L4: PRIMARY HEALTH CARE Flashcards by Shania Twain

A joint WHO-UNICEF international conference was held in 1978 in Alma Ata (USSR)

ALMA-ATA CONFERENCE

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How many countries were part of the Alma-Ata Conference?

134 countries

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The conference jointly called for a ______ to the health
care.

REVOLUTIONARY APPROACH

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The conference declared ‘The existing gross inequality in the health status of
people particularly between developed and developing countries as well as within countries is politically, socially and economically unacceptable’.

ALMA-ATA CONFERENCE

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the concept of Primary Health Care (PHC) came into existence globally in 1978 because of:

ALMA-ATA CONFERENCE

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By virtue of _____, PHC was adopted in the Philippines, making it the first country in ASIA to embark on meeting the challenge of PHC.

Letter of Instruction (LOI) 949 of 1979

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

PHC according to Alma-Ata Declaration

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Is characterized by partnership and empowerment of the people that shall permeate as the core
strategy in the effective provