Public Health in Malaysia (2014)
This slide presentation contain
1.The Development of public health in Malaysia.
2.Public Health today in Malaysia
3.General Outlook of Public Health
4.Policy and action from our government.
5.The 1Care Program (1Care Concept)
6.1Malaysia Clinics
7.Vaccination
8.Disease Control For Vector Species
9.MySihat
10.Private Events For Public Health
11. etc.
Public Health in Malaysia (2014)
This slide presentation contain
1.The Development of public health in Malaysia.
2.Public Health today in Malaysia
3.General Outlook of Public Health
4.Policy and action from our government.
5.The 1Care Program (1Care Concept)
6.1Malaysia Clinics
7.Vaccination
8.Disease Control For Vector Species
9.MySihat
10.Private Events For Public Health
11. etc.
CONTENTS
Introduction
NHM
NRHM
Components of NRHM
NUHM
Components of NRHM
Difference between NRHM and NUHM
Future goals
Conclusion
References
INTRO:
National Health Mission
Ministry of health and family welfare
NHM - approved in May 2013
Sub missions – NRHM & NUHM
It aims at improving and correcting the deficiencies in the health care delivery system with a focus on integrating all thee available healthcare facilities like Ayush along with ongoing vertical programme.
Main programmatic components
- RMNCH+A
- control of NCDs & Comm. d/s
NRHM:
Launched in 5th April 2005 for 7 years by GOI
Intended for 2005 - 2012
Recently extended to 2017
Operational in whole country & Special focus on 18 states
Correct the deficiencies of health system
The Mission adopts a synergistic approach by relating health to determinants of good health viz. segments of nutrition, sanitation, hygiene and safe drinking water.
Objective of the mission:
Reduction in child and maternal mortality.
Universal access to public health services.
Prevention and control of communicable and noncommunicable diseases, endemic diseases
Stabilization and demographic balance.
Revitalizeimunisation programme
Access to integrated phc.
Revitalize local local health tradition.(Ayush)
Promotion of healthy life style
COMPONENTS UNDER NRHM:
Comprehensive Primary Health Care (CPHC) through Ayushman Bharat Health and Wellness Centers (HWCs)
National Ambulance Services (NAS)
National Mobile Medical Units (NMMUs)
Free Drugs Service Initiative
Free Diagnostics Service Initiative
Community Participation
a)Accredited Social Health Workers (ASHA)
b)Rogi Kalyan Samiti (Patient Welfare Committee) / Hospital Management Society
c)VHSNCs
Mera Aspataal
Kayakalp
SUMAN (Surakshit Matritva Aashwasan)
Mission Indradhanush
TB Harega Desh Jeetega Campaign
Eat Right India Movement, with ‘Sahi Bhojan Behtar Jeevan’
AYUSHMAN BHARATH HWCS:
Ayushman Bharath is an attempt to move from a selectiv approach to health care to deliver range of services like preventive,promotive,curative,rehabilitative,and palliative care
It has 2 components
1) Health and wellness centre(HWCs) 1,50,000
2)Pradhan mantri jan Arogya yojan (PM-JAY)
Health insurance cover 5 lakh / year – 10 crore poor ppl
The first Health and Wellness Centre was inaugurated by Hon’ble Prime Minister on 14th April 2018 in Bijapur district of Chhattisgarh.
So far, 51,484 HWC are formed
Objectives:
upgrading the Sub Health Centers (SHCs) and Primary Health Centers (PHCs) in rural and urban area
provide Comprehensive Primary Health Care
common NCDs such as Hypertension, Diabetes and 3 common cancers of Oral, Breast and Cervix.
primary healthcare services for Mental health, ENT, Ophthalmology, Oral health, Geriatric and Palliative health care and Trauma care as well as Health promotion and wellness activities like Yoga.
CONTENTS
Introduction
NHM
NRHM
Components of NRHM
NUHM
Components of NRHM
Difference between NRHM and NUHM
Future goals
Conclusion
References
INTRO:
National Health Mission
Ministry of health and family welfare
NHM - approved in May 2013
Sub missions – NRHM & NUHM
It aims at improving and correcting the deficiencies in the health care delivery system with a focus on integrating all thee available healthcare facilities like Ayush along with ongoing vertical programme.
