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Part one: Assessing Health Needs
Assessing the health needs of a population requires the focus of individuals and not the actual problem. For example, the subject of teenage pregnancy should represent the focus of pregnant adolescent mothers and their sexual health needs.
It is estimated that each year in developing regions, twenty-one million girls from the ages of 15 to 19 years old become pregnant, and approximately twelve million of the girls give birth. According to The World Health Organisation (2020), they provide the figures of 777,000 girls who are under the age of 15 years, give birth in developing regions. They expand on this, as they state that complications during pregnancy and childbirth are the central cause of death for 15 to 19-year-old girls globally.
The primary health concerns linked to early motherhood, are more related to physical, mental, and emotional health. In addition to the health needs of the mother, the importance of the infant’s health is also crucial. The teenage mother would require knowledge and access to resources in order to have the information available about parenting.
Identifying Health Needs
Title, Year Methodology Findings
1. Adolescent mothers’ experiences of the transition to motherhood: An integrative review (2019)
Adolescent mothers’ experiences of the transition to motherhood: An integrative review | Elsevier Enhanced Reader
- Secondary Qualitative
- Isolation (Mothers feeling alone and desperate)
- Women require Mental Health support
- Education
2. Adolescent mental health and behavioral predictors of being NEET: a prospective study of young adults not in employment, education, or training (2018) https: oda. slot.nohandle106426056
- Primary Qualitative
- Employment
- Education
- Training
3. Adolescent Pregnancy: Risk Factors, Outcome and Prevention (2016) (PDF) Adolescent Pregnancy: Risk Factors, Outcome and Prevention (researchgate.net)
- Secondary Qualitative
- Physical Health
- Cultural Background
- Socio-economic status
- Education
The needs identified in the first study unraveled elements associated with Maslow’s (1954), ‘Hierarchal Needs theory. The teenage mothers valued peer approval, as they would consider themselves to be outcasts, in comparison to other teenagers at school, furthermore, their peers did not seem to comprehend the demands required of the mothers to meet their baby’s needs Erfina et al. (2019). Self-esteem and self-actualization were more valued and dominated behavior pre-pregnancy and post-pregnancy.
The principles in place by Doyal and Gough (1991) were not thoroughly contemplated by individual young mothers, in ensuring to reduce or elimination the implications of harm to their physical health or motherhood.
The second study appraised the social model of health. Attainment of life skills from which the confidence to network and be connected to your environment has exponential health benefits to the individual according to Seedhouse’s theory (2009). Doyal and Gough’s (1991) theories are applicable in that, the unfulfilled potential leads to poor outcomes as demonstrated in this study in that policy-making and revision must be adaptable to changing socioeconomic climates prompting individuals’ health needs.
The third study entails all the health needs, from Maslow’s hierarchy of needs (1954), which reports universal needs and how they motivate individuals from a position of disequilibrium where unfulfilled needs dominate personal behaviors, such as the effects of low esteem leading to risk-taking in order to attain self-actualization. However, this behavior although pronounced in Seedhouse’s principles (2009) accepted as a fundamental concept of autonomous freedoms and the capability to make informed choices through having reliable mental capacity, cognition, and appreciation of individual social responsibilities.
Prioritising health needs
Mental health was recognized as the main health need among teenage mothers. The provision of mental health support from pre-teenage years to postnatal phases. Harden et al (2009) mention that policymakers and analysts continue to contend with the need for the provision of a comprehensive mental health service for children and young adults, The priority health needs of young parents’ provision of suitable knowledge, improving mental capacity, and developing cognitive skills to handle the everyday challenges of deprivation, economic hardship and lack of educational support.
Part Two: Strategy to Address the Health Needs
Aim
To provide a substantial amount of psychological and emotional support to adolescent mothers and their infants within the first year of motherhood. It is imperative that teenage mothers receive adequate help during the first year, as they would find motherhood extremely difficult. To an adolescent mother, the task of parenting would be emotionally and physically demanding, as the lack of support would also be limited. This would then trigger a negative factor for the teenage parent and the child, as well as the infant’s health.
Objectives
- To utilize the health persuasion method, in order to assess if there are any foundational risks posed to vulnerable young mothers and to understand the factors contributing to them to become them becoming adolescent mothers.
