Introduction
Community analysis has become a useful tool in guiding the implementation process of policies at the community level. The fact that policies are developed at the national level makes the tool important when specific objectives with major implications in the delivery of healthcare are required. In essence, community analysis follows a systematic approach that ensures the reinforcement of the required strategies hence enhancing the achievements of the analysis (Robinson, 2006, para 6-15). This essay will discuss the recently announced policy on disability as outlined in the Equality Act 2010 of United Kingdom. A manual that will provide a step by step guide of the implementation process in the local level will duly be discussed while linking it to the applicable theories and available literature.
Background information
Disability is estimated to affect slightly above 10 per cent of the world population. Hundreds of millions of people across the globe live with a disability and the figure is expected to increase particularly as aging of the population occurs. While the largest burden is found in the developing countries, the developed countries and in particular the United Kingdom has a sizeable proportion of the disabled persons (Disabled World, 2010, p. 43). According to United Nation Development Program (UNDP), more than eighty percent of disabled persons live in developing countries (2010, p. 12). In particular, there are many disadvantages conferred by the disability in terms of access to social amenities. In fact, UNDP asserts that slightly more than 20 % of the world population living in poverty is affected by certain kinds of disability. New variants of diseases, increased /life expectancies, natural calamities and largely armed conflict have been blamed for the increasingly number of disabled persons.
Although several causes have been brought forward, the increase in life expectancy combined with new variation of diseases and impairments are overly blamed for the surge in the population living with disability in the United Kingdom. About 8 million people live with one or more forms of disability in the United Kingdom with slightly higher than 8% of them utilizing wheelchairs. More importantly, statistics depict that about 20% of adults and 13% of the working population in UK are disabled (UN Development Programme, 2010, p. 6). Economic and social exclusion occasioned by the disability is estimated to cost the economy more than 19 billion sterling pounds. Taking into account that about 40 per cent of the population is above 45 years, an increase in the levels of disability is anticipated. The challenges faced by the disabled in accessing services such as medical care and public transport occasioned the development of the community analysis.
In tandem with analysis, the government has recently enacted the Equality Act of 2010 that streamlines the regulations governing the treatment of people affected by disabilities in all aspects of the lives. With regard to disability, the Act requires the employers to make special reservations aimed at boosting the functioning of the disabled persons (Freeney et al, 1999, p. 8). Unconditional provision of services particularly healthcare is also emphasized. Taking into account the prevalence of disability and mental health cases, protection of their right to access of medical care is overly needed (Badger, Gagan & Mcniece, 2001, p. 23; Equality Act 2010, 2010, p. 32).
The National Health Service (NHS) provides holistic services to the residents of the United Kingdom. With regard to the services, the disabled persons may fail to enjoy owing to the inadequacies in the supporting frameworks (National Health Service, 2010, para. 3). The people living with disabilities require special healthcare needs. Unlike the normal people, provision of basic facilities and infrastructure to accommodate their unique needs is imperative. Manchester has a sizeable proportion of its population affected by disability. The devolved structures of the NHS confer the hospitals the overall mandate of providing basic services to the citizens in their region of operation. In addition, the hospitals have to take special considerations when dealing with the special cases presented by the disabled persons (National Health Service, 2010, para. 5). Owing to the nature of the families in the United Kingdom, majority of the people living with disability usually find themselves under the care of nurses or social workers either in a hospital or a geriatric facility. The fact that majority of the families in the area are involved in formal employment means less time is spent with the disabled persons.
The situation is compounded especially when the affected individual is overly reliant on the services of the family members with regard to movements and normal house chores. In some instances, cases of mistreatments and discrimination has been observed and reported in various home settings within the Manchester. Although such occurrences are prevalent around the UK, an increase of the number of cases reported over the last several years has occasioned the revival of efforts to sensitize the community and the hospital staff on the major impacts of the equality act of 2010(National Health Service, 2010, para. 5). The hospitals in the Manchester area are also experiencing the same problem with reported cases of harassment against the people with disability. The affected individuals usually report use of abusive language and unfairness when getting services as the main forms of discrimination they have to endure every day. In order to curtail the spread of the vice in the area, community analysis will involve an integrated approach that will introduce best practices in the community and within the hospital establishment.
