LECTURE 1 AND 2-INTRODUCTION.pptx
- 1. PRIMARY HEALTH CARE LECTURE 1 AYO NELSON CLINICAL INSTRUCTOR LIRA INSTTITUTE OF HEALTH AND MANAGEMENT SCIENCES EMAIL: ayonelson617@gmailo.com
- 2. COURSE DESCRIPTION • This course equip trainee with general public health knowledge so as to be resourceful to different health care needs in the community.
- 3. COURSE OBJECTIVES By the end of the course, the trainee should be able to • Describe the concept of primary health care • Explain the pillars of primary health care • Describe the role of the different players( government, public, private sector) in primary health care • Explain approach in health promotion • Describe the level of health care delivery in the country • Ability to carryout health promotion activities eg(community sensitization, mobilization and participation)
- 4. INTRODUCTION • Many disparities in Basic Health Services (BHS) necessitated a different approach to provision of health care. These disparities were revealed by studies carried out by many organisations, e.g. • In 1975, a joint WHO-UNICEF study estimated that only 20% of the rural population in developing countries received any basic health care on regular basis. • In 1976, an ILO study estimated that about 67% of the population of developing countries lived in serious poverty
- 5. INTRODUCTION • Declaration of Alma-Ata, USSR on 6-12 September 1978: • The International Conference on Primary Health Care, expressed the need for urgent action by all governments, all health and development workers, and the world community to protect and promote the health of all the people of the world. • WHO defines Primary health care as, essential health care based on practical, scientifically sound and socially acceptable methods and technology, made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford and maintain at every stage of their development in the spirit of self-reliance and self-determination.
- 6. MEANING OF THE WORDS IN PHC • The word Primary in PHC means the first, or basic, or essential, or most important, or most urgent need(s). • The word Health: is defined by WHO as state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity (disability)”. This definition was made 60 year ago and there are many problems associated with it. The definition assumes a human body as a machine, and well-being is not easy to measure. This is why health indicators are usually used, as proxies, to measure health.
- 7. MEANING OF THE WORDS…….. • The word Care: care means looking after, or protection of, or giving attention to, or maintaining sometime. This care includes the following services: - prevention - promotion - curative - rehabilitative • Primary care: means those activities undertaken before a person develops a disease. • Secondary care: means services rendered when a disease has occurred, but it is silent; and even a person might not know that he/she has the disease. The main activity in secondary care is screening to detect the disease early for early treatment • Tertiary care: is provided when a person shows signs and symptoms of disease to prevent disability and death.
- 8. Concept of primary health care • HC is for all especially the needy, regardless of social and economic status every individual must access health • community and there must be The services should be acceptable by the active involvement of the community • The services should form an integral parts of country’s health system. • The program must be efficient, multisectoral because health does not exist in isolation
- 9. LEVEL OF HEALTH CARE • Primary care level The first level of contact of individual and community and is the most effective. This include; VHTs etc. • Secondary care level High level of care at which complex problems are dealt with. This include; health centers and hospital • This is where specialization health care are provided and include; teaching hospitals, regional referral hospital, care hospitals and specialized hospital. • Tertiary care: is provided when a person shows signs and symptoms of disease to prevent disability and death.
- 10. PRINCIPLES OF PHC The are 4 core principles of PHC • Equity • Community participating • Intersectoral coordination • Appropriate technology
- 11. Principles cont…….. • Equity/equitable distribution. The first key principle of PHC strategy is equitable distribution of health services. Health services should be shared equally irrespective of poor, rich or disable Currently health services are mainly in town and there are inability of majority of people in developing countries to obtain good health. • Community participation Overall its responsibility of the state, but involvement of families, communities in promotion of their own health care is important. PHC achieve by their involvement.
- 12. Principle cont. • Intersectoral coordination In addition to health sector, all related sectors and aspects of development should be embraced to ensure PHC. In particularly, education,agriculture,animal husbandry,food,industry and housing. • Appropriate technology Technology that are scientifically sound, adaptable to local needs and acceptable to those that apply it.
- 13. Essential component/elements of PHC 1. Education concerning prevailing health problems and methods of identifying, preventing and controlling them 2. Promoting of food supply and proper nutrition and adequate supply of safe water and basic sanitation 3. Maternal and child care including family planning 4. Immunization against major infectious diseases 5. Preventing and controlling locally endemic diseases 6. Treatment of common diseases and injuries 7. Promotion of mental health 8. Provision of essential drug
- 14. Cont…. However currently, the extended elements include; • Expanded option on immunization • Reproductive health needs • Provision and essential technologies to health • Health promotion • Prevention and control of non communicable diseases • Food safety and provision of selected food supplements
- 15. Reference text books • WHO&UNICEF; ALMA-ATA 1978 primary health care • Primary health care concept and challenges in changing world, E. Tarimo,E.G Webster, WHO/ARA/97.1 • Infection control, policies and procedures department of quality assurance ministry of health Uganda, Kampala • Community health,3rd edition by Chris wood, AMREEF(2008) Nairobi keneya
- 16. Assignment 1. Describe the role of a pharmacy personnel in PHC? 2. What should be done to make quality PHC accessible and affordable for every one and every where? 3. What are the challenges hindering globalization of PHC for all 4. Why is PHC important for every country? 5. List and explain the Alma-Ata declaration on primary health 1978.
