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Global Healthcare Comparison Matrix and Narrative Statement

Global Healthcare Comparison Matrix and Narrative Statement

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Global Healthcare Comparison Matrix and Narrative Statement

Global Health Comparison

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Global Health Comparison Grid Template

Use this document to complete the Module 6 Assessment Global Healthcare Comparison Matrix and Narrative Statement

Global Healthcare Issue  

Tobacco smoking among pregnant women


Tobacco smoking is the leading cause of preventable deaths in the world. According to WHO (2020), smoking kills more than 8 million people per year. Smoking while pregnant is a risk to two lives. Tobacco use during pregnancy can lead to complications such as pre-term birth, low birth weight, abnormal bleeding, and miscarriage, among others (Forray, 2016).



United States


Describe the policy in each country related to the identified healthcare issue The US has excise taxes and smoking in public places bans as the main way of discouraging smoking (Tax Foundation, 2020).







Australia has adopted socio-campaigns using graphic marketing tactics and increased cigarette taxes (Australian Department of Health, 2020).
What are the strengths of this policy? This has reduced the inequalities among smokers. The largest percentage of smokers comes from lower social classes; hence, increasing excise duties and discouraging public smoking increases the cost of cigarettes while criminalizing public smoking. This has encouraged pregnant women to quit smoking (Levy et al., 2018).









The highest percentage of pregnant women smokers are among Aboriginal women in Australia (Bovill et al., 2018). The graphic advertisements that target these women, along with the high taxation rates on cigarettes, discourage the use of tobacco. This group of women smokers also happen to be among the poorest, and thus, these moves by the government aim and have succeeded in reducing tobacco use among these women (Tobacco in Australia, 2016).
What are the weaknesses of this policy? The world has become a global village. Even with the high taxes on locally manufactured cigarettes, the policy fails to cover imports from countries such as China. Smokers can bring up to 1 carton containing 200, duty-free cigarettes into the country. Any goods valued at more than $800 are taxed; therefore, anyone wanting to smoke cheaper cigarettes can import them from China as long as the price of goods is below $800 (Von Lampe, 2019).










Smoking among Aboriginal women is more of a cultural thing than a past-time habit. Women are considered to be ‘of age’ and encouraged to smoke cigarettes (Bovill et al., 2018). So while the policy aims to reduce the rate of smoking among pregnant women, it does not address the cultural aspect of smoking. This makes it difficult for a cessation to be spread at a larger scale as it should be.
Explain how the social determinants of health may impact the specified global health issue. (Be specific and provide examples)


The social determinants impacting tobacco use among pregnant women include education, wealth, and knowledge of the harmful effects of smoking while pregnant. The more educated, wealthier, and the more knowledgeable categories of women are, the more likely they are to stop smoking while pregnant, while the reverse is true  (Do et al., 2018). Culture,  poverty, and low education are the main social determinants that encourage tobacco use among pregnant women. As mentioned earlier, the Aboriginal culture allows women to smoke as a sign of maturity. Besides Aboriginal women, Australian women are more likely to be tobacco users when they have less information on the health impacts of smoking while pregnant and also if they come from low economic backgrounds (Gould, Lim & Mattes, 2017).
How has each country’s government addressed the cost, quality, and access to the selected global health issue? The CDC offers resources at state and community levels for controlling and preventing the use of tobacco. The Smoke-free Women website offers professional support and assistance, evidence-based and accurate information, in support of the long-term needs of pregnant women and women in general who want to stop smoking. These services are offered free of charge, as the government bears the cost (CDC,2020). In addition, cigarette packaging is required to have a warning sign clearly indicating the age limit as 18 and above, which limits access to young pregnant women. Warning labels also indicating the harmful effects of smoking makes the consumer aware that the product quality is harmful to one’s health, no matter the manufacturer (Lempert & Glantz, 2018).









The government funds tobacco-control mass media education. Similar to the US, warning labels discourage tobacco use among teens and children and inform users on the low quality of health impact as a result of tobacco use (Sarma, 2018).
How has the identified health policy impacted the health of the global population? (Be specific and provide examples) The US uses the revenue from the high taxation to subsidize Universal health care. The tax revenue majorly funds smoking cessation and prevention programs as well as cancer research (Kagan, 2018). In Chicago, for example, the additional revenue is also used to fund the Healthy Chicago Plan, which encourages smoking cessation and initiation  (Goldman, 2016).








