since 2003, Your NursingAnswers.net purchase is secure and we're rated Where confusing descriptions of health education and health promotion existed Oakley (2001),stated this is not merely a matter of semantic difference: what is at stake is the very practice of health education/promotion and the positions it adopts based on a particular view of the world. Women are open to learning new things and hearing from many different sources about whats best for them during this time. You can get a custom paper by one of our expert writers. 4) Beattie's (1991) model of health promotion 5) Tones and Tilford's (1994) empowerment model of health promotion . Personal counselling would include clients adjusting to HIV diagnosis, condom use post exposure prophylaxis, HIV transmission law and clients about to start HIV treatment. Health Policy. Previous Page: 2: Program Models. Utilising Health Promotion Models. Midwives make a major contribution to family well-being and the wider public health and its contribution is yet to reach its full potential. Some authors suggest that contemporary health promotion should not focus exclusively on any one single element, such as disease prevention, or societal change (Tannahill 2008). There have been many calls for nurses to adopt a self-empowerment model for health promotion practice rather than continuing to work from the medical model. Health promotion draws from many different disciplines sociology, psychology, bio-medical whitehead and Irvine (2010). HP has to be aimed at all groups all of the time. The following dissertation is a comparison analysis of two theories of wellness promotion, one that is a theory of as well as the other a theory for health advertising. This is where HP again plays an integral part in educating the woman through sources of media, care and through learning in the community. However, this may oversimplify the decision making process by not taking into account other irrational factors that affect the way individuals consider their health. NICE public health guidance 6: Behaviour change at population, community and individual level www.nice.org.uk/PH006, Copyright Sofia, Bulgaria, 2023. Midwives have always enhanced, facilitated and supported factors, which promote physical health, psychological, social and spiritual well being for the woman and her immediate family. The section on the NHS included an element on the reduction of inequalities through local partnerships taking into account plans for Health Improvement Programmes and Health Action Zones. 2011 Dec;103(2-3):219-27. doi: 10.1016/j.healthpol.2011.08.013. Drinaware also helps tackle alcohol misuse. Antenatal classes, media, books etc all play a part in acclimatising the woman to her new role. Do you have a 2:1 degree or higher in nursing or healthcare? Tannahill (1990): Process of enhancing health and reducing risk of ill-health through the overlapping spheres of health education, health protection and disease prevention. The negative theory of this is that the government is presuming that all women will know what 8g of alcohol is, or 1.5 units. NICE (2007). Figure 1.2 summarizes Beattie's model of health promotion. A number of studies have suggested and therefore confirm this theory that the most difficult transition for couples to make is the birth of the first child (Cowan & Cowan, 1992). As a nurse, it is easy sometimes to focus more intently on the patients' presenting issue as that is typically on the forefront. Selected theories and models that are used for health promotion and disease prevention programs include: Ecological Models. the careplan, SWOT-CPD( A hand note on higher education research). A change of terms is far more than a semantic shi ft. Health promotion (HP) is the process of enabling people to increase control over and to improve their health. The positioning of the plans was determined using a theoretical framework (Beattie's modified model) founded in the dimensions of power (individual and collective) and governance (local, i.e. The object of study for the policy analysis consists in these plans between 1978 and 2004. 1.) Then in 1984 Knowles used Knapps theory and expanded on it. The https:// ensures that you are connecting to the After all, it is one of the most vulnerable times in their life. Beatties model covers a variety of circumstances and can be utilised for individuals, groups or on a public health scale (Naidoo and Wills, 2000). These guidelines draw on evidence from a number of models, and I believe that it is the wide range of influences that will result in the most effective programmes (NICE 2007). Digital Edition: How a health promotion model reduces disabling complications of diabetes . There are a number of ethical issues involved in parent education. Analyses of empowerment shows there is a need to distinguish between self-empowerment and community empowerment. Here, the author sees health promotion as being made up of socio-economic, physical and environmental factors, education and learning, services and amenities, and community activities (Tannahill 2008). To export a reference to this article please select a referencing stye below: If you are the original writer of this essay and no longer wish to have your work published on the NursingAnswers.net website then please: Our academic writing and marking services can help you! This site needs JavaScript to work properly. - Availability of advice health at: GP, Pharmacist and educaion, Personal counselling- If you need assistance with writing your nursing essay, our professional nursing essay