Through my education and training, I am learning how prevention, education, and community empowerment can reduce the burden of disease and promote healthier environments. I am committed to promoting sustainable practices in healthcare, supporting clean and safe living conditions, and educating communities on how everyday actions affect long-term well-being. By embracing simple actions like reducing waste, supporting clean energy, and promoting public awareness, I aim to make a lasting impact, starting where I am, with what I have. Sustainability begins with responsibility, and I choose to take that responsibility seriously, for the health of today’s world and the generations to come.

Promoting, Preventing and Protection

Using different methods of epidemiology to identify the roots and causes of the diseases.

Making policies that each and every individual can afford.

Protecting environment by using recycled products.

For example: A nurse can educate patients and communities to avoid environmental risks and health impacts.At same time a nurse can also advocate policies that support sustainability.

Conserve resources- turning of machines , using water consciously

Educate ourselves and others.

(pandemics, antibiotics resistance)

reduce long term healthcare costs

improve quality of life

• Poor health infrastructure: Clinics are understaffed and lack equipment, so people don’t get proper care or follow-up.

• Fragmented coordination – The Health, housing, and sanitation sectors don’t work together effectively.

• Poverty and informal jobs – Residents work long hours and can’t prioritize health or afford healthy choices.

• Weak policy implementation – Government health plans exist but are not applied well due to political issues.

• Lack of health data – No electronic records means health workers can’t track patient progress or plan services.

8. What role do social determinants of health play in exacerbating poor outcomes in this population?

• Low income limits access to healthy food, medicine, and care.

• Unsafe housing and poor sanitation increase disease risk and stress.

• Low education levels make it harder to understand or act on health advice.

• Insecure environments prevent physical activity and increase violence or injury risk.

• Gender roles may stop women from getting timely maternal care.

• Fragmented governance and policy implementation: Despite existing UHC policies, political instability and poor coordination between sectors (health, housing, sanitation) limit their impact.

• Under-resourced healthcare infrastructure: Local clinics lack staff, equipment, and preventive services, making consistent, quality care inaccessible.

• Lack of health information systems: Without electronic health records, continuity of care and monitoring of NCDs or maternal outcomes are nearly impossible.

• Limited preventive health services: Focus remains on acute care rather than addressing root causes or promoting long-term health behaviors.

• Inadequate health workforce: Shortage of trained professionals, especially in underserved areas, reduces access to skilled care and health education.

Question 2. What role do social determinants of health play in exacerbating poor outcomes in this population?

Social determinants of health significantly worsen health outcomes in this informal settlement:

• Poverty and unstable employment: Long working hours and financial insecurity lead to poor diet, stress, and reduced healthcare access.

• Low education and health literacy: Residents may not understand or prioritize preventive behaviors due to limited health knowledge.

• Poor living conditions: Lack of clean water, safe spaces, and adequate housing increases disease risk and limits physical activity.

• Gender inequality and maternal health access: Women face greater barriers to prenatal care and rely on unlicensed attendants, increasing maternal complications.

• Environmental insecurity: Unsafe surroundings reduce mobility, contributing to sedentary lifestyles and chronic disease risk.

Several structural challenges are impeding progress toward SDG 3 in this community:

• Weak Health System Capacity: Local clinics face severe shortages in staff and resources, limiting their ability to provide consistent preventive and primary care. The lack of electronic health records further complicates patient follow-up and coordinated treatment.

• Poor Cross-Sector Collaboration: Although policies supporting universal health coverage exist, the lack of integration between sectors such as health, housing, and sanitation prevents comprehensive and effective responses to health needs.

• Political Instability: Unstable governance undermines health system planning and the execution of essential public health policies and programs.

• Limited Focus on Prevention: Health services tend to be reactive rather than preventive, which limits early intervention efforts for chronic diseases and maternal health issues.

• Shortage of Trained Personnel: The scarcity of qualified health professionals restricts access to essential services, especially in maternal and non-communicable disease care, affecting progress on key SDG 3 targets.

8.What role do social determinants of health play in exacerbating poor outcomes in this population?

