INTRODUCTION TO PRIMARY HEALTH CARE AND HEALTH CARE Flashcards by RIA RICCI RABISANTO

an essential health care made universally acceptable to individuals and
families in the community by means acceptable to them through their full participation and at a cost that
the community and country and can afford at every stage of development.

Primary Health Care (PHC)

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adopted resolution which decided that the main socialtarget of governments and of WHO should be the attainment by all the people of the world by the year
2000 a level of health that will permit them to lead a socially and economically productive life.

30th World Health Assembly (May 1977)

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International Conference in PHC was held at

Alma Ata, USSR (Russia)

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He issued Letter of Instruction (LOI)
949 which mandated the then Ministry of Health to adopt PHC as an approach towards design, development, and implementation of programs which focus health development at the community level.

Ferdinand Marcos

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Ferdinand Marcos issued the Letter of Instruction on

October 19, 1979.

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a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

Health

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a whole-of-society approach to health and well-being centered on the needs and
preferences of individuals, families and communities. It addresses the broader determinants of health and
focuses on the comprehensive and interrelated aspects of physical, mental and social health and wellbeing.

Primary Heatlh Care

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Elements of Primary Health Care

Expanded Program of Immunization
Health Education
Maternal and Child Health
Nutrition
Provision of Essential Drugs
Safe and good waste disposal
Treatment of communicable and non-communicable disease
Treatment of locally endemic diseases

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essential health
care based on practical, scientifically sound and socially acceptable methods and technology made
universally, accessible to individuals and families in the community by means of acceptable to
them, through their full participation and at a cost that community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination.

PHC

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Rationale of Primary Health care

▪ Magnitude of Health Problems
▪ Inadequate and unequal distribution of health resources
▪ Increasing cost of medical care
▪ Isolation of health care activities from other development activities

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Rationale of Primary Health care

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ultimate goal of primary health care

better health for all.

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five key elements to
achieving better health for all:

➢Reducing exclusion and social disparities in health (universal coverage reforms);
➢Organizing health services around people’s needs and expectations (service delivery reforms);
➢ Integrating health into all sectors (public policy reforms);
➢ Pursuing collaborative models of policy dialogue (leadership reforms); and
➢ Increasing stakeholder participation.

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Strategies of Primary Health Care

Elevating health to a comprehensive and sustained national effort
Promoting and supporting community managed health care
Increasing efficiency in health sector
Advancing essential national health research

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Attaining health for all Filipinos will require expanding participation in health and health
related programs whether as service provider or beneficiary. Empowerment to parents,
families and communities to make decisions of their health is the desired outcome.

-Advocacy must be directed to national and local policy making to elicit support and
commitment to major health concerns through legislations, budgetary and logistical
considerations.

Elevating health to a comprehensive and sustained national effort

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Health in the hands of the people brings the government closest to the people. It
necessitates a process of capacity building of communities and organization to plan,
implement and evaluate health programs at their levels.

Promoting and supporting community managed health care

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Using appropriate technology will make services and resources required for their
delivery, effective, affordable, accessible and culturally acceptable.

-Development of human resources must correspond to the actual needs of the nation
and the policies it upholds such as PHC.

The Department of Health (DOH) continue to support and assist both public and private
institutions particularly in faculty development, enhancement of relevant curricula and development of standard teaching materials.

Increasing efficiency in health sector

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Essential National Health Research (ENHR) is an integrated strategy for organizing and
managing research using intersectoral, multi-disciplinary and scientific approach to
health programming and delivery.

Advancing essential national health research

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an integrated strategy for organizing and
managing research using intersectoral, multi-disciplinary and scientific approach to
health programming and delivery.

Essential National Health Research (ENHR)

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The bibliographic citation for this definition is:

Preamble to the Constitution of WHO

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A health system, also sometimes referred to as

health care system or as healthcare system,

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the organization of people, institutions, and resources that deliver health care services to meet the health needs of target populations.

health system

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According to the _________, a well- functioning health care system requires a financing mechanism, a well-trained and adequately paid workforce, reliable information on which to base decisions and policies, and well-maintained health facilities to deliver quality medicines and technologies.

