The document discusses primary health care, including its definition, principles, and organization. It defines primary health care as the first level of contact between individuals and the health system, providing essential care close to people's communities. The key principles of primary health care are equitable distribution of services, community participation, and intersectoral coordination between health and other sectors. Primary health care operates at three levels - primary, secondary, and tertiary - with primary care focused on health education, promotion, and treatment of common issues.
A process aimed at encouraging people to want to be healthy, to know how to stay healthy, to do what they can individually and collectively to maintain health and to seek help when needed.
The level of prevention topic will help you to know about how to prevent any particular disease in humans. Level of prevention is categorized into four
Primordial prevention
Primary prevention
Secondary prevention
Tertiary prevention
A process aimed at encouraging people to want to be healthy, to know how to stay healthy, to do what they can individually and collectively to maintain health and to seek help when needed.
The level of prevention topic will help you to know about how to prevent any particular disease in humans. Level of prevention is categorized into four
Primordial prevention
Primary prevention
Secondary prevention
Tertiary prevention
National Vector Borne Disease Control Programme (NVBDCP)Vivek Varat
The National Vector Borne Disease Control Programme (NVBDCP) is an umbrella programme for prevention and control of malaria and other vector borne diseases. Under the programme, it is ensured that the disadvantaged and marginalised sections benefit from the delivery of services so that the desired National Health Policy and Rural Health Mission goals are achieved. The Directorate of NVBDCP under the Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, is the nodal agency responsible for planning, coordination, implementation, monitoring and evaluation of NVBDCP programme at all levels.
RMNCH+A approach has been launched in 2013 and it essentially looks to address the major causes of mortality among women and children as well as the delays in accessing and utilizing health care and services. The RMNCH+A strategic approach has been developed to provide an understanding of ‘continuum of care’ to ensure equal focus on various life stages.
The RMNCH+A appropriately directs the States to focus their efforts on the most vulnerable population and disadvantaged groups in the country. It also emphasizes on the need to reinforce efforts in those poor performing districts that have already been identified as the high focus districts.
National Vector Borne Disease Control Programme (NVBDCP)Vivek Varat
The National Vector Borne Disease Control Programme (NVBDCP) is an umbrella programme for prevention and control of malaria and other vector borne diseases. Under the programme, it is ensured that the disadvantaged and marginalised sections benefit from the delivery of services so that the desired National Health Policy and Rural Health Mission goals are achieved. The Directorate of NVBDCP under the Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, is the nodal agency responsible for planning, coordination, implementation, monitoring and evaluation of NVBDCP programme at all levels.
RMNCH+A approach has been launched in 2013 and it essentially looks to address the major causes of mortality among women and children as well as the delays in accessing and utilizing health care and services. The RMNCH+A strategic approach has been developed to provide an understanding of ‘continuum of care’ to ensure equal focus on various life stages.
The RMNCH+A appropriately directs the States to focus their efforts on the most vulnerable population and disadvantaged groups in the country. It also emphasizes on the need to reinforce efforts in those poor performing districts that have already been identified as the high focus districts.
This presentation contains ;-
1. Definition of community
2. Definition of health
3. definition of nursing
4. Causes of poor health
5. Definition of community health nursing
6. Types of communities
7. community health
8. Public health
9. Aims of public health
10. Aims of community health nurse
11. Objectives of community health nursing
12. Principles of community health nursing
13. Function of community health nurse
14. The mission of community health nursing
15. concepts of health
16. components of community health nursing
17. Scope of community health nursing
18. Community health nursing roles
CM 17.3 Principals of Primary Health Care.pptxAnjali Singh
HEALTH CARE SCENARIO:
Health care has always been a problem area for India, a nation with a large population and a larger percentage of this population living in urban slums and in rural area, below the poverty line.
Before independence the health structure was in dismal condition i.e. high morbidity and high mortalities, and prevalence of infectious diseases. Since independence emphasis has been put on Primary Health Care and we have made considerable progress in improving the Health Status of the country.
