Problem
Examine the determinants of health of selected "cases." Consider the determinants of health of the persons described in each of two vignettes noted below and the most important risk factors they face or faced.
I. For each of the vignettes below, explain how the person acquired the health problem described in the scenario. Be sure to include a description of the social, political and economic determinants, as well as the more "immediate" health determinants.
II. Having identified the determinants of health for each vignette, briefly discuss what could be done in the short and long run to address those determinants.
i. Sarah Lived in Rural Pakistan and was pregnant with her 2nd child. When she went into labor, Sarah called for the traditional birth attendant, which most women did in her town. As Sarah's labor continued, she and the birth attendant realized that the labor was complicated. Sarah needed to go to a hospital to deliver the baby. In this part of Pakistan, however, women could not be taken to the hospital without their husbands' permission. Sarah's husband was working in another city and was not available to give such permission. Several hours later, Sarah and the baby died at Sarah's home.
ii. Rashmi lived in the eastern part of Nepal in a modest home. She often had difficulty breathing. This was linked to the way Rashmi cooked, with an unvented household stone that was fueled by cow dung or wood. She cooked 2 meals a day on the stone, and she often held her new baby on her back as she did so. She heard about different stones and about using kerosene or gas for fuel. However, she lacked the money to buy a new stove or use kerosene or gas for cooking
iii. Maria was 33 years old and lived in the mountains of Peru. For some time, she had not been feeling well. She often had a fever, was coughing a lot and had night sweats. Maria had tuberculosis (TB) earlier and worried that this might be TB again. Maria was correct. In fact, this time, she had drug resistant TB which would be difficult and expensive to treat and might not be curable. When Maria was sick the 1st time, she started her prescribed 6 months of treatment. However, because she felt much better after the first 2 months of drugs, she did not take the rest of them.