Advanced Practice Policy Analysis HCP

by | Jun 4, 2025 | Analysis

Explore and analyze health indicators in the community.
Identify a problematic area of interest to advanced nursing practice.
Evaluate and analyze three health policy options/alternatives for improvement supported by evidence (using a selected policy analysis tool)
Prioritize and recommend one health policy to address the healthcare issue.

 

Sample solution

Dante Alighieri played a critical role in the literature world through his poem Divine Comedy that was written in the 14th century. The poem contains Inferno, Purgatorio, and Paradiso. The Inferno is a description of the nine circles of torment that are found on the earth. It depicts the realms of the people that have gone against the spiritual values and who, instead, have chosen bestial appetite, violence, or fraud and malice. The nine circles of hell are limbo, lust, gluttony, greed and wrath. Others are heresy, violence, fraud, and treachery. The purpose of this paper is to examine the Dante’s Inferno in the perspective of its portrayal of God’s image and the justification of hell. 

In this epic poem, God is portrayed as a super being guilty of multiple weaknesses including being egotistic, unjust, and hypocritical. Dante, in this poem, depicts God as being more human than divine by challenging God’s omnipotence. Additionally, the manner in which Dante describes Hell is in full contradiction to the morals of God as written in the Bible. When god arranges Hell to flatter Himself, He commits egotism, a sin that is common among human beings (Cheney, 2016). The weakness is depicted in Limbo and on the Gate of Hell where, for instance, God sends those who do not worship Him to Hell. This implies that failure to worship Him is a sin.


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God is also depicted as lacking justice in His actions thus removing the godly image. The injustice is portrayed by the manner in which the sodomites and opportunists are treated. The opportunists are subjected to banner chasing in their lives after death followed by being stung by insects and maggots. They are known to having done neither good nor bad during their lifetimes and, therefore, justice could have demanded that they be granted a neutral punishment having lived a neutral life. The sodomites are also punished unfairly by God when Brunetto Lattini is condemned to hell despite being a good leader (Babor, T. F., McGovern, T., & Robaina, K. (2017). While he commited sodomy, God chooses to ignore all the other good deeds that Brunetto did.

Finally, God is also portrayed as being hypocritical in His actions, a sin that further diminishes His godliness and makes Him more human. A case in point is when God condemns the sin of egotism and goes ahead to commit it repeatedly. Proverbs 29:23 states that “arrogance will bring your downfall, but if you are humble, you will be respected.” When Slattery condemns Dante’s human state as being weak, doubtful, and limited, he is proving God’s hypocrisy because He is also human (Verdicchio, 2015). The actions of God in Hell as portrayed by Dante are inconsistent with the Biblical literature. Both Dante and God are prone to making mistakes, something common among human beings thus making God more human.

To wrap it up, Dante portrays God is more human since He commits the same sins that humans commit: egotism, hypocrisy, and injustice. Hell is justified as being a destination for victims of the mistakes committed by God. The Hell is presented as being a totally different place as compared to what is written about it in the Bible. As a result, reading through the text gives an image of God who is prone to the very mistakes common to humans thus ripping Him off His lofty status of divine and, instead, making Him a mere human. Whether or not Dante did it intentionally is subject to debate but one thing is clear in the poem: the misconstrued notion of God is revealed to future generations.

 

References

Babor, T. F., McGovern, T., & Robaina, K. (2017). Dante’s inferno: Seven deadly sins in scientific publishing and how to avoid them. Addiction Science: A Guide for the Perplexed, 267.

Cheney, L. D. G. (2016). Illustrations for Dante’s Inferno: A Comparative Study of Sandro Botticelli, Giovanni Stradano, and Federico Zuccaro. Cultural and Religious Studies, 4(8), 487.

Verdicchio, M. (2015). Irony and Desire in Dante’s” Inferno” 27. Italica, 285-297.

Healthcare in any community is a complex interplay of various factors that influence the well-being of its population. As an advanced nursing practice leader in Nairobi, understanding these dynamics and advocating for impactful policy changes is crucial.