Social determinants significantly influence the health outcomes of this community:

• Economic Hardship: Irregular and low-income employment forces residents to depend on inexpensive, unhealthy food options, contributing to the rising burden of non-communicable diseases.

• Unsafe Living Conditions: Environmental challenges limit opportunities for physical activity and increase exposure to health risks, affecting overall well-being.

• Low Health Literacy: Limited education and access to reliable health information reduce the effectiveness of public health messages and hinder informed health choices.

• Gender Disparities in Health Access: Women face barriers to quality maternal care, often relying on untrained providers, which increases the risk of complications and mortality.

• Barriers to Healthcare Access: Financial and logistical obstacles, combined with an under-resourced healthcare system, delay treatment and reduce the likelihood of positive health outcomes.

Together, these factors create a cycle of poor health and inequality, obstructing progress toward achieving the goals outlined in SDG 3.

Inadequate health infrastructure: Clinics lack staff, equipment, and resources to provide consistent preventive or follow-up care.

Lack of digital systems: Without electronic health records, continuity of care is compromised.

Urban poverty: Poor living conditions, insecure employment, and limited access to essentials drive poor health outcomes.

Cultural disconnects: Health campaigns often fail to connect due to differences in language, literacy, or local practices.

Social exclusion

Lack of access to essential health services

Environmental factors

Health disparities

2.) Conflicts

3.) Lack of Resources

4.) Lack of policy making

Answer7.

By providing good health services like PHC and health care team,

By providing employement and proper education to the society

Culturally adapted materials: Use visuals, storytelling, and local languages.

Community participation: Involve residents in developing and delivering health messages to build ownership.

Behavioral economics tactics: Use nudges like community competitions for steps walked, healthy meals, etc.

2.) Influencing people in a positive way

Social determinants of health, such as:

1. Poverty and limited employment opportunities

2. Environmental insecurity (e.g., lack of clean water)

3. Inadequate housing and living conditions exacerbate poor health outcomes in this population by increasing vulnerability to NCDs, maternal complications, and limited access to healthcare.

These determinants intersect with health factors, perpetuating health disparities and poor outcomes. Addressing these social determinants is crucial for improving health equity.

Impact of environmental factors, like air pollution and noise pollution. And mental health challenges are also major issues

1- SDG 3 (Good Health and we'll being) 1-limited Healthcare infrastructure and resources 2-Insufficient health financing, making health care unaffordable 3-health inequalities 4-weak governance and political instability 5-shortage of healthcare workers, especially in low-income areas 6-Inaccessibilitu to medicines and vaccines. 7-cultural and social barriers preventing health care 8-environmental threats 9-fragmented health system 10-Emerging health threats such as pandemics,diverting resources.

complications and limited access to prenatal care, with some depending on unlicensed

traditional birth attendants.

Local clinics are understaffed, under-resourced, and unable to offer preventive services

consistently. There are no electronic health records, making follow-up care difficult.

Government health policies are in place to address universal health coverage (UHC),

but implementation has stalled due to political instability and fragmented coordination

between sectors (e.g. housing, sanitation, and health)

Local clinics are understaffed, no electronic health records, political instability, long working hours and environmental insecurity, limited access to healthcare.

Question 8

They make it difficult for the poor to get stable healthcare.

.workforce shortage

.difficulty in health care access

.unstable environment

.no records

2.what role do social determinants of health play in exacerbating poor outcome in this population

.economic stability

.limited resource

lack of knowledge, lack of training for health professionals,

Question 7

Less number of health professionals, Low socio economic back ground, Lack of communication

Staff shortage

Difficulty in health care access

Under resource

No records

8.roles

Economic stability

resources

The poor health, low income, limited access to the health care settings,poor housing sanitation,weak policy implementation,poor diet,bad health habits, lack of education and health care records and documents.

Answer 8

Poor living condition such as sanitation ,food ,water

Poor economic instability,

Gender inequality, lack of education.

Poverty ,Education problem, Housing,Employement issue can worsen health outcomes by limiting access to health care, Healthy food, and safe living conditions and these factors can increase the risk in many ways like diseases, mental health issues, poverty..etc.

