Concept Of Phc
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Concept Of Phc Concept Of Phc Presentation Transcript

  • CONCEPT OF HEALTH,HEALTH FOR ALL AND PRIMARY HEALTH CARE
    Dr AbdelrahimMutwakel
  • LEARNING OBJECTIVES
    • Concept, principles and dimensions of health
    • Causatives factors and effects on human life
    • Concepts of ‘health for all’ and ‘primary health care’
    • Role of different stakeholders.
    • Challenges for PHC
  • HEALTH
    “a state of complete physical, mental and social well-being
    and
    not merely absence of the disease or infirmity”
    WHO, 1947
  • SIGNIFICANCE OF HEALTH
    Fundamental human right.
    Central to quality of life and human development
    Essence of a productive life
    An intersectoral issue and an integral part of socioeconomic system
    Involves individuals, community, state and international responsibilities
    A major social investment
    Worldwide a social goal
  • DIMENSIONS OF HEALTH
    PHYSICAL
    Functioning of body organs
    Ability to do daily tasks
    MENTAL
    Balance with surroundings
    Self- esteem
    Know problems and goals
    Self control
    Faces problems.
    SOCIAL
    Harmony with society
    Involvement with community
    Social skills
  • DETERMINANTS OF HEALTH
    INTERNAL
    EXTERNAL
    • Environmental
    • Socioeconomic conditions
    • Welfare services
    • Food and nutrition
    • Education
    • Occupation
    • Culture
    Biological and cognitive
    Genetics, race, sex, age
    Diabetes, breast cancer are genetic in nature
    Diarrhoea more common in children
    Psychological and spiritual
    Life stress causes mental disorders, hypertension, heart attack, diabetes, gastric ulcer
  • PHYSICAL ACTIVITY
    INCOME
    JOB
    DISEASE AFFECTS
    LIFE STYLE
    SOCIAL CONTACTS
    SADNESS
    ANXIETY
  • HEALTH FOR ALL
    Attainment byall people of the world of a level of health that can permit them to lead a socially and economically productivelife.
    “30th World health assembly, Alma Ata, 1977”
  • PRIMARY HEALTH CARE
    “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 the country can afford to maintain at every stage of their development in the spirit of self-determination. ”
    “WHO, 1978”
  • PRINCIPLES OFPRIMARY HEALTH CARE
    • Equity
    • Acceptable
    • Accessible
    • Affordable
    • Community participation
    • Appropriate technology
    • Intersectoral coordination
  • COMPONENTS OF PRIMARY HEALTH CARE
    Health education
    Food supply and nutrition
    Safe drinking water and sanitation
    Maternal and child health, family planning
    Expanded Programme on Immunization (EPI)
    Prevention and control of endemic diseases
    Appropriate treatment of common diseases, injuries and accidents
    Provision of essential drugs
  • COMMUNITY HEALTH CARE SYSTEM
    • Health facility accessible to all
    • Clear responsibility – individuals, family and community
    • Linkage – community and community health workers
    • Community involvement in
    • Realizing needs/priorities
    • Implementation and management
    • Active women groups, nongovernmental organizations
    • Community organizations
    • Intersectoral coordination
  • RIGHTS AND RESPONSIBILITIES
    Individual
    Personal hygiene
    Healthy lifestyles
    Vaccination and preventing diseases
    Medical examination/treatment
    Healthy environment
    Safe water, sanitation
    Family planning and population management
  • RIGHTS AND RESPONSIBILITIES
    Community
    • Utilizing health facilities
    • Supporting and strengthening health centres
    • Activist for health promotion and protection
    • Community health workers training
    • Improving sanitation and environment
    • Food safety, adequate water
    • Promoting family planning, breastfeeding, healthy life styles
    • Restricting causative factors of ill health like poverty
  • RIGHTS AND RESPONSIBILITIES
    Government
    • Policies and plans
    • Resources
    • Accessibility
    • Awareness-building
    • Human resources development
    • Monitoring/support
    • Outbreak control
    • Exchanging of experiences
  • RIGHTS AND RESPONSIBILITIES
    International
    • Human resources development
    • Capacity building
    • Technical cooperation among developing countries
    • South-to-south cooperation
    • Information sharing
    • Technical support
    • Building partnerships
    • Financial support
  • Introduction and Overview
    Responding to the challenges of a changing world
    Growing expectations for better performance
    From the packages of the past to the reforms of the future
    Four sets of PHC reforms
    Seizing opportunities
  • The PHC reforms necessary to refocushealth systems towards health for all
  • The challenges of a changing world
    Unequal growth, unequal outcomes
    Longer lives and better health, but not everywhere
    Growth and stagnation
    Adapting to new health challenges
    A globalized, urbanized and ageing world
    Little anticipation and slow reactions
    Trends that undermine the health systems’ response
    Hospital-centrism: health systems built around hospitals and specialists
    Fragmentation: health systems built around priority programmes
    Health systems left to drift towards unregulated commercialization
    Changing values and rising expectations
    Health equity
    Care that puts people first
    Securing the health of communities
    Reliable, responsive health authorities
    Participation
    PHC reforms: driven by demand
  • The shift towards noncommunicable diseases and accidents as causes of death*
  • Five common shortcomings ofhealth-care delivery
    Inverse care. People with the most means – whose needs for health care are often less – consume the most care, whereas those with the least means and greatest health problems consume the least. Public spending on health services most often benefits the rich more than the poor in high- and low income countries alike.
    Impoverishing care. Wherever people lack social protection and payment for care is largely out-of-pocket at the point of service, they can be confronted with catastrophic expenses. Over 100 million people annually fall into poverty because they have to pay for health care.
    Fragmented and fragmenting care. The excessive specialization of health-care providers and the narrow focus of many disease control programmes discourage a holistic approach to the individuals and the families they deal with and do not appreciate the need for continuity in care. Health services for poor and marginalized groups are often highly fragmented and severely under-resourced, while development aid often adds to the fragmentation.
    Unsafe care. Poor system design that is unable to ensure safety and hygiene standards leads to high rates of hospital-acquired infections, along with medication errors and other avoidable adverse effects that are an underestimated cause of death and ill-health.
    Misdirected care. Resource allocation clusters around curative services at great cost, neglecting the potential of primary prevention and health promotion to prevent up to 70% of the disease burden. At the same time, the health sector lacks the expertise to mitigate the adverse effects on health from other sectors and make the most of what these other sectors can contribute to health.
  • Primary care: putting people first
    Good care is about people
    The distinctive features of primary care
    Effectiveness and safety are not just technical matters
    Understanding people: person-centred care
    Comprehensive and integrated responses
    Continuity of care
    A regular and trusted provider as entry point
    Organizing primary-care networks
    Bringing care closer to the people
    Responsibility for a well-identified population
    The primary-care team as a hub of coordination
    Monitoring progress
  • How experience has shifted the focus of the PHC movement