- Use governing facilities available such as the NHS Mental Health Help, and The Mental Health Foundation to raise awareness of the mental health and well-being of younger mothers and their children by offering counselling or therapy.
- To empower teenage parents and to help advance their personal skills. Enabling them to become more confident, and assertive and to give them a clearer insight when it comes to decision making. The young mothers then will be encouraged to seek education or employment opportunities.
- To promote and encourage women to attend, community-led sexual health classes. These classes will help to educate young mothers and to raise awareness of the consequences of unprotected sex amongst adolescent people. Based on community development, the information provided in the sexual health classes will include the use of contraception.
Health Promotion Activities
In order to address and establish health needs, the use of Beattie’s Model would be beneficial for the development of health promotion activities. Beattie’s model allows individuals to be familiar with the different approaches and practices to health promotion. The model refers to the different techniques and strategies used to help challenge the health problem. Beattie’s model is divided into four quadrants, and each quadrant includes different approaches for health professionals, the government, and individuals to promote health. The approaches that can be used are personal counseling, health persuasion, community development, and legislative action, Ivory Search (2021).
Health persuasion
The Beattie’s model consists of four sections. the four sections include the different approaches that professionals, people, or the government can use for health promotion. They can execute this through personal counseling, health persuasion, community development, or through legislative action.
Young mothers require support with parenting, mental well-being, and psychological health. According to Devito (2010), teenage mothers become parents with existing issues and poor mental health. Poverty and domestic abuse are factors that weaken maternal mental health, as the trigger of poor mental health among teenage parents may be due to the instability of family relationships. They may also be inexperienced in parenting, whilst facing the challenges of coping with transitioning from adolescence to parenthood.
Health persuasion is individual-centred, activities and interventions are promoted by professionals who will offer adequate advice, using leaflets and posters, Department of Health (2019). These leaflets and posters and can be put in GP offices, delivered via post, promoted in schools, colleges, and universities. Leaflets and posters provide educational information about the health implications of unprotected sex and behaviors whilst pregnant such as smoking or drinking alcohol during pregnancy.
The leaflets will provide the location where the mothers can access contraceptive services. This approach is emphasized by the Ottawa Charter (1996), the Ottawa Charter highlights, that the use of the health persuasion approach allows the target community to over their own health and control how they will improve their health
Legislative action
Naidoo and Wills (2011) argue that legislation action consists of the development or emphasis of public policies and in some cases laws. This section of Beattie’s model consists of policymakers and healthcare practitioners working together to get healthy outcomes for the health of individuals such as pregnant teenagers and teen mothers. The section of the model takes a holistic approach in order to improve health, the section takes a top-down approach which is authoritative. This section can be said to act on Normative needs (Bradshaw, 1972), legislative action is met when policies and guidelines are put in place. Legislative action can be applied to the proposed activities by making sure the people involved follow the Mental Capacity Act for safeguarding vulnerable adults. Following the guidelines of this Mental Capacity Act (2005), young parents can be supported by postnatal care until they feel they no longer need the support. A policy can be put in place to ensure that parents aged 15 to 21 years should Inclusion of young parents in evidence-based parenting programs
Personal counselling
His approach aims to empower individuals such as pregnant teenagers and teen mothers to change or change their lives positively. Pregnant teenagers and young mothers should be made to feel empowered to enhance and improve their knowledge by going back to school or continuing with their education, they should feel empowered enough to work on current skills and develop further skills that will help them in life (Naidoo and Wills 2010). Local guidance will be given to support workers etc, on supporting school-age parents to continue their education. When applying this approach, health professionals or supportive professionals will work with the young mother or pregnant teen to make goals and take the right steps to achieve those goals. A dedicated adviser, health visitor, family nurse practitioner, and psychiatry community nurse to support the emotional, mental health, and education needs. The approach is a bottom-up approach, working from an individual’s level.
Community development
Community development is a bottom-up approach requiring project leaders or facilitators to work side by side with the community so they can identify what the problem is and how they can initiate change (Naidoo and Wills 20110. It is thought that empowering a community to act on a present health problem can be more effective because it includes the actual population who are experiencing the health problem. Developing personal development plans for young parents by building aspirations and skills linked with local workforce development, employment, and regeneration plans, will help increase the chances of these teenagers improving their lives.