Revenue from tobacco taxation is also used to fund education initiatives in smoking cessation and also advertising. These strategies are part of the agenda to have a smoke-free Australia (Durkin et al., 2020). An example of such a program is Quit Victoria, which aims to reduce smoking among disadvantaged groups, including Aboriginal women (Victoria State Government, 2020).
Describe the potential impact of the identified health policy on the role of nurse in each country. As an educator, a nurse must take advantage of this information to discourage smoking. As mentioned, the poorer society members tend to be the ones impacted by the high taxes. With this information, a nurse should encourage the pregnant woman to quit smoking for the health of her and her child, save on the unnecessary expense of cigarette costs, and instead use the money to live a healthier life (Mancine, 2015).







As stated, a nurse should use the high cost of cigarettes to discourage pregnant women smokers from purchasing cigarettes. The nurse should also inform the patient on how the money saved from non-purchase can be used to live a healthier life by the mother and her child. The long-term effects of smoking cessation on both mother and child should be emphasized, especially in saving oneself from unnecessary hospital visits resulting from smoking-related illnesses (Mancine, 2015).


Explain how global health issues impact local healthcare organizations and policies in both countries. (Be specific and provide examples) More than 480,000 deaths occur each year from tobacco users. More women die from tobacco-smoking-related lung cancer compared to breast cancer every year. Smoking causes overall diminished health, an increase in healthcare costs, and increased work absenteeism (CDC, 2019).










19,000 Australians die every year from smoking-related illnesses. Smoking is the leading cause of preventable deaths in Australia. Smoking also contributes to 9% of the total burden of disease in the country (Australian Bureau of Statistics, 2019).
General Notes/Comments The country needs to continue increasing its tobacco tax rates and remove the free-tax waiver on imported cigarettes. This will be more effective









The country’s policymakers should look into investing more in cultural-sensitive education on the harmful effects of smoking while pregnant. This will have a bigger impact on the Aboriginal populace.



Australian Bureau of Statistics, (2019). National Health Survey: First Results, 2017-18 , Smoking.

Australian Department of Health, (2020). National Tobacco Campaign.

Bovill, M., Gruppetta, M., Cadet-James, Y., Clarke, M., Bonevski, B., & Gould, G. S. (2018). Wula (Voices) of Aboriginal women on barriers to accepting smoking cessation support during pregnancy: Findings from a qualitative study. Women and Birth31(1), 10-16.

CDC, (2019). Smoking and Tobacco Use.

CDC, (2020). Become a Smoke-Free Woman.

Do, E. K., Green, T. L., Prom-Wormley, E. C., & Fuemmeler, B. F. (2018). Social determinants of smoke exposure during pregnancy: Findings from waves 1 & 2 of the Population Assessment of Tobacco and Health (PATH) Study. Preventive medicine reports12, 312-320.

Durkin, S. J., Schoenaker, D., Brennan, E., Bayly, M., & Wakefield, M. A. (2020). Are anti-smoking social norms associated with tobacco control mass media campaigns, tax and policy changes? Findings from an Australian serial cross-sectional population study of smokers. Tobacco Control.

Forray, A. (2016). Substance use during pregnancy. F1000Research5.

Goldman, T.R. (2016). Tobacco Taxes.

Gould, G. S., Lim, L. L., & Mattes, J. (2017). Prevention and treatment of smoking and tobacco use during pregnancy in selected Indigenous communities in high-income countries of the United States, Canada, Australia, and New Zealand: an evidence-based review. Chest152(4), 853-866.

Kagan, J. 2018). Tobacco Tax/Cigarette Tax

Lempert, L. K., & Glantz, S. A. (2018). Heated tobacco product regulation under US law and the FCTC. Tobacco control27(Suppl 1), s118-s125.

Levy, D. T., Tam, J., Kuo, C., Fong, G. T., & Chaloupka, F. (2018). Research full report: the impact of implementing tobacco control policies: the 2017 tobacco control policy scorecard. Journal of Public Health Management and Practice24(5), 448.

Mancine, D. V. (2015). Frequency of Nurse-led Tobacco Cessation Interventions and Influencing Factors. 2015 NCUR.

Sarma, S. (2018). Australia: Prevention of Tobacco use and Cigarettes.

Tax Foundation  (2020). Cigarette and Tobacco Taxes.

Tobacco in Australia, (2016). Smoking cessation and Aboriginal peoples and Torres Strait Islanders.

Victoria State Government (2020). Quit.

Von Lampe, K. (2019). The illegal cigarette trade. International and Transnational Crime and Justice, 49.

WHO (2020). Tobacco.

Part 2: A Plan for Social Change

Explain how you would advocate for the incorporation of a global perspective or lens into your local practice and role as a nurse leader.

I would pitch for the implementation of a tobacco cessation program that targets pregnant women at the clinic. The program will be prepared by myself and other team members. It will also include, upon approval, the participation of different departments, including the pre and post-natal care, nutrition and dietetics, child and social services, and nurses. The program will be founded on the Five A’s of Tobacco and Nicotine Cessation described in Appendix 1.

