NURS 6050: Global Healthcare Comparison Matrix and Narrative Statement

Part 1: Global Healthcare Comparison Matrix Sample

Global Healthcare Issue Healthcare access to all citizens (universal healthcare coverage)
Description The World Health Organization (WHO) global agenda focused on equitable healthcare to all people regardless of their economic status. Various countries have responded to this global health issue by formulating specific policies to ensure accessible health care to all citizens. This matrix compares the US policy and Kenyan Policies that relate to universal coverage.
Country United States Kenya
Describe the policy in each country related to the identified healthcare issue The Affordable Care Act:This policy was initially called The Patient Protection and Affordable Care Act. It is informally referred to as ‘Obamacare.’ This policy aimed at improving healthcare insurance among Americans to promote the affordability of healthcare (Isola & Reddivari, 2020). Universal Healthcare Coverage (UHC)In Kenya, a UHC policy was enacted recently with the objectives of providing affordable and essential care to all citizens. The policy had three pillars: service delivery, governance, and health financing (Barasa et al., 2018).
What are the strengths of this policy? This policy has increased health insurance for Americans. The number of uninsured citizens has significantly dropped. The policy allows for insurance of minors and youths below 26 years to remain under the parents’ health insurance.  It promoted minors’ insurance with preexisting conditions by baring insurance companies from declining cover for such age groups (McIntyre & Song, 2019). The policy has increased the utilization of public hospitals by the patients. The cost of insurance is catered for by the government. The government partially covers expensive imaging and surgical procedures, subsidized in some cases.  Therefore, citizens can participate fully in their healthcare delivery through supportive and early detection of diseases (Okech & Lelegwe, 2015).
What are the weaknesses of this policy? The policy faces challenges from legal and private sector practices. The citizens end up subscribing to insurance policies that they do not ‘need.’ The policy created overcrowding in hospitals. The patients seek medical attention for every condition at the same time to utilize their free insurance. The policy is also expensive on government expenditure. The national coverage is yet to be established.
Explain how the social determinants of health may impact the specified global health issue. (Be specific and provide examples) The expertise qualification to register and enroll the participant in Obamacare was not sufficient. The number of unexpectedly sick citizens would overwhelm the insurers in the program. The human resources to enroll and stratify citizens into who needed to take insurance cover for their health urgently and who did not need this service could overwhelm the human resource (McIntyre & Song, 2019). The number of employed doctors by the government in the public sector is low. According to the Voice of Africa News, the current ratio of doctor to patient ratio in Kenya is 1:16000. This means that one doctor is to serve 16000 Kenyans. With the introduction of government sponsored UHC, citizens have shifted to public healthcare (Okech & Lelegwe, 2015). The doctors are likely to be overwhelmed.
How has each country’s government addressed cost, quality, and access to the selected global health issue? The US federal government has not solved unequal Medicaid expansion due to its inability to cover fully for middle- and a low-income class of citizens. There is no available documented evidence on Obamacare’s impact on the quality of healthcare (Isola & Reddivari, 2020). The Kenyan program is yet to cover all 47 counties of the country. The insurance policy is being piloted in four counties. Due to cost issues, there is a need to ensure, only those who need free health cover are catered for by the policy (Barasa et al., 2018). The issue of quality of healthcare is yet to be solved.
How has the identified health policy impacted the health of the global population? (Be specific and provide examples) Obamacare had a tremendous positive impact on the health of noninsured Americans. The need for insurance had made access to quality healthcare possible and cheaper than the fee for service methods (Manchikanti et al., 2017). Unfortunately, six million had lost their insurance by 2017 while 20 million had gained health insurance. Therefore, not all the population was positively impacted by the policy. The agenda has impacted the health of the nation. The county dwellers with the pilot program have had affordable access to many conditions that they would not rather see a doctor for if they fell ill. This has led neighbouring county residents seeking residence in the counties with this novel health care program. The policy has conformed with the universal health care coverage agenda advocated for by the WHO, but yet to serve the whole nation’s population (Barasa et al., 2018).
Describe the potential impact of the identified health policy on the role of the nurse in each country. This policy enabled the nurse to incorporate primary care to a larger population, and in the process, preventive care was enacted for several citizens through patient education. With many health care seekers, the nurse had a duty to do broadly follow up with patients. With this policy, the nurses have to work over time, round the clock to ensure the increasing number of patients is served adequately. There has been a need to offer patient education to many patients seeking care with different unrelated conditions (Barasa et al., 2018).
Explain how global health issues impact local healthcare organizations and policies in both countries. (Be specific and provide examples) The private health care providers have declined due to their lower ability to follow the new policies financially. The pressure has gone to Medicaid to expand its services to several states. The change of regime gas caused legal implications with some states such as Texas declaring the policy unconstitutional. The policy has put more pressure on other counties that do not have the policy. The Healthcare government in Kenya is managed by the federal government and the county governments at different levels. The need to conform to the global standards entirely has caused discontent among patients. Kenya is a third world country and cannot fully abide by the global healthcare standards propositions without economic constraints. The general impact is the decline in the quality of care offered by public institutions.
General Notes/Comments The policy worked well until the change in political regime and need to conform fully with constitutional requirements. To create accessible health care, the policy has led to a decline in health care quality and has resulted increased waiting time to access healthcare services.

Part 2: Narrative Statement

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

From the information I have compared from the Kenyan and American situation, I would advocate for equitable enactment of the respective policies. Providing citizens with what they need, not what everyone should work with, should be the primary objective of any healthcare cover. Generalizations have made both citizens subscribe to what they may feel ‘unimportant’ at the time. The health policies should ensure prudent use and access to the healthcare they need at the time of application.

  1. Explain how incorporating a global perspective or lens might impact your local practice and role as a nurse leader.

This incorporation would make the quality of nursing care more patient-centred and specific. My roles as a nurse would be relevant to the patients because the conditions for which they are treated would be appropriate. The one-size-fits-all approach would be unnecessary because the patients would be getting the care they need.

  1. Explain how incorporating a global perspective or lens into your local practice as a nurse leader represents and contributes to social change. Be specific and provide examples.

Incorporating universal health care into my practice would significantly impact the social determinants of my patients’ health. By determining each patient’s social determinants, there would be a different social approach to patient-based care. For example, there would be a need to form a social collaboration between nurses to care for patients with related conditions. However, this bears the risks of resulting in a decline in the quality of work conditions due to a decline in nurse to patient ratio.


  • Barasa, E., Nguhiu, P., & McIntyre, D. (2018). Measuring progress towards Sustainable Development Goal 3.8 on universal health coverage in Kenya. BMJ Global Health, 3(3), e000904.
  • Isola, S., & Reddivari, A. (2020). Affordable Care Act. Retrieved 1 November 2020, from
  • Manchikanti, L., Helm Ii, S., Benyamin, R. M., & Hirsch, J. A. (2017). A Critical Analysis of Obamacare: Affordable Care or Insurance for Many and Coverage for Few?. Pain Physician, 20(3), 111–138.
  • McIntyre, A., & Song, Z. (2019). The US Affordable Care Act: Reflections and directions at the close of a decade. PLOS Medicine, 16(2), e1002752.
  • Okech, T., & Lelegwe, S. (2015). Analysis of Universal Health Coverage and Equity on Health Care in Kenya. Global Journal Of Health Science, 8(7), 218.