaku, E., Baker, A., Ferrario, A., Godman, B., Achieng, L. and Kibuule, D., 2017. Assessing adherence to antihypertensive therapy in primary health care in Namibia: findings and implications. Cardiovascular drugs and therapy, 31(5-6), pp.565-578.
Pennel, C.L., McLeroy, K.R., Burdine, J.N., Matarrita-Cascante, D., and Wang, J., 2016. Community health needs assessment: potential for population health improvement. Population Health Management, 19(3), pp.178-186.
Phillips, C., and Boyd, M., 2016. Assessment, management, and health implications of early-onset preeclampsia. Nursing for Women’s Health, 20(4), pp.400-414.
Shah, G.H., 2018. Local health departments’ role in nonprofit hospitals’ community health needs assessment.
Shin, H., Lee, S.J., Lee, Y.N., and Shon, S., 2019. Community health needs assessment for a child health promotion program in Kyrgyzstan. Evaluation and program planning, 74, pp.1-9.
Swystun, A.G., and Davey, C.J., 2019. A needs assessment for a minor eye condition service within Leeds, Bradford, and Airedale, UK. BMC Health Services Research, 19(1), p.609