Evaluate factors within the case study that may lead to inequalities in health, including health economics and resource allocation within care systems

Case Study 3

Sergio Richards was born to Carl and Monica Richards, their first child 4 weeks ago. The family live in a rented end terrace house with two bedrooms. Carl works as a supervisor in a local fast-food restaurant; often working long and unsocial hours and Monica is on maternity leave from her factory job however she is only eligible for 4 weeks full pay. Although the couple have friends in the area, they have limited other support; Monica’s family live in Eastern Europe and Carl has a temperamental relationship with his own family who live nearby. Carl had the statutory 2 weeks paternity leave when Sergio was born. Luckily for the couple, the COVID pandemic hasn’t impacted on Carl’s ability to work, however Monica has been by herself with Sergio for the last 2 weeks.

Sergio was born at full term, via normal delivery weighing 4.5kg and 38cm head circumference. His parents consented to routine screening for Sergio and results of the New-born blood spot (NBS) screening test, often referred to as the heel prick test, were positive for Cystic Fibrosis. There was no family history of Cystic Fibrosis and the family have little understanding of the condition or the effect that this condition would have on Sergio`s development.

Since birth Monica and Carl report that Sergio had struggled to gain weight; his current weight (aged 4 weeks) is 4.6kg. Monica originally intended to fully breast feed Sergio but due to his slow weight gain Sergio is now exclusively formula fed and the unexpected cost of the formula is putting added pressure on the couple’s finances. Monica feels guilty for not only being unable to breastfeed her baby but also for the unexpected financial implications.

In addition to his poor weight gain, Sergio appeared to be constantly full of mucus and making snuffle type sounds especially from his nasopharynx, a symptom which increases when having his feed. Monica has visited the GP with Sergio on three different occasions with a chesty cough, increased mucus production, breathing difficulties and poor feeding. Sergio also has bowel movements constantly, which both parents’ think may be abnormal.

The increased mucus is more prominent at bedtime after Sergio’s feed which results in him being difficult to settle, and usually ties in when Carl is returning from a 14-hour shift at the restaurant.

Following the positive NBS, Sergio was referred to a Paediatrician at the local District General Hospital who arranged for Sergio to have a Sweat Chloride Test. This test showed a sweat chloride concentration of > 60 mmol/L which supported the diagnosis of cystic fibrosis. Following on from this diagnosis, both Monica and Carl were referred for genetic testing.

Assessment questions

1. Evaluate factors within the case study that may lead to inequalities in health, including health economics and resource allocation within care systems (LO3).
2. Explain and evaluate the principles of two prevention strategies; one related to screening and one related to immunisation programmes which will support Sergio to maximise his health and well-being (LO4)