Ethics, Policy and Health Care Delivery Systems: Health, Medicine, Nursing Essay

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Measles, also known as Rubeola, is a preventable contagious viral infectious disease. It is caused by a virus, which can be transmitted by airborne spread or person-to-person contact. Measles is a significant cause of mortality and morbidity in unvaccinated areas, such as Africa and Southeast Asia. Despite the measles vaccine's presence, the disease accounts for around 140,000 deaths every year (WHO, 2019). 
Measles was first officially reported in 1765. By 1912, it was recognized as a highly infectious and deadly disease, which caused an average of 6,000 annually (Atkinson et al., 2011). The invention of the measles vaccine in 1968 helped reduce the transmission of the disease. More than 95% of measles' incidence was reduced and eradicated epidemic cycles (Atkinson et al., 2011). 
In 1989 -1991, however, a resurgence of measles occurred. During this period, there was a total of 55,622 cases of measles within three years (Atkinson et al., 2011). The incidence of measles among Hispanics and blacks are 4 to 7 times higher among non-Hispanic white for children younger than 5. This resurgence was due to low vaccination coverage in low-income Hispanic communities. Fortunately, in the 1990s, the vaccine coverage gap among the racial and ethnic populations narrowed to 2% (Hutchins et al., 2004). Implementing the dual strategy narrowed the said gap. The dual strategy was composed of a multi-component set of interventions such as targeted and universal activities. By 2017, 92.2% of children aged 19 to 35 months received the MMR vaccine, proving that the Hispanic and Latino communities' vaccine coverage has improved ever since (Hill et al., 2018).
Vaccine safety confidence is a major determining factor in acquiring vaccines by the Hispanics. Such is influenced by several factors, such as fatalism, health literacy, and health coverage. The associations of such factors vary by sub-group, which suggests that the vaccine safety confidence is influenced a cultural, structural, and policy-level elements (Moran et al., 2017). Thus, vaccination promotion should aim towards broad strategies for the whole community and creating specific plans for each subgroup. 
GROUP LEVEL
General Goals
Address linguistic barriers and improve the accessibility of healthcare
According to Herell (2008), Language and cultural barriers severely hamper access to health care by Hispanics and Latinos. There is a significant lack of health worker who can cater to monolingual Spanish speaking patients. Such lack can be an obstacle in effective communication with the patient's primary caretaker during vaccine administration. Training Hispanic health workers or teaching health workers Spanish may help address this problem. Education programs conducted by Hispanic health workers may also help raise awareness regarding measles vaccines and encourage vaccine adherence. Such training is recommended to be mandatory in every hospital. The number of participants should be proportional to the Hispanics or Latino population in the community to ensure adequate service. 
School-Entry Vaccination Requirement
Vaccination mandates are positively associated with increased vaccina...