Identification of community needs
To ascertain the knowledge and overall understanding of matters pertaining to disability, a survey was conducted within the hospital establishment and the catchment area. Data collection through questionnaires showed a below average understanding of disability matters (World Health Organization, 2001, p. 12). The respondents were recruited through random sampling which yielded 200 participants in a population of 10000 clustered in 1000 families.
Data analysis denoted that more than half of the respondents have at one time acted irresponsibly towards the people living with disability. Although, about 30% of the families had at one time lived together with affected individuals, the survey noted that majority of the respondents lacked awareness of the various ways unfair treatment of the disabled persons occurred. In addition, lack of concrete information on the contents of the equality act and matters pertaining to discrimination means that there is a knowledge gap that requires urgent need. The staff working in the hospitals admitted to having the knowledge of the Equality Act 2010. However, laxity and failure in supportive frameworks coupled with ignorance has led to slow implementation of the aspirations in the act. Skewed attitudes and use of inappropriate verbal and non verbal language when dealing with disabled persons were the major forms of discrimination the workers brought forward in the questionnaires. Interaction with the people living with disabilities produced glaring responses of how they usually encounter various forms of discrimination during their everyday life. On healthcare, they reported difficulties in accessing quality services in the public hospitals. Inn addition, they denoted facing enormous forms of discrimination particularly during consultations and admission. Having suffered from physical incapacitation and learning disabilities meant that they received inappropriate treatment particularly with regard to accessing facilities such as lavatories (Kronenfeld, 2002, p. 76).
Implementation
After candid reflection on the findings, a clear cut path to address the knowledge gap on the policy and implications to the healthcare was devised. More importantly, the shortcomings in the practice where the community and the healthcare staff failed to implement the policies as outlined in the guidelines. Before conducting a rigorous sensitization campaign, the findings from the study were compiled to enhance the development of a holistic curriculum. Adoption of the Maslow hierarchy of needs will come into play at this stage (Maslow, 1954, p. 12). The curriculum incorporated the basic concept behind the equality act especially with regard with disability and access to healthcare. Identification of the specific situations the policy has major implications as well as the roles of the concerned stakeholders in enhancing the efficacy of the policy with regard to achieving its intended goals and objectives (AED Center for Early Care & Education & American Indian Technical Assistance Network, 2006, p. 13).
The sensitization would be carried out in two phases; community and the hospital setting. In view of the different roles and understanding of the policy guidelines, both groups will receive will be sensitized separately with much emphasis on the healthcare staff (Shrestha, Shrestha & Deepak, 2009, p. 21). The functioning of each group with regard to best practices will receive wide acknowledgment in the training session. In fact, the applicability of the policy in every day life and practice will be stressed to ensure the transfer of the knowledge to practice. Theories of social justice and learning will be incorporated in the training to enhance the linkages of the policy with life (Faden & Powers, 2006, p. 23; Bandura, 1977, p. 11). In addition, the theoretical frameworks will bring empathy among the community and the staff hence bringing positive outcomes with policy practice. The economic, social and cultural benefits occasioned by the embracement will be put into perspective. In fact, the overall health and dependency costs mainly due to neglect of people with disabilities is enormous. Briefing the concerned stakeholders with respect to this will boost motivation to embrace and ensure sustainability of the practice (Robinson, & Eklan, 1996, p. 54).