- 17. RESPONSIBILITIES OF INDIVIDUALS AND COMMUNITIES IN HEALTH LECTURE 2 AYO NELSON CLINICAL INSTRUCTOR LIRA INSTTITUTE OF HEALTH AND MANAGEMENT SCIENCES EMAIL: ayonelson617@gmailo.com
- 18. ROLES OF PHARMACY TECHNICIAN • Managing of patients • Recommend appropriate sources of support for patients experiencing Common health problems. • Advice patients on current health promotion compaign • Refer patients for the management of medication therapy needs that fall beyond their individual scope of practice.
- 19. Roles of community Health workers in Health (CHW) • Creating connection between vulnerable population and health care system • Facilitating health care and social services system navigation • Managing care and care transition for vulnerable population • Reducing social isolation among patients population • Determining eligible and enrolling individual in health insurance plan • Ensuring cultural competence among health care professional services vulnerable population.
- 20. Roles of community Health workers in Health……. • Educating health system providers and stake holders about community health needs • Providing cultural appropriate health education on topic related to chronic disease prevention, physical activities and nutrition. • Advocating for underserved individual to receive appropriate services • Collecting data and relaying information to policy makers to inform policy change and development • Providing informal counselling,health screening and referral • Building capacity to address health issues.
- 21. ADVANTAGES OF CHEWs • Develop trusting one on one relationship with patient • Act as liaison between providers, patients and families • Gain support from other organization serving communities • Strengthen care coordination by connecting patients with available health care and social support services • Extent the reach of health care providers and services • Deliver services that are appropriate based on patients language and culture
- 22. ROLES OF GOVERNMENT/LOCAL LEADERS IN HEALTH Potential public health action of responsive government classified in to the following Promoting free and open health information • Regulating advertisement law • Nutritional facts channel • Public reporting of health care providers performance • Sex education for teens, antitobacco advertisement • Promoting pharmaceutical package inserts/information leaflets
- 23. ROLES OF GOVERNMENT/LOCAL LEADERS IN HEALTH……. Protecting individual form harms caused by others • Non adulteration of food and protecting against counterfeit drugs • Law against alcohol impaired driving • Infectious disease reporting • Laws requiring smoke free places • Protecting against natural occurring health hazards • Elimination of artificial trans fat • Restricting sales and marketing of alcohol to children
- 24. ROLES OF GOVERNMENT/LOCAL… Taking societal actions to promote and protect health • Vaccination mandate • Water treatment • Micronutrient fortification of manufactured food eg.iodized salt
- 25. ROLES OF HEALTH PRACTITIONERS • Health education • Early diagnosis and treatment of disease • Counselling for behavioral change • Immunization and chemoprophylaxis
- 26. Assignment 2 • Describe the role of the following in health promotion in relation to cholera outbreak in the society 1. Community 2. Media 3. Village health 4. Local leaders
- 27. Answer to assignment 1 • Question 1, refer to lecture 2 • Question 2, promotion of access and affordability to health Improving means of transport Health workers arranging appropriate opening hours Having welcoming attitude by health workers/service providers Locating health facilities near where people live Cost of training, treatment must be with resource that people can afford Careful selection and promoting of essential medicine list
- 28. Cont… • Question 3, challenges to global health for all Weak health system Rising inequalities Aging population Toll of non communicable disease Pressure from urbanization
- 29. Cont…. • Question 4, importance of PHC Address vast majority health needs Improve quality of services while reducing inequalities in health along the life course Empower individual and communities Responds to day-to-day needs and foster trust in health workers It boost resilience and enables a faster more effective response Build foundation for effective, efficient and equitable health system Accelerate progress towards universal health coverage.
- 30. Cont…. • Question 5 Alma-Ata recommend/declarations It recommended the government diagnosing the community in accessing to incorporate strengthen the primary health care with other sectors The health services should be comprehensive which includes preventive, promotive,culative and inhabilitative PHC should aim at the health problems and appropriate actions for promote of health PHC should encourage community’s participation and appropriate technologies The health system should be organized in such a way to strengthen and support PHC through various sector The conference identified the needs to train health personnel at all levels for better implementation of health services The conference recommends provision of maximum care to special risk group It recognized that PHC requires continuous supply of drugs and proper managerial process including planning, organizing, monitoring and evaluation of health services.