Main programmatic components
- RMNCH+A
- control of NCDs & Comm. d/s
NRHM:
Launched in 5th April 2005 for 7 years by GOI
Intended for 2005 - 2012
Recently extended to 2017
Operational in whole country & Special focus on 18 states
Correct the deficiencies of health system
The Mission adopts a synergistic approach by relating health to determinants of good health viz. segments of nutrition, sanitation, hygiene and safe drinking water.
Objective of the mission:
Reduction in child and maternal mortality.
Universal access to public health services.
Prevention and control of communicable and noncommunicable diseases, endemic diseases
Stabilization and demographic balance.
Revitalizeimunisation programme
Access to integrated phc.
Revitalize local local health tradition.(Ayush)
Promotion of healthy life style
COMPONENTS UNDER NRHM:
Comprehensive Primary Health Care (CPHC) through Ayushman Bharat Health and Wellness Centers (HWCs)
National Ambulance Services (NAS)
National Mobile Medical Units (NMMUs)
Free Drugs Service Initiative
Free Diagnostics Service Initiative
Community Participation
a)Accredited Social Health Workers (ASHA)
b)Rogi Kalyan Samiti (Patient Welfare Committee) / Hospital Management Society
c)VHSNCs
Mera Aspataal
Kayakalp
SUMAN (Surakshit Matritva Aashwasan)
Mission Indradhanush
TB Harega Desh Jeetega Campaign
Eat Right India Movement, with ‘Sahi Bhojan Behtar Jeevan’
AYUSHMAN BHARATH HWCS:
Ayushman Bharath is an attempt to move from a selectiv approach to health care to deliver range of services like preventive,promotive,curative,rehabilitative,and palliative care
It has 2 components
1) Health and wellness centre(HWCs) 1,50,000
2)Pradhan mantri jan Arogya yojan (PM-JAY)
Health insurance cover 5 lakh / year – 10 crore poor ppl
The first Health and Wellness Centre was inaugurated by Hon’ble Prime Minister on 14th April 2018 in Bijapur district of Chhattisgarh.
So far, 51,484 HWC are formed
Objectives:
upgrading the Sub Health Centers (SHCs) and Primary Health Centers (PHCs) in rural and urban area
provide Comprehensive Primary Health Care
common NCDs such as Hypertension, Diabetes and 3 common cancers of Oral, Breast and Cervix.
primary healthcare services for Mental health, ENT, Ophthalmology, Oral health, Geriatric and Palliative health care and Trauma care as well as Health promotion and wellness activities like Yoga.
It is the small topic from the 3rd unit of Bsc nursing, delivery of community health nursing , in which u will come to know about organization, staffing and functions of rural health services provided by Govt.
At the end of this session, you will be able to
1. Describe the delivery of family planning services at various levels of health care delivery
2. Define unmet need of contraception and enumerate it’s reasons
3. List the various evaluations done on family planning services
The orderly process defining national Health problems, identifying the unmeet needs, surveying the resources to meet them, and establishing the priority goals to accomplish the purpose of proposed Programme.
INTRODUCTION
The concept of “Primary Health Care” came into existence, following a joint WHO-UNICEF International Conference at Alma-Ata, USSR on 12th September 1978.
The governments of 134 Countries and many voluntary agencies at Alma-Ata Conference called for acceptance of WHO goal of “Health for All by 2000 AD” and proclaimed Primary Health Care as a way to achieving Health for All.
This approach has been described as “Health by the people” and “placing people’s health in people’s hand”.
Primary Health Care is the first level of contact of individuals, the family and community with the national health system, where essential health care is provided.
At this level that health care will be most effective within the context of the area’s need and limitations.
DEFINITION
• Primary Health Care is defined as,
“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 community and the country can afford to maintain at every stage of their development in the spirit of self-determination.”
• The Alma-Ata Conference defined Primary Health Care as follows: -
“Primary health care is essential health care made universally accessible to individuals and acceptable to them, through their full participation and at a cost the community and country can afford.”
CHARACTERISTICS OF PRIMARY HEALTH CARE
• It is essential health care, which is based on practical, scientifically sound and socially acceptable methods and technology.
• It should be rendered universally acceptable to individuals and the families in the community through their full participations.
• Its availability should be at a cost, which the community and country can afford to maintain at every stage of their development in a spirit of self-reliance and self-development.
• It requires joint efforts of the health sector and other health related sector like education, food and agriculture, social welfare, animal husbandry, housing, etc.
