The U.S. is often identified as the country with the “best” healthcare system in the world. While it may be true that the U.S. outspends all national counterparts, accessibility of the system appears to lack. The result is a troublesome ranking of 27th in the world with relation to infant mortality rates. In addition, the HIV incidence rate correlates. This report addresses the French, U.S., and Nigerian incidences of Infant mortality and HIV occurrence, in an attempt to better understand how to improve the current U.S. model.

The World Health Organization (WHO) estimates that the current incidence of HIV, across the globe is 35 million inhabitants. Subsequently, of these 35 million 3.2 million are children that have inherited the viral disease by vertical transmission, from the mother (AIDS, 2014). Within the U.S. the U.S. 1.1 million residents are infected with the disease, and more surprisingly 18% of this population is simply unaware that they are infected. In order to compare the methods of managing this disease on a global scale, the model of prevention, and treatment will be compared, with respect to the Healthcare delivery system, for: France, U.S., and Nigeria. These nations have been selected based on the varying degrees of the healthcare systems that they possess. The purpose of this report is to determine if the U.S. has the most effective model for managing the disease and/or if a separate country handles it better. A summary of what the U.S. may learn from each respective country is provided for comparison and for the purposes of enhancing the U.S. model.

In order to create a system of comparison the infant morality rates of the respective countries will be presented in contrast to the nations HIV rates. It is well known that developing nations such as Nigeria typically possess higher infant mortality rates due to various conditions that include the geopolitical situation of the land. This comparison will serve to determine if it is possible to derive the health of a nations entire population, based on its infant mortality rates and the HIV incidence rates. Currently, the U.S. infant mortality rate is ranked at 27th in the world (AIDS, 2014). This is a particularly troubling statistic, as most would assume that the U.S. would have a ranking in the top five (5). Nevertheless, for each 1,000 people born in the U.S. 6.2 will die almost immediately. France on the other hand may boast an infant mortality rate of 3.6 and is ranked at 13th best in the world.

At this point it is important to note that the U.S. does contain the best facilities in the world with highly trained doctors and state of the art equipment. In addition the U.S. healthcare spending rate is ranked #1 in the world and is considered a trillion dollar industry. The issue that drives the infant mortality rate up appears to be the accessibility of healthcare for citizens/residents (Ingraham, 2014). The growing income gap in the U.S. appears to chart in a fashion that is identical to the infant mortality rate. More mothers are becoming single and are forced to care for a child on their own. The result is that there is not enough income and/or guidance for the mother to raise a healthy child. This is apparent at the amount of deaths for children at or below age one (1) are 6 per live-births for “disadvantaged mothers” and two (2) for wealthy mothers (Ingraham, 2014). While this information may be troubling the infant mortality rate for Nigeria is a staggering 82 per 1,000 live births. This indicates a serious lack of resources and essential needs that are required to bring a child to the age of one (1). It should also be noted that ½ of the Nigerian population lives at a level that is below the current poverty line. These individuals are not likely to have the basic necessities such as vaccinations, clean water, antibiotics, and enough food to sustain the life of a new born child (Ingraham, 2014). In parallel to the infant mortality rates, the incidence of HIV appears to correlate directly. As previously stated the U.S. has approximately 1.1 million inhabitants that live with the disease. France however contains only 160,000 individuals or 0.4% of the entire population. This number sits in contrast with the U.S. model, which is only slightly higher. As expected Nigeria contains approximately 3.4 million inhabitants with the disease making up a prevalence of 3.1% of the entire population (Worldbank, 2014).

When comparing the healthcare systems of these nations it is noted that the French model is financed by obligatory contributions that touch the salaries and taxes of all working individuals. The system that is generated is one of true universal healthcare. In this model it will not matter if the parent of a child or the person with HIV does or does not have money because all citizens will have coverage. The U.S. model appears to be based more on financial advantages. Those with good insurance coverage are able to access the care desired, while those with no or substandard coverage will find that it is more difficult to access care. Nigeria stands far behind both nations, as it neither has the trained personnel, facilities, or economic resources to support its citizens.

The current nursing body in the U.S. will require expansion in the event that the Affordable Care Act remains implemented. 40 million new patients will stretch the current model and the system must evolve to meet these new demands. The workforce will benefit because more nurses are needed to provide primary care to individuals that are new to the system. Initially we can expect to run into difficulties to streamline the delivery in which care is administered slower than expected and/or there are long waits prior to the patient meeting the caregiver. The nursing body should be trained to identify individuals that will require further guidance as these individuals may become lost in the realm of determining effective pediatricians or specialists. It is up to the workforce to ensure that the patient is led into the right direction. In addition, nurses may expect to enter into a workforce that is extremely demanding but quite rewarding, as it may take a universal effort to bring the U.S. to the top of the list in lower infant mortality and HIV diagnosis rates.

There is very little doubt that the U.S. has the worlds best healthcare system. This system spends the most money to obtain the best medication/therapies, machinery, doctors, administrators, etc. in the world. Nevertheless, the U.S. must face the reality that the current model is truly wasteful and does not provide care to all of its residents. Learning from the French model, we may see how access truly impacts the disease incidence rates, as well as, the infant mortality rates. In contrast to the Nigerian model, the U.S. far outpaces that of this developing nation. The Nigerian model is by no means comparable, however the U.S. may utilize information from this model to determine what should not be done. Finally, the role impact on the nursing body with regards to care of Infants and HIV patients (or at risk) will be expanded as coverage is expanded. The nursing body must grow and adapt to meet these new and exciting challenges.