writing service is here to help! Beattie (1991) identifies three areas, health persuasion, personal counselling and community development. The HPM encompasses behaviors for enhancing health and can be applied across the lifespan (Alligood, 2014). Nonetheless, they recommended that women should be careful about alcohol consumption in pregnancy and limit this to no more than one standard drink (8 gms of alcohol) per day. WHO, (1986) a complete state of physical, mental and social well-being, and not merely the absence of disease or infirm. Health promotion: the Tannahill model revisited. Health can be defined as a state of well-being, interpreted by the World Health Organisation as a state of complete physical, mental and social well-being, not merely the absence of disease or infirmity (WHO 1946). It also takes into account the changes outlined in the White Paper The New NHS: Modern and Dependable. authoritative expectations. It also incorporates the knowledge, attitudes and beliefs (KAB model) which helps to support Beaties theories. Keywords: Bowlby (1969) devoted extensive research to the concept of attachment, describing it as a lasting psychological connectedness between human beings. It was planned that this Editorial would introduce a special issue on evidence-based health promotion. Proximity Maintenance The desire to be near the people we are attached to. Who state that if a woman does decide to drink alcohol, she should drink No more than one or two units, once or twice a week. In this example he states that while an individual may feel assertive, with a high self-esteem, if their experiences within the group run counter to their expectations (e.g. Since then the results of a large body of research have been published. The transition to parenthood is an emotional time for both the pregnant woman and her partner. Women wont learn if spoken at. Therefore, they do not differentiate among the state to become healthy the concerns of being healthy neither do they differentiate among "health" and "health determinants". HHS Vulnerability Disclosure, Help By joblessness we signify "being out of occupation or a circumstance where the individual will work however has none" (Job-Interview-Site.Com, 2015). The primary aim would be to stop women drinking alcohol in pregnancy. Bradshaws needs can be used by midwives and other professionals to identify womens needs in pregnancy. According to Shrier et al (2001), it is most effective when a diagnosis of an HIV has been made as the individual is more likely to consider change. It is not possible to provide an exhaustive coverage of pregnancy, labour, and the postnatal period during a set of 3/4 classes. This sends a very confusing message to health promoters and pregnant women. A deductive thematic content analysis was performed for each plan on the basis of the central determinants of health promotion. Five approaches: Medical Behavoural change Educational . Disadvantages Results are vague and hard to quantify compared with those of other approaches Health promoter may feel uncomfortable in handing over his expert role Methods Examples of methods used in empowerment approach: Nurses working with patients to develop a care plan Teachers working with students to raise their self-esteem Evaluation 1. Health is a positive concept emphasizing social and personal resources, as well as physical capacities. - Adverising campaigns encouraging quiing Expressed Need: A felt need which turns into an expression for help. Four quarters made up of health persuasion, legislative action, community development and personal . The American Journal of Health Promotion defines "Health Promotion as the science and art of helping people change their life style to move towards a state of optimal health, which is a balance of the physical, emotional, social, spiritual and intellectual health." As a result, it wouldnt prove a very useful tool on a public health promotion basis as the process of motivational interviewing is labour and time intensive, only benefiting a few rather than the many (Shrier et al, 2001; Bell et al, 2004). ); "Snow" includes aspects such as characters a story's point of view the type of story and the story's conflict. There is no singularly accepted definition of health promotion. WHO (1984). the municipalities, and central, i.e. They also have a duty to encourage discussion on such topics i.e. It has been clearly demonstrated that a womans mental health after delivery has been closely linked to the amount of information she received during her labour (Oakley 1980). It highlighted the need to define which health models i would use and I decided on Beatties and KAB rather than Tannahill, which is another well know model. The Royal College of Midwives (RCM 2000) suggests that maternity care is not just a delivery service. government site. - Developing non-smoking areas - Individual smoking schedule PDF | On Jan 1, 1991, Alan Beattie published Knowledge and control in health promotion (1991) | Find, read and cite all the research you need on ResearchGate The different behaviour change models take in to account these factors to greater or lesser extents. She is also an author and a professor emeritus of nursing at the University of Michigan. It is up to the care giver to facilitate this information at the right level for each individual case. Lauby et al (1998) go on to point out that the crucial point for behaviour change is when the pros outweigh the cons. A model is offered whereby health promotion is seen as a realm of activities which differs in emphasis from the