Example-People living in poverty may not have access to healthy food, safe housing, or adequate healthcare. This can lead to higher rates of chronic diseases like diabetes or hypertension. Additionally, lack of education may result in poor health literacy, leading individuals to delay seeking medical care, worsening their health conditions

Apart from this , unavailability of resources such as clean water, can also be a predominant factor that hinder attaining SDG3.

1. Care giver: As a care giver, nurse can help in diagnostic and treatment of people.

2. Advocate: can stand with local people and argue for their health and basic needs to authorities

3. Researcher: can conduct surveys in a specific area or a group and can understand the prevailing health issues as well as disease triggering factors and can work effectively to crack such issues

4. Educator: based on the surveys conducted and acquired knowledge, nurse can educate the society in promoting, preventing, diagnosing and treating disease also can help with rehabilitation and palliative care.

5. Counselor: nurse can be a counselor to address mental instabilities and raise their voice against many social stigmas and taboos based on evidence based practices

By providing equal access to health care and tackling of health care waste.

Providing health education regarding the prevention of non-communicable diseases, healthy lifestyle practices, cessation of smoking and alcohol etc.

Providing awareness and free regular health check-ups camps in their areas.

Provide awareness regarding the clinics nearer to them and prenatal care.

2.    Sustainable development goal 3 is good health and well-being. The barriers faced are lack of healthcare staffs and resources. lack of awareness regarding

 good lifestyle practices and medications. Poor housing and sanitation.

3.    Lack of physical activities, poverty, lack of education, inadequate housing and sanitation

1.

What role can advanced practice nurses play in reducing the NCD burden in underserved urban areas?

Advanced Practice Nurses (APNs)—including Nurse Practitioners, Clinical Nurse Specialists, and Nurse Educators—can play a transformative role in reducing the burden of non-communicable diseases (NCDs) in underserved urban areas through:

• Community-Based Health Education: APNs can lead culturally sensitive education programs focused on NCD prevention, nutrition, smoking cessation, and physical activity, tailored to the community’s lifestyle and constraints.

• Primary Care Delivery: They can offer accessible, cost-effective primary care services, including screening, diagnosis, and management of NCDs, especially where physicians are scarce.

• Care Coordination: APNs can bridge gaps between patients and fragmented health services by coordinating follow-ups, referrals, and connecting individuals to social services.

• Task Shifting and Capacity Building: They can train and supervise community health workers and even traditional birth attendants, integrating them into a safer, regulated care model.

• Policy Advocacy: APNs can advocate for community needs, contributing evidence-based insights to push for implementation of universal health coverage and health systems strengthening.

2.

What systemic barriers exist that prevent the achievement of SDG 3 in this setting?

Sustainable Development Goal 3—“Ensure healthy lives and promote well-being for all at all ages”—faces several systemic barriers in this context:

• Fragmented Governance: Poor coordination between sectors (e.g., health, housing, sanitation) limits the impact of health initiatives.

• Political Instability: Changes in leadership and lack of political will stall progress on UHC implementation and public health investment.

• Resource Constraints: Chronic understaffing, inadequate funding, and lack of medical supplies hinder preventive care and effective chronic disease management.

• Data Gaps: Absence of electronic health records and community-level surveillance impedes tracking health outcomes and follow-up care.

• Inequitable Health Infrastructure: Urban informal settlements are often excluded from urban planning, leading to limited access to essential services such as clean water, waste disposal, and emergency care.

3.

What role do social determinants of health play in exacerbating poor outcomes in this population?

Social determinants of health (SDOH) play a foundational role in shaping the health outcomes of residents in informal settlements:

• Economic Instability: Low wages and precarious employment reduce access to nutritious food, healthcare, and medications.

• Environmental Insecurity: Poor housing, pollution, and lack of safe recreational spaces discourage physical activity and contribute to chronic stress.

• Limited Education and Health Literacy: Low literacy levels impede understanding of health messages and adherence to treatment regimens.

