Primary health care by dr najeeb memon

Primary health care by dr najeeb memon

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  ByBy DR: NAJEEB MEMONDR:NAJEEB MEMON MPH,DFHCMPH,DFHC Asst: ProfessorAsst: Professor F.C.M & P.H.SF.C.M & P.H.S LUMHS, Jamshoro, SindLUMHS, Jamshoro, Sind PAKISTANPAKISTAN e mail mnajeeb80@gmail.come mail mnajeeb80@gmail.com
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  Levels of CareLevelsof Care Primary health carePrimary health care Secondary health careSecondary health care Tertiary health careTertiary health care
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  Primary Health CarePrimaryHealth Care  Anew approach to health care Came in to existence inAnew approach to health care Came in to existence in 19781978 following an international conferencefollowing an international conference atat Alma-Ata (USSR)Alma-Ata (USSR) This known asThis known as ““Primary Health Care”Primary Health Care”
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  It has allthe hallmarks of a Primary health careIt has all the hallmarks of a Primary health care delivery, first proposed bydelivery, first proposed by “Bhore Committee“Bhore Committee in 1946,in 1946, & now espoused world-wide by international& now espoused world-wide by international agencies & national Govt:agencies & national Govt: Global strategyGlobal strategy forfor ““Health for AllHealth for All”” 3434thth WorldWorld Health assembly in 1981.Health assembly in 1981. Bhore CommitteeBhore Committee
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  Primary Health carePrimaryHealth care Before Alma-Ata, “Primary Health care” synonymousBefore Alma-Ata, “Primary Health care” synonymous ““Basic Health services”Basic Health services” ““First Contact Care”First Contact Care” ““Easily Accessible Care”Easily Accessible Care” ““Services provided by generalists”Services provided by generalists” etc.etc. Alma-Ata, international conferenceAlma-Ata, international conference defined “PHC” asdefined “PHC” as follows:follows:
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  PRIMARY HEALTH CAREPRIMARYHEALTH CARE ““ It is anIt is an essential health careessential health care made universallymade universally accessible toaccessible to through their full participation & at a cost thethrough their full participation & at a cost the community & country can affordcommunity & country can afford””.. individualsindividuals & acceptable to them& acceptable to them essential health careessential health care individualsindividuals
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  PRIMARY HEALTH CARE( WHO)PRIMARY HEALTH CARE ( WHO) ISIS UNIVERSALLY ACCESSIBLEUNIVERSALLY ACCESSIBLE HEALTH CAREHEALTH CARE THAT ISTHAT IS SOCIALLY ACCEPTABLESOCIALLY ACCEPTABLE,, AFFORDABLEAFFORDABLE ANDAND REQUIRES INDIVIDUALS TO BEREQUIRES INDIVIDUALS TO BE MORE SELF-MORE SELF- RELIANTRELIANT WITH THEIRWITH THEIR HEALTH CARE NEEDSHEALTH CARE NEEDS..
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  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 ofLevels of CareCare LUM Hospital
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  Concepts of PHCConceptsof PHC  For all ( especially for needy )For all ( especially for needy ) AcceptableAcceptable  CommunityCommunity Active involvementActive involvement
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  BASIC ELEMENTSBASIC ELEMENTSOFOF ““PRIMARY HEALTH CARE”PRIMARY HEALTH CARE”  Health educationHealth education ( Health problems- preventing & controlling)( Health problems- preventing & controlling)  Identifying & controlling prevailing health problems.Identifying & controlling prevailing health problems.
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   Promotion ofFood supply and properPromotion of Food supply and proper nutrition.nutrition.  Provision of safe water and basic sanitation.Provision of safe water and basic sanitation.  Maternal & child health care,Maternal & child health care, including family planning.including family planning.
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  BASIC ELEMENTSBASIC ELEMENTS(cont:)(cont:)  ImmunizationImmunization  Prevention and control of locally endemicPrevention and control of locally endemic diseasedisease
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   Appropriate treatmentof common diseases andAppropriate treatment of common diseases and injuriesinjuries  Promotion of mental healthPromotion of mental health  Provision of essential drugsProvision of essential drugs
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  PrinciplesPrinciples Equitable Distribution PHC mustbe given toPHC must be given to all individuals in equalall individuals in equal amount in communityamount in community irrespective of theirirrespective of their gender, age, caste,gender, age, caste, color, urban, rural andcolor, urban, rural and social class.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.
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  PHC in PakistanPHCin Pakistan Health facilities are offered through severalHealth facilities are offered through several  BHUBHU  RHCRHC
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  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
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  RHC Each has 25beds 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
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  Selective Primary HealthCareSelective Primary Health Care  Is a policy of selective interventions to deal withIs a policy of selective interventions to deal with thethe most serious public health problemsmost serious public health problems,, rather than comprehensive PHC which israther than comprehensive PHC which is consideredconsidered too costlytoo costly && requires a large no: ofrequires a large no: of trained persons.trained persons.
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  UNICEF’s Proposed SelectiveUNICEF’sProposed Selective ApproachApproach  Growth monitoringGrowth monitoring  ORSORS  Breast feedingBreast feeding  ImmunizationImmunization  Family planningFamily planning  Female educationFemale education
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  ComprehensivenessComprehensiveness  Comprehensiveness ofcare means thatComprehensiveness of care means that care iscare is provided for all types of health problemsprovided for all types of health problems..
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  THE FUNCTIONS OFPRIMARY HEALTH CARETHE FUNCTIONS OF PRIMARY HEALTH CARE 1. To provide continuous and comprehensive care1. To provide continuous and comprehensive care 2. To refer to specialists and/or hospital services2. To refer to specialists and/or hospital services 3. To co-ordinate health services for the patient3. To co-ordinate health services for the patient 4. To guide the patient within the network of social4. To guide the patient within the network of social welfare and public health serviceswelfare and public health services 5. To provide the best possible health and social5. To provide the best possible health and social services in the light of economic considerations.services in the light of economic considerations.