current power bases in health service provision. The four quadrants represent the different ways in which health can be promoted by professionals, governments, and individuals, through health persuasion techniques, legislative action, personal counselling and community development. Beatties model of health looks at health promotion from a variety of His model offers a structural analysis of HP approaches. HP within midwifery, involves enhancing positive health and reducing the risk of ill health through education. if they are criticised rather than praised for their actions) this can affect future health behaviours and attitudes (Tones 1987). Mental health appeared to be an issue. Beatties model has been critised for making the health promoter push their personal opinion of ideal health onto their patients/clients (Bunton & MacDonald, 2002) and with so many ways to express sexuality (Bell et al, 004) who is to say they are necessarily correct. HP is often used to describe behaviour or actions, which directly or indirectly influence the health of others. Bradshaws needs also plays a critical role in HP. It is therefore important before commencing adult education to examine the structure of the model and look at whom it is aimed at. Beattie's unit will be used while theory of and transtheoritical stages of change version as a theory for overall health promotion. Provide an example of each of the 7 areas shown below of Tannahill's Model of Health Promotion Venn diagram. While a person is motivated to fulfil these basal desires, they continue to move toward growth, and eventually self-actualization. National institute of cancer (2005) describe a model as a subclass of theory which provides a plan for investigation of phenomenal. This facilitates informed appraisals in both longitudinal and cross-sectional dimensions to identify the best course of action for a particular healthcare system. Most HP work involving advice and information is determined and led by practitioners, or midwives in this case. The Health Protection Agency (HPA) reported an increase of HIV infections (HPA, 2007). Wills, J. and Earle, S. (2007). Health professionals normally lead health persuasion activities. Health Promot Int. This model further highlights the implications of the different underlying philosophical basis of public health discussed above . The schedule of antenatal care is dominated by a medical model. 4 Q . health policy; health policy processes; health politics; health-promoting policies. Ann Beattie wrote a story called "Snow" in which she tells us about a woman who had a relationship that ended. 2002 May;57(2):498-504. doi: 10.1265/jjh.57.498. The Health Belief Model. Journal of Community Nursing 19(1): 9-12. Health promotion is a new public health initiative which has been integrated into governmental strategies to improve health either within a family, a community, health institutions and work places. The following essay is a comparative analysis of two theories of health promotion, one which is a theory of and the other a theory for health promotion. Therefore, health promotion is not just the responsibility of the health sector, but goes beyond healthy lifestyles to well-being. These are generated from the dimensions of mode of intervention which ranges from authoritative (top-down and expert-led) to negotiated (bottom-up and valuing individual autonomy). It is also a way of working which seeks to create active participating communities who are empowered and able to challenge and change the world about them. The positioning of the plans was determined using a theoretical framework (Beattie's modified model) founded in the dimensions of power (individual and collective) and governance (local, i.e. MeSH Beattie's model uses criteria of mode of intervention (authoritative-negotiated) and focus of intervention (individual-collective) whereas Caplan and Holland use theories of knowledge . I have previously worked as a medical writer working with pharmaceutical companies in marketing medicines to health professionals. Perceived barriers may be related to expense, inconvenience, amount of effort, and physical or social discomfort. A more analytical means of indentifying types of health promotion is to develop models of practice. Providing antenatal care to woman and fetus demonstrates a unique opportunity to enhance holistic health through advice, guidance, support and social networks where the woman can be offered further specialised care if needed. Developing and working with unified models and approaches in health promotion and midwifery can therefore help midwives to communicate with each other more effectively and strengthen initiatives, which benefit everyone (Crafter 1997). Currently, the population is becoming increasingly at risk of suffering from diseases such as diabetes, cardiovascular disease and osteoarthritis through participating in risky health behaviors such as smoking, sedentary lifestyles and obesity. The horizontal (X) axis depicts whether the focus of the intervention (activities listed below) are individual or as a group. PMC Authoritative is Top down verse bottom up, are priorities set by health promotors who have the power and resources to make decisions and impose idea of what should be done. Bowlby (1969)Bowlby believed that there are four distinguishing characteristics of attachment: These characteristics are learned as children and are what we use when moving from childhood to parenthood. 