ELEMENTS OF PRIMARY HEALTH CARE
The Alma-Ata Declaration has outlined 8 essential components of Primary health care,
1. Education concerning prevailing health problems and the methods of preventing and controlling them.
2. Promotion of food supply and proper nutrition.
3. An adequate supply of safe water and basic sanitation.
4. Maternal and child health care, including family planning.
5. Immunization against major infectious diseases.
6. Prevention and control of locally endemic diseases.
7. Appropriate treatment of common diseases and injuries.
8. Provision of essential drugs.
PRINCIPLES OF PRIMARY HEALTH CARE
1) Equitable distribution: -
Health service must be shared equally by all people irrespective to their ability to pay.
Primary health care aims to redress ‘Social injustice’ by shifting the centre of gravity of health care system from c
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It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
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5. Describe the cough and sneeze reflexes
Study Resources:
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2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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2. Introduction…
• At the International Conference on Primary Health Care in
1978 at Alma Atta, Primary Health Care has been
identified as a key to attaining Health For All
3. PRIMARY HEALTH CARE
Definition
The World Health Organisation (WHO) has
defined Primary Health care as :
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 at every stage of their development in the spirit
of self-reliance and self-determination.
(WHO, 1978)
4. PRIMARY HEALTH CARE
• It is intended to reach everybody, particularly
those in greatest need
• It is intended to reach to the home and the
family level, and not be limited to health
facilities
• It is intended to involve a continuing
relationship with persons and families
5. • - There are at least 8 essential services to be
provided to every individual in the community :
• Health education
• food supply and proper nutrition
• safe water and basic sanitation
• maternal and child care
• immunization
• prevention and control of endemic diseases
• basic treatment of health problem
• provision of essential drugs
PRIMARY HEALTH
CARE
6. PRIMARY HEALTH CARE in Malaysia
The Eight (+ One) Elements
Malaysia, even before 1978, has always had these at all
rural clinics, and additional ninth element, dental care.
• Maternal and Child Health, including family planning and childhood
immunization
• Out-patient Curative Care (inc dispensary)
• Dental Health
• Control of Communicable Diseases
• Environmental Sanitation
• Health Education for the public
• Clinical Laboratory
• School Health Program
• Nutrition
7. • In the 6 and 7th
MP:
To ensure adequate emphasis is given to Primary Health
Care (PHC) , it has been proclaimed as the “Thrust of
Health Services of the country” in the Seventh
Malaysia Plan.
It will provide comprehensive services : ---
Promotion
• Preventive
• Curative
• Rehabilitative
8. What we did in 7th
MP
• Plan and implement expanded and extended
scope of PHC services
• Transfer of outpatient service
• Upgrade PHC facilities and support services
• Develop ICT for health – Telehealth,
Teleprimary care, Lifetime Health Record
• Human resource planning and procurement
• Develop policy on Traditional/Complementary
Medicine
9. PHC Objectives in 8th
MP
• To provide PHC service to the population and to promote
wellness and facilitate maximum recovery from illness
10. PRIMARY HEALTH CARE
SECTION
• started as one unit in 1996,
• Became a section in 1997
• Now we have 12 staffs ,
• – take care of health services provided at first point of
contact, by health clinics and community clinics to all
clients.
11. Primary Health Care :
- policy planning and development related to health care
services at primary care level.
