Free «Mandatory Infant Testing» UK Essay Paper
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Since the introduction of the mother-to-child prevention program in Malaysia, the birth rate of HIV positive infants has significantly reduced. For every 1,000 infants born, nine of them are born HIV positive, which actually represents a 0.9% infant infection rate. Low levels of infection rates follow prolonged media campaigns that have insisted on expectant mothers taking HIV tests so that one can know her status and take the right course of action. For infected expectant mothers, the mother-to-child program is implemented to prevent a HIV positive mother from infecting the infant. Campaigns have largely succeeded to the effect that almost every expectant mother in Malaysia knows her HIV status. This research seeks to evaluate advantages as well as the disadvantages of compulsory HIV infant testing and its effectiveness in saving lives and reducing the spread of HIV.
Obtaining consent from parents for testing the newborn has several advantages, including the following: mother will also be a willing participant in the process and thus will continue with the medication program if the test turns out positive. The mother will be aware of the child’s HIV status and thus cooperate with medical officers in administering post-testing treatment. The consent will also ensure that the mother takes charge of the newborn’s health since testing in terms of nutrition and medication (Padian et al., 2007).
Testing is important since it will also determine whether the mother breastfeeds the baby or employs other feeding options as advised by nurses. Testing the infant will enable the government to get crucial data for carrying out a comparison of several successive years to ascertain whether the measures taken have any impact on the rates of infection. If the comparison indicates the impact is insignificant, then the government may consider a change in the strategy to make campaigns more effective. In brief, infant testing program will provide the Malaysian government with vital statistics that would form a basis for comparison relating to the success achieved over some successive years (Padian et al., 2007).
Significance of Mother’s Consent to Infant Testing
Obtaining consent from the mother before testing the newborn is also important since by testing the child, one will also be testing the mother since if one was not under the MTCT prevention program, the status of the mother resembles the status of the child. It is good to seek consent from the mother since it will help prepare her psychologically for the outcome of results (Bajunirwe & Muzoora, 2007). Psychological preparation reduces stigma and stress in the event of a positive outcome and creates room for counseling the mother and giving her appropriate advice in the future.
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It is also advantageous to seek the mothers’ consent before testing the infant for HIV for cooperation. Some mothers may refuse to cooperate completely by way of preventing nurses from collecting blood samples from the infant for testing. Some will also refuse to collect results of the test and thus render them purposeless. Mother’s cooperation remains very important in the entire process of infant testing as at that stage the infant has no ability to act on the results and, thus, the mother acts on his/her behalf (Bajunirwe & Muzoora, 2007). Acting on behalf of the infant entails taking appropriate medication for positive results, as well as taking preventive measures if the results turn out negative. The mother’s consent in general increases cooperation and makes the entire process successful.
Disadvantages of Seeking Mother’s Consent to Infant Testing
However, seeking consent from the mother comes with its disadvantages as some mothers might complicate the process, especially if they do not support it. Consent might create a leeway for them to sabotage the entire process. Testing infants also increases stigma, especially if the infant tested turns out positive. Others stigmatize the mother in most cases, which may lead one to harm the infant. Cases of mothers deserting infants in hospitals or in the streets have increased sharply, in particular due to stigmatization that existed in the early years (Bajunirwe & Muzoora, 2007).
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Parents should not be permitted to refuse from child testing since testing provides important demographic data that enable the government to plan for the future. The data also enable external and internal donors to identify areas to support and required aid (Bajunirwe & Muzoora, 2007). Parents should also never be permitted to refuse from child testing since the testing will enable health workers to advise the mother appropriately on the best way to protect the child if he/she is not infected, and if the baby is infected, they will still advise on the best way of keeping the child healthy.
Case Study - Malaysia
HIV positive newborns in Malaysia are administered with antiretroviral drugs to boost their immune systems. The newborns start taking these drugs as soon as possible since the newborns’ immune system is usually very weak and an early boost saves lives. The drugs boost their CD4 count and help their body immune system to fight opportunistic infections (Padian et al, 2011). HIV treatment in Malaysia has been a major source of concern due to its economic impact. HIV treatment consumes nearly a half of financial resources allocated to the health sector from the budget.
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The cost arises from the purchase of drugs for treatment, purchase of testing equipment, as well as sustaining programs aimed at creating HIV awareness among the population (Bajunirwe & Muzoora, 2007). This cost has seen the Malaysian government increase its annual budgetary allocation towards the health sector to help curb the disaster. HIV has also affected the Malaysian economy through the reduction of labor. Most infected individuals are the youth between eighteen years and thirty, which also represents the most productive bracket. Since the majority of them die from HIV-related illnesses, the country is left with an acute shortage of labor to run the economy with a slow economic growth.
Scarcity of labor also increases the cost of production, thus making commerce expensive and resulting in less commercial activities and low investment. Testing newborns will reduce the economic burden since the mortality rate will reduce and thus enable the country to have enough labor for economic development and reduce the cost of treatment that would have arisen if testing were to occur later in case of a HIV positive infant (Bajunirwe & Muzoora, 2007). It will also reduce economic burden as the government will prepare and plan for infants in the event that the testing turns out negative.
