This document defines key concepts in public health including health, dimensions of health, public health, primary health care, and levels of health care. It discusses that health is a state of complete physical, mental, and social well-being, not just the absence of disease. There are major dimensions of health like physical, mental, and social dimensions and minor dimensions like spiritual and emotional. Public health aims to protect and improve community health through organized efforts including education, health services, and protecting from harm. Primary health care is essential health care that is accessible to all. Health systems are generally organized into three levels - primary, secondary, and tertiary care.

1. LECTURE 1: CONCEPTS OF HEALTH, PUBLIC HEALTH
AND PRIMARY HEALTH CARE (PHC)
Segufta Dilshad (SgD), MDS, EMPH
Course Instructor
Introduction to Public Health (PBH 101)
Department of Public Health
School of Health and Life Sciences
North South University
Spring 2017
segufta.dilshad@northsouth.edu
Cell# 01711638208

2. What is Health?
 “Health is a state of complete physical, mental and
social wellbeing and not merely an absence of disease
or infirmity”-World Health Organization, 1948
 The ability to lead a socially and economically
productive life

3. Dimensions of Health
 Major Dimensions of Health
 Physical Dimension
 Mental Dimension
 Social Dimension
 Minor Dimensions of Health
 Spiritual Dimension
 Emotional Dimension

4. Physical Dimension
 Ability of human body to function properly
 Signs of Good Physical Health:
 Good complexion
 Clear skin
 Bright eyes
 Good appetite
 Sound sleep
 Regular activity of bowels and bladder
 Smooth, easy and coordinated movement
 All the senses are intact

5. Mental Dimension
 A state of balance between the individual and the
surrounding world.
 Criteria of a Mentally Healthy Person:
 Is free from internal conflict
 Is well adjusted
 Has a strong sense of self-esteem
 Knows himself/herself, his/her needs, problems and
goals
 Knows his/her strength and weakness
 Has good self-control
 Faces problems and tries to solve them intelligently

6. Social Dimension
 Ability to interact with others
 Criteria of a Social Person:
 Interact with people and be receptive to their ideas
with an open mind.
 Accept and understand diverse cultural norms.
 Build networks among different kinds of people.
 Adopt a positive self-image.
 Enhance interpersonal communication skills.

7. Emotional Dimension
 Ability to cope, adjust and adapt
 Criteria of Emotionally Established Person:
 Setting realistic goals.
 Explore every opportunity with an open mind.
 Be aware of the demands and expectations others
have from you.
 A positive outlook, especially when dealing with
conflicts.

8. Spiritual Dimension
 Spiritual health refers to our personal beliefs and values and to seek
meaning and purpose of life.
 Activities for spiritual awareness and growth are Meditation, Prayer,
Visualization, Stretching, Yoga etc.
 Qualities of Spiritually Healthy Person:
 Hope
 Positive outlook
 Acceptance of death
 Forgiveness
 Self-acceptance
 Commitment
 Clear values
 Peace
 Self-esteem

9. Philosophy of Health
 Health is a fundamental human right
 Health is inter-sectoral
 Health is an integral part of development
 Health and its maintenance is a major social investment
 National Govt all over the world are working to expand and improve
their health care services
 The current situation is
 Urban oriented
 Mostly curative focus
 Changing diseases patterns
 Emerging new infections

10. Public Health
 Public Health is the art and science of protecting and
improving the health of a community through an
organized and systematic effort that includes
education, assurance of the provision of health
services and protection of the public from exposures
that will cause harm.
 According to World Health Organization (WHO),
“Public health refers to all organized measures (whether
public or private) to prevent disease, promote health, and
prolong life among the population as a whole.”

11. Public Health and Global Health
 Public health is concerned with protecting the health of
entire populations. These populations can be as small as
a local neighborhood, or as big as an entire country or
region of the world.
 Global health is the health problems, issues and concerns
that exceeds national boundaries.

