introduction of phc

8/6/2019 Introduction of Phc

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Primary Health CareAn Introduction

Primary Health CareAn Introduction


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Health!!!!Health!!!!

Worldwide, Health is defined

in negative terms as:

ABSENCE OF DISEASE


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negative concept of healthnegative concept of health

The negative concept of health

( = absence of disease):

tended to determine decision making,

planning and

expenditure on health .. Services for sickness are named health

services


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Accordingly

Emphasis was put on building health

infrastructure in the form of:

Hospitals

Health Centers

Dispensaries


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role of health personalrole of health personal

Consequently the role of health personnel

was primarily that of:

Providers Whereas people (community members)

were:

the Recipients


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Coverage & AccessibilityCoverage & Accessibility

Coverage:

Less than 30%

Accessibility: Limited to those who:

Could afford to pay

Lived within reasonable short distance


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Primary Health CarePrimary Health Care

Workingtogether for

better health


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PHC historyPHC history

WHOs Constitution 1946

Health for All by the year 2000 (Assembly) 1977

International Conference on Primary 1978

Health Care (Alma Ata)


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What is Primary Health Care ?


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Primary Health Care Definition

Primary Health Care:

is the first level of contact of individuals, thefamily and the community with the national

health system, bringing health care as close as

possible to where people live and work


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Primary Health Care Definition

Primary Health Care:

is essential care based on practical, scientifically

sound, socially acceptable methods andtechnologies, made universally accessible toindividuals and families in the communitythrough their full participation and at a cost thecommunity and country afford to maintain

Alma Ata declaration, 1978


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Primary Health Care- Definition

Primary Health Care includes:

Primary Care (physicians, midwives & nurses); Health promotion, illness prevention;

Health maintenance & home support;

Community rehabilitation;

Pre-hospital emergency medical services; &

Coordination and referral to other areas of health

care.


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Primary Health Care DefinitionPrimary Health Care Definition

Primary Health Care is different in eachcommunity depending upon:

Needs of the residents;

Availability of health care providers;

The communities geographic location; &

Proximity to other health care services in the area.


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Primary Health Care - BenefitsPrimary Health Care - Benefits

PHC focuses on keeping people healthy & addressingillness early so as to increase probability of cure;

PHC is client focused;

Individuals have access to appropriate care; Services are matched to community needs;

Targeted services will have a positive impact on theutilization of health and social services; &

Healthy communities with healthy people contributeto a vibrant & stable economy.


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Principles of primary health carePrinciples of primary health care

Universal access

Health equity

Community

participation

Inter-sectoral

actions

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Principled health care improvements required

based on Declaration of Alma Ata: 1978

International Conference on Primary Health Care, Alma-Ata, USSR, 612September 1978


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Population Health

Principles of Primary Health CarePrinciples of Primary Health Care

Continuity of Care

Efficiency

AccessibilityIntersectoral /

Interdisciplinary

Affordable & Sustainable

Community Participation

Appropriateness


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Primary Health Care ReformPrimary Health Care Reform

1. Treatment

2. Illness

3. Cure

4. Episodic care

5. Specific problem

6. Individual practitioners

7. Health sector alone

8. Professional dominance

9. Passive reception

1. Health promotion

2. Health

3. Prevention, care, cure

4. Continuous care

5. Comprehensive care

6. Teams of practitioners

7. Intersectoral collaboration

8. Community participation

9. Joint responsibility

Barbara Starfield, Johns Hopkins University


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PHC Programmes

These programs include measures for:

Health promotions

Disease prevention

Basic diagnosis, therapy and rehabilitation


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Fundamental Principles for Health for

All

Fundamental Principles for Health for

All

1. Health is fundamental human right and a worldwide social goal

2. Health is an integral part of development

3. The existing gross inequality in the health status of people is of commonconcern to all countries and must be drastically reduced.

4. People have the right and the duty to participate individually andcollectively in the planning and implementation of their health care

5. Governments have a responsibility for the health of their people

6. Countries must become self-reliant in health matters.

7. Fuller and better use must be made of the worlds resources to promotehealth and development.


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HealthEducation Food Supply

Safe water

MCH

Immunization

Prevention of endemic

diseases

Treatment of common

Disease

Essential

drugs

PHC


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Main Elements of PHCMain Elements of PHC

1. Health Education concerning prevailing

health problems and the methods of

preventing and controlling them;

2. Promotion offood supply and proper

nutrition;

3. An adequate supply ofsafe water and basic

sanitation.


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PHC is supposed to be implemented

through the following1. Assigning the responsibility for this care of the

individual, the family and the community, with the

national health care system undertaking a supportiverole.

2. Active community participation in the process of

defining needs and the development of ways to meetthem.


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3. Utilizing resources of each local communityalong with national resources

4. Using of appropriate technology which is lesssophisticated and cheaper

5. Mobilizing other sectors (e.g. Education,

Agriculture, Housing, Public Work, Information,Communications, Industry) to contribute toPHC implementation

PHC is supposed to be implemented

through the following


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Resources for unsuccessful

implementation of PHC

1.- Lack of community participation

2.- Lack of intersectoral collaboration3.- Lack or misuse of human and material resources

4.- Concentration on sophisticated technology

5.- Mismanagement6.- Lack of intercountry collaboration

7.- Lack of operational research


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A Group of Health Workers

working together to achieve a

common objective


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How to create a health team

CLEAR OBJECTIVES

Frequent meetings

Allowing health workers to express their viewsopenly

Respecting different ideas

Sharing agreed objectives Leadership


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cont. implementation

Leadership

A leader should have:

Knowledge about the objectives

Vision

Skill of listening

Justice

Decisional (say NO in a kind manner) Skills of problem-solving


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Factors lead to dissatisfaction:

Inefficient administration

Incompetent supervision

Poor interpersonal relation

Inadequate pay


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Types of Evaluation

Monitoring records and reports

Case Study

Survey research


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Steps of Evaluation

Decide what to evaluate?

Collect information

Compare the results with the targets

Judge

Decide:

To continue

To change

To stop


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What to evaluate?

Effectiveness

Efficiency (impact, quality ..)

Cost-benefit

Accounting


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Problems of evaluation

Failure to provide information

Don

t evaluate everythin

g

Length of time

Review your resources


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The end

Thank u

introduction of phc

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