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SPM > Health Care Of Community > Flashcards

Health Care Of Community Flashcards

1
Q

Health has been declared as

A

Fundamental human right

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2
Q

Who is responsible for health care

A

The government

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3
Q

The current criticism against health care services

A

A)predominantly urban-oriented

(b) mostly curative in nature, and
(c) accessible mainly to a small part of the population.

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4
Q

What is medical care

A

medical care” is not synonymous with “health care”. It refers chiefly to those personal services that are provided directly by physicians or rendered as the result of physicians’s instructions. Medical care is a subset of health care system.

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5
Q

What is health care

A

A public right, and it is the responsibility of governments to provide this care to all people in equal measure. These principles have

services provided to individuals or communities by agents of the health services or professions, . for the purpose of promoting, maintaining, monitoring, or restoring health”

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6
Q

health needs of the community are meet by

A

Health system which delivers the health service

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7
Q

2 major themes in the delivery of health services

A

(a) First, that health services should be organised to meet the needs of entire populations and not merely selected groups. Health services should cover the full range of preventive, curative and rehabilitation services. Health services are now seen as part of the basic social servic~s of a country (2); (b) Secondly, it is now fully realised that the best way to provide health care to the vast majority of underserved rural people and urban poor is to develop effective “primary health care” services supported by an appropriate referral system.

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8
Q

Levels of health care

A

primary, secondary and tertiary care levels

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9
Q

Primary health care

A

provided by the complex of primary health centres and their subcentres through the agency of multipurpose health workers, village health guides and trained dais. essential” health care

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10
Q

Why primary health care is called essential health care?

A

It is the first level of contact of individuals, the family and community with the national health system, where “primary health care”is provided

it is close to the people, where most of their health problems can be dealt with and resolved.

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11
Q

Secondary health care

A

more complex problems are dealt with

This kind of care is generally provided in district hospitals and community health centres which also serve as the first referral level

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12
Q

Tertiary care level

A

The tertiary level is a more specialized level than secondary care level and requires specific facilities and attention of highly specialized health workers (5). This care is provided by the regional or central level institutions, e.g., Medical College Hospitals, All India Institutes, Regional Hospitals, Specialized Hospitals and other Apex Institutions.

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13
Q

referral system.

A

two-way exchange of information and returning patients to those who referred them for follow-up care

ensure continuity of care and inspire confidence of the consumer in “the system.

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14
Q

Comprehensive health care

A
  • used by the Bhore Committee in 1946 meant provision of integrated
  • preventive, curative and promotional health services from “womb to tomb” to every individual residing in a defined geographic area.
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15
Q

The Bhore Committee defined comprehensive health care as having the following criteria :

A

(a) provide adequate preventive, curative and promotive health services,
(b) be as close to the beneficiaries as possible,
(c) has the widest cooperation between the people,
the service and the profession,
(d) is available to all irrespective of their ability to
pay,
(e) look after specifically the vulnerable and weaker
sections of the community; and
(f) create and maintain a healthy environment both
in homes as well as working places.

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16
Q

concept formed the basis of national health planning in India and led to the establishment of a network of primary health centres and subcentres.

A

Comprehensive health care

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17
Q

sphere of service did not extend beyond a

A

2-5 km radius.

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18
Q

primary health centres were not able to effectively cover the whole population under their jurisdiction why ?

A

These facilities often did not enjoy the confidence of the people because they were understaffed and poorly supplied with medicines and equipment; as a result, there was growing dissatisfaction with the delivery M health services.

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19
Q

basic health services” was used by

A

UNICEF/WHO in their joint health policy

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20
Q

Basic health services defn

A

“A basic health service is understood to be a network of coordinated, peripheral and intermediate health units capable of performing effectively a selected group of functions essential to the health of an area and assuring the availability of competent professional and auxiliary personnel to perform these functions

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21
Q

drawbacks of the basic health services are

A

lack of community participation, lack of intersectoral coordination and dissociation from the socio-economic aspects of health.

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22
Q

Primary health care came into existence in

A

1978, following an international conference at Alma-Ata (USSR).

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23
Q

primary health care delivery, first proposed by the

A

Bhore Committee in 1946

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24
Q

The Alma-Ata international conference gave primary health care a wider meaning. The Alma-Ata Conference defined primary health care as follows

A

“Primary health care is essential health care made universally accessible to individuals and acceptable to them, through their full participation and at a cost the community and country can afford”.