12. Public Health Issues
 Public Health Enemy Number One: Tobacco
 Public Health Threat number two: Poor Diet & Physical Inactivity
 Environmental issues –Clean water, Clean air, sound, Safe food & Drugs
 Injuries
 Maternal & child health as social problem
 Aging population, Non Communicable Diseases; like - Diabetes and heart
disease
 Emergency Responses
 Public Health Research and solutions
 Sexually transmitted infections in young women
 Violence against women
 TB, Malaria, Diarrhea, HIV/AIDS

13. Public Health Campaigns
 Vaccination and control of infectious diseases
 Motor-vehicle safety
 Safer workplaces
 Safer and healthier foods
 Safe drinking water
 Healthier mothers and babies and access to family
planning
 Decline in deaths from coronary heart disease and
stroke
 Recognition of tobacco use as a health hazard
 Healthy life

14. Objectives of Public Health
 Prevention of diseases
 Prolongation of life
 Promote quality of life and wellbeing
 Promote productive life
 Elevation of the standard of living

15. Features Public Health Clinical Medicine
Objective • To prevent diseases, prolong life
and promote health & efficiency
through an organized community
effort
• To prevent diseases, prolong life and
promote health & efficiency through
interception of diseases process
Coverage • Services offered to entire
population of a country
• Services offered to groups of
individuals and individuals within
these groups
Emphasis • Stress placed on both personal
and interpersonal measures of
direct and indirect nature
• Greater stress placed on personal
level measures of direct nature
Functionaries • Well-organized health teams lead
by Public health experts
• Health professionals working
individuals or in groups
Overlap • When practiced in group level, it
approaches preventive medicine
• When practiced of mass scale, it
becomes public health
Operation • Deals with control, elimination and
eradication of national health
• Deals with risk-intervention
procedures in a variety of special
Differentiations between Public Health and Clinical Medicine

16. Opportunities for a
Public Health Professional/Expert
 Government agencies, such as
Ministry of Health, Centers for
Disease Control and
Prevention (CDC), Food and Drug
Administration or
the Environmental Protection
Agency
 Many international NGO’s i.e.:
WHO, USAID, UNDP, UNFPA etc
 Some research institution i.e.:
ICDDRB
 Health care organizations, such
as hospital systems and long-
term care facilities.
 Private sector companies, such
as health insurers and
pharmaceutical companies.
 Colleges and universities, such
as schools of public health or
medicine.
 As an researcher

17. How Health Services Organized? or
Level of Care in Health System
 Health systems are generally organized into three levels
of care:
 Primary Care
 Secondary Care
 Tertiary Care

18. Levels of Health Care
 Primary Care Level
The “First” level of contact between individual, family
and community with health system
Most effective and close to the people
Essential health care is provided.
The closest to the people.
Provided by the primary health centers, Community
Clinics.
General Practitioner, village doctor

19. Levels of Health Care
Secondary Care Level
More complex problems are dealt with.
Comprises curative services
Provided by the district hospitals
The 1st referral level

20. Levels of Health Care
 Tertiary Care Level
Offers super-specialist care
Provided by regional/central level institution.
Provide training programs
Specialized health care- Bangladesh Sheikh Mujib Medical University
(BSMMU), Dhaka Medical College (DMC)
Specific private facilities- Square Hospital, United hospital, Apollo hospital,
Green Life Hospital etc.
Specializes hospitals-
Children Hospital
National Heart Institute
TB Hospital

21. Primary Health Care (PHC)
 Primary healthcare (PHC) refers to "essential health
care" that is based on scientifically sound and socially
acceptable methods and technology, which make
universal health care accessible to all individuals and
families in a community.

22. Health System Challenges:
 How to cope with an aging population and increasing amount of
non communicable disease
 The quality of governance
 The number, quality and distribution of health care personnel
 The mobilization of sufficient financial resources for the health
sector
 How to provide health care at an appropriate level of quality
 How to ensure access to and equtable provision of services
 The creation of mechanisms to provide the poor with protection
from the costs of health services

23. Lessons Learned
 There are strong link between health, human development, productivity
and economic development
 Health status determined by a variety of factors, including income,
education, knowledge of healthy behavior, social status, sex, genetic
makeup, and access to health care services
 There are enormous progress in improvement of health status over the
last fifty years.
 Till the progress in health status has been very uneven and enormous
disparities.
 Countries do not need to be high income to enjoy good health status.
 Health status determined by an individuals and families own knowledge of
health hygiene. People and communities have tremendous abilities to
enhance their own health status.
 We should think the health of All.

24. THANK YOU