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primary health care should be accessible, affordable, acceptable ,equally distributed along with use of appropriate technology. ...

primary health care should be accessible, affordable, acceptable ,equally distributed along with use of appropriate technology.

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  • can u send me documents of primary health care saeidzaxo28@gmail.com
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  • Thanks for your presentation. It's very useful for me. Can you send me documents of primary health care.(references).My e-mail is hangnt108@gmail.com. Thank you so much!
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  • Your notes on primar health care are the best we could find on the net. We have incorporated them in our freely available educational platform ( http://study.myllps.com/nursing ), specifically in the community nursing section within the nursing studies in nursing Nepal. You are invited to review your presentations within the context of other learning resources for community nursing here.
    http://study.myllps.com/nursing/nursing-nepal/b.sc-nursing-tu/bsn-community-health-nursing/primary-health-care

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  • NICE PPT KINDLY MAIL IT TO MY EMAIL ID: mishrasmart2012@gmail.com
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  • 1.  PRIMARY HEALTH CARE.  SECONDARY  TERITIARY HEALTH CARE. HEALTH CARE.
  • 2. “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 to maintain every stage of their development in the spirit of self-determination.” Declaration of Alma Ata
  • 3. “Essential health care made universally accessible to individuals and acceptable to them through their full participation and cost of the community and country can afford.” WHO
  • 4.  in post-independent era in 1947, when the bhore committee brought its recommendations.  To provide comprehensive health services to the people in rural areas through the network of primary health centres.  A short term plan was formulated.
  • 5.  1978  launched primary health care RECOMMENDATIONS OF ALMA ATA CONFERENCE:  to incorporate and strengthen the primary health care with other sectors.  The health services should be comprehensive.  community participation and appropriate technology.
  • 6.  strengthen and support primary health care through various sectors.  maximum care to the special risk groups.  Training.  proper use of resources.  continuous supply of drugs and proper managerial process, includes planning, organizing, monitoring and evaluation of health services.
  • 7.  health for all is ‘ the attainment of a level of health that will enable every individual to lead a socially and economically productive life.’ WHO
  • 8. SPECIFIC GOALS TO BE ACHIEVED BY 2000 AD :  Reduction of infant mortality from the level of 125 to below 80.  To raise the expectation of life at birth from the level of 52 years to 64 years.  To reduce the crude death rate from the level of 14 per 1000 population to 9 per 1000 population.  To reduce the crude bith rate from the level of 33 per 1000 population to 21 per 1000 population.  To achieve a net reproduction rate of one
  • 9. Evaluation of HFA [1979-2006]:  Insufficient political commitment.  Failure to achieve equity in access to all PHC.  The continuing low status of women.  Slow socio economic development.  Unbalanced distribution of resources.  Wide spread inequality of health promotion efforts.  Weak health information systems and lack of baseline data.  Pollution, poor food safety and lack of water supply and sanitation.
  • 10.  Rapid demographic and epidemiological change.  Inappropriate use and allocation of resources for high cost of technology.  Natural and man-made disasters.  Misinterpretation of the PHC concept.  Misconception that PHC is the 2nd rate of health care for the poor.  Lack of political will.  Centralized planning and management.
  • 11. Priorities:  Nutrition.  Prevention of food adulteration and quality of drugs.  Water supply and sanitation.  Environment protection.
  • 12.  Immunization programmes.  Maternal and child health services.  School health programmes.  Occupational health services
  • 13.  To establish one HSC for every 5000 [3000 for hilly areas].  To establish one PHC for every 30,000 population.  To establish one CHC for every 1,00000 population.  To train village health guides selected by the community for 1,000 population in each village.  To train TBAs in each village.  Training of various categories of field functionaries
  • 14. Indicator IMR PNMR CDR MMR UFMR LIFE EXPECTANCY  MALE  FEMALE LBW Goals by 2000 60 33 9 2 10 64 64 10% Achieved by 2000 70 46 8.7 4 9.4 62.4 63.4 26%
  • 15. Indicator CBR CPR NBR Growth rate Family size AN care TT pregnant DPT OPV BCG Fully immunized Goal by 2000 Achieved by 2000 21 60% 1 1.2 2.3 100% 100% 85% 85% 85% 85% 26.1 46.2% 1.45 1.93 3.1 67.2% 83% 87% 92% 82% 56%
  • 16.  Eradicate polio and yaws -2005  Eliminate leprosy -2005  Eliminate Kala- azar -2010  Eliminate filariasis -2015  Zero level growth of HIV/AIDS -2007  Decreasing mortality of TB by 50% -2010
  • 17.  Decreasing malaria and other vector borne disease -2010  Decreasing prevalence of blindness 0.5% -2010  Increasing utilization of public health service from 20% to 75% -2010  Decreasing IMR to 30/1000 and MMR 100/1lakh -2010
  • 18.  5th april, 2005 for a period of 7 years.  main aim of NRHM is to provide accessible, affordable, accountable, effective and reliable primary health care, and bridging gap in rural health care through creation of a cadre of Accredited social health activist.
  • 19. The goals to be achieved by NRHM:  NATIONAL  Infant LEVEL: mortality rate reduced to 30/1000 live births.  Maternal mortality ratio reduced to 100/100000.  Total fertility rate reduced to 2.1.  Malaria mortality rate reduction- 50% by 2010.  Kala-azar mortality reduction-100% by 2010.
  • 20.  Filaria rate reduction-70% by 2010.  Cataract operation: increasing to 46 lakhs per year by 2012.  Leprosy prevalence rate: reduce from 1.8/10000 in 2005 to less than 1/10000 thereafter.  Tuberculosis DOTS services: maintain 85% cure rate through entire mission period.  Upgrading community health centers to public health standards.  Increase utilization of first referral units from less than 20% to 75%.  Engaging 250000 female ASHA in 10 states.