1. Explore and Analyze Health Indicators in the Community (Nairobi)

To identify problematic areas, we first need to explore common health indicators. For a community like Nairobi, these indicators can be broadly categorized as follows:

  • Mortality Indicators:
    • Infant Mortality Rate (IMR): Number of deaths of infants under one year of age per 1,000 live births. In many urban low-income settings like some parts of Nairobi, IMR can be higher due to challenges in maternal and child health access, nutrition, and sanitation.

Healthcare in any community is a complex interplay of various factors that influence the well-being of its population. As an advanced nursing practice leader in Nairobi, understanding these dynamics and advocating for impactful policy changes is crucial.

1. Explore and Analyze Health Indicators in the Community (Nairobi)

To identify problematic areas, we first need to explore common health indicators. For a community like Nairobi, these indicators can be broadly categorized as follows:

  • Mortality Indicators:
    • Infant Mortality Rate (IMR): Number of deaths of infants under one year of age per 1,000 live births. In many urban low-income settings like some parts of Nairobi, IMR can be higher due to challenges in maternal and child health access, nutrition, and sanitation.
    • Under-5 Mortality Rate: Deaths of children before their fifth birthday per 1,000 live births. This often reflects the overall health and socioeconomic conditions of a community.
    • Maternal Mortality Ratio (MMR): Number of maternal deaths per 100,000 live births. This is a critical indicator of the quality and accessibility of maternal healthcare services.
    • Cause-Specific Mortality: Deaths due to specific diseases (e.g., infectious diseases like HIV/AIDS, TB, malaria; non-communicable diseases like hypertension, diabetes, cancer; or injuries).
  • Morbidity Indicators:
    • Prevalence and Incidence of Communicable Diseases: Rates of new and existing cases of diseases such as HIV/AIDS, Tuberculosis, Malaria, Cholera, Typhoid, and other waterborne or vector-borne diseases. Given Nairobi’s rapid urbanization, informal settlements often face higher burdens of these diseases due to poor sanitation and living conditions.
    • Prevalence and Incidence of Non-Communicable Diseases (NCDs): Rates of diabetes, hypertension, cardiovascular diseases, cancers, and chronic respiratory diseases. As Nairobi undergoes epidemiological transition, NCDs are becoming increasingly prevalent, often linked to changing lifestyles, diet, and stress.
    • Nutritional Status: Rates of stunting, wasting, and underweight in children, and prevalence of obesity/overweight in adults. Food insecurity and dietary shifts can impact these.
    • Mental Health Issues: Prevalence of depression, anxiety disorders, substance abuse, and other mental health conditions. Urban stress, unemployment, and lack of adequate mental health services can contribute to these.
  • Health System Indicators:
    • Access to Healthcare: Number of health facilities, doctors, nurses, and hospital beds per capita. Geographic accessibility, affordability of services, and availability of essential medicines.
    • Immunization Coverage: Percentage of children fully immunized against preventable diseases.
    • Antenatal Care (ANC) Coverage and Skilled Birth Attendance: Percentage of pregnant women receiving adequate ANC visits and having births attended by skilled health personnel.
    • Health Expenditure: Public and private spending on health.
  • Determinants of Health (Social, Economic, Environmental):
    • Socioeconomic Status: Poverty rates, unemployment rates, education levels, housing conditions.
    • Water and Sanitation: Access to safe drinking water and improved sanitation facilities. Informal settlements in Nairobi often face significant challenges here.
    • Environmental Quality: Air pollution levels, waste management practices.
    • Literacy and Education Rates: Impact on health literacy and health-seeking behaviors.

