Cytoskeleton and Cell Inclusions - Dr Muhammad Ali Rabbani - Medicose Academics
FAILURE OF PRIMARY HEALTH CARE PPTX.pptx
1. FAILURE OF PRIMARY HEALTH CARE
SUBMITTED BY
SHREE RAM KASICHHWA
SYMBOL NO: 7621108
A Seminar Report
Submitted to Population and Health Department in
Practical Fulfillment of the Seminar Issue in
Population Education
2. Acknowledgement
I would like to express our deep sense of gratitude to our
teacher Mr. Balaram Devkota of the Sanothimi
Bhaktapur for guiding us clearly to that made our work
so worthy and ease. I would like to express our
gratitude to his cooperative friendliness, invaluable
suggestions instruction and comprehensive guidance
to undertake this as a seminartopic.
I would like to express our gratitude to all the member of
the department of Health Physical and Population
Education of their direct or indirect contribution in
carrying out this work we are indented to our family
and group who were always on hand to accomplish this
seminar.
3. Introduction
Background of the study
Nepal has made significant progress on health indicators over the past several
decades. The impressive achievement in health indicators was the result of
globalization in health including economic development via-a-viz strengthening
of primary (mostly peripheral) health care (PHC) health care (PHC) system
particularly through investments to establish the health care infrastructure. PHC
service in Nepal has been active since 1978 through a network of district and
the distal network that reaches to the community served by health posts and
sub-health posts. At the community level, nearly 50,000 Female Community
Health Volunteers are mobilized throughout the country. Significant progress
has been achieved by such a vast network of PHC in Nepal, a lot of which are
reflected in millennium and sustainable development goal indicators.
Transforming health system to achieve millennium and sustainable
development goal indicators also reflects how globalization has promoted
health system to adopt these goals. The infant mortality rate declined by two
fold from 78 deaths per 1000 live births in 1990 to 32 deaths per 1000 live
births in 2016 and pregnancy related mortality rate declined by half from 543
deaths per 100,000 live births in 1989–1996 to 259 deaths in 2009–2016
4. Objectives of the study
Every piece of work Aims to achieve specific result with
a time frame and available result I have also set some
objective and as follows.
To list out the health problem
To identify failure of primary health care
5. Materials and methods
To prepare this seminar paper I have reviewed and collected
information from manual as well as electronic data based
secondary sources from the journals articles and webs like
Nepal.
6. Review of Content:
The primary health care (PHC) principles of universal
accessibility, community involvement, inter-sectoral
coordination, and appropriate technology have been central to
the national health care policies of the Government of Nepal,
since the signing of the Alma Ata declaration by Nepal in 1978.
During the 1970s the Government looked beyond vertical control
programs for diseases such as malaria, smallpox and leprosy and
focused on the establishment of district health services. The
Government’s emphasis also shifted from curative health care
towards provisions for family planning, services for maternal and
child health and facilities for drinkable water. However, Nepal’s
path to provide equitable as well as affordable preventive,
curative and rehabilitative health care services has not been
straightforward.
7. Contd…
Nepal’s Himalayan terrain has always provided challenges for infrastructural
improvements in health service delivery. Additionally, Nepal’s ever-changing
political landscape has impeded stable governance and delivery of
governmental services. Multiparty democracy was restored in Nepal following
the People’s Movement of 1990. After this political transition a new National
Health Policy was introduced in 1991, with the primary aim of expanding PHC
services to rural and disadvantaged populations. The government aimed to
set up a health facility for every village development committee and a PHC
Centre with a birthing facility for every electoral constituency. The delivery of
PHC in Nepal is still based on networks of district level and below district level
health care facilities such as Sub-Health Posts. The Government has also been
successful in mobilising Female Community Health Volunteers for basic health
care services such as distribution of contraceptives, folic acid, Vitamin A and
oral rehydration packets. At the grassroots level the combination of Health
Posts and Female Community Health Volunteers has been at heart of PHC
work in Nepal.
8. Contd…
Currently, PHC is being bolstered by the Nepal Health Sector Program-II (2010–
2015), which aims to improve essential health care services through the
Primary Health Care Revitalisation Division established in 2009. Pilot programs
have begun for community health insurance. The government is also working
on public-private partnerships. Free health care services have also been
provided: 70 essential drugs can be obtained from governmental Health Posts.
The Government has also made inpatient and emergency services free for
groups such as senior citizens, poor citizens, Dalits, Female Community Health
Volunteers and differently-abled people. The Government is also initiating
urban health programs, implementing the Equity and Access Program for
women’s empowerment and continuing primary health care outreach services
to improve access to family planning and safe birthing facilities. The
Government is additionally making an effort to provide universal access to
essential medical services.