CG:Central Government
PH:Primary Health
MCH:Maternal and Child Health
Health is a human right, which has also been accepted in the constitution. Its accessibility and affordability has to be insured. While the well-to-do segment of the population both in rural & urban areas have acceptability and affordability to wards medical care, at the same time cannot be said about the people who belong to poor segment of the society. It is well known that more then 75% of the population utilizes private sectors for medical care unfortunately medical care becoming costlier day by day and it has become almost out of reach of the poor people. Today there is need for injection of substantial resources in the health sectors to ensure affordability of medical care to all. Health insurance is an important option, which needs to be considered by the policy makers and planners.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
The prostate is an exocrine gland of the male mammalian reproductive system
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
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
1. Dr. Anjali Wagh.
Prof. & HOD
Dept. of Community Medicine
D.Y.Patil Medical College, Kolhapur
2. Medical care:
personal services provided directly by physicians.
Health care :
Integrated care including preventive, promotive,
curative, rehabilitative services for individuals from
womb to tomb.
Health care includes medical care.
3. The three tier system of health careThe three tier system of health care
Tertiary level [Regional hospital,
medical college hospital]
Secondary level [community
health centre, district
hosp.]
Primary level
[primary health
centre, sub centre]
4. Primary health care
Village level [grass root level]-
First level of contact bet n. health system and
individual
Provided by –Village health guide
Traditional birth attendant/dai
Anganwadi workers
ASHA
5. Secondary health care
The First referral level
More complex problems are dealt with.
Comprises curative services
Provided by the district hospitals
Tertiary health care
Offers super-specialist care
Provided by regional/central level institution.
Provide training programs
6.
7. EVOLUTION OF PRIMARY HEALTH
CARE
The Alma-Ata Conference
International conference on primary health care
Conducted from 6-12th September 1978 at Alma Ata
Mile stone in the history of public health
Key to the attainment of the goal of the Health for All
8.
9. 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.
10. PRIMARY HEALTH CARE
“Primary Health Care is
essential health care made
universally accessible to
individuals & acceptable to
them, through their full
participation & at a cost the
community & country can
afford”.
13. The Basic Requirements for Sound PHC
(the 8 A’s and the 3 C’s)
Appropriateness
Availability
Adequacy
Accessibility
Acceptability
Affordability
Assessability
Accountability
Completeness
Comprehensiveness
Continuity
24. Principles for primary health carePrinciples for primary health care
PHC based on the following principles
25. Equitable distribution
‘ Key’ principle of Primary Health Care
• Remove social injustice & services must be equally
distributed to all people of the community.
Irrespective of the cast, religion, community & ability
to pay ( rich or poor), urban or rural
Services must be accessible to all.
Needy & vulnerable group of population like
poor rural and urban slum.
26. EQUITABLE DISTRIBUTION
Access to health care - horizontal equity & vertical equity
Horizontal equity - “equal access for equal needs”
equal resources
equal access to health care
equal utilization of health services
equal health
27. EQUITABLE DISTRIBUTION
Vertical equity - unequal should be treated in proportion of
their inequality
Individuals with more need should have more treatment
The central theme of “need” therefore determines equity
28. Examples of equitable distribution in access to health care in
India:
Tripura- helicopter service to reach the remote set of tribal
hamlets
Andhra Pradesh- free bus passes to pregnant women for the
antenatal visits
Assam - Akha-ship to provide primary care services in riverine
Island through boat clinics
Tamil Nadu – concept of birth resorts is introduced in remote
and hilly areas for institutional deliveries
29. 2) Community Participation
“Promote maximum community and individual self-
reliance and participation in the planning, organization,
operation and control of primary health care, making
fullest use of local, national and other available resources;
and to this end develop through appropriate education the
ability of communities to participate”
Cost effective method.
Placing the health of people in their hands – It is by the
people, of the people and for the people.