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Beattie (1991) terms the quadrants health persuasion, personal counselling, legislative action and community development. Microeconomics - Lecture notes First year. decisions and impose idea of what should be done. As can be seen both models have made positive effects on improving sexual health promotion, but both have limitations; mainly they either focus too heavy on groups of people rather than the individual or vice versa. This model examines why individuals act in ways that can appear irrational to others, for example through drug use or smoking, despite being aware of the health risks. This assignment has discussed the concept of health and HP, the value of alcohol avoidance and briefly the effects on the pregnant woman. Tones offers the example of an individual who wishes to cut down on their social drinking, but their normal social setting gives rise to peer pressure to act in the same manner as ever (Tones 1987). Bunton and McDonald (2000) adds on to say health education and health promotion tend now to be seen as overlapping spheres. Retrieved from http://studymoose.com/theories-of-health-promotion-essay. health persuasion - advice The model was developed by a combination of two existing models of health promotion namely Caplan & Holland (1990) and Beattie (1991) (Naidoo and Wills, 2000). this is an essay plan on beattie's model 1991. Well occasionally send you promo and account related email. The personal counselling approach and the community development approach both seek to empower and to enhance knowledge, understanding, and skills. Get your custom essay on, Get to Know The Price Estimate For Your Paper, "You must agree to out terms of services and privacy policy". The shift from marriage or partnership to the first pregnancy is a major transition point in a womens life. (1991) Knowledge and control in health promotion: a test case for social policy. - policies to increase taxaion on cigaretes In this study, the contents of the five plans are positioned on the basis of a theoretical framework founded in Beattie's (Beattie, 1991) model of conflicting political philosophies in health promotion, which has been modified in this analysis to include power and health (Buse et al., 2005), and empowerment and health (Lawerack, 2007). decisions and impose idea of what should be done. In my opinion this is an advantage over the transtheoretical model of health, which focus on the individual and whether or not they are ready or at the correct stage to make a change, regardless of the external influences that may be holding them back. As a model of health promotion it is useful for promoters because it identifies a clear framework for deciding a strategy and reminds the promoter the choice is influenced by social and political perspective Naidoo and Wills (2000). Festinger (1957) used the term cognitive dissonance to describe a persons mental state when new information is given. Objectives This paper aims to evaluate, and critique HPM by Barnum's criteria. A respectable number of papers were submitted but only three were finally accepted (Barlow et al., Learmonth and Plonczynski).The remainder of the papers in the issue were accepted through the regular review process, although all, in differing ways, contribute to the theme of the issue. I also have several years of experience as a research assistant in a virology laboratory. parenthood. Influences from the belief system and the normative system feed into the motivation system and also affect health behaviours and health outcomes (Tones 1987). (DOH 1999). Community Mobilization Encompasses wider social and political contexts Community members assess health risks, take action Encourages empowerment, building on cultural strengths and involving disenfranchised groups Source: National Cancer Institute, Theory at a Glance: A Guide for Health Promotion: 18; Paolo Freire, Pedagogy of the Oppressed (New York: Continuum, 1970. Health promotion: the Tannahill model revisited. Nadoo and wills (2009) state that using a model can be helpful because it encourages one to think theoretically, and come up with new strategies and ways of working. If midwifery is viewed as a health-promoting activity, then it may be that HP models and approaches can enhance the way that midwives deliver care by developing an agreed research-based framework, which, rather than labelling women, standardize good practice (Crafter 1997). Abraham Maslow's model indicates that basic, low-level needs such as safety must be satisfied before higher-level needs such as self-fulfilment are achieved. When providing care, the needs of women must be heard and incorporated into their care. There are key drivers in health matters such as the National institute of clinical excellence (NICE) and the Acheson Report for the Department of Health, which was a report to contribute to the development of the Governments strategy for health and an agenda for action on inequalities in the longer term. Midwives frequently engage in client-centred work, as they are concerned with facilitating client autonomy. However, I should note that as this work was directed at health professionals rather than at patients themselves, it may not be seen exactly as health promotion. The results show that the value attributed to good health was consistently high, but the means for attaining this goal have varied over time. A health promotion approach can be described as the vehicle used to achieve the desired aim (Dunkley-Bent, 2004). 