9. Analysis
Nepal is a poor country, one which has been put in the group of those which are least developed. In this
context, therefore, we have nothing to boast about. They tell us however that things are going to get better by
the end of this century viz. by the year 2000. We have been hearing this for some time now. More recently
there has been talk of liberalisation and privatisation. The talk is of public and private mix in the delivery of
health care services. Though the writing is not quite clear on the wall, the intention seems to be to hand over
the curative services to the private sector and for the government to restrict itself to just promotive health
care. Whilst this is an easier option this seems tantamount to washing ones hands from having to do the
difficult task of providing reasonable health services to the people at large. As one looks over the list of
diseases occurring in Nepal, one realises that the people are subjected to a relatively large number of
afflictions, present almost all the time. Besides these endemic illnesses, one sees as one looks over the medical
records, that a number of other diseases take epidemic proportions from time to time. The cholera epidemic
during the time of Chandra Shumsher was but one of such episodes in the history of diseases in Nepal. At such
times it is necessary to shift large amount of resources viz. men, money and materials to tackle the problems as
they occur. In such situations it is also realised that this is not the best way to do things, it being costly and
unsatisfactory. It makes much more sense to try to work on the premise, “Prevention is better than cure”. This
is the reason why health policies are made and it is obligatory to try to put into practice what has been
delineated as policy. The post Rana period is an example of this as a number of specific projects were started to
deal with the various problems of the populace. Primary Health Care in Nepal 75 + The major causes of
morbidity and mortality vary tremendously according to which sources one has consulted or which data one
has unearthed. By examining some of these figures, one can deduce that the summer months are the time of
the year when most people are ill. A large part of this illness is due to gastrointestinal upset, brought about by
way of faecal contamination of water or food by various offending organisms. A clean environment with a good
water supply and proper sewage disposal will get rid of all the major illnesses associated with this.
10. Causes of Failure
1. Managerial Deficiencies
2. Service Delivery Failure
3. Community Causes
11. Causes of Failure
Managerial Deficiencies
• Lack of trained managers
• Lack of selection and training criteria for managers
• Lack of proper performance evaluation of health managers
• Lack of motivation leading to professional and financial corruption
Service Delivery Failure
a) Accessibility problems
b) Utilization Failure
c) Efficiency problems
Community Causes
• Community participation has been virtually non-existent in PHC
• Gap in Community and Public sector has widened the bridge.
• Health education has been given a backseat in PHC.
• Low literacy levels and economic deprivation has forced people to shift entire responsibility of their health
on state shoulders.
12. Problem of PHC
lack of adequate health human resources,
poor supply chain logistics -medicines and
equipment,
attrition of health staff, their responsiveness and
poor account abilit
lack of education
13. Issues and challenge
Because of the progress made over the years by PHC service delivery system in the
area of behavior change, the time has now come to address other areas of importance
besides Child Health, Family Health and Communicable Diseases. For example, high
death and high birth rate scenario has changed into low birth and high death phase of
demographic change in our country. The age structure is changing with more elderly
population. Something is to be done for the care of elderly. Likewise, with population
pressure in the urban areas, the issue of urban health should now be another priority.
Roll back malaria and HIV/AIDS are few diseases demanding fresh look and higher
attention. The non-communicable diseases such as high blood pressure, cancer,
diabetes etc are increasing as a result of life-style changes in the population. These
diseases now need to be addressed Nepal 17 through prevention and curative service
at PHC service delivery level. Unprecedented diseases like Avian Influenza are a big
threat for public health and MoHP has started work on it.
The GON/MoHP has initiated strengthening public private partnership for proving
better, quality health care service and covering more people. In order to materialize
this, there is a need to give more attention in the area of human resource
development working in the private sector and their involvement in public sector. The
private sector should join hand with the government for delivery of primary health
care.
14. Conclusion
The main role of primary health care is to provide continuous and
comprehensive care to the patients. It also helps in making the patient
available with the various social welfare and public health services initiated
by the concerned governing bodies and other organizations. The other major
role of a primary health care center is to offer quality health and social
services to the underprivileged sections of the society.
As for the benefits of primary health care to the members of a community, it
offers the first set of professional care to the patients by incorporating a
proactive approach that utilizes several preventive measures, management of
chronic disease, and promoting self-care. Along with that, primary health care
provides increased accessibility to advanced health care system for the
community, which results in excellent health outcomes and prevention of
delay.
All primary health care clinics contain a dedicated team of healthcare
professionals offering the best medical services. They provide a coordinated
approach to the delivery of health care that ensures that the beneficiaries
receive the best care from the right health provider.
15. Suggestion
The government must support to primary health care.
Government for providing health services and free medical care.
Improving the Economic and Social Welfare of Old Age Persons →
Improving the Health Status of Old Age Persons.
The community should facilitate economic help to the aged. The aged
can be helped to receive their pension, and be made aware of the
different grant-in-aid sachems of the government.
Social workers can help the elderly to be aware about the various
policies and programs related to the welfare of the aged in our country.
This will help the elderly to protect their rights.
To help them psychologically counseling classes to be arranged.
The elder people with physical disabilities should be exemplaryand
facilities various part of the state.
