Class 3 Flashcards
Lalonde report 1974
-Propose a new perspective on the health of Canadians (shifted the focus on HEALTH PROMOTION)
Lalonde Framework
Human biology
Environment
Lifestyle
Healthcare organization
Alma-Ata conference 1978 (WHO)
Highlight Primary Health Care as a strategy to achieve ‘‘Health for All’’ (Country, organization and non-profit organization get together–> Intersectorial and community driven)
Event globally happen that lead to Alma-Ata
- After WWII country process to reforming healthcare.
- National program (ex. barefoot doctors)
- Non-governmental organization involved in community activity.
- THinkers, research, philosophy
PRIMARY HEALTH CARE
A philosophy/worldview for health care (essential health care, universally accessible, with their full participation)
What is a model/ framework for health care services.
(Philosophy, highlights values and final goal)
GOAL of PHC
Prevent illness, promote health to the pt, family, community and whole population
8 elements from Alma-Ata
- Education on health problems, methods of prevention and control
- Promoting adequate food supply & nutrition
- Promoting supply of safer water and sanitation
- Promoting maternal and child health including family planning
- Immunization against infectious diseases
- Prevention and control of local pandemic diseases
- Promoting tx of common diseases & injuries
- Providing essential drugs
5 Principles of Primary Health Care
- Accessibility
- Public participation
- Health promotion
- Intersectoral cooperation
- Appropriate skills & technology
Underlying values of PHC
Health for All, Social Justice and Equity
Health Equity
Fair distribution of resources for health and absence of systematic disparities in health (power, prestige..)
–> ethical principle and human rights principles.
Social Justice:
(foundation of nursing) Fair distribution of society’s benefits and responsibilities, and focus on eliminating the root causes of inequalities.
Health for All:
eliminate structure that encourages inequality
Bangkok Charter
affirmed that policies and partnerships to
empower communities and improve health and equity should be at the center of global and national development
Health disparities
Different in health, among group of person
Equity vs Equality?
Equity: Give everyone what they need to success
Equality: Treating everyone the same
Universal approach
based on the belief that each member of society should have equal access to basic services such as education or health care.
Targeted approach
based on a belief that social constructs (ex: classism, sexism, racism and colonization) are barriers to equitable access to the determinants of health, and that interventions directed to disadvantaged members of society are needed to close the health gap.
Targeted universalism approach
defines goals for all, identifies the obstacles faced by specific groups and tailors strategies to address the barriers in those situations.
Proportionate universalism approach
Programs and policies must include a range of responses for different levels of disadvantage experienced within the population.
EPP framework ‘‘Achieving Health for All’’ (1986)
Health promotion mechanisms (3)
Establish the HEALTH PROMOTION DIRECTORATE in Canada
defined health promotion in terms of a social goal (reducing inequities), a service goal (increasing prevention) and an individual-level goal (enhancing coping).
Health promotion mechanisms: self-care, mutual aid, health environment
Vertical
V: focus on single disease, donor driven (ex. malaria)
Public Health essential functions
Health promotion Disease and injury prevention Health surveillance Population health assessment Emergency preparedness and disaster response
Canadian Community Health Nursing Standards of practice
Health promotion
prevention and health protection
health maintenance, restoration & palliation
Building capacity
Professional relationship
Access and equity
professional responsibility & accountability
Types of essential care of PHC
Promotive Preventive Curative Rehabilitative Supportive-palliative
PHC components
Primary care Disease prevention Health promotion Population health Community development
Levels of prevention
Primary
Secondary
Tertiary
Primary Care
Delivery of community-based clinical health services. First door of entry into the system. More narrow than PHC.
Community Development
process of social change, bring community together, work cooperatively to identify strenght and commun issues affecting health.
Overall message in developed world of the Alma-Ata declaration:
Political and social components
Margaret Chan is
WHO PDG; went back to Alma-Ata principles.
The 8 elements from Alma-Ata are linked to:
Social determinants of health
Horizontal approach
H: cover all health-related issues with strengthening the syst. in general
Diagonal approach
D: Accomplish disease-specific goals by means of health syst. strengthening
Primary prevention:
Eg.
Upstream approach. Prevents occurrence of disease
Eg: Vaccination, public policies)
Secondary prevention:
Eg.
Detect disease and STOP the development
Eg: Screening
Tertiary prevention:
Eg.
Reduce negative effects once a disease has established itself.
Eg: Rehabilitation