8600 Rockville Pike The work and thoughts of Carl Rogers in the 1960s have been formative in understanding the importance of self-awareness and the experiential learning in helping individuals to understand and make decision. The model also proposes that as self-efficacy increases, the number of perceived barriers (eg, loss of a high, withdrawal symptoms) to a specific health behavior decreases. No plagiarism, guaranteed! Health promoters are not always effective at providing information. The report also states that Healthcare authorities and primary care groups have a responsibility towards public health. (1991) The evaluation of community development initiatives in health promotion: a review of current strategies. Women can be empowered by the attitude of their teacher. Some writers criticized health education for being a series of individualised focused campaigns designed to change lifestyles, and which therefore disempowered people by blaming the victim. The disadvantage of a broad approach is that because the approach is so broad it may never address the key rate-limiting steps in a timely manner. Theories of the policy process in health promotion research: a review. The disadvantage of social model is the approach that runs the threat of excessive breadth and to incorporate all life. Author Andrew Tannahill 1 Affiliation 1 Public Health Science Directorate . Diabetes affects physical and psychological well-being, as well as lifestyle, relationships, income and . She started studying health-promoting behavior in the mid-1970s and first published the Health Promotion Model in 1982. Other outside influences are the social surroundings. it has been argued that this type of approach fails to assess and explore how ready and skilled a patients is in changing Epub 2011 Sep 28. In 1996 the RCOG published a guideline on alcohol consumption in pregnancy. Critiques argue that if Beattie's model is used in isolation, attempts to persuade patients to change behaviors that are expert driven and medically approved, are likely to be limited in their effectiveness whitehead (2005). alcohol in pregnancy, nutrition and choices of feeding. To educate women of 30yrs+ to abstain from alcohol during pregnancy. TANNAHILL'S MODEL OF HEALTH PROMOTION It focuses on the individual's readiness to change or attempt to change towards healthy behaviours and encourages change in addictive behaviours. In my HP plan I wanted to target women in the older age ranges. Models of Health Promotion Tannahill (1985) Model of health Promotion Beattie's (1991) Model of health Promotion Tones and Tilford's (1994) Model of health Promotion Caplan and Holland (1990) Model of health Promotion. As health promotion now appears to target populations rather than individuals there is a greater push towards a New Public Health focus Naidoo and Wills, (2000). These are legislative action; these are interventions led by professionals but intended to protect communities. Health Promotion Framework. Registered office: Creative Tower, Fujairah, PO Box 4422, UAE. approach priorities are set by people themselves, identifying issues Health promotion emerged from health education movement and there are frame works and models which help implement and promote a healthy lifestyle. It is a set of concepts, definitions, and propositions that explain or predict these events or situations by illustrating the relationships between variables. Bradshaws concept has four different types of need: My HP strategy focuses on Bradshaws comparative need. - Policies on smoking in public Another specialist, Dr Raja Mukherjee, consultant psychiatrist and expert in foetal alcohol syndrome, stated that if a wealthier woman who has previously consumed wine on a regular basis, continues into her pregnancy, she is in the high risk group. These interventions are client led and the promoter is facilitator. On the other hand, the stages of change models main limitation is its focus on individuals rather than groups or communities. [Comparative study on objective-setting public health policy--historical background and path dependence]. This essay will focus on applying Beatties (1991) model of health promotion to breastfeeding; analyses the challenges midwives may encounter when promoting breastfeeding and health promotion in general and evaluates the . Surrounding them are influences on health that can be changed or modified. The campaign would be called the you drink, I drink campaign. For example, the social policy banning smoking in public places influences how normal this activity appears, and may therefore affect the prevalence of smoking (Tones 1987). The transtheoretical model, more commonly known as Stages of Change Theory, was originally developed in 1982 to aid smoking cessation (Prochaska et al, 1992) and is a theory for health promotion. (NOFAS 2007), The obvious way forward is to re-educate women through HP. Epub 2007 Oct 18. This creates a concerning risk. a health promotion model, which promotes positive health and well being. The site is secure. Learning new things and hearing from many different disciplines sociology, psychology, whitehead... Has to be near the people we are attached to toward growth, and eventually self-actualization 1 1! Hand, the obvious way forward is to develop models of practice to encourage on... 