Health Promotion Implementing Hypertension Treatment Programs for Pregnant Women in Iraq

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HealthPromotion: Implementing Hypertension Treatment Programs for PregnantWomen in Iraq

TableOf Contents

Coverpage ……………………………………………………………………………………..1

Tableof contents ……………………………………………………………………………….2

Executivesummary …………………………………………………………………………….3

Introduction………………………………………………………………………….…………4

Leadershipstructure …………………………………………………………………………….5

Staffrecruitment process ………………………………………………………………………..6

Mission………………………………………………………………………………………….7

Promotingthe outreach program ………………………………………………………………….7

ChallengesFacing Implementation of the Outreach Health Program…………………………….7

  1. Poorly Organized Health Care Delivery Plan……………………….……………..…….8

  2. Challenges with the Labor Force………………………………………………..………..9

  3. Shortage of Resources…………………………………………………………..………..9

StaffingRequirements………………………………………………………….……………….10

OutreachService Compliance………………………………………………………………..…10

Registrationof the Program………………………………………………………………….…..11

TheNature of Treatment Offered to Patients…………………………………………………….11

OperationTime Frame…………………………………………………………………….…….12

Enhancingthe Morale of the Staff………………………………………………….…………….13

Summary…………………………………………………………………………………….…..14

References…………………………………………………………………………………..……16

ExecutiveSummary

Expectantwomen need dependable health care to ensure vigorous development ofthe fetus. One of the requirements involves attending maternalclinics on monthly basis to monitor their wellbeing progress.Hypertension is one of the major conditions that are monitored eachtime a woman visits a treatment center for pregnancy evaluation. Itis noteworthy that even healthy mothers who have never suffered fromhigh blood pressure are susceptible to the illness due to thepregnancy. While it can be controlled when a patient can get propermedical attention on time, women living in combat zones, such asIraq, can hardly access the necessary medical care. Sohn (2016)asserts that the majority of therapists often flee the fightingprecincts. Moreover, the few who remain cannot provide efficientservices because the clinics are often destroyed and essentialresources such as clean water as well as electricity are rarelyavailable. In that case, Sohn describes expectant women in theconflict regions as ‘forgotten victims’. The objective of thisessay is to develop a plan for implementing a hypertension treatmentprogram for pregnant women in Iraq.

HealthPromotion: Implementing Hypertension Treatment Program for PregnantWomen in Iraq

Accordingto the International Society of Hypertension (2014), high bloodpressure is the most common cause of both disability and deathsworldwide. The study also provides that at least 9.4 million peopledied in 2010 alone. Half of the patients who succumbed to thecondition suffered from heart illness that resulted in either heartfailure or stroke. Furthermore, 13% of the patients succumbed todiabetes that was escalated by high blood pressure. Finally, theresearch states that high blood pressure is the most common causematernal deaths and infant mortality during human gestation period(International Society of Hypertension, 2014). Many countries areyet to establish policies that would, in turn, enhance bothprevention and control of the hypertension condition. It isnoteworthy that even healthy women can develop preeclampsia afterconception. Similarly, expectant women whose blood pressure was undercontrol before they conceived may suffer from the condition too. Inmany cases, gestational hypertension occurs from the twentieth week.For most women living in regions where quality medical care isreadily accessible, the condition can be controlled efficiently usingvarious medications. Nevertheless, women living in war zones canhardly reach the needed healthcare. This essay explores the bestleadership approach to take while implementing a hypertensiontreatment program in Iraq’s combat zones for the expectant women.The World Health Organization and some private foundations havecollaborated to finance the program. The war zone used in this caseis Iraq.

Accordingto Sohn (2016), pregnant women in combat areas are vulnerable tosuccumbing from hypertension because there are hardly any health carefacilities offering treatment for the condition. The author cites aneditorial compiled by Andrew Weeks, a maternal obstetrician andprofessor, regarding the effects of warfare on pregnant women. Thedoctor notes that the majority of the clinics are often destroyedduring the conflict, and it is hard to find doctors attending topatients. Furthermore, Weeks described scary events where a snipershot a woman in labor on the belly. He also adds that similarattacks, of mothers in the labor room, also happened in Nigeria.Given that the majority of midwives and doctors often flee from thewar zones, finding the staff needed to establish a hypertensiontreatment program for aiding women in the region could be a bigchallenge. There are many difficulties since anarchy makes it hard tofind basic needs such as clean and running water required for optimumoperation of the treatment centers. Moreover, the staff issusceptible to sexual violence and brutal attacks from the combatantunits (Sohn, 2016).