  • 21. AT COMMUNITY LEVEL:  Provide drug .  Health day at anganwadi .  Availability of generic drugs .  Good hospital care.  Improved access to universal immunization.  Improved facilities for institutional delivery.  Provision of household toilets.  Improved outreach services
  • 22. GOALS  Elimination of preventable disease, disability, injury and premature death.  Achievement of health equality.  Elimination of health disparities.  Creation of social and physical environment that will promote good health and healthy development and behaviour at every stage of life.
  • 23. targets to be achieved by the year 2020 are:  Decease infant mortality rate below 60.  To increase the expectation of life from 52 years to 64 years.  To decrease the crude death rate from 14/1000 population to 9/1000 population.  To achieve a net reproduction rate of 1.  To provide water to the entire population
  • 24. E- Education
  • 25. LE- Locally endemic disease control expanded programme immunization.
  • 26. M- Maternal and child health E- Environment sanitation
  • 27. N- T- Nutritional services Treatment of minor ailments.
  • 28.  S- School health services
  • 29. Expanded options of immunization. Reproductive health needs. Provision of essential technologies for health. Prevention and control of noncommunicable diseases. Food safety and provision of selected food supplements
  • 30. Equity in health care Available for all. Available to all. Available by all. Affordable by all
  • 31.  Community involvement:
  • 32.  Focus on prevention
  • 33. Appropriate  Scientifically technology: sound.  Acceptable.  Compatible.  adaptable.  Understandable
  • 34.  Multi-sectorial approach
  • 35.  Accessibility, Availability, Affordabilit y and Acceptability of Health Services Health services delivered where the people are  one community health worker per 1020 households  Use of traditional medicines 
  • 36.  Provision of quality, basic and essential health services Training.  Attitudes, knowledge and skills developed.  Regular monitoring and periodic evaluation. 
  • 37.  Community Participation Awareness on health and health-related issues.  Planning, implementation, monitoring and evaluation done through small group meetings  Selection of community health workers  Formation of health committees.  Establishment of a community health organization.  Mass health campaigns and mobilization 
  • 38.  Self-reliance Community generates support for health programs.  Use of local resources  Training of community in leadership and management skills.  Incorporation of income generating projects, cooperatives and small scale industries. 
  • 39.  Recognition of interrelationship of health and development Convergence of health, food, nutrition, water, sanitation and population services.  Integration of PHC into national, regional, provincial, municipal development plans.  Coordination of activities with economic planning, education, agriculture, industry, ho using, public works, communication and social services.  Establishment of an effective health referral system. 
  • 40.  Social Mobilization  Establishment of an effective health referral system.  Multi-sectoral and interdisciplinary linkage.  Information, education, communicatio n  Collaboration between government and non-governmental organizations.
  • 41.  Decentralization Reallocation of budgetary resources.  Reorientation of health professional and PHC.  Advocacy for political and support from the national leadership down. 
  • 42. environment Health services nutrition economic Health services politics Education & communication
  • 43.  Village  Village level: health guides  Local dais  Anganwadi workers  ASHA
  • 44.  Sub-centre  Maternal level health care.  Counseling and appropriate Adolescent health care.  Assistance to school health services.  Promotion of sanitation.  Field visits.  Community need assessment.  Curative services.  Training.  Implementation of national health programmes
  • 45. Primary health center level ACTIVITES include:  Medical care.  MCH including family planning.  Safe water supply and basic sanitation.  Prevention and control of locally endemic diseases.  Collection and reporting of vital statistics.  Education about health.  National health programmes.  Referral services.  Training of health guides, health workers, local dais and health assistants.  Basic laboratory services. 
  • 46.  Requirements for a sound PHC  Appropriateness.  Availability.  Adequacy.  Accessibility.  Acceptability.  Affordability.  Assessability.  Accountability.  Completeness.  Comprehensiveness.  Continuity
  • 47.  Community  Care health centre level of routine and emergency.  24 hour delivery services.  Essential and emergency obstetric care.  Full range of family planning services.  Safe abortion services.  Newborn care.  Routine and emergency care of sick children.  foreign body removal, tracheostomy etc  Implementation of national health programmes.
  • 48.  Combining country efforts and policy instruments with global reach  Integrated service delivery models  Financing universal coverage  Human resources for health  Medicines  Infrastructure and technology  Health governance
  • 49.  Minimal policy and organizational commitment  Poorly defined functions  Poor selection:  Deficiencies in training and continuing education  Lack of support and supervision  Uncertain working conditions
  • 50.  Undetermined cost and sources of finance  Lack of monitoring and evaluation  Lack of transport facilities  Insecurity of female staff  Inadequate supply of drugs and stationeries  Medical officers are not interested to work in rural areas
  • 51.  Inadequate human resources  Failure to deliver universally  Failure to deliver effectively  Poor leadership, public regard, and professional status  Funding models that are unresponsive  fail to ensure treatments are effectively distributed and universally available for common serious acute diseases  Lack of effective information systems
  • 52. the changing environment Advances in health and Technology  Lack of health personnel The double burden of disease
  • 53.  Collaborator  Advisor:  Consultant  Advocate:  Preventor of illness
  • 54. Promotor of health Care provider Team leader Participant: Observer Manager Potentiator