Sophia is a 28 years old female who lives in Harar, Oromia. She delayed college because she chose to care for her mother with terminal breast cancer. After her death, Sophia went back to school and enrolled at her local health science college. Sophia needed to work to help her family out financially, so she juggled working full time and going to school part-time. Sophia loved to cook prior to her mom’s illness, but soon found that she had very little time to cook. She began relying on fast food and snacks from her local convenience store as her main source of food during the day. While attending classes, Sophia met her boyfriend Alemu, who is also a student at the health science college. He is the first guy that she was sexually active with, though he had previous relationships and was treated once for chlamydia. Sophia takes her birth control regularly, but the couple doesn’t use condoms. Sophia is currently searching for a permanent job, but currently works as a live-in cleaner in chemical industry warehouse. She has unfortunately developed Type II diabetes from her years of eating unhealthy foods and rapid increase in weight. Due to financial problems, she is only able to afford a few clinic visits to get prescriptions for her diabetes. She doesn’t have time during her appointments to discuss any other health problems and has refused to get any vaccines due to fears about their effects.

Question

What are the risks? And why
What is the goal? (Preconception goal)
How would you help her reach this goal and what resource would you use?

Answer 1

### Risks and Why

1. **Untreated Diabetes**: Sophia has developed Type II diabetes, but her limited financial resources mean she is not receiving comprehensive care or regular monitoring. This could result in uncontrolled blood sugar levels, which can lead to serious complications such as heart disease, kidney damage, nerve damage, and vision problems.

2. **Sexually Transmitted Infections (STIs)**: Sophia's boyfriend, Alemu, has a history of chlamydia. Despite taking birth control, the couple does not use condoms, putting Sophia at risk for STIs, including chlamydia, gonorrhea, syphilis, and HIV.

3. **Nutritional Deficiencies**: Sophia's reliance on fast food and convenience store snacks likely leads to poor nutritional intake, which can exacerbate her diabetes and overall health.

4. **Work Environment**: Working as a live-in cleaner in a chemical industry warehouse may expose Sophia to harmful substances, increasing her risk of respiratory issues, skin conditions, and other health problems.

5. **Vaccination Hesitancy**: Sophia has refused to get vaccinated, which leaves her vulnerable to preventable diseases such as measles, influenza, and COVID-19. This is particularly concerning given her existing health issues.

### Goal (Preconception Goal)

To improve Sophia's overall health and minimize risks, especially if she plans to conceive in the future. An optimal preconception goal includes managing her diabetes effectively, ensuring she is free from STIs, improving her nutrition, minimizing exposure to harmful substances, and addressing her vaccination concerns.

### How to Help Her Reach This Goal and Resources to Use

1. **Diabetes Management**:
- **Education**: Provide Sophia with educational resources about managing Type II diabetes, including information on diet, exercise, and medication.
- **Community Health Programs**: Refer her to community health programs or clinics that offer sliding scale fees for diabetes management.
- **Online Resources**: Utilize free online resources from reputable sources like the American Diabetes Association or local equivalents to help Sophia manage her diabetes.

2. **Sexual Health**:
- **Screening and Education**: Encourage Sophia to get screened for STIs and educate her about the importance of using condoms to prevent STIs, even if she is on birth control.
- **Local Clinics**: Provide information on affordable clinics that offer sexual health services.

3. **Nutritional Guidance**:
- **Dietician**: Refer to a dietitian who can provide affordable or free consultations. Some community health programs offer nutritional counseling.
- **Cooking Classes**: Suggest local cooking classes or online tutorials that focus on healthy, budget-friendly meals.

4. **Work Environment**:
- **Occupational Health**: Recommend that she inquire about any available occupational health services through her employer. Provide information about protective measures she can take to minimize exposure to harmful chemicals.

5. **Vaccination Information**:
- **Educational Materials**: Provide reliable information about the safety and benefits of vaccines from reputable sources like the World Health Organization or Centers for Disease Control and Prevention.
- **Counseling**: Suggest speaking with a healthcare provider who can offer personalized advice and address her concerns comprehensively.

6. **Access to Healthcare**:
- **Healthcare Programs**: Inform Sophia about local or national healthcare programs that provide financial assistance for medical visits and medications.
- **Financial Planning**: Provide resources or referrals to financial advisors who specialize in healthcare budgeting and can help her manage her expenses more effectively.

### Resources to Use

1. **Community Health Clinics**: Often provide sliding scale fees and comprehensive care, including diabetes management, sexual health services, and nutritional counseling.

2. **Non-Profit Organizations**: Such as Diabetes Associations, Planned Parenthood, and local food banks offering nutritional advice and budget-friendly meal plans.

3. **Online Educational Platforms**: Websites like the CDC, WHO, and ADA offer a wealth of information and resources that are free to access.

4. **Support Groups**: Both online forums and local support groups can provide emotional support and practical advice.

By addressing these areas comprehensively, Sophia can improve her health, reduce her risks, and work towards a healthier future.