Tag Archives: patient care

The Power and Shortcomings of Healthcare Interventions

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Posted by Katie Magoon

I was living in rural Kenya the first time I really began to think critically about the power and shortcomings of healthcare interventions.  I stumbled upon this totally accidentally as I was studying the economic empowerment of females in the “informal sector” of Kenya’s rural economy.   Specifically, I was exploring the ways in which women create and distribute their wealth, and the how these decisions impact the communities in which they live.  As I looked more intimately into the lives of these women, I realized that one could not truly understand the role of a female in an economy without understanding a variety of aspects related to her health.

In talking with many women, it became clear that some of their economic concerns were in large part related to the number of children their husbands/communities expected them to have.  Some women secretly obtained birth control in order to shelter their families from the economic hardships that they would face with having more and more children.  In some cases, their husbands would begin to suspect this and abuse them or use it as an excuse to have extra-marital affairs with other women (often bringing home sexually transmitted infections or HIV).  In many settings, women bear the brunt of raising families.  As a result their individual health is extraordinarily important to the health of an individual female’s family as well as community.  Issues such as lack of access to birth control, “back-alley” abortions, the dangers of childbirth, lack of empowerment for sexual decision-making and boundary setting, and even post partum depression can have a tremendous impact on the economic health of a community.  Such issues were so pervasive in the lives of the women with whom I spoke that it quickly became clear that these women could not achieve economic security without accessible and effective healthcare that is responsive to their specific needs.

Many believe that these are problems that do not apply to women in the United States.  I have found this belief to be grossly inaccurate.  In my work as a nurse practitioner, I encounter young women every single day who are forced to have sex, pressured to leave school and have children, and struggle with depression and other mental health problems that can make employment and/or caring for children very difficult.  Often these women put faith in their “boyfriend” who quickly moves on when their belly starts to grow or times get tough.  A young woman may be left to support a family with very limited resources.  Further, she has already stopped school to have and begin to raise the child, leaving her even more vulnerable to economic hardship.  This has obvious implications for her family and community.

Health interventions can address a small portion of this problem by offering family planning to women.  Women that do not want or are not ready to have more children can use birth control.  If need be, they can do this without the knowledge of their partner.  However, a woman is more likely to be successful with the use of her birth control if her partner is supportive.  In my mind, this simultaneously points to a success and shortcoming of the health system.  In this example, birth control is simply addressing a symptom of a larger problem in society—gender inequality.  Birth control could be considered a single disparity-decreasing intervention that can help women, and in turn their communities.  However, in a world that often does not value women as it values men, I cannot help but to ask: Is birth control enough?  Internationally and domestically, when will women finally be empowered to make their own decisions about what happens to their bodies, and offered support for those decisions?

Katie Magoon is a North Canton, Ohio native who currently works as a nurse practitioner at an adolescent community center in Manhattan.  She is an HPAM student, specializing in policy.

 


Who I Am and What I Hope to Achieve

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Posted by Jacob Victory

While inaugural game-day outings, presidential swear-ins, or grand openings of the local laundromat tend to have a lot of noise, glamour and “a 15 percent discount on your first five pounds of laundry,” my premier blog post comes with a large dose of humility, a little about who I am and what I hope to achieve with this blog.

 About Me: As a kid, I was the one who batted a home-run but couldn’t catch the ball (the mitt was too tight remains my excuse). As an artist, I paint my portraits to zoom-in on what I think is going on behind the mask of someone’s face. As a person, I believe in merit and in understanding that the ego doesn’t matter. As a professional, I seek to make an impact in serving those who are vulnerable—in other words, those who are rich, poor or like spicy foods, anyone who needs health care, healthy or otherwise, is always in a vulnerable spot. Why am I sharing my thoughts? Well, I want to give you my angle and I remember what is was like to be a student or what it was like early in my career and I’d like to share my thoughts because I’ve learned a thing or two from my experiences that others could benefit from. I also want to open up a discussion so we all can learn more, too.

My Blogging Roadmap: My blog will primarily focus on two areas. First, I write as an NYU-Wagner alum whose goal is to encourage current students and fellow alums to focus on what is relevant, what I consider smart things to do and not do, and how to work with others to chip away at making an impact. I’d like to address the need for mentorship, for reflection, and for relationship building. Also, I think students and alums always need strategies for job hunting or an understanding of how to network and find who may seem to be an elusive mentor.

Second, as a quiet observer of, but an active participant in, the theatrics of health care delivery, outcomes and, these days, reform, I wish to offer the practical viewpoint of what matters, what gets in the way, and what, in my self-exalted viewpoint, we should focus on. I’ll zero in on the need to maintain the viewpoint that “patient care is the only reason we are here” and what is needed to support this view; the need for collaboration between clinicians and “those business folks;” how performance improvement and succession planning must be priorities; as well as what I think the federal, state and local levels need to tackle in order to help health care organizations, clinicians, and administrators make this health care reform work..

Perhaps most importantly, I’m looking for a dialogue with you. If I can stretch your thinking (or make you chuckle), I’ll consider this blog successful. I’m flattered to write and excited to share.

Jacob Victory, an NYU-Wagner alum, is the Vice President of Performance Management Projects at the Visiting Nurse Service of New York. Jacob spends his days getting excited about initiatives that aim to reform and restructure health care.  He’s held strategic planning, clinical operations and performance improvement roles at academic medical centers, in home health care and at medical schools. Jacob also exercises the right side of his brain. Besides drawing flow charts and crunching numbers all day, he makes a mean pot of stew and does abstract paintings, often interpreting faces he finds intriguing.