Health Policy in Australia

 

 

 

 

 

 

Health Policy in Australia

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HEALTH POLICY IN AUSTRALIA

Introduction

Background Information

According to Blankenship, et al., (2013) alcohol exposure is considered to be the major cause of fetal alcohol spectrum disorder (FASD). There are a number of more specific descriptors such as Fetal Alcohol Syndrome (FAS). This condition is a birth defect syndrome, which is associated with exposure to alcohol especially for the unborn children. This condition was first mentioned by dysmorphologists (Jones & Smith, 1973). Behavioral and cognitive dysfunction, anomalies in faces, neurodevelopmental impairments and growth deficiency are among the features of this condition. Substantial literature that exists emphasize that FASD is the major cause of intellectual disability especially in western countries.

Fetal alcohol spectrum disorder (FASD) is a major arising crisis that has emerged widely within the concerned institutions; health sector, education sector, criminal justice sector and social care systems of many countries, basically majoring in Australia. Current prevalence occurrences suggest that over one in a hundred children and young aged people have FASDs. This publication has greatly involved professionals, families and academic fields from all over the world that have shared expertise and insights on FASDs. This disorder mostly affects babies who are exposed to alcohol while still in the womb. The consistence of fetal alcohol spectrum disorder symptoms varies whereby some children experiencing them to a far greater extent than others.

 

 

Analysis

FASD greatly comes about when one is pregnant and drinks alcohol throughout the pregnancy period. Alcohol enters the bloodstream and reaches the developing fetus by moving across the placenta, the alcohol consumed causes higher blood alcohol concentrations in the body of the developing baby than in your body due to the fact that the fetus metabolizes alcohol slower than the adult does (Jones & Smith, 1973)   . The Alcohol then goes and interferes with the delivery of oxygen and optimal nutrition to the developing baby (Abel & Sokol, 1987). Exposure to alcohol before birth can harm the development of tissues and organs and cause permanent brain damage in your baby since the immunity of the baby to fight the alcohol is lower hence the baby is highly affected by Fetal Alcohol Spectrum Disorders (FASDs).

The more one drinks while pregnant, the greater the risk to the unborn baby (Armstrong, 1998, 2003)   . However, any small amount of alcohol consumed puts the baby at a greater risk. The baby’s brain, heart and blood vessels start developing in the early weeks of pregnancy, before one may know she is pregnant. Impairment of facial features like the heart and other organs, including the bones, and the central nervous system may occur due to drinking of alcohol during the first trimester.(May, Blankenship, et al., 2013). This is when these parts of the fetus in the womb are in major stages of development. However, the risk is present at any time during pregnancy provided the formation of fetus begins. The diagnosis of neurodevelopmental disorders currently is being addressed by a foundation called Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013).

There are physical defects that alien with FASD which include; distinctive facial features that include small eyes, smooth skin surface between the nose and upper art of the lip, deformities of joints, limbs and fingers, slow physical growth before and after birth, vision difficulties and hearing problems, Small head circumference and brain size, Heart defects and problems with kidneys and bones and also brain and central nervous system problems. . (Gavaghan, 2009).   These effects begin to manifest as soon as the infant begins to grow from birth.

This disorder can be prevented or tackled through differently through different instrumental policies. The National FASD action plan is one of the strategies to tackle the disorder. NOFASD Australia has come up with a working group, the ministerial Council on Drug Strategy FASD working group, the Department of Health and Ageing and Drug and Alcohol held a FASD workshop whose goal was to identify potential future directions and strategies to alcohol use in pregnancy. The international charter also focused on the prevention of fetal alcohol spectrum disorder. There is set up of centers like Australian indigenous alcohol and other drugs knowledge Centre which also aims at the prevention of FASD. .A project in Australia has also been set up to develop a diagnostic instrument for FASD in Australia. This project included consumers, health professionals, researchers and community members

The major instrumental policy based here is the National FASD plan which has set up many projects to counteract this disorder. The commonwealth government set out a national inquiry to dig deep into the prevention measures, diagnosis and the management of FASD which was to be carried out in the House of Representatives Standing committee on social policy and Legal Affairs. Another project set out is The Foundation for Alcohol Research and Education (FARE) which included doctors, families and communities. The major goal was to increase community awareness of FASD and prevent prenatal exposure to alcohol, to improve the capacity of diagnosis for FASD in Australia, to improve the data collection process so as to understand the extent 0f FASD in Australia. Government of Western Australia Education and Health Standing Committee released its report on FASD as the Invisible Disability in order to create awareness among communities and families

