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Primary Health CareAn Introduction
Primary Health CareAn Introduction
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Health!!!!Health!!!!
Worldwide, Health is defined
in negative terms as:
ABSENCE OF DISEASE
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negative concept of healthnegative concept of health
The negative concept of health
( = absence of disease):
tended to determine decision making,
planning and
expenditure on health .. Services for sickness are named health
services
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Accordingly
Emphasis was put on building health
infrastructure in the form of:
Hospitals
Health Centers
Dispensaries
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role of health personalrole of health personal
Consequently the role of health personnel
was primarily that of:
Providers Whereas people (community members)
were:
the Recipients
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Coverage & AccessibilityCoverage & Accessibility
Coverage:
Less than 30%
Accessibility: Limited to those who:
Could afford to pay
Lived within reasonable short distance
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Primary Health CarePrimary Health Care
Workingtogether for
better health
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PHC historyPHC history
WHOs Constitution 1946
Health for All by the year 2000 (Assembly) 1977
International Conference on Primary 1978
Health Care (Alma Ata)
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What is Primary Health Care ?
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Primary Health Care Definition
Primary Health Care:
is the first level of contact of individuals, thefamily and the community with the national
health system, bringing health care as close as
possible to where people live and work
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Primary Health Care Definition
Primary Health Care:
is essential care based on practical, scientifically
sound, socially acceptable methods andtechnologies, made universally accessible toindividuals and families in the communitythrough their full participation and at a cost thecommunity and country afford to maintain
Alma Ata declaration, 1978
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Primary Health Care- Definition
Primary Health Care includes:
Primary Care (physicians, midwives & nurses); Health promotion, illness prevention;
Health maintenance & home support;
Community rehabilitation;
Pre-hospital emergency medical services; &
Coordination and referral to other areas of health
care.
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Primary Health Care DefinitionPrimary Health Care Definition
Primary Health Care is different in eachcommunity depending upon:
Needs of the residents;
Availability of health care providers;
The communities geographic location; &
Proximity to other health care services in the area.
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Primary Health Care - BenefitsPrimary Health Care - Benefits
PHC focuses on keeping people healthy & addressingillness early so as to increase probability of cure;
PHC is client focused;
Individuals have access to appropriate care; Services are matched to community needs;
Targeted services will have a positive impact on theutilization of health and social services; &
Healthy communities with healthy people contributeto a vibrant & stable economy.
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Principles of primary health carePrinciples of primary health care
Universal access
Health equity
Community
participation
Inter-sectoral
actions
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Principled health care improvements required
based on Declaration of Alma Ata: 1978
International Conference on Primary Health Care, Alma-Ata, USSR, 612September 1978
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Population Health
Principles of Primary Health CarePrinciples of Primary Health Care
Continuity of Care
Efficiency
AccessibilityIntersectoral /
Interdisciplinary
Affordable & Sustainable
Community Participation
Appropriateness
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Primary Health Care ReformPrimary Health Care Reform
1. Treatment
2. Illness
3. Cure
4. Episodic care
5. Specific problem
6. Individual practitioners
7. Health sector alone
8. Professional dominance
9. Passive reception
1. Health promotion
2. Health
3. Prevention, care, cure
4. Continuous care
5. Comprehensive care
6. Teams of practitioners
7. Intersectoral collaboration
8. Community participation
9. Joint responsibility
Barbara Starfield, Johns Hopkins University
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PHC Programmes
These programs include measures for:
Health promotions
Disease prevention
Basic diagnosis, therapy and rehabilitation
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Fundamental Principles for Health for
All
Fundamental Principles for Health for
All
1. Health is fundamental human right and a worldwide social goal
2. Health is an integral part of development
3. The existing gross inequality in the health status of people is of commonconcern to all countries and must be drastically reduced.
4. People have the right and the duty to participate individually andcollectively in the planning and implementation of their health care
5. Governments have a responsibility for the health of their people
6. Countries must become self-reliant in health matters.
7. Fuller and better use must be made of the worlds resources to promotehealth and development.
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HealthEducation Food Supply
Safe water
MCH
Immunization
Prevention of endemic
diseases
Treatment of common
Disease
Essential
drugs
PHC
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Main Elements of PHCMain Elements of PHC
1. Health Education concerning prevailing
health problems and the methods of
preventing and controlling them;
2. Promotion offood supply and proper
nutrition;
3. An adequate supply ofsafe water and basic
sanitation.
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PHC is supposed to be implemented
through the following1. Assigning the responsibility for this care of the
individual, the family and the community, with the
national health care system undertaking a supportiverole.
2. Active community participation in the process of
defining needs and the development of ways to meetthem.
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3. Utilizing resources of each local communityalong with national resources
4. Using of appropriate technology which is lesssophisticated and cheaper
5. Mobilizing other sectors (e.g. Education,
Agriculture, Housing, Public Work, Information,Communications, Industry) to contribute toPHC implementation
PHC is supposed to be implemented
through the following
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Resources for unsuccessful
implementation of PHC
1.- Lack of community participation
2.- Lack of intersectoral collaboration3.- Lack or misuse of human and material resources
4.- Concentration on sophisticated technology
5.- Mismanagement6.- Lack of intercountry collaboration
7.- Lack of operational research
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A Group of Health Workers
working together to achieve a
common objective
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How to create a health team
CLEAR OBJECTIVES
Frequent meetings
Allowing health workers to express their viewsopenly
Respecting different ideas
Sharing agreed objectives Leadership
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cont. implementation
Leadership
A leader should have:
Knowledge about the objectives
Vision
Skill of listening
Justice
Decisional (say NO in a kind manner) Skills of problem-solving
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Factors lead to dissatisfaction:
Inefficient administration
Incompetent supervision
Poor interpersonal relation
Inadequate pay
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Types of Evaluation
Monitoring records and reports
Case Study
Survey research
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Steps of Evaluation
Decide what to evaluate?
Collect information
Compare the results with the targets
Judge
Decide:
To continue
To change
To stop
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What to evaluate?
Effectiveness
Efficiency (impact, quality ..)
Cost-benefit
Accounting
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Problems of evaluation
Failure to provide information
Don
t evaluate everythin
g
Length of time
Review your resources
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The end
Thank u