World Health Organization (WHO)

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is the maintenance or improvement of health via the prevention, diagnosis, treatment,
recovery, or cure of disease, illness, injury, and other physical and mental impairments in people.

Health care

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Health care is delivered by health professionals in _______________.

allied health fields

part of these health professionals.

Physicians and physician associates

consists of all organizations, people and actions whose primary intent is to promote, restore or maintain health. This includes efforts to influence determinants of health as well as more direct health-improving activities. A

Health system

WHO has identified 3 main goals for health systems:

(1) Improving the health of populations (2) Improving the responsiveness of the health system to the population it serves (3) Fairness in financial contribution i.e. the extent to which the burden of paying for health system is fairly distributed across households.

5 components must contribute to overall health system attainment:

1. Improving the responsiveness of the health system 2. Improving the health of the population 3. Minimizing difference in health between people 4. Minimizing inequalities/disparities in responsiveness 5. Fairness of financial contribution

more likely to engage in risky health-related behaviors and to experience higher rates of chronic conditions and activity limitations.

The rural population

more likely to be uninsured for longer periods of time, and are less likely than urban residents to receive some types of health care, including tests for various chronic conditions.

Rural residents

Limited access to health care in rural areas is generally associated with the fact that there are ________.

fewer providers

held international conference in 1978 at Alma-Ata (USSR),the governments of 134 countries and many voluntary agencies called for a revolutionary approach to healthcare.

WHO-UNICEF

called for acceptance of the WHO goal for Health for All(HFA) by the year 2000 and proclaimed primary health care as a way to achieving

Alma-Ata conference

HFA means

Health For All

promotive services

- Health education - nutrition. - safe water & sanitation.

preventive services

- Maternal & child health care. - Immunization - Prevention & control of locally endemic diseases.

curative care services.

- Provision of essential drugs. - treatment of common diseases & injuries.

to provide the rural population in developing countries with at least the basic minimum of health services.

concept of PHC

PHC principles

1- Equity in distribution. 2- Appropriate technology. 3- Multisectoral approach. 4- Community participation

1.Services to all 2.More services to needy & vulnerable

Equity

Health services must be shared equally by all people irrespective of their ability to pay

Equitable Distribution

while continuing to provide essential health care for all the population irrespective of social, economical & cultural preferences, extended care is to be provided to the ________________ groups in the community either within the health centers or by referral from the health centers to a higher level of care

"high risk"

Involvement of individuals, families, & communities in promotion of their own health and welfare

Community PArticipation

A continuing effort to secure meaningful involvement of the community in:

Planning. Implementation. Maintenance of health services. Evaluation of health services.

Maximum reliance on local resources such as:

Manpower. Money. Materials.

There is an increased realization of the fact that the components of PHC cannot be provided by the health sector alone

3. Intersectoral coordination

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

4. Appropriate Technology

Health technologies are required not only for: Diagnostic maneuvers. Therapeutic maneuvers. But also for:

Disease prevention. Disease control. Health promotion

Though it is commonly perceived that person who is going to apply it is a trained health professional, in PHC practice there are instance where technology may applied by

Individual. Family. Community.

Illness (or sickness) is called

Disease

For maintaining a good health, the following conditions are essential

1. Nutrition 2. Exercise and Rest 3. Good Habits

Determinants of health

- Heredity - Environmental - Behavior _ Health services

Physical, social, biological and man-made

Environmental

Actions ❖ Habits ❖ Reactions ❖ Belief, attitudes ❖ Practices (Lifestyles)

Behavior

Promotive, preventive, curative, rehabilitative

Health services

considered to be the most important determinant and input of health.

Environment

2 parts of environment

a.)external factors b.) internal factors

Physical aspects of environment like Air, water, light, heat, radiation, gravity, pressure, and chemical agents etc. ❖man tries a great deal to control these factors.

external factors

➢ Infectious agents of diseases(tuberculosis,hepatitis B) ➢ reservoirs of infective agents(habitat in which the agent normally lives, grows, and multiplies inludes humans, animals and environment) ➢ vectors that transmit diseases, plants and animals.(mosquitos,ticks,triatomine bugs,sandflies, and blackflies)

Biological causes

➢ housing ➢Transport ➢Industries ➢communication “artificial environment “

Man made environment

defined “as a state of well being in which the individual realized his or her own abilities

Mental health/Behavior

➢ability to mix up with others ➢balanced manner ➢observes adequate personal hygiene ➢Unduly not suspicious of others

Behavior

includes inter-relation ➢Interaction of human beings ➢ability of a person to adjust with others in his social life, at home, at work place and with people.

Social wellbeing

Social wellbeing can be measured on scale by taking in to consideration of indicators like income, literacy and occupation

Heredity

➢physically fit ➢Adequate body weight

Practices lifestyles

a fundamental human right. The attainment of highest possible level of health is the most important world wide social goal.

Health

process of enabling people to increase control over

Promotive

prophylaxis

Preventive

physician,healthcare practitioners,surgery,medications and therapies

Curative

=core health service (Availability,AccessibilityAffordability,acceptability of health services)

Rehabilitative

“without ease” (uneasiness) ➢ is defined as a condition that is diagnosed by a physician or other medical expert

Disease

A disorder of structure or function in a human, animal, or plant, especially one that produces specific sign or symptoms or that affects a specific location and is not simply a direct result of physical injury.

Disease

Lack of various minerals and vitamins in our food brings various diseases. Disease caused by malnutrition

Deficiency Disease

also known as “edematous malnutrition” because of its association with edema (fluid retention), is a nutritional disorder most often seen in regions experiencing famine. It is a form of malnutrition caused by a lack of protein in the diet.

Kwashiorkor

a form of severe malnutrition

Marasumus

defined as the ill health the person identifies themselves with, often based on self reported mental or physical symptoms

Illness

the state of being ill

sickness

Night Blindness

Vitamin A Deficiency

Bery-bery

Vitamin B1 Deficiency

Cracking of skin

Vitamin B2 Deficiency

Anaemia

Vitamin B12 Deficiency

Scurvy

Vitamin C Deficiency

Rickets

Vitamin D Deficiency

Sterility

Vitamin E Deficiency

Hemorrhage

Vitamin K Deficiency

Vitamin k is also known as

Phytomenadion

Refers to the course of a disease over a period of time, unaffected by treatment.

Natural History of Disease

_______ occurrence is usually insidious ➢ Chronic diseases evolve over a long period and have their own progression.

Disease

Stages of diseases

1. Stage of susceptibility 2. Stage of pre-symptomatic disease 3. Stage of clinical disease 4. Stage of terminations 5. Stage of sequels

Risk factors that favors the occurrence of a disease are operating in this stage. During this stage the person remains free of clinical diseases

Stage of susceptibility

Three important factors ➢ Host ➢ agent ➢ environment interact to initiate pathogenic changes that is adequate to cause a disease. Still the disease does not clinically manifest.

Stage of pre-symptomatic disease

signs and symptoms develop ➢ During this stage a disease can be sub classified in to its own severity grades.

Stage of clinical disease

Disease terminates and follow the following trend

Stage of terminations

something that takes place after or a result of an earlier event.

Sequels

Disease may extinct but aftermath remains may be an impairment is left.

Stage of sequels

Stages of Cancer

I. Localized II. Local Lymph nodes are involved III. Involvement of other organs within the same region IV. Distant metastases

Sequence of events in disease

Disease Impairment Disability Handicap

“Any loss or abnormality of psychological, physiological or anatomical structure or function”. e.g. Loss of foot, defective vision, mental retardation.

Impairment

“Any restriction or lack of ability to perform an activity in the manner or within or within the range considered normal for a human being”.

Disability

Definite disadvantages for a given individual resulting from an impairment or a disability that limits or prevents the fulfillment of a role that is normal for him/her depending on his/her age, sex, social and cultural factors or for that individual.

Handicap

Accident Loss of foot Cannot walk Unemployed

Disease Impairment Disability Handicap

Reducing exclusion and social disparities in health

Universal coverage reforms

Organizing health services around people's needs and expectations

Service delivery reforms

Integrating health into all sectors

Public policy reforms

Pursuing collaborative models of policy dialogue

Leadership reform