12. Objectives
• To plan and monitor programs implemented & integrated
at primary care level
• To plan human resource requirement and their
development
• To plan and monitor the infrastructure development –
layout plan, equipment, support services and ICT
13. Objectives ….
• To develop policy and operational policy at the clinic
level
• To monitor the traditional/complementary medicine
practices
• Others : NGO, Quality program, Health Technology
Assessment
14. ORGANISATION
Director General of Health
Deputy Director General of Health (Public Health)
Director of Family Health Development Division
Primary Health Care Section
Infrastructure Human Resource Policy/T/CM
15. RURAL HEALTH SERVICE – has always
been a major component of health facility
development
• It is provided by Ministry of Health, except in the
estate/Orang Asli settlement
• The services are provided at Health Clinics and
Midwife Clinic -cum- Quarters
• It practices the Primary Health Care Concept
• The initial structure was a three-tier system (each unit
for50,000) population)
• After 1971, it was upgraded by phases into two- tier
system (each unit for 15,000 – 20,000 populations) to
improve accessibility
16. Upgrading of health
facilities
• In 1971, there was a modification of the rural health unit
from a 3-tier system into a 2-tier system through the
upgrading of Sub-health Centres and Mid-wife Clinics
into Main Health Clinics and “Klinik Desa” (community
clinic)
• This Rural Health Clinic covers a population of 15,000 to
20,000 and the Klinik Desa provides services to a
population of 4,000-5,000
17. Healthcare providers at various
level of Primary Health Care
- Health Facility Level
Type of facility :
Dispensary, Community Clinic, Health Clinic or a consultation
room of a General Practitioner’s clinic
Category of Health Personel :
Medical Officer, Public Health Nurse, Community Nurse,
Medical Assistant, Public Health Inspector, Dispenser, Junior
Laboratory Assistant/Medical Laboratory Technologist/)
Supportive facilities: Clinical laboratory Services, Essential
drugs, no X-Ray facility, no ultrasound machine
18. URBAN HEALTH SERVICES
• It is provided by Local Authority, Ministry of
Health and private sector
• Service range:
• - Maternal & Child Health Services
- Out patient Care
• It is mainly curative services
19. PRIMARY HEALTH CARE
NOW & FUTURE
• Expand the scope of PHC services
• Human resource development
• New plan for Health Clinics and Rural Clinics
• Development of physical facilities (x-ray, labs)
• Emphasis to develop Urban Health Clinics
• Involving NGO’s and community in health care
• Involve local private primary care providers to
provide PHC
• Health Care Financing Options
20. Existing services
• Maternal health
• Child health
• Family planning
• Outpatient curative care
• Home delivery and nursing
• Dental health
• School health
• Disease Prevention & Control
• Environmental health
• Health education
• Pharmacy
• Clinical Laboratory
• New’ services
• Well Adult Clinic
• Workers’ health
• Adolescent health
• Care of the Elderly
• Community Mental Health
• Care of Children with Special
Needs
• Rehabilitation
• Diagnostic Imaging
(ultrasound, x-ray)
• Alternative Birthing Centre
21. PHC Elements …
In 7th
MP and on …
Health care for the Elderly
Adolescent health
Occupational health
Care for children with special needs
Rehabilitative service
Community mental health
Well adult clinic
Home care nursing
22. PRIMARY HEALTH CARE
Malaysian achievement
Number of health facilities and facility : population
ratio in Malaysia, 1970-1996Type of
facilities
1970 1980 1990 1995
MCQ/Rural
Clinics
26 703
(1:12200)
1977
(1:5380)
1987
(1: 4720)
Health
Clinics
16
(1:625000)
178
(1:73000)
611
(1:29100)
772
(1: 26800)
Source: Ministry of Health, Malaysia.
2001
1940
855
(1:25730)
23. Infrastructure Planning
and Development
For the 8th
Malaysia Plan, Standard Plan for
Health Clinics has been reviewed
Type 1 - > 800 patients per day
Type 2 - 500 – 800 patients per day
Type 3 - 300 – 500 patients per day
Type 4 Semenanjung - < 300 patients per day
Type 4 Sabah/Sarawak - 150- 300
Type 5 Sabah/Sarawak - < 150
Type 6 Sabah/Sarawak - < 50
24. • Lab facilities
• Radiological facilities
• Pharmaceuticals
• Rehabilitative facilities
• Health Promotion facilities
• IT and networking
• Training -CME/CEPH
• Technology - Teleprimarycare
25. Human Resource
Development
- Introduction of new categories of
staffs
• Family Medicine Specialist
• Radiographer
• Occupational Therapist
• Physiotherapist
• Medical Social Worker
• Audiologist
• Dietician
• Speech Therapist
26. FAMILY MEDICINE SPECIALIST (FMS)
- Will provide comprehensive and continuity of specialist
care at first point of contact, and takes responsibility for
providing the patient’s care , extended to their family and
community
- Currently, there are 95 Family Medicine Specialists
serving through out the country
•
27. Support Services
- Having FMS at the PHC level of care, the support services
also being upgraded
• - Specialist drugs (List A) are available and can be
prescribed by the specialist
- Laboratory services : Upgrading of laboratory services from
clinical to Level 1 (upgraded ) has been continuous effort
- Diagnostic imaging : Service has developed tremendously
since 1989, now 61 health clinic equipped with diagnostic
imaging services , which is run by radiographer
- Ultrasound : So far 83 health clinics equipped with
ultrasound machine
28. Future of Primary Health
Care Delivery
Home
testing &
monitoring
Medical
advice via
telephone
Coordinated &
integrated delivery of
care
Best practice
interactive
technology
Contemporay
education
media and
technology
Wellness &
prevention at work