Improving the Health of the Poor in Mexico

Below is the answer to two colleages response to a group discussion of a case study. I am to respond to their reply with feedback, adding addtional information, agreeing or disagreeing or supporting their response. I have attached a copy of the case study
DISCUSSION A:   Politics affect healthcare in a number of ways. As Dr. Carol Holtz states in this week’s Laureate Education video, the influence of politics on healthcare primarily is the following: access to healthcare, access to health supplies, access to health care providers, and effect on the accumulation of wealth (Laureate Education, 2010). Economics, finances, policies all factor into how healthcare is provided, how healthcare is funded from country to country and the healthcare outcomes that people experience (Holtz, 2017). It appears that politics is at the core of healthcare in every country. Furthermore, Dr. Carol Holtz states that politics has such a tremendous effect on healthcare and this can be seen especially throughout many developing countries; for example, a big issue that developing countries face is that government corruption causes health care supplies that reach nations not to reach the people (Laureate Education, 2010).
In the case study “Improving the Health of the Poor in Mexico,” Levine (2007) discusses the program known as “Progresa,” which offered mothers of poor families in rural Mexico cash awards in an effort to improve health care, nutrition, and school attendance of the families. As described in the case study, the outcomes of the program were majorly successful in both adults and children in poor families; hence, bringing forth the benefits of using this cash incentive program which resulted in families obtaining more preventative health care services, nutritional counseling/making healthier food choices, and children attending school regularly (Levine, 2007). However, regardless of the benefits of this program, I believe potential ethical/social problems could arise. Families not qualified for this program due to above poverty income could resent the cash incentives and free counseling and could demand the same nationwide. Additionally, the sole fact of giving incentives and accessible services to these poor families could enable them to only partake in these requirements because they require the cash grant, and if the program were ever to be removed, they might stop these newly formed habits because there is no longer a cash incentive to go along with it. Additionally, I do not believe resources were ethically distributed; resources were only allocated to the mothers of families because they believed that the fathers would be more likely to spend these cash grants on alcohol and cigarettes (Levine, 2007). Furthermore, the cash grant was capped at $70 monthly per family because they did not want this incentive to cause the poor to have more children if it were to be unlimited per child (Levine, 2007). I am torn about my feelings about this program. On the one hand, I see a significant benefit, but on the other, I see several potential social issues and a distributive resources methodology that is rooted in stereotypes.
Suppose the Progresa/Oportunidades program was to be discPolitics and Economics influence health and health care.  Health policies and laws that are put into place are directly impacted by politics and political leaders.  Economics plays a significant role in the way society views individuals and also affects their ability to pay for health care services.  Unfortunately, health disparities do exist.  Individuals who reside in impoverished and segregated communities tend to have poorer health than their non segregated, middle class counterparts ( Do, D.P., Frank, R., & Iceland, J. 2017).  The reality is politics and economics directly impact the choices and opportunities individuals have regarding health and health care.
DISCUSSION B: The Progresa (Oportunidades) Program was created in Mexico to encourage the poorest families in Mexico to make better decisions regarding education, health care and nutrition by providing direct cash payments to families who participated in the program and followed the protocols.  The program resulted in improved outcomes for both children and adults.  Benefits of the cash grants for mothers included the perception that mother’s would be more likely to spend the cash benefits on household needs versus fathers.  This is a stereotype that suggested fathers would be irresponsible with cash benefits (purchasing alcohol and cigarettes) and not invested in the health and well being of their families (LeVine 2007).
In my opinion, funds would be ethically distributed if they were given to the heads of individual households.  Although women tend to be the primary caregivers in many situations, it is an unfair assumption to suggest that only women can responsibly provide for the household needs.  The decision to fund mother’s suggest that poor Mexican father’s are irresponsible and incapable of caring for their household needs.
When it comes to continued funding the best way to ensure that funding for a heath related grant or contract is continued is through appropriately documenting the improved outcomes.  An efficient way to do this is through  SMART goals.  Tracking the improvement over regular intervals gives validation for continuing funding in the future.  Nurses can work with people involved in programs on an individual basis to help them identify, achieve and revise their SMART goals.  When individuals have a personal incentive or motivation to change it is more likely the change will be long lasting.
I do believe that cash incentives can be a great way to improve health in impoverished communities.  In a recent study, cash incentives resulted in improved health outcomes for low income patients.  Patients who received a cash incentive reported a decrease in both pain and depression (Bradley, C.J., &Saunders, H.G. 2020).  It is important to note that individuals in this study did not have health insurance.  I think cash incentives can also be a positive way of encouraging improved health outcomes in individuals who do have health insurance.  For example, my employer offers cash incentives for employees who complete health activities like getting a checkup, lowering your blood pressure or adhering to weekly exercise.  This is a good way to motivate individuals to take control of their health.ontinued, as a nurse, in that case, I could advocate for maintaining funding by saying that there are tremendous benefits to this program in more children in low-income families attending school regularly, and both adults and children obtaining immunizations and preventative healthcare services as well as nutrition. There is a similar problem in my community with low-income families not seeking preventive health care, malnutrition, and school attendance. However, from my experience, these families are low-income but don’t meet poverty requirements for specific government programs. I believe this type of program would not work in my community since these low-income families are very busy working to provide for their families.

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