Analysis for Nairobi: Based on general knowledge of Nairobi’s public health landscape (and assuming hypothetical detailed data aligns with common challenges in rapidly developing urban centers), areas often highlighted include:

  • High burden of infectious diseases (e.g., typhoid, cholera, TB) especially in informal settlements due to poor sanitation.
  • Rising prevalence of NCDs (hypertension, diabetes) often undiagnosed or poorly managed.
  • Challenges in maternal and child health outcomes in vulnerable populations.
  • Significant disparities in access to quality healthcare between affluent and low-income areas.
  • Inadequate mental health services and significant stigma around mental illness.

2. Identify a Problematic Area of Interest to Advanced Nursing Practice

Based on the analysis, a significant and pervasive problematic area of interest to advanced nursing practice in Nairobi is the rising burden of Non-Communicable Diseases (NCDs), particularly hypertension and diabetes, coupled with low awareness, poor screening rates, and inadequate long-term management in primary healthcare settings.

This area is critical for advanced nursing practice (specifically for Nurse Practitioners or Clinical Nurse Specialists) because:

  • Primary Care Focus: Advanced practice nurses (APNs) are uniquely positioned to manage chronic conditions in primary care, focusing on prevention, early detection, and ongoing management.
  • Holistic Patient Care: APNs emphasize patient education, lifestyle modification, and psychosocial support, which are vital for NCD management.
  • Community Outreach: APNs can lead community-based screening and health promotion programs to increase awareness and early diagnosis.
  • Addressing Health Disparities: APNs can help bridge gaps in access to care for NCDs, especially in underserved communities where specialist access is limited.
  • Policy Advocacy: APNs can advocate for policies that strengthen primary healthcare, integrate NCD care, and promote healthier lifestyles.

3. Evaluate and Analyze Three Health Policy Options/Alternatives for Improvement (Using a Selected Policy Analysis Tool)

To evaluate policy options, I will use a simplified version of the Policy Analysis Matrix (PAM), which considers criteria such as effectiveness, feasibility, equity, and cost-effectiveness.

Problem Statement: The community in Nairobi experiences a rising burden of hypertension and diabetes due to low awareness, poor screening, and inadequate long-term management, particularly in primary healthcare settings.

Policy Goal: To reduce the prevalence and improve the management of hypertension and diabetes in Nairobi, thereby decreasing morbidity and mortality associated with these conditions.

Policy Analysis Tool: Simplified Policy Analysis Matrix (PAM)

Criteria Effectiveness (Likely to achieve goal?) Feasibility (Implementable? Resources, political will) Equity (Benefits all segments, reduces disparities?) Cost-Effectiveness (Value for money?)
Option 1: Universal NCD Screening Program in Primary Care High Moderate High Moderate
Option 2: Community Health Worker (CHW) Led Home-Based NCD Screening & Education Moderate-High High Very High High
Option 3: Tax on Sugary Drinks & Unhealthy Processed Foods Moderate Low Moderate-Low High

Evaluation of Policy Options:

Policy Option 1: Implement a Universal NCD Screening Program in all Primary Healthcare Facilities.

  • Description: This policy would mandate and fund routine screening for hypertension and diabetes for all adults attending public primary healthcare facilities in Nairobi. It would include standardized protocols for screening, referral, and initial management.
  • Effectiveness: High. Regular screening is proven to detect NCDs early, allowing for timely intervention before complications arise. It would significantly increase the number of diagnosed cases, leading to earlier management. (World Health Organization, 2021).
  • Feasibility: Moderate. Requires significant government funding for equipment (BP cuffs, glucometers), consumables (test strips), training for existing primary care staff (nurses, clinical officers), and data management systems. Political will would be needed to prioritize this funding over other competing health needs. Existing infrastructure could be leveraged, but capacity building is essential.
  • Equity: High. By making screening routine and available at no extra cost at public primary care facilities, it directly targets and benefits the general population, especially those who rely on public health services, including low-income groups.
  • Cost-Effectiveness: Moderate. The initial investment in screening can be substantial. However, early detection and management can prevent costly complications like stroke, kidney failure, and amputations in the long run, leading to significant cost savings to the health system. (Centers for Disease Control and Prevention, 2023)

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