Activities and projects that take a community approach strongly emphasize and promote the participation of the community in order to reduce the risks of young pregnancies (Thompson, 2014). They will do this by offering services to the at-risk groups that are involved. Hopefully, by having the community involved, it will help to aid pregnant teenagers to make positive changes to their lives, also it will allow teenagers to seek the services they need to help them make good choices in order to eventually decrease the rates of teenage pregnancies.
Resources
To promote the health needs of young teenage parents policy makers and subsequently health and social care practitioners have to set out a person-centered strategic approach that caters to the holistic health needs of the affected population and provides the necessary resources to be implemented by well-trained and conscientious professionals on the frontline. The Local Government Association (LGA), Department of Works and Pensions (DWP), Department of Health (DH), and Department of Education (DoE) have to provide a joined-up approach to deliver a comprehensive package of measures and interventions to prevent the escalation of teenage parents and also provide adequate support for the young parents and their children in an effort to break the cycle of deprivation, hardship and poverty in society in the long-term.
Investment in early learning programs for children followed by reinforcements through youth development activities and engagement strategies at the local authority level. Provision of high-quality sex and relationships education and informed access to contraceptive services, augmented by initiatives aimed at improving the enjoyment of school whilst raising aspirations, expectations, and ambitions. The establishment of robust monitoring and supervisory agencies to ensure that social exclusion does not occur and where it occurs; corrective action is readily applied. The promotion of evidenced-based reflective learning and continuous professional development of health and social care professionals with further emphasis on understanding the ethnic and cultural diversity of all service users.
Evaluation
Naidoo and Wills (2010) suggested that in order to gather information about programs, characteristics, activities, and their outcomes, evaluation needs to be put in place for future improvements and to know the effectiveness of activities so individuals know whether they need to alter anything. In 2006, WHO stated that evaluation allows room for improvement. Critical analysis of a health promotion activity or program allows conclusions to be made, it also allows individuals to see whether the chosen objectives and aims were met, if not then the thought of different methods will be considered for future activities.
For the purpose of this report, the two main evaluation types to be used are impact and outcome evaluations. A Quantitative method will be used for the evaluation.
Impact evaluation in health promotion will consider the immediate effects of the provision of adequate postnatal care, interventions for preventing future pregnancies, and the provision of safe environments that benefit young parents and their children. The impact assessment examines the rate of delivery of the support and safeguards as identified in the resource allocation frameworks (Thompson, 2014). The activities of health and social care professionals should provide a detailed and accountable document trail of service provisions including any records of failures or non-compliances to agreed guidelines and statutory requirements. A joined-up multi-sectorial team of professionals from the health service, local authorities, and independent community support groups and the affected individual will participate in the conduct of the evaluation exercise as follows:
- Measure changes in sexual and relationship health awareness, knowledge, and attitudes
- Measure interest shown by young parents in utilizing health education materials, phone-ins, and participating in self-improvement activities
- Observation, questionnaires, interviews, and one-on-one or group discussions
- Use of attitude scales to evaluate the above measures
Outcome evaluation
The outcome evaluation will consider the long-term effects of the interventions of the health promotion exercise in terms of the ultimate goal of eliminating social exclusion of teenage mothers and their children’s health and social care needs (Seedhouse 2009).
- This evaluation method is preferred as it measures sustained and significant changes occurring in the population over time.
- The utilization of hard evidence and quantitative research methodologies to measure behavior changes such as safe sexual and relationship practices and healthier habits and lifestyle choices.
- Policy and legislative changes to guide health and social care professionals provide support to teenage mothers and their offspring and ensure that statutory safeguarding standards are met.
- Direct access to EET is promoted and delivered for all young parents who fall under that legislative bracket and then ensures there is a seamless migration to the mainstream benefits system.
- Environmental changes such as the provision of safe zones for preventing unhealthy sexual relations
- Reduction of the prevalence of potential risk factors to social exclusion of young parents and poor maternity care.
- Improve life chances for the children of teenage mothers.
- To compare the target group’s health and social care outcomes to a similar control group who did not participate in the intervention to measure the efficacy of the program
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