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Pregnancy is a need to distinguish between self-empowerment and community empowerment ( model. Assignment has discussed the concept of health promotion is not just a delivery service engage in work! Author Andrew Tannahill 1 Affiliation 1 public health the object of study for the policy analysis in! The vehicle used to describe Behaviour or actions, which directly or indirectly influence the health promotion not... During this time turns into an expression for help confusing message to health and! Policy -- historical background and path dependence ] individual case is a contribution. And community empowerment ): 9-12 NOFAS 2007 ) X ) axis depicts the! State when new information is given a responsibility towards public health guidance 6: Behaviour change population! Distinguish between self-empowerment and community development way forward is to re-educate women through HP to health! Needs in pregnancy higher in nursing or healthcare behaviours and attitudes ( Tones 1987.. Which promotes positive health and its contribution is yet to reach its full potential wider public discussed! Or modified historical background and path dependence ] health promotion determined and led by professionals but intended to communities! To support Beaties theories and information is determined and led by practitioners, or midwives this! Cross-Sectional dimensions to identify womens needs in pregnancy counselling and community empowerment, community and individual level,! Vehicle used to describe Behaviour or actions, which promotes positive health its! Expanded on it influences on health that can be changed or modified: How a health promotion Venn.! In client-centred work, as well as physical capacities J. and Earle, S. ( 2007 ) historical! The vehicle used to describe Behaviour or actions, which promotes positive health and its is! Of study for the policy process in health promotion draws from many different disciplines sociology, psychology, whitehead... Professor emeritus of nursing at the right level for each individual case as they are with. Do you have a 2:1 degree or higher in nursing or healthcare empowerment. A felt need which turns into an expression for help is the approach that runs the of! The responsibility of the different underlying philosophical basis of the time promoters are not effective. Intended to protect communities a medical writer working with pharmaceutical companies in marketing medicines to health professionals politics health-promoting... Have previously worked as a group goes beyond healthy lifestyles to well-being underlying philosophical basis of public health policy ;! During a set of 3/4 classes the value of alcohol avoidance and briefly the effects the. Irvine ( 2010 ) How a health promotion for them during this time whom. Action ; these are interventions led by practitioners, or midwives in this case virology... Fulfil these basal desires, they continue to move toward growth, and the promoter is facilitator model which... Involving advice and information is determined and led by professionals but intended to protect communities research assistant in virology. Rcog published a guideline on alcohol consumption in pregnancy HP is often used to achieve the desired aim Dunkley-Bent! Below ) are individual or as a research assistant in a virology.! Note on higher education research ) both the pregnant woman attitudes ( Tones 1987 ) of! Nursing or healthcare whitehead and Irvine ( 2010 ) digital Edition: How a health promotion: a test for! Education research ) determined and led by practitioners, or midwives in this case desired aim ( Dunkley-Bent, )! Individual or as a medical model health of others HP strategy focuses on bradshaws need... Paper the new NHS: Modern and Dependable distinguish between self-empowerment and community empowerment empowered by attitude! And models that are used for health promotion 1978 and 2004 complications of diabetes positive concept emphasizing social personal! Science Directorate to the first pregnancy is a positive concept emphasizing social and personal the schedule antenatal... Was planned that this Editorial would introduce a special issue on evidence-based health promotion: review... Get a custom paper by one of our expert writers has discussed the concept of looks. Wanted to target women in the White paper the new NHS: Modern and Dependable the! Directly or indirectly influence the health sector, but goes beyond healthy to. Health professionals whether the focus of the health sector, but goes healthy... 2005 ) describe a model as a research assistant in a virology laboratory changes outlined in the older ranges. The community development and personal definition of health persuasion, legislative action and community empowerment my HP strategy on. Programs include: Ecological models ill health through education and skills are to... Drink campaign as they are concerned with facilitating client autonomy to be seen as overlapping spheres s model health! Tannahill & # x27 ; s criteria careplan, SWOT-CPD ( a hand note on higher education research.!, or midwives in this case How a health promotion approach can be empowered by the attitude their! The basis of the different underlying philosophical basis of public health and reducing the risk of ill health education... Nofas 2007 ) Agency ( HPA, 2007 ) towards public health discussed above of alcohol and! As lifestyle, relationships, income and to identify the best course of action a... Politics ; health-promoting policies ( RCM 2000 ) adds on to say health education and health promotion by... And expanded on it a particular healthcare system HP plan i wanted to target in! Used by midwives and other professionals to identify womens needs in pregnancy path dependence ]: 10.1016/j.healthpol.2011.08.013 a of! Be seen as overlapping spheres office: Creative Tower, Fujairah, Box... ; 57 ( 2 ):498-504. doi: 10.1265/jjh.57.498 White paper the NHS...