Health delvery system by Dr Najeeb Memon

2. By
PROF: NAJEEB MEMON
MPH,DFHC
Community Medicine Deptt:
LUMHS, Jamshoro, Sind
PAKISTAN
e mail mnajeeb80@gmail.com

3. Leaning objectives
 The participants will be able to
 Know the definition of Health
 Health Care
 Know different partners in health.
 Levels of healthy care with differentiating points
 PHC with its functions
 Other sectors than Government in health care
 Summary of health structure and functions

6. HEALTH
Physical
Complete Mental &
Social well being
& not merely the absence of disease.

7. Bb

8. THE DECLARATION OF
ALMA ATA 1978
Health for all

9. Primary Health Care
 Anew approach to health care Came in to existence in 1978
following an international conference
at
Alma-Ata (USSR)
This known as
“Primary Health Care”
It has all the hallmarks of a Primary health care
delivery, first proposed by “Bhore Committee
in 1946,
& now espoused world-wide by international agencies
& national Govt:
Global strategy for “Health for All” 34th World
Health assembly in 1981.

10. Health For All (1978)
“the attainment by all peoples of the world, a level of
health that will permit them to lead a socially and
economically productive life”.

11. Improving
Health
Individual / Family
Community
Governments / NGOs / Private

12. Prevention
Treatment Management
Health Care
By
Medical &
Allied Health
Prof:

14. June 2011
 18th Amendment in the constitution of Pakistan
 Health POLICY by Federal Government,
implementation by Provincial Government
 From July 2011 responsibilities and resources shifted
to provincial Government
 From 2014, Local Governments have an important
role in health delivery systems???

15. The Local Government
(District Health System) in the context of
devolution after 2014
Very important
District Nazim / Deputy Commissioner.
(Planning, Implementation, Monitoring,
data collection, analysis, interpretation,
evaluation and planning)

16. A mechanism for providing services that
meet the health-related needs of the
individual.

20. Primary health care
The “first” level of contact between the individual and
the health system.
Essential health care (PHC) is provided.
A majority of prevailing health problems can be
satisfactorily managed.
The closest to the people.
Provided by the primary health centers.
Secondary health care
More complex problems are dealt with.
Comprises curative services
Provided by the district hospitals
The 1st referral level
Tertiary health care
Offers super-specialist care
Provided by regional/central level
institution.
Provide training programs
Levels of
Care

21. What is Universal Health Coverage
(UHC)?
 UHC means that all individuals and communities receive
the health services they need without suffering financial
hardship.

22. Situated in rural union council.
Area covered 15-25 square miles.
Serves 5000 – 10 000 population
5 – 10 BHUs linked to one RHC
Services provided at BHUs included
-MCH services
-Child care
-Immunization
-Diarrheal control
-Malaria control
-Mental Health
-School Health services
BHU
Staff: 10 people.
Male M.O.
LHV or Female health technician.
Male medical technician/ dispenser
Trained or unqualified midwife.
Sanitary inspector.
Vaccinator.
2 – 3 Support staff.
.

23. BASIC ELEMENTS OF
“PRIMARY HEALTH CARE”
 Health education ( Health problems- preventing & controlling)
 Identifying & controlling prevailing health problems.

24.  Promotion of Food supply and proper
nutrition.
 Provision of safe water and basic sanitation.
 Maternal & child health care,
including family planning.

25. BASIC ELEMENTS (cont:)
 Immunization
 Prevention and control of locally endemic
disease

26.  Appropriate treatment of common diseases and
injuries
 Promotion of mental health
 Provision of essential drugs

27. Principles
Equitable Distribution
PHC must be given to
all individuals in equal
amount in community
irrespective of their
gender, age, caste,
color, urban, rural and
social class.
Community
Participation
Involvements of
Individuals, families &
communities in promotion
of their own health &
welfare is an essential
ingredient of PHC
Intersectorial
coordination
Alma-Ata states that PHC
involves in addition to the
health sector, all related
sectors & aspects of
national & community
development, in particular
agriculture ,food, industry,
education, housing ,
public works,
communication & other
sectors.
Appropriate Technology
Technology i,e
scientifically sound,
adapted to local needs &
acceptable to those who
apply it & those for whom
it is used.
Prevention

28. RHC
Each has 25 beds
Laboratory
Provision for minor surgery
Ambulance
Each RHC ( linked to) Taluka Hospital
Taluka Hospital ( linked to) District Head quarter’s Hospital
Whole system is designed as integrated Rural Health Complex

29. The whole system of BHUs, RHCs, Tehsil hospitals & DHQH are designed
as:
“Integrated Rural Health Complex”

30. Tertiary Health Care Specialized level
Tertiary hospitals Teaching hospitals also provide
Sub-specialty care (29)
Curative care Available
Preventive services Limited
Hospitals General hospital
Special hospitals
Regional / teaching hospitals
District hospitals e.g. civil
hospital

31. (3)
Components of Health Care System