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25
Q

The concept of primary health care has been accepted by all countries as the key to the attainment of

A

Health for All by 2000 AD

It has also been accepted as an integral part of the country’s health system.

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26
Q

Elements of primary health care

A
  1. education concerning prevailing health problems and the methods of preventing and controlling them;
  2. promotion of food supply and proper nutrition;
  3. an adequate supply of safe water and basic
    sanitation;
  4. maternal and child health care, including family
    planning;
  5. immunization against major infectious diseases;
  6. prevention and control of locally endemic diseases;
  7. appropriate treatment of common diseases and
    injuries; and
  8. provision of essential drugs.
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27
Q

Principles of primary health care

A

Equitable distribution

Community participation

Intersectoral coordination

Appropriate technology

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28
Q

The first key principle in the primary health care strategy is

A

equity or equitable distribution of health services, i.e., health services must be shared equally by all people irrespective of their ability to pay, and all (rich or poor, urban or rural) must have access to health services

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29
Q

health care must be built on the principle of

A

community participation

30
Q

One approach that has been tried successfully in India for community participation is

A

the use of village health guides and trained dais.

31
Q

village health guides and trained dais, Asha , anganwadi workers roles in community participation

A

They are selected by the local community and trained locally in the delivery of primary health care to the community they belong, free of charge. By overcoming cultural and communication barriers, they provide primary health care in ways that are acceptable to the community. It is now considered that “health guides” and trained dais are an essential feature of primary health care in India

32
Q

Intersectoral coordination

A

The declaration of Alma-Ata states that “primary health care involves in addition to the health sector, all related sectors and aspects of national and community development, in particular agriculture, animal husbandry, food, industry, education, housing, public works, communication and others sectors”

33
Q

To achieve such intersectoral cooperation, countries may have to

A

review their administrative system, reallocate their resources and introduce suitable legislation to ensure that coordination can take place. This requires strong political will to translate values into action. An important element of intersectoral approach is planning - planning with other sectors to avoid unnecessary duplication of activities.

34
Q

Appropriate technology

A

technology that is scientifically sound, adaptable to local needs, and acceptable to those who apply it and those for whom it is used, and that can be maintained by the people themselves in keeping with the principle of self reliance with the resources the community and country can afford

35
Q

National strategy for HFA/2000

A

Reduction of infant mortality

To raise the expectation of life at birth

To reduce the crude death rate

To reduce the crude birth rate

To achieve a net reproduction rate of one.

To provide potable water to the entire rural
population.

36
Q

Community Diagnosis.

A

An assesment of the health status and health problems is the first requisite for any planned effort to develop health care services. This is also known as Community Diagnosis.

37
Q

The data required for analyzing the health situation and for defining the health problems comprise the following :

A
  1. Morbidity and mortality statistics.
  2. Demographic conditions of the population.
  3. Environmental conditions which have a bearing on
    health.
  4. Socio-economic factors which have a direct effect
    on health.
  5. Cultural background, attitudes, beliefs, and practices which affect health.
  6. Medical and health services available.
  7. Other services available.
38
Q

Demographic profile - A major concern today is

A

population explosion.

39
Q

demographic profile is characterised by:

A

a. large population base
b. high fertility both in terms of birth rate and family size
c. low or declining mortality
d. “young” population (about 35.35 per cent of the population) is below the age of 15 years
e. the proportion of illiterate population is close to 34.62 per cent: this explains why the decline in birth rate has been so slow
f. dependency ratio of 62 per 100; that is, every economically productive member has to support almost one dependant

40
Q

India: Demographic profile

A 
Total population (2014)
Crude birth rate (2012)
Crude death rate (2012)
Annual growth rate % (2011)
Population doubling time (at current growth rate) 
Population rural % (2011) 
Adult literacy rate % (2011)
Density of population per sq.km (2014) ·
Sex ratio female per 1000 male (2011)
Population below 15 years %(2012) 
Population above 60 years %(2012) 
Average family size (2012)
Age at marriage, female (2012) Annual per capita GNP
(at current prices 2011-12)
41
Q

Mortality profile

A

Refer book pg 931

42
Q

The HEALTH PROBLEMS of India may be conveniently grouped under the following heads :

A
  1. Communicable disease problems
  2. Non-communicable disease problems 3. Nutritional problems
  3. Environmental sanitation problems 5. Medical care problems
  4. Population problems.
43
Q

Communicable disease problems

A

Malaria

Tuberculosis

Diarrhoeal diseases

Acute respiratory infection

Leprosy

Filaria

Aids

Other kala Azar , meningitis , viral hepatitis, dengue fever, enteric fever etc….

