Concept Of Phc


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Concept Of Phc

  2. 2. LEARNING OBJECTIVES<br /><ul><li>Concept, principles and dimensions of health
  3. 3. Causatives factors and effects on human life
  4. 4. Concepts of ‘health for all’ and ‘primary health care’
  5. 5. Role of different stakeholders.
  6. 6. Challenges for PHC</li></li></ul><li>HEALTH<br />“a state of complete physical, mental and social well-being <br />and <br />not merely absence of the disease or infirmity”<br />WHO, 1947<br />
  7. 7. SIGNIFICANCE OF HEALTH <br /> Fundamental human right.<br /> Central to quality of life and human development<br /> Essence of a productive life<br />An intersectoral issue and an integral part of socioeconomic system <br /> Involves individuals, community, state and international responsibilities <br /> A major social investment <br /> Worldwide a social goal<br />
  8. 8. DIMENSIONS OF HEALTH<br />PHYSICAL<br />Functioning of body organs<br />Ability to do daily tasks<br />MENTAL<br />Balance with surroundings<br />Self- esteem<br />Know problems and goals<br />Self control<br />Faces problems.<br />SOCIAL<br />Harmony with society <br />Involvement with community<br />Social skills<br />
  9. 9. DETERMINANTS OF HEALTH<br />INTERNAL<br />EXTERNAL<br /><ul><li>Environmental
  10. 10. Socioeconomic conditions
  11. 11. Welfare services
  12. 12. Food and nutrition
  13. 13. Education
  14. 14. Occupation
  15. 15. Culture</li></ul>Biological and cognitive<br />Genetics, race, sex, age<br />Diabetes, breast cancer are genetic in nature<br />Diarrhoea more common in children<br />Psychological and spiritual<br />Life stress causes mental disorders, hypertension, heart attack, diabetes, gastric ulcer<br />
  17. 17. HEALTH FOR ALL<br />Attainment byall people of the world of a level of health that can permit them to lead a socially and economically productivelife. <br />“30th World health assembly, Alma Ata, 1977”<br />
  18. 18. PRIMARY HEALTH CARE<br />“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. ” <br />“WHO, 1978”<br />
  19. 19. PRINCIPLES OFPRIMARY HEALTH CARE<br /><ul><li> Equity
  20. 20. Acceptable
  21. 21. Accessible
  22. 22. Affordable
  23. 23. Community participation
  24. 24. Appropriate technology
  25. 25. Intersectoral coordination</li></li></ul><li>COMPONENTS OF PRIMARY HEALTH CARE<br />Health education<br />Food supply and nutrition<br />Safe drinking water and sanitation<br />Maternal and child health, family planning<br />Expanded Programme on Immunization (EPI)<br />Prevention and control of endemic diseases<br />Appropriate treatment of common diseases, injuries and accidents<br />Provision of essential drugs<br />
  26. 26. COMMUNITY HEALTH CARE SYSTEM<br /><ul><li>Health facility accessible to all
  27. 27. Clear responsibility – individuals, family and community
  28. 28. Linkage – community and community health workers
  29. 29. Community involvement in
  30. 30. Realizing needs/priorities
  31. 31. Implementation and management
  32. 32. Active women groups, nongovernmental organizations
  33. 33. Community organizations
  34. 34. Intersectoral coordination</li></li></ul><li>RIGHTS AND RESPONSIBILITIES<br />Individual<br /> Personal hygiene<br /> Healthy lifestyles<br /> Vaccination and preventing diseases <br /> Medical examination/treatment<br /> Healthy environment<br /> Safe water, sanitation<br /> Family planning and population management<br />
  35. 35. RIGHTS AND RESPONSIBILITIES<br />Community<br /><ul><li>Utilizing health facilities
  36. 36. Supporting and strengthening health centres
  37. 37. Activist for health promotion and protection
  38. 38. Community health workers training
  39. 39. Improving sanitation and environment
  40. 40. Food safety, adequate water
  41. 41. Promoting family planning, breastfeeding, healthy life styles
  42. 42. Restricting causative factors of ill health like poverty</li></li></ul><li>RIGHTS AND RESPONSIBILITIES<br />Government <br /><ul><li> Policies and plans
  43. 43. Resources
  44. 44. Accessibility
  45. 45. Awareness-building
  46. 46. Human resources development
  47. 47. Monitoring/support
  48. 48. Outbreak control
  49. 49. Exchanging of experiences</li></li></ul><li>RIGHTS AND RESPONSIBILITIES<br />International <br /><ul><li> Human resources development
  50. 50. Capacity building
  51. 51. Technical cooperation among developing countries
  52. 52. South-to-south cooperation
  53. 53. Information sharing
  54. 54. Technical support
  55. 55. Building partnerships
  56. 56. Financial support</li></li></ul><li>
  57. 57. Introduction and Overview<br />Responding to the challenges of a changing world <br />Growing expectations for better performance <br />From the packages of the past to the reforms of the future<br />Four sets of PHC reforms<br />Seizing opportunities<br />
  58. 58. The PHC reforms necessary to refocushealth systems towards health for all<br />
  59. 59. The challenges of a changing world<br />Unequal growth, unequal outcomes <br />Longer lives and better health, but not everywhere <br />Growth and stagnation <br />Adapting to new health challenges <br />A globalized, urbanized and ageing world <br />Little anticipation and slow reactions <br />Trends that undermine the health systems’ response <br />Hospital-centrism: health systems built around hospitals and specialists <br />Fragmentation: health systems built around priority programmes<br />Health systems left to drift towards unregulated commercialization <br />Changing values and rising expectations <br />Health equity <br />Care that puts people first <br />Securing the health of communities <br />Reliable, responsive health authorities <br />Participation <br />PHC reforms: driven by demand<br />
  60. 60. The shift towards noncommunicable diseases and accidents as causes of death*<br />
  61. 61. Five common shortcomings ofhealth-care delivery<br />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.<br />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.<br />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.<br />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.<br />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.<br />
  62. 62. Primary care: putting people first<br />Good care is about people <br />The distinctive features of primary care <br />Effectiveness and safety are not just technical matters <br />Understanding people: person-centred care <br />Comprehensive and integrated responses <br />Continuity of care <br />A regular and trusted provider as entry point <br />Organizing primary-care networks <br />Bringing care closer to the people <br />Responsibility for a well-identified population <br />The primary-care team as a hub of coordination <br />Monitoring progress<br />
  63. 63. How experience has shifted the focus of the PHC movement<br />