• Gender Inequality: Women face compounded risks due to inadequate maternal health services, lack of autonomy in health decisions, and overreliance on unregulated birth attendants.

• Inadequate Access to Services: Distance, cost, and availability of clinics prevent routine screening and early intervention for NCDs.

In conclusion, to effectively reduce the NCD burden and improve overall health outcomes, there must be an integrated response that empowers APNs, addresses systemic inefficiencies, and tackles the root social determinants of health through multi-sectoral collaboration.

~collaboration with other non health sectors for eg sanitation’s , housing and education policies.

~providing preventive health education , health education and promotions via schools.

~use EBP(evidenced based practices) to have good outcomes.

~to record the data and do documentation for feedback and reporting.

To achieve all these there must be collaboration of all Health teams and non health policies.

ANS.8

Relevance to SDG 3 (Good Health and Well-being):

This scenario touches directly on multiple targets under SDG 3, such as:

~Reduce mortality from NCDs

~ Improve maternal health and achieve UHC

~Increase health workforce capacity

~Strengthen early warning and risk reduction for health risks

By providing employment so that they can have access to food , housing etc. which are essential for maintaining health.

By providing preventative health measures and promoting health measures.

There should be no discrimination while giving health care to the society this might effect their mental health also

APNs also play an essential role in health education, promoting lifestyle modifications such as proper nutrition, physical activity, and smoking cessation. By fostering trust within communities, they are uniquely positioned to deliver culturally competent care, improve health literacy, and encourage adherence to treatment regimens. Additionally, they serve as care coordinators and patient advocates, ensuring continuity of care and connecting patients to necessary support services.

2. What systemic barriers exist that prevent the achievement of SDG 3 in this setting?

Systemic barriers that hinder progress toward Sustainable Development Goal 3 (Good Health and Well-being) in underserved urban areas include:

Inadequate Healthcare Infrastructure: Many urban slums and low-income areas lack sufficient healthcare facilities and trained personnel to address NCDs effectively.

Financial Barriers: High out-of-pocket costs and lack of health insurance limit access to necessary diagnostic and treatment services.

Policy Gaps and Poor Governance: Weak implementation of urban health policies and limited investment in preventive healthcare exacerbate existing inequalities.

3. What role do social determinants of health play in exacerbating poor outcomes in this population?

Social determinants of health (SDOH) such as poverty, education, housing, employment, and environmental conditions significantly influence NCD outcomes in underserved urban populations. For example:

Economic Disadvantage limits access to nutritious food, safe environments for physical activity, and healthcare services, increasing vulnerability to NCDs.

Low Educational Attainment is linked to poor health literacy, which impedes disease prevention, early detection, and self-management of chronic conditions.

Systemic Barriers to Achieving SDG 3:

A. Fragmented Governance: Lack of coordination between sectors like housing, sanitation, education hinders comprehensive action.

B. Underfunded Health Infrastructure: Under-resourced clinics cannot offer preventive care, diagnostics, or follow-ups.

C. Workforce Shortages: Limited health personnel compromises quality and accessibility to care.

D. Lack of Data Systems: The absence of electronic health records limits continuity and planning of care services.

E. Cultural and Behavioral Barriers: Resistance to change in dietary habits or preference for traditional practices complicates intervention.

3

Public Health personnel can advocate for multisectoral collaboration in the following ways:

A. Community Mobilization: Use participatory methods to engage community members and stakeholders across sectors.

B. Coalition Building: can lead or join interdisciplinary coalitions to align goals and pool resources.

C. Policy Influence: Represent the health sector in local government meetings and advocate for equitable resource distribution.

D. The use of social media to raise awareness about the importance of multisectoral collaboration and promote policy change.

E. Holding meetings and discussions with stake holders to foster relationships and advocate for

multisectoral collaboration.

