Elements and Principles of Primary health care

Question 1

The 8 Essential elements:

Answer 1

1. Health Education.
2. Food supply.
3. Safe water and sanitation.
4. Maternal and child health.
5. Immunization.
6. Prevention and control of endemic diseases.
7. Treatment of diseases and injuries.
8. Provision of drugs.

Question 2

Health Education

Answer 2

• Is meant to be provided to communities concerning prevailing health problems, those prevalent in those communities, and how to identify a specific health problem, measures to take to prevent the disease and control health problems, the health education also helps prevent diseases from spreading on a personal level.

Examples:
- Tuberculosis
>cough etiquette
>signs
>contact tracing
>Importance of completing treatment
- HIV 
>prevention
>early testing
>ART - counseling about adherence to meds

Question 3

Health education about COVID-19?

Answer 3

• What health education is important to provide to communities?
  
  • How is it transmitted - Address conspiracy theories
  • Prevention:
    
    • Wash hands regularly and properly
    • Avoid touching your face
    • Cough and sneeze etiquette
    • Mask wearing
    • Social distancing
• Address concerns about vaccination
• Importance of quarantine and isolation to break the chain of transmission.

Question 4

Promotion of food supply and proper nutrition

Answer 4

• Adequate supply of safe and basic nutrition is important
• Nutrition is important for maintaining good health status, people also use food supplements.
• Good nutrition prevents malnutrition and starvation.
• It also prevents diseases and conditions like: Kwashiorkor and anaemia.

Question 5

Adequate supply of safe water and sanitation

Answer 5

• There is a close relationship between supply water and sanitation. No water means the sanitary conditions will automatically be affected.
• The supply of clean, safe drinking water.
• Basic sanitation measures regarding trash, sewage and water cleanliness.
• This element helps to improve the health of a population by reducing and possibly eliminating many preventable diseases like: diarrhoea, cholera, typhoid, roundworm, dysentery.

Question 6

Maternal and Child health care

Answer 6

• High risk of health problems AND vulnerable group. This provides adequate counselling on family planning and safe sex.

Question 7

Immunization

Answer 7

• Expanded programme of immunisation against major infectious diseases
• Provision vaccines is not sufficient - health system needs to support cold chain [from the time the vaccination is made is it in appropriate temperature], and safe administration [are there required provisions for safe administration]
• What is on the list of EPI in SA?

Question 8

Prevention and control of legally endemic diseases

Answer 8

• Many diseases may vary based on location
• e.g schistosomiasis, malaria
• Prevention and control: multi-faceted
• Health education, vector control, safe water, adequate supply of medication for prevention or the treatment of disease.

Question 9

Appropriate treatment of common diseases and injuries

Answer 9

• Treatment of communicable and non-communicable disease

- Promotion of mental health

Question 10

Provision of drugs

Answer 10

• Correct treatment of disease will prevent complications

- Availability and distribution

Question 11

Primary Health care Elements

Answer 11

• The first three elements are: PROMOTIVE SERVICES
• The middle three elements are: PREVENTIVE SERVICES
• The last two elements are: CURATIVE CARE SERVICES

Question 12

PROMOTIVE SERVICES [promote good health]

Answer 12

• Education
• Food supply
• Safe water & Sanitation

Question 13

PREVENTIVE SERVICES

Answer 13

• Immunisation
• Maternal and child health
• Prevention and control of endemic diseases

Question 14

CURATIVE CARE SERVICES

Answer 14

• Provision of drugs

- Treatment of diseases and injuries

Question 15

Extended Elements in 21st Century

Answer 15

> These are intended to improve health indices and outcomes - life expectancy, maternal mortality, and child mortality.
Intention is also to reverse global trends in five major pandemics:
1. Malaria
2. Tuberculosis
3. HIV/AIDS
4. Tobacco-related diseases
5. Violence and trauma

Question 16

These are the expanded elements of health in 21st Century:

Answer 16

• Expanded options of immunizations
• Reproductive health needs
• Provision of essential technologies for health
• Health promotion
• Prevention and control of non-communicable diseases
• Food safety and provision of selected food supplements

Question 17

PRINCIPLES OF PRIMARY HEALTH CARE

Answer 17

• all elements of PHC should be organised and delivered on the basis of:
  
  • equity in distribution
  • appropriate technology
  • multisectoral approach
  • community participation

Question 18

Equity in distribution

Answer 18

> Health services shared equally by all people irrespective of ability to pay
Shifting the focus of the health care system from cities to rural areas = decentralisation
Equity is about Services to all and providing more services to needy & vulnerable people.
To ensure equity:
- The population to be served must be known.
- The vulnerable groups identified & reached.
- The equitable distribution is hampered by:
resources and
limited geographical access [must fix roads and facilities but would have to provide transport as well]
- improve access by:
- increasing number of health facilities
- improving transport conditions
- outreach services

Question 19

Multisectoral approach

Answer 19

• Elements of PHC cannot be provided by the health sector alone
• Declaration of Alma-Ata:
  “PHC involves in addition to the health sector, all related sectors & aspects of national & community development, in particular agriculture, animal husbandry, food, industry, education, housing, public works, communication & others sectors”
• Promotes overall human development and ensure economic development of communities.

? Animal husbandry is the branch of agriculture concerned with animals that are raised for meat, fibre, milk, eggs, or otherproducts. It includes day-to-day care, selective breeding and the raising of livestock.

Question 20

Appropriate technology

Answer 20

ORS: 1 litre of boiled and cooled water , with 8 teaspoons of sugar and half teaspoon salt

• Technology that is scientifically sound, adaptable to local needs, & acceptable to those who apply it & those for whom it is used.
• It should able to be maintained by the people themselves in keeping with the principle of self reliance with the resources the community & country can afford.
• Not necessarily high end technology that we refer to, meaning not only diagnostic & therapeutic technology and machines.
• Also for disease prevention & control and health promotion.
• Not necessarily high level technology that is administered at the health facility. e.g of simple technology:
  
  • ORS instead of expensive intravenous replacement of fluids in mild or moderate dehydration
  • Growth charts: maintained by health workers
  • Water filters or chlorination tablets.
  • Applications on smart phones used to track and assist patients.

Question 21

Community participation

Answer 21

• involvement of individuals, families, & communities in promotion of their own health & welfare on:
  
  • planning
  • implementation
  • maintenance of health services
  • evaluation of health services
  • local resources
• This addresses the felt health needs of the people, might find other needs not met.
• Helps us ensure:
  
  • social responsibility among the community
  • sustainability
  • cost sharing
  • enhancement of knowledge
• encourages intersectoral collaboration