primary health care by dr najeeb memon
TRANSCRIPT
ByByDR: NAJEEB MEMON DR: 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 [email protected] mail [email protected]
Levels of CareLevels of Care
Primary health carePrimary health care
Secondary health careSecondary health care
Tertiary health careTertiary health care
Primary Health CarePrimary Health Care Anew approach to health care Came in to existence in Anew approach to health care Came in to existence in 19781978 following an international conference following an international conference at at Alma-Ata (USSR)Alma-Ata (USSR)
This known asThis known as ““Primary Health Care”Primary Health Care”
It has all the hallmarks of a Primary health care It has all the hallmarks of a Primary health care delivery, first proposed by delivery, 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 for for ““Health for AllHealth for All”” 34 34thth World World Health assembly in 1981.Health assembly in 1981.
Bhore CommitteeBhore Committee
Primary Health carePrimary Health 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” as defined “PHC” as follows:follows:
PRIMARY HEALTH CAREPRIMARY HEALTH CARE“ “ It is an It is an essential health careessential health care made universally made universally
accessible to accessible to
through their full participation & at a cost the through 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
PRIMARY HEALTH CARE ( WHO)PRIMARY HEALTH CARE ( WHO)
IS IS UNIVERSALLY ACCESSIBLEUNIVERSALLY ACCESSIBLE HEALTH CARE HEALTH CARE
THAT IS THAT IS SOCIALLY ACCEPTABLESOCIALLY ACCEPTABLE, ,
AFFORDABLEAFFORDABLE AND AND
REQUIRES INDIVIDUALS TO BE REQUIRES INDIVIDUALS TO BE MORE SELF-MORE SELF-RELIANTRELIANT
WITH THEIR WITH THEIR HEALTH CARE NEEDSHEALTH CARE NEEDS..
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 hospitalsThe 1st referral level
Tertiary health careOffers super-specialist care
Provided by regional/central level institution.
Provide training programs
Levels of Levels of CareCare
LUM Hospital
Concepts of PHCConcepts of PHC
For all ( especially for needy )For all ( especially for needy )
AcceptableAcceptable Community Community
Active involvementActive involvement
BASIC ELEMENTSBASIC ELEMENTS OFOF ““PRIMARY HEALTH CARE”PRIMARY HEALTH CARE”
Health education Health education ( Health problems- preventing & controlling)( Health problems- preventing & controlling)
Identifying & controlling prevailing health problems.Identifying & controlling prevailing health problems.
Promotion of Food supply and proper Promotion 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.
BASIC ELEMENTSBASIC ELEMENTS (cont:) (cont:)
ImmunizationImmunization
Prevention and control of locally endemic Prevention and control of locally endemic diseasedisease
Appropriate treatment of common diseases and Appropriate treatment of common diseases and injuriesinjuries
Promotion of mental healthPromotion of mental health
Provision of essential drugsProvision of essential drugs
PrinciplesPrinciples
Equitable Distribution
PHC must be given to PHC must be given to all individuals in equal all individuals in equal amount in community amount in community irrespective of their irrespective of their gender, age, caste, gender, age, caste, color, urban, rural and color, 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.
PHC in PakistanPHC in Pakistan
Health facilities are offered through severalHealth facilities are offered through several BHUBHU RHCRHC
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
RHC
Each has 25 beds
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
Selective Primary Health CareSelective Primary Health Care
Is a policy of selective interventions to deal with Is a policy of selective interventions to deal with the the most serious public health problemsmost serious public health problems, ,
rather than comprehensive PHC which is rather than comprehensive PHC which is considered considered too costly too costly && requires a large no: of requires a large no: of trained persons.trained persons.
UNICEF’s Proposed Selective UNICEF’s Proposed Selective ApproachApproach
Growth monitoringGrowth monitoring ORSORS Breast feedingBreast feeding ImmunizationImmunization Family planningFamily planning Female educationFemale education
ComprehensivenessComprehensiveness
Comprehensiveness of care means that Comprehensiveness of care means that care is care is provided for all types of health problemsprovided for all types of health problems..
THE FUNCTIONS OF PRIMARY 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 social 4. 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 social 5. To provide the best possible health and social services in the light of economic considerations.services in the light of economic considerations.