LeadershipStructure

Giventhat few people are willing to work in war zones, the management ofthe hypertension treatment program may need to adopt anadministration structure that would attract skilled workers. Transformational leadership offers the best management approach forkick starting the healthcare program as it focuses on encouragingpeople to adopt changes. According to Smith (2011), transformationalmanagers identify sectors that require change, and then foster itthrough motivation of workers. They give employees duties that keepthem motivated as they allow everyone to own up to the programaccomplishment. Subsequently, every worker feels the obligation togive only the best service.

McCleskey(2014) notes that transformational leaders (TL) motivate the staff topractice creativity. Furthermore, the workers are given newopportunities to learn fresh skills that could aid in solving theproblem of sick women in the war zone. Smith (2011) adds that TLsovercome challenges through identification of the sectors thatrequire being changed, and then inspiring followers to accomplish thedesired outcome. In this case, the leaders need individuals who canvolunteer to work in the hostile environment. The ambition can beachieved through the recruitment of the locals.

StaffRecruitment Process

Theprogram intends to enlist local Iraqis in the villages they areintending to serve. Although the majority of the natives areuneducated, the organization intends to provide training tovolunteers. Nevertheless, the World Health Organization backs theprogram, so the people who will successfully complete the two-monthtraining will receive a certificate. The document is essential as itproves that they have the desired experience to serve the citizens,which also enhances their job opportunities. Any other firm operatingin the region recognizes the certificate issued to candidates whohave successfully completed the exercise.

Themanagement realizes the danger facing workers in Iraq. As a result,it also gives priority to military personnel who seek to registerwith the program. Using the assistance of the local citizens, theorganization is to recruit individuals from all backgrounds,irrespective of their allegiance in the war. The director alsorecommends observing strict Islamic regulations because the majorityof the target clients are Muslims. The logic behind recruitingworkers from all the warring factions is to ensure that the programwill remain politically neutral. Furthermore, it will have skilledrepresentative who can access expectant women in every place,including, the hostile areas that are restricted to foreigners.

Itis noteworthy that the organization will also be interested in hiringtranslators who will help in eliminating the language barrier. Thesenior administrators come from non-Arabic speaking countries.Consequently, employees who can speak English and native languages inIraq such as Kurdish, Arabic and Assyrian Neo-Aramaic will be givenpriority when selecting the workers (Huttner, 2015).

Mission

Themission of the hypertension treatment program is to provide qualityhealth care to pregnant women in Iraq at zero costs. The World HealthOrganization supplies the drugs and treatment equipment among otherresources needed to keep the program running. Moreover, the groupaims to offer flexible and free maternity care for women sufferingfrom pregnancy-induced high blood pressure. The funds used tosustain its operation come from diverse donors such as Gates andMelinda Foundation.

Promotingthe Outreach Program

Theprogram intends to spread the knowledge about its presence throughthe word of mouth and the national media as well. In addition, thedirectors are focused on portraying the exercise as a local treatmentservice delivered by Iraqis. Subsequently, the administration strivesto train as many local health care providers as possible.

ChallengesFacing Implementation of the Outreach Health Program

Accordingto Shabila, Tawil, Hadithi, Sondorp, and Vaughan (2012), the primaryhealthcare system in Iraq experiences countless challenges thatundermine its efficiency.Similarly, executing the hypertensiontreatment program is bound to come across similar problems. It iscrucial for the administrators to have prior knowledge of thedifficulties so that they can prepare appropriately. The issues cangenerally be classified into weak health service provision systems,difficulty in finding skilled workers, inadequate resources, and badleadership.