44
Q

Non-communicable diseases (NCDs)

A

diabetes mellitus, CVDs, cancer, stroke, and chronic lung diseases have emerged as major public health problems due to an ageing population and environmentally-driven changes in behaviour.

45
Q

Nutritional problems

A

Protein-energy malnutrition marasmus is more frequent than kwashiorkor.

Nutritional anaemia

Low birth weight

Xerophthalmia

Iodine deficiency disorders

Others lathyrism , endemic fluorosis

46
Q

Environmental sanitation

A

The twin problems of environmental sanitation are lack of safe water in many areas of the country and primitive methods of excreta disposal.

47
Q

“new” problems in Environmental sanitation

A

resulting from population explosion, urbanization and industrialization leading to hazards to human health in the air, in water and in the food chain.

48
Q

Medical care problems and population problem

A

Refer book 933

49
Q

basic resources for providing health care are :

A

(i} Health manpower

(ii) Money and material; and (iii) Time

50
Q

health manpower” includes

A

professional and auxiliary health personnel

51
Q

An auxiliary is defined by WHO a

A

technical worker in a certain field with less than full professional training

52
Q

Health manpower requirements of a country are based on

A

(i) health needs and demands of the population; and (ii) desired outputs.

53
Q

Health manpower planning is based on

A

a series of accepted ratios such as doctor-population ratio, nurse- population ratio, bed-population ratio,

54
Q

Nurses 1 per

A

5000 population

55
Q

Health worker both male and female 1per

A

5000 in plain area and 3000 in tribal and hill area

56
Q

Trained dia

A

One for each village

57
Q

Health assistant 1 per

A

30000 population in plain area

20000 population in tribal and hill area

58
Q

Pharmacists 1 per

A

10000 population

59
Q

Lab assistant 1 per

A

10000 population

60
Q

Asha 1 per

A

1000 population

61
Q

Money is an

A

important resource for providing health services. Scarcity of money affects all parts of the health delivery system.

62
Q

In most developed countries, average government expenditure for health is about

A

18 per cent of GNP

63
Q

In developing countries government expenditures for health is

A

less than 1 per cent of the GNP and it seldom exceeds 2 per cent of the GNP.

64
Q

Health expenditure according to who for health for all

A

5 % of GNP

65
Q

India is spending about

A

3 per cent of GNP on health and family welfare development.

66
Q

Money and material

A

refer book 934

67
Q

Time

A

refer book 935

68
Q

HEALTH CARE SERVICES goals

A

mortality and morbidity reduction, increase in expectation of life, decrease in population growth rate, improvements in nutritional status, provision of basic sanitation, health manpower requirements and resources development and certain other parameters such as food production, literacy rate, reduced levels of poverty, etc.

69
Q

broad agreement that health services should be

A

(a) comprehensive (b) accessible (c) acceptable (d) provide scope for community participation, and (e) available at a cost the community and country can afford. These are the essential ingredients of primary health care which forms an integral part of the country’s health system, of which it is the central function and main agent for delivering health care (9).

70
Q

5 sectors of health care systems

A
  1. PUBLIC HEALTH SECTOR
    (a) Primary Health Care Primary health centres
    Sub- centres
    (b} Hospitals/Health Centres Community health centres
    Rural hospitals
    District hospital/health centre Specialist hospitals
    Teaching hospitals
    (c) Health Insurance Schemes Employees State I.nsurance
    Central Government Health Scheme
    (d) Other agencies Defence services
    Railways
  2. PRIVATE SECTOR
    (a) Private hospitals, polyclinics, Nursing homes, and dispensaries
    (b) General practitioners and clinics
  3. INDIGENOUS SYSTEMS OF MEDICINE
    Ayurveda and Siddha Unani and Tibbi Homoeopathy Unregistered practitioners
  4. VOLUNTARY HEALTH AGENCIES
  5. NATIONAL HEALTH PROGRAMMES

SPM (3 decks)

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