The project majorly bases on advising and encouraging expectant women to a restrain from alcohol during pregnancy and if you’re pregnant and can’t stop drinking, one should ask her primary care doctor or mental health professional for help in the situation before it gets out of control. (Chudley et al., 2005).Since early diagnosis may help reduce the risk of long-term effects for children who already have been infected with fetal alcohol syndrome by letting your child’s doctor know if you drank alcohol while you were pregnant.( Langan & Keynes, 2011)If you have adopted a child or you are acting as a foster parent, it might not occur to you if the biological mother of the child drank alcohol while pregnant — thus it might not occur to you initially that your child may have fetal alcohol syndrome (FAS). However, if you notice that your child has difficulties with learning and social behavior, talk with his or her doctor so that the underlying cause might be identified and diagnosed at an early stage (Kobor & Weinberg, 2011). Public health has put in more efforts to curb and prevent FASD problems. (Streissguth (Kobor & et al.1991).

Fetal alcohol spectrum disorder may cause greater social impacts on the well-being of an affected child. ( Wilson & Cudd, 2011).   The child may experience difficulties in school due to loneliness and feeling out of social class with other children especially during playtime this disorder in a child might develop trouble in getting along with others in school both in class and in the playground fields (Astley & Clarren, 1999). It causes trouble in adapting to changes or switching from one particular task to another due to slow functioning of the brains since the brains are much affected (Long & Elhai, 2009). The child as a victim also faces the problem of staying on a particular task when assigned to since the slow thinking mind also has divided attention.

The affected child experiences poor concept of time, still mentioned as a social impact that constrains him/her from being accurate in time management throughout their life. They are faced with poor judgmental skills where they cannot make correct hypothesis based on what they are seeing or what is laid ahead of them on actual ground.( May, Tabachnick, et al. 2013) . This is very dangerous since the child is exposed to many risks and dangers that may arise from his poor judgment of issues and events (Astley & Clarren, 1999). This disorder brings along difficulty in planning or working towards a goal in the life of a child since his/her reasoning and thinking abilities are low thus they cannot make useful decisions based on an issue or a goal.

The cost of illness study has examined the impact of FASD on the material  welfare of the of the Australian  society through analysis of direct cost of resources extended to health care and its facilities, law enforcement policies to curb alcohol consumption especially by pregnant mothers, children and youth in care, special education for the affected children, prevention and research, supportive housing, as well as the indirect costs of productivity losses of  individuals with FASD due to their increased premature mortality ( Langan & Keynes, 2011)  . The cost of productivity losses due to premature mortality is the highest contributor to the economic burden of FASD followed by the cost of health care which is also a high economy consumer.

The worldwide incidence of the fetal alcohol spectrum disorder has highly dominated among live births. (Riley & McGee, 2005)   . These incidence rates vary considerably depending on the study site of the research. Conservatively estimated for instance United States, the economic cost associated with FASD-growth retardation, surgical repair in the brains and of organic anomalies, treatment of sensor neural problems and mental retardation is over millions of money per year which is very costly to the economy of the country (Pope, 1995)  . The current treatment costs for FASD-related problems are almost a hundred times that of federal funding for FASD research necessary to form cost-effective early identification and prevention strategies.

Governments have come up with volumetric tax approaches that would have the advantage of generating more income, a proportion of which would be set aside for treatment programs and other approaches to alcohol related harm. A floor price method which involves imposing a lower limit on price per unit of alcohol is also implemented thus preventing the sale of cheap alcohol. This is likely to reduce alcohol consumption and related harm most among the disadvantaged population and young population Evidence-based, cost-effective and high-impact policy measures which have been implemented by various governments are also available to help prevent FASD. The three best buys policies all help to reduce overall level of alcohol consumption in a population and alcohol’s physical, social, financial and psychological existence in communities, families and societies.

Apart from price, there is another determinant of alcohol consumption which is its ready availability including the take away trading hours. Such restrictions have strictly been applied in many places and have helped in the reduction of excessive and pure alcohol thereby causing a decline in alcohol related harm problems and alcohol related offences. Home visiting programs have been organized that assist women from disadvantaged families by two strategies of which are helping women who want to become pregnant avoid alcohol and helping those who are consuming alcohol to avoid becoming pregnant. This helps in reducing the risk of a child getting the FASD.

These alcohol control measures have been proven to be cost-effective. In addition, there are other preventive measures which include the provision of quality information and services, including information on the effects of alcohol on health outcomes for expectant women and unborn infants. Improved access to a better diagnostic system and interventions to help people with FASD and their families to have a better quality life is among the highly encouraged approaches. Better early diagnosis and appropriate interventions can help to reduce and also avoid secondary disabilities and enable people with FASD to work and have families with fewer struggles and constrains

In many countries, the alcohol norm has to be changed and myths about alcohol have to be revised. The alcohol industry is aggressively availing alcohol into all aspects of life, thus making it more and more difficult for communities and societies to choose to live and stay free from alcohol. Facts show that pregnancy is really one of the phases in lives that should be alcohol free.  Therefore, activities to challenge and completely change the alcohol norm are important addition to the efforts to prevent FASD.