7

Tailored Health promotion strategies are:

A. Culturally Relevant Messaging: Use storytelling, local languages, and familiar icons to deliver health education.

B. Peer Educators: Engage trusted community members as health advocates.

C. Flexible Scheduling: Offer activities during evenings or weekends to accommodate work schedules.

D. Low-Literacy Tools: Use visuals, audio messages, and drama-based outreach for communication.

8

Social determinants of health play a significant role in exacerbating poor health outcomes in this population. Some key social determinants include:

A. Social and economic inequality: Women in the settlement face high rates of maternal complications and limited access to prenatal care, highlighting the need to address gender-based health disparities.

B. Income Insecurity: Limits ability to afford nutritious food, medications, or transport to clinics.

C. Education Levels: Impact health literacy and engagement in preventive care.

D. Environmental Conditions: Poor housing and sanitation directly impact disease risk and maternal health outcomes.

E. Employment Conditions: Long hours and informal work reduce time and access for self-care and clinic visits.

1. Nurses play a vital role in preventing and reducing NCDs. By identifying the risk factors in the community a nurse can implement methods for reducing NCDs. By providing health education the people will be aware of the precautions which needs to be taken during a disease. Conducting screening tests and surveys, conducting immunization programs which paves ways to reduce NCD burden

2. Sustainable goal 3 is Good Health and wellbeing. The barriers which prevent the achievement of SGD 3 are the hospitals are understaffed, under trained, lack of resources and there is no electronic records system which makes them difficult for do the follow up.

3. Low income, lack of education, poor housing and sanitation, poverty, environment factors

   
   

   
   

2.SDG3 is good health and wellbeing. The barriers include smoking, eating ultra-processed foods, and engaging only in limited physical activity due to long working hours and environmental insecurity.

3.low income, insecure environments, lack of education, unsafe housing and poor sanitation.

1

The Systematic barriers preventing the achievement or the SDG3 are :

**Insufficient NCD Prevention and Treatment Programs:

Public health initiatives often focus on infectious diseases, leaving NCDs relatively neglected. This includes a lack of screening programs, early detection services, and comprehensive treatment options.

** Lack of Financial Resources:

Investing in NCD prevention, treatment, and care requires significant financial resources. Many countries struggle to allocate adequate funding for these purposes, especially when competing with other development priorities.

**Persistent Health Inequalities:

Social determinants of health, such as poverty, lack of education, and discrimination, contribute to disparities in access to healthcare and healthy living conditions. These inequalities disproportionately affect marginalized groups and hinder the progress towards universal health coverage.

**Weak Governance and Policy:

Inadequate coordination between different sectors, weak regulatory frameworks, and a lack of political commitment can hinder the development and implementation of effective NCD prevention and control .

3

Nursing leadership or public health personnel can advocate for multi sectoral collaboration through the following ways ;

**Policy Changes:

They can actively participate in policy-making processes to ensure that health equity and multisectoral collaboration are prioritized in legislation and funding decisions, according to the National Institutes of Health (NIH) .This involves serving on advisory committees, commissions, and boards where policy decisions are made.

They can also advocate for funding and resources for programs that address social determinants of health, such as housing, sanitation, and education, according to the National Institutes of Health (NIH)

**Building Partnerships:

They can forge strong partnerships with representatives from other sectors, including housing, sanitation, education, and social services, according to the American Nurses Association (ANA).

This can involve attending community meetings, establishing joint committees, and collaborating on research projects.

Promoting Interprofessional Collaboration:

They can foster interprofessional collaboration by creating a culture of shared responsibility and accountability within their organizations.

This can involve developing and implementing interprofessional education programs and providing ongoing support for interprofessional teamwork.

**They can also advocate for the use of technology to facilitate communication and collaboration among different healthcare professionals.

**Prioritizing Community Engagement:

They can actively engage with communities by conducting needs assessments, participating in community events.

**Investing in Public health Education and Training:

They should advocate for increased investment in nursing education and training, particularly in areas related to leadership, management, and interprofessional collaboration.

This can involve providing nurses with opportunities for continuing education, mentorship, and professional development.

**They can also advocate for the development of specialized training programs that focus on cross-sectoral collaboration and health equity.

7

Tailored health promotion strategies are ;

**Understand the Community:

Conduct thorough community assessments to identify cultural norms, beliefs, and values that influence health behaviors and also Incorporate Local Traditions;

Integrate community-specific traditions and celebrations into health promotion efforts, ensuring that messages are not seen as conflicting with cultural practices.