Explain how the incorporation of a global perspective or lens might impact your local practice and role as a nurse leader.

When specifically targeting pregnant women, a decline in tobacco use is expected. Studies show that the more informed a mother-to-be is regarding the negative health impact of smoking while pregnant, the higher the likelihood of cessation. The program will aim at increasing access to this information. For the nurse to impart this knowledge, one needs to have the necessary training on patient education and effective communication. Therefore, nurses enrolled in the implementation of this program will be required to undergo training to ensure an enhanced impact of the program on the target group.

Explain how the incorporation of a global perspective or lens into your local practice as a nurse leader represents and contributes to social change.

Smoking while pregnant endangers the health of the mother and her unborn child. Some of the impacts of maternal smoking on the unborn child include low birth weight, preterm birth, and birth defects of the mouth and lips. Smoking during and after pregnancy also increases the risk of sudden infant death syndrome (SIDS). Nicotine can cause brain and lung damage to the fetus (Greaves et al., 2016). The program will inform patients on these dangers that smoking imposes on the unborn child. With this information, pregnant women are likely to cease smoking during and after giving birth (Siu, 2015).


Greaves, L., Hemsing, N., Poole, N., Bialystok, L., & O’Leary, R. (2016). From fetal health to women’s health: expanding the gaze on intervening on smoking during pregnancy. Critical Public Health26(2), 230-238.

Siu, A. L. (2015). Behavioral and pharmacotherapy interventions for tobacco smoking cessation in adults, including pregnant women: US Preventive Services Task Force recommendation statement. Annals of internal medicine163(8), 622-634.


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Global Healthcare Comparison Matrix and Narrative Statement

Assignment: Global Healthcare Comparison Matrix and Narrative Statement
Note: This Assignment is due on Day 5 of Week 11.

Global Healthcare Comparison Matrix and Narrative Statement

Global Healthcare Comparison Matrix and Narrative Statement

If you talk about a possible poor health outcome, do you believe that outcome will occur? Do you believe eye contact and personal contact should be avoided?

You would have a difficult time practicing as a nurse if you believed these to be true. But they are very real beliefs in some cultures.

Differences in cultural beliefs, subcultures, religion, ethnic customs, dietary customs, language, and a host of other factors contribute to the complex environment that surrounds global healthcare issues. Failure to understand and account for these differences can create a gulf between practitioners and the public they serve.

In this Assignment, you will examine a global health issue and consider the approach to this issue by the United States and by one other country.

To Prepare:

  • Review the World Health Organization’s (WHO) global health agenda and select one global health issue to focus on for this Assignment.
  • Select at least one additional country to compare to the U.S. for this Assignment.
  • Reflect on how the global health issue you selected is approached in the U.S. and in the additional country you selected.
  • Review and download the Global Health Comparison Matrix provided in the Resources.

The Assignment: (1- to 2-page Global Health Comparison Matrix; 1-page Plan for Social Change)
Part 1: Global Health Comparison Matrix

Focusing on the country you selected and the U.S., complete the Global Health Comparison Matrix. Be sure to address the following:

  • Consider the U.S. national/federal health policies that have been adapted for the global health issue you selected from the WHO global health agenda. Compare these policies to the additional country you selected for study.
  • Explain the strengths and weaknesses of each policy.
  • Explain how the social determinants of health may impact the global health issue you selected. Be specific and provide examples.
  • Using the WHO’s Organization’s global health agenda as well as the results of your own research, analyze how each country’s government addresses cost, quality, and access to the global health issue selected.
  • Explain how the health policy you selected might impact the health of the global population. Be specific and provide examples.
  • Explain how the health policy you selected might impact the role of the nurse in each country.
  • Explain how global health issues impact local healthcare organizations and policies in both countries. Be specific and provide examples.

Part 2: A Plan for Social Change

Reflect on the global health policy comparison and analysis you conducted in Part 1 of the Assignment and the impact that global health issues may have on the world, the U.S., your community, as well as your practice as a nurse leader.

In a 1-page response, create a plan for social change that incorporates a global perspective or lens into your local practice and role as a nurse leader.

  • Explain how you would advocate for the incorporation of a global perspective or lens into your local practice and role as a nurse leader.
  • Explain how the incorporation of a global perspective or lens might impact your local practice and role as a nurse leader.
  • Explain how the incorporation of a global perspective or lens into your local practice as a nurse leader represents and contributes to social change. Be specific and provide examples.

By Day 5 of Week 11
Submit Part 1 and Part 2 of your Assignment.

Submission and Grading Information
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