‘Democratization’ of health services
30. COMMUNITY PARTICIPATION
Involvement of the individuals,
families and community
Determines both collective needs and priorities
Important role in formulating a health problem, make informed
choices ,objectives with community priorities
Universal coverage cannot be achieved without the involvement
of the local community
31. Types of community participation
Active - co-operation + resources, Passive -
cooperation
Marginal – limited, transitory participation of people
e.g. organization of camp with local support
• Substantial – community plays active role in
determining priorities & helping carrying out health
activities like health education, hygiene maintenance
e.g. Panchayati Raj Institutions
• Structural – community becomes integral part of
program & major basis of health activities
32. Planning steps in community participation:
Identification and prioritization of the problems
Planning together
Implementation by community members
Evaluation by community members
33. Examples of community participation in India:
Village health guides, trained dais, ASHA
Selected by the local community and trained locally
Essential feature of health care in India
34. Bare foot doctors:
In China, lack of availability of rural
health services was addressed from 1965 to 80
by development of bare foot doctors.
Rural farm workers were given basic heath
training to provide combination of traditional
and western medicine.
Regarded as model for development of
community health workers
35. Advantages of community participation
Cost effective method of providing health services
People begin to view health more objectively, they are
more likely to accept the care
Greater commitment of the people resulting in the
success of health care services
Health awareness in village people
Health workers get support for their activites
Health care services become more relevant to the
health needs of the people
Quality of health care improves
36. 3) Intersectoral co-ordination
“Involve, in addition to the health sector, all related
sectors and aspects of national and community
development
agriculture
animal husbandry
food industry
education
housing
public works
Communication
Voluntary organisation
38. Pre-requisites for Intersectoral Coordination:
Proper orientation of policies and programme
Formation of joint coordination committee at each level
Defining role and responsibilities of participatory agencies
Participatory decision making
Developing formal system of interaction, discussion and
debate
Sharing of the problems faced in implementation
39. Mechanism of co-ordination:
List out names of different sectors
Identify the NGOs and voluntary organisation
Constitute the district level co-ordination committee
Formulate specific task forces
Jointly decide the objectives and areas
Decide the role and responsibility
Development a plan
40. Difficulties facing intersectoral co-ordination:
Create conflicts of interest and disequilibrium
Power struggles
Agencies must be able to compromise and impose change on the
normal working patterns
Cultural changes may occur within organisations
Co-ordination may turn out to be more expensive in terms of
time, money and manpower
41. Irrespective of the disadvantages, intersectoral coordination is
the key principle outlined by WHO if Health for All has to be
achieved
An outstanding example of the intersectoral coordination at the
grass root level - Anganwadi as a part of ICDS programme
42. 4) Appropriate technology
Technology of Health care service provided must be
Simple,
Scientifically sound,
Practically adaptable,
Culturally acceptable ,
Economically cheaper
Operationally convenient,
Maintainable with local resources
Acceptable to users and recipients
43. APPROPRIATE TECHNOLOGY
“Technology that is scientifically sound, adaptable to local
needs and acceptable to those who apply it and those for
whom it is used and is maintained by the people themselves in
keeping with the principle of self reliance with the resources
the country and the community can afford”
44. Examples for the appropriate technology
Use of coloured tapes for measuring mid upper arm
circumference
Use of ORS
Tender coconut for oral hydration
Growth chart maintenance for under five children
Low cost mosquito repellent creams
Simple water purification
45. Informational technological advancements that have been
proven to ultimately enhancing the service delivery-
Health Management Information System
Telemedicine
Immunization programs,
DOTS , Nutritional supplementation
Distribution of DDK for domiciliary midwifery services
Distribution of IFA tablets
Biogas plant for cooking, heating and lighting.
Smokeless chulhas for cooking
46. To Summarize
Primary care is an approach that:
Focuses on the person not the disease, considers all
determinants of health
Integrates care when there is more than one problem
Uses resources to narrow differences
Forms the basis for other levels of health systems
Addresses most important problems in the
community by providing preventive, curative, and
rehabilitative services
Organizes deployment of resources aiming at
promoting and maintaining health.
47. “When We talk about capacity, We absolutely must talk
about the importance of primary health care. it is the
cornerstone of building the capacity of health systems”
- dr. margaret chan
director general
Who