PoorlyOrganized Health Care Delivery Plan

Oneof the challenges expected are excess and frequent visits to thecenter by the patients suffering from other diseases apart frompreeclampsia. It is expected that numerous patients will seektreatment from the center because the service is free. Nonetheless,the staff would be prepared to deal with all sorts of clientsdemanding to receive health care services. It will be challenging todecline to accept some of the patients who will have traveled severalmiles from home, but the strained resources can only supportoutpatient treatment of women with hypertension (Shabila et al.,2012).

Second,the physicians expect to handle several cases of patients who areaddicted to prescription drugs or who have been taking incorrectmedication. Due to the lack of reliable policies for controlling thesale of drugs, a lot of nurses and doctor assistants are nowoperating as unlicensed pharmaceuticals. Nonetheless, some of themoften dispense regulated drugs to patients without a prescription.The users end up being addicted to the pills (Shabila et al., 2012).

Third,the program administrators may need to retrain the experiencedpersonnel because they are used to serving clients using anirrational approach. For instance, the physicians in some publichospitals only allow each patient a couple of minutes to explaintheir problems. Regardless whether they have been adequately served,the patients are requested to leave so that the therapists can attendto other sick people. Retraining will emphasize on the significanceof serving patients within a short time, but the therapists shouldalso listen to the ill individuals (Shabila et al., 2012).

Third,the clinics tend to have a poor referral system. As such, themanagers of the program will rely on using its resources to informthe concerned women about the new service they are providing. Nonetheless, the program might face opposition from the owners ofprivate clinics. Some of them are used to providing below standardservices to women suffering from pregnancy-induced hypertension atextremely high cost. Nonetheless, the new free service willdrastically cut their source of huge returns (Shabila et al., 2012).

Moreover,the infrastructure is damaged badly in Iraq. The staff will havetrouble when visiting some regions that are not accessible withvehicles. The administrators also note that foreigners are unwelcomein some territories, especially, the strongholds of ISIS. For suchcases, the organization would hire experienced local doctors who canquickly reach the controlled zones using alternative transport suchas camels (Shabila et al., 2012).

Challengeswith the Labor Force

Despitethe organization offering free training to the staff, accessingskilled labor will still be a challenge. Iraq has few medicaleducation facilities that are still in operation. Most of thecolleges and institutions shut down since the political upheavalsbegan. Additionally, most of the skilled individuals tend to beconcentrated in specific urban regions. The program managementexpressed optimism that they will need to capitalize on the provisionof attractive compensation perks to attract the skilled staff to workin hostile environments. The salaries will also be reviewedoccasionally to curb the high turnover rates experienced in manyIraq-based enterprises (Shabila et al., 2012).

Shortageof Resources

Thetreatment of preeclampsia requires the application of advancedtechnology. Several health care centers lack the equipment becausethey are either not available locally or since their financialcapability limits them. Nevertheless, the program management wouldinvest in mobile clinics that would make it easy to reach clients whocannot access a physical center conveniently. Moreover, the mobileclinics will double-up as ambulances for fetching and treating sickwomen during emergencies (Shabila et al., 2012).

StaffingRequirements

Asuccessful implementation of the preeclampsia treatment process needsthe program managers to come up with an efficient plan for hiringstaff members. The first step would be evaluating number of thetarget patients to know the number of workers needed. In this case,the administrators will determine the employees required through theevaluation of the estimated number of patients. For a start, theorganization intends to run the program in Baghdad before proceedingto other regions. It estimates that it would initially require 20experienced doctors, 100 nurses, 8 drivers and 27 subordinate staffmembers. The big challenge lays in finding competent therapists andnurses.

Eligibledoctors for the task will need to have experience of work in a healthfacility specializing in hypertension management. Moreover, expertswith experience in gynecology will also be given priority in therecruitment process. The first group of experienced professionalswill, in turn, help in training educated, but inexperienced medicalprofessionals. Baghdad has an approximate population of 5,672,513,which makes it the most densely inhabited center in the country. Considering that Iraq received 1257201 live births, as per the 2015statistics, it has several expectant women in need of the treatment(Iraq population, 2016). Afterward, the service will be available insatellite cities, with dense populations, such as Al Basrah, AlBasrah al Qadimah and Al Mawsil al Jadidah among others (Iraqpopulation, 2016).