Malaysia is a country with a strong cultural heritage that has been passed down from one generation to the other. Most Malaysians strongly believe in the powers of traditional healers. In fact, conservatives in Malaysia do not visit hospitals, but rather prefer to consult local healers for various treatments (Bajunirwe & Muzoora, 2007). They believe that their herbal medicines are more beneficial than the ones offered in government hospitals. Some men also find it hard to receive medical care from a female practitioner, instead opting to visit local healers. At the same time, some men do not allow their wives to receive medical care from male doctors due to cultural restrictions.
This makes it very hard for the recommendation to be adopted. Medical ethics would also render the implementation of these recommendations difficult since it restricts the act of carrying out HIV testing on an individual, whether a child or an adult, without his/her consent. In the event of a child, the parent or the guardian must be consulted beforehand. The ethical provision is a major setback in the implementation of the recommendation since there is no guarantee of one getting the consent to carry out the test. Time is also wasted in seeking the consent, thus prolonging the process unnecessarily. This ethical provision has landed some practitioners in problems as parents of infants tested without their consent have filed legal suits, accusing practitioners of engaging in professional misconduct. This has seen some medical experts lose their jobs, while others have found themselves behind bars and paying heavy fines. Generally, this ethical provision stands as the main obstacle in the implementation of the recommendation. Stakeholders in the health sector ought to sit down and revise the ethical provision if they intend to make any progress in the matter and implement the recommendation (Padian et al., 2007).
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The fact that infant testing remains optional also acts as a setback towards implementation of the recommendation. The government ought to declare it compulsory and even declare it failing to take an infant for HIV testing as a criminal offence. This will motivate mothers to take their kids for testing; otherwise, little progress will be achieved in terms of implementing the recommendations (Padian et al., 2007). All medical practitioners adhere to the ethical provision that emphasizes that all medical practitioners should endeavor to save life at all costs. Testing infants stands as a part of life-saving exercise and, thus, the ethical provision supports the act of mandatory infant testing. All health practitioners in all government institutions ought to pursue this ethical provision and carry out infant testing so as to prescribe the ideal medical care for them if they are found positive. This will help save life as statistics indicates that half of infants infected with HIV survive to their first birthdays (Bajunirwe & Muzoora, 2007). Testing will enable early diagnosis and treatment of HIV, allowing the child to enjoy a happy healthy life.
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Mandatory HIV testing for infants as discussed above has far-reaching consequences for both the country’s economy and citizens of a given country, which is Malaysia in this case. The recommendation for mandatory infant testing will automatically reduce the number of expectant mothers attending their postnatal treatment. Those with the newborn will also stay away from government health facilities due to a fear of having their infants tested. The fear of stigmatization that accompanies infant testing forms the basis that comes with all the negativity associated with infant testing (Padian et al., 2007).
Another general impact of the recommendation for mandatory infant testing is increased government expenditure on the health sector. Since the testing will require experts and equipment, as well as mobilization that require cash, it will have an overall negative impact on the economy. The same financial resources allocated for infant testing would have been used to cater for other things. The mandatory testing will also push the government into taking more foreign loans to implement the recommendation. Foreign loans come at high interest rates, which will push the country further into poverty (Padian et al., 2007).
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Mothers with infants staying away from government medical services due to compulsory infant testing will also affect negatively the economy since the act will automatically increase infant mortality rate that will result in a low rate of population growth. A country requires a normal population growth rate in order to meet ever-growing economic demands (Bajunirwe & Muzoora, 2007). Low population growth denies it the highly needed labor force for driving the economy towards prosperity. At some point, the government might be forced to import work force, which is actually a very expensive undertaking for any developing country like Malaysia.
On the flipside, however, mandatory infant testing will be very important for Malaysia as a country as it will actually enable the government to plan adequately for its citizens in terms of medical care. Planning in this case entails soliciting of alternative financial resources to cater for the increased medical expenditure (Padian et al., 2007). Planning will also entail training of the staff to care for the population at various medical facilities in the country. The government might, for instance, increase enrollment rate of medical students to meet a large demand for HIV positive infants at government facilities.
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It suffices to conclude that even though infant mandatory infant testing has some negative impacts on the society in general, its merits outweigh these demerits. The exercise will provide crucial data necessary for drawing an effective strategy to guide the government on the best approach to handling of the disaster. The exercise will also enable the health sector to address the issue of infection from the infant’s tender age, thus making it easy to control infection rates of the disease. Reducing infection rates remains the ideal strategy of handling the disaster. HIV is a major issue in many governments with Malaysia being one of them. The government of Malaysia spends a lot on HIV testing and treatment, which has influenced the country’s economy negatively. However, creating awareness programs has greatly helped to reduce stigma associated with HIV and the latest recommendation of compulsory infant testing will push ahead the fight against the disaster. Infant testing will not only provide the government with crucial data for planning, but will also equip mothers with skills of handling HIV positive babies and enable them to lead a healthy normal life. However, the media can help reduce resistance to this new recommendation by encouraging mothers to take their infants for testing. Use of the media to fight stigma associated with infant testing will push the fight to the next level.
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