Conclusion

In conclusion, accurate and ground based data on the prevalence of FASD is needed in order to come up with prevention strategies and services. In the present state there is no requirement to report FASD nationally and alcohol use by pregnant women is not often screened for the newly developed agreed guidelines for the diagnosis of FASD will help in easily identifying FASD and providing early management and advice to affected families. (Premier, 1973). Further work and research is needed to provide specific support services for FASD and also to increase the health capacities and other services to respond to families affected by FASD.

 

 

 

 

 

 

 

 

 

 

 

 

 

References

Abel, E. L., & Sokol, R. J. Incidence of fetal alcohol syndrome and economic impact of FAS-related anomalies. Drug and Alcohol Dependence, (1987) 19, 51–70.

American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. (2013).

Armstrong, E. Diagnosing moral disorder: The discovery and evolution of fetal alcohol syndrome. Social Science & Medicine, (1998) 47, 2025–2042.

Armstrong, E. Conceiving risk, bearing responsibility: fetal alcohol syndrome & the diagnosis of moral disorder. Baltimore, MD: Johns Hopkins University Press (2003).

Astley, S. J., & Clarren, S. K. (1995). A fetal alcohol syndrome screening tool. Alcoholism: Clinical and Experimental Research, 19, 1565–1571.

Astley, S. J. Diagnostic guide for fetal alcohol spectrum disorders: The 4-digit diagnostic code (3rd ed.). Seattle: University of Washington Publication Services. (2004).

Chudley, A. E., Conry, J. C., Cook, J. L., Loock, C., Rosales, T., & Leblanc, N. Fetal alcohol spectrum disorder: Canadian guidelines for diagnosis. Canadian Medical Association Journal, (2005) 172(5 Suppl.), S1–S21.

Gavaghan, C. “You can’t handle the truth”; medical paternalism and prenatal alcohol use. Journal of Medical Ethics, (2009) 35, 300–303

Kobor, M. S., & Weinberg, J. Epigenetics and fetal alcohol spectrum disorders. Alcohol Research & Health, (2011) 34, 29–37.

Langan, M., & Keynes, M.  Parental voices and controversies in autism. Disability and Society, (2011) 26, 193–205.

Long, M. E., & Elhai, J. D. Posttraumatic stress disorder’s traumatic stressor criterion: History, controversy, and clinical and legal implications. Psychological Injury and Law, (2009) 2, 167–178.

May, P. A., Blankenship, J., Marais, A.-S., Gossage, J. P., Kalberg, W. O., Joubert, B., … Seedat, S. Maternal alcohol consumption producing fetal alcohol spectrum disorders (FASD): Quantity, frequency, and timing of drinking. Drug and Alcohol Dependence, (2013) 133, 502–512.

May, P. A., Tabachnick, B. G., Gossage, J. P., Kalberg, W. O., Marais, A.-S., Robinson, L. K., … Adnams, C. M. (2013).Maternal factors predicting cognitive and behavioral characteristics of children with fetal alcohol spectrum disorders. Journal of Developmental and Behavioral Pediatrics, (2013) 34, 314–325.

Pope, K. Logical fallacies in psychology: 22 types. Available from http: //.kspope.com/fallacies/fallacies.php. (1995).

Riley, E. P., & McGee, C. L. Fetal alcohol spectrum disorders: An overview with emphasis on changes in brain and behavior. Experimental Biology & Medicine, (2005) 230, 357–365.

Premier.  Jones, K. L., Smith, D. Recognition of the fetal alcohol syndrome in early infancy. Lancet, (1973) 2(7836), 999–1001.

Price K, Miskelly K. Why Ask Why? Logical Fallacies in the Diagnosis of Fetal Alcohol Spectrum Disorder. Ethics & Behavior [serial on the Internet]. (2015, Sep), [cited June 4, 2017]; 25(5): 418-426. Available from: Academic Search.

Streissguth, A., Aase, J. M., Clarren, S. K., Randels, S. P., LaDue R. A., & Smith, D. F. Fetal alcohol syndrome in adolescents and adults. Journal of the American Medical Association, (1991) 265, 1961–1967.

Wilson, S. E., & Cudd, T. A. The use of animal models for the study of fetal alcohol spectrum disorders. Alcohol Research & Health, (2011) 34, 92–98.

 

 

 

 

 

 

 

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