On the implementation of policy, the management of the facility and community leaders will be trained on operationalizing the Act. In tandem with the guidelines and concerns raised during the data collection, the supporting frameworks will be given first priority (ByWaters & Mcleod, 1996, p. 43). Education of the community and staff on best practices of handling and treatment of people living with disability will be carried out simultaneously with organizing the supporting frameworks. The supporting frameworks entails provision of friendly infrastructure, wheel chairs, recreational facilities, dedicated staff and ensuring their concerns are overly explained. The facilities should be available at the hospital setting while improvisation should occur at the household level. People living with disabilities should be supported at the community level by ensuring support in accessing basic amenities. People with learning and cognitive disabilities must be accorded due support and encouragement in learning basic things. In addition, psychological help must be given in abundance to improve their self esteem. Ensuring the customer charter take note the special needs in addition to the basic rights accorded to all patients must be emphasized (Freeney et al, 1999, p. 18). The disabled persons will overly receive due attention and care when accessing healthcare. To enhance the achievement of the objectives set in the policy guidelines, both groups together with the disabled persons will be trained on the utilization of the various special facilities in order to avoid breakages.
Evaluation
Evaluation of the adherence and success of the process will be conducted after six months interval. Evaluation entails the observation and interviewing of the people with disabilities to assess their views with regard to access to healthcare and basic amenities. More importantly, observation will come in handy in ascertaining the treatment and social interactions within the community with a view of instituting programs to improve the situation (AED Center for Early Care & Education & American Indian Technical Assistance Network, 2006, p. 32).
Evaluation will be based on set standards such as high level of interaction with the staff and community with special attention given to them. More importantly, the understanding and applying best practices with regard to the treatment of disabled persons must be exhibited within the community and staff with the former well conversant with their rights (World Health Organization, 2001, p. 76). To this end, rating of the success of the implementation will be done and remedial measures taken.
Conclusion
Community analysis not only helps the people living with disabilities realize their rights but also encourages the community and healthcare staff to embrace the former hence integrating them in the community set up. In view of the above, it is imperative for incorporation of theories of social learning, health seeking behavior and social justice to improve the success of the community analysis process.
Reference List
AED Center for Early Care & Education & American Indian Technical Assistance Network. (2006). Five Steps to Community Assessment for American Indian/Alaska Native Head Start Programs. Washington, D.C: Department of Health & Human Services.
Badger, T., Gagan, M. & Mcniece, C. (2001). Community Analysis for Health Planning With Vulnerable Populations. Clinical Nurse Specialist. Vol. 15, issue 3, pp. 95-104.
Bandura, A. (1977). Social Learning Theory. New York: General Learning Press.
ByWaters, P. & Mcleod, E. (1996). Working for equality in health. London: Routledge.
Disabled World. (2010). World Facts and Statistics on Disabilities and Disability Issues. Web.
Equality Act 2010. (2010). Web.
Faden, R. & Powers, M. (2006). Social Justice: The Moral Foundations of Public Health and Health Policy. New York, USA: Oxford University Press.
Freeney, M., Cook, R., Hale, B. & Duckworth, S. (1999). Working in Partnership to Implement Section 21 of the Disability Discrimination Act 1995 Across the National Health Service. London: The Grass Roots Group PLC.
Kronenfeld, J. (2002). Health Care Policy: Issues and Trends. New Jersey: Praeger.
Maslow, A. (1954). Motivation and Personality. New York: Harper.
National Health Service. (2010). Disability and social care. Web.
Robinson, J. & Eklan, R. (1996). Health needs assessment: theory and practice. London: Churchill Livingstone.
Robinson, W. (2006). Community Analysis. Web.
Shrestha, S., Shrestha, K. & Deepak, S. (2009). A Community Assessment of Poverty and Disability among Specific Rural Population Groups in Nepal. Asia Pacific Disability Rehabilitation Journal. Vol. 20, issue 1, pp. 83-99.
UN Development Programme (UNDP). (2010). Factsheet on Persons with Disabilities. Web.
World Health Organization. (2001). Community Health Needs Assessment An introductory guide for the family health nurse in Europe. Copenhagen: Nursing and Midwifery Programme, World Health Organization Regional Office for Europe.