**Addressing Literacy and Socio-Economic Constraints with Multi-lingual Materials :

Provide health information in multiple languages to accommodate diverse linguistic needs. Accessible Formats

of information in various formats, such as posters, flyers, videos, and audio recordings, to cater to different learning styles and literacy levels.

** Community-Based Resources:

Tap into local community resources, such as faith-based organizations, community centers, and local leaders, to facilitate outreach and support.

Address Economic Barriers:

Recognize and address socio-economic barriers that may hinder access to healthy foods, healthcare, and safe environments.

** Community-Led Initiatives:

Empower community members to lead health promotion activities, as they are often more effective at addressing local needs and cultural contexts.

** Promoting Health Literacy and Empowerment:

Provide Information,Offer evidence-based information about NCDs, risk factors, prevention strategies, and available resources.

**Focus on Prevention:

Emphasize the importance of prevention, rather than focusing solely on the disease .

8

Social determinants of health plays an important role in exacerbating poor outcome in this population .Some of the key Social determinants are;

** Socioeconomic Factors:

Poverty and Inequality;

Low income and wealth are strongly linked to higher rates of NCDs like heart disease, stroke, diabetes, and hypertension. People with limited financial resources may struggle to afford healthy food, access quality healthcare, or participate in recreational activities, increasing their vulnerability.

**Education:

Lower education levels are associated with increased NCD risk factors and poorer health outcomes. This can affect individuals' knowledge and ability to make healthy choices, access healthcare, and navigate complex health systems.

** Environmental

Conditions: Poor housing and poor sanitation directly impact disease risk and maternal health outcomes.

** Employment Conditions: Long hours and informal work reduces time and access for self care and checkups.

Oluwatosin Oredeko

• Community-based interventions – Implement mobile clinics, telemedicine, and home-based care.

• Policy advocacy – better clinic funding, health infrastructure, and policies addressing social determinants.

• Train community health workers and traditional birth attendants.

• collaboration – Work with social services, housing, and urban planning to improve health conditions.

• Primary care & chronic disease management – Provide accessible healthcare, screenings, treatment, and lifestyle counselling.

  
  

  2.systemic barriers exist that prevent the achievement of SDG 3 in this setting?

• Achieving effective healthcare in underserved urban settlements is hindered by several systemic barriers, including political instability that leads to fragmented health policies and inconsistent implementation. Chronic underfunding and understaffing of health facilities make preventive care and disease management difficult, while broader social determinants such as poverty, food insecurity, environmental hazards, and limited education further exacerbate health disparities. Inadequate healthcare infrastructure, particularly the absence of electronic health records, disrupts continuity of care, while cultural and behavioral barriers—such as misinformation and reliance on unlicensed providers—complicate health-seeking behaviors. Additionally, the lack of coordination between essential sectors like health, housing, sanitation, and employment prevents the development of holistic solutions necessary for sustainable health improvements.

3.What role do social determinants of health play in exacerbating poor outcomes in this population?

Factors like poverty, food insecurity, and unstable housing limit access to nutritious food, clean water, and safe living conditions, increasing vulnerability to non-communicable diseases and maternal complications. Environmental hazards, such as pollution and inadequate sanitation, elevate risks of respiratory illnesses and infections, while limited education and health literacy reduce awareness of preventive care and healthy behaviors. Additionally, employment insecurity and long working hours discourage physical activity and make healthcare unaffordable, leading to delayed diagnosis and treatment.

7.To effectively promote health, tailor your approach to the community's needs by:

- Developing culturally relevant messages and materials

- Engaging in community outreach and education

- Providing clear, actionable guidance

- Making health information accessible and easy to understand

This targeted approach can enhance the impact of health promotion efforts.

Tailor health promotion by:

1. Using culturally sensitive messaging

2. Creating simple, visual materials

3. Utilizing community-based outreach

4. Providing practical, actionable advice

5. Offering education in accessible locations