OutreachService Compliance

Beforeinitiating the operations of the treatment plan, the management needsto register the organization with the Iraqi government. The listingprocess involves the provision of a proposal for the activities ofthe group. The plan defines the form of employment that would beavailable. For instance, the staff could be either part-time orfull-time workers. In this case, the program administration intendsto hire full-time employees so that they can focus on theirdevelopment. Furthermore, the organization plans to offer long-termjobs due to the shortage of skilled workers. An extendedrelationship allows the management to provided training to theiremployees over time.

Registrationof the Program

Theorganization will be registered as a not-for-profit venture. Theintention of the union is assisting women in the conflict zones ofIraq to deliver safely. Preeclampsia is a dangerous malady that maycause death when it is not treated appropriately. Moreover, a bignumber of healthy women succumb to the pregnancy complications whenthey fail to receive appropriate medical care. To avoid theregistration hassle, the firm will hire a local attorney to follow upon the listing process. Registration of companies intending to offerhumanitarian missions has become easy since the establishment of thedemocratic regime in 2003.

TheNature of Treatment Offered to Patients

Althoughthe health promotion program mainly targets providing care toexpectant mothers, their obligations extend to addressing post-partumhypertension. The condition may occur as a result of recurrentpreeclampsia, or a patient could have had high blood pressure evenbefore she conceived. In some cases, some women experience de novopost-delivery that originates from secondary complications. Thehealth experts in charge of the treatment should be well trained inhandling women affected by gestational hypertension as it could leadto the death of either the mother or the fetus, and in worst cases,both parties could pass away (Sibai, 2012).

Accordingto Sibai (2012), healthcare experts should monitor several things toensure maximum safety of the Iraqi mothers and their young ones. Someof the warning signs that the specialists in the program will besearching when attending to patients include early symptoms of highblood pressure such as malfunction of organs. Additional warningsigns of women who may suffer from preeclampsia include renalfailure, infarction, pulmonary edema, hemolytic uremic syndrome, andstroke.

OperationTime Frame

Theorganization will operate 24 hours a day throughout the year. Thepurpose of the service is to save lives of mothers suffering fromsevere gestational hypertension complications. However, the staffwill alternate in 8-hour shifts. This implies that there will be atleast three shifts every day. The aim of recommending the changes isto ensure that the employees are not overworked even though theydedicate a substantial amount of time in contributing positively tothe needs of the target community.

Theadministrators aim to develop a long-term service that will deliverhypertension medication to Iraqi women on a long-term basis.Nonetheless, the continuation of the program will depend on theaccomplishment the organization will experience in the first twoyears. While the managers strive to guarantee the success of theprogram through ascertaining it complies with the set regulations,the attitude of the people will also influence the duration it willremain in operation.

Enhancingthe Morale of the Staff

Accordingto Inc. Staff (2010), the easiest way for a firm to improve itsperformance is through motivating workers. The study further addsthat happy employees transform group output and personal performancedrastically. Similarly, the implementation of the program in Iraqwould be more successful if the executive would offer incentives tothe workers.

Westgate(2014) recommends planning getaway trips that would be held inpleasant environments away from work. The author cites P.J. Clouds,a consultant in the medical field, who asserts that he kept his staffhappy and united by taking them on a cruising sail in his vessel. Each worker had a role to play in the boat thereby, they developedcohesion that fostered good work relationship back in the office.

CarolStryker, a management consultant, adds that supervisors should listento the side of an employee as well when he or she makes a mistake.Even if the worker could have been wrong right from the beginning, heor she would feel respected if the boss seeks to understand his orher perspective when addressing the problem.

McAllister,a director of a pediatric facility, proposes that the managementshould encourage the clients served to review the service. Moreover,the reviewers should provide both the positive and negativeexperiences. The feedback makes the staff willing to give out theirbest. Besides, positive reviews should be followed by rewards such aspaid holidays (Westgate, 2014).

Dahl,a management expert, recommends the management to engage the staff inbrainstorming solutions for delivering improved services. Whenemployees are involved in coming up with resolutions in a given firm,they develop a sense of ownership. The possessive spirit improves thewillpower to attain above average performance (Westgate, 2014).

Finally,the administrators should conduct an occasional assessment of theoutput of individual workers. The analysis helps them to identify themost efficient employees and the underperformers. Subsequently, thestaff with below average productivity should be dismissed as long asthe supervisors satisfy the terms and conditions specified in thework contract (Westgate, 2014).

Summary

Preeclampsiarefers to hypertension that develops in expectant mothers, especiallyfrom the twentieth week. It can arise from the physical changesassociated with pregnancy for healthy individuals with no history ofthe disease. On the contrary, women with the preexisting conditionthat is stabilized before conceiving may develop severe hypertensionduring the gestation period. The illness can be contained when apatient receives appropriate treatment. The mother and the fetus maydie in case they lack immediate professional therapy. In conflictzones, such as Northern Iraq, accessing reliable maternal healthcareservices is a big challenge because of the ongoing war. As a result,healthcare promotion programs offered by international not-for-profitinstitutions provide alternative treatment to the mothers in suchlocations. The objective of this paper is to outline a structure thatcan be used to develop and launch a pregnancy-induced hypertensioncontrol program. It promotes the essential factors thatadministrators should bear in mind for the venture to be successful.The activities range from the registration of the organization,financing, the qualification of staff members, methods of motivatingthe staff and the compliance plan. It emerges that Iraq is a populousnation with high reproduction rate. Nonetheless, accessing bothprenatal and postnatal maternity care can be challenging for womenliving in regions that have been directly affected by theconfrontation that began since Saddam Hussein was ousted from power.The study has also listed potential challenges that the management ofthe organization is likely to face when recruiting and commencingoperations in Iraq. Among the notable problems identified in theplan, include the difficulty of finding skilled physicians, languagebarrier, destruction of infrastructure and health care facilities,lack of clean water as well as inaccessibility in ISIS strongholds.

References

Huttner,E. (2015, Feb 23). Country profile: The languages of Iraq. TheLingua File.Retrieved

Inc.Staff, (2010). 7 tips for motivating employees. Inc.Web. Retrieved on 18 Aug 2016 fromhttp://www.inc.com/guides/2010/04/tips-for-motivating-employees.html

InternationalSociety of Hypertension, (2014). High blood pressure: Why preventionand control are urgent and important. FactSheet from the World Hypertension League.Web. Retrieved fromhttp://ish-world.com/data/uploads/WHL_ISH_2014_Hypertension_Fact_Sheet_logos.pdf

Iraqpopulation. (2016, Jan 1). Countrymeters.Web. Retrieved from http://countrymeters.info/en/Iraq

McCleskey,J.A. (2014). Situational, transformational, and transactionalleadership and leadership development. Journalof Business Studies Quarterly, 5(4),117- 131.

Shabila,N.P., Al-Tawil, N.G., Al-Hadithi, T.S., Sondorp, E. &amp Vaughan, K.(2012). Iraqi primary care system in Kurdistan region: providers’perspectives on problems and opportunities for improvement. BMCInternational Health and Human Rights.DOI:10.1186/1472-698X-12-21

Sibai,B.M. (2012). Etiology and management of postpartumhypertension-preeclampsia. AmericanJournal of Obstetrics &amp Gynecology,206(6),470–475.

Smith,M.A. (2011). Are you a transformational leader? NursingManagement, 42(9),44-50. Doi: 10.1097/01.NUMA.0000403279.04379.6a

Sohn,E. (2016, May 4). Pregnant women are the `forgotten victims` of war.National Public Radio. Web. Retrieved on 17 August 2016 fromhttp://www.npr.org/sections/goatsandsoda/2016/05/04/476496946/pregnant-women-are-the-forgotten-victims-of-war

Westgate,A. (2014, July 7). Top 12 ways to motivate medical practice staff.PhysiciansPractice.Web. Retrieved on 18 Aug 2016 fromhttp://www.physicianspractice.com/staff/top-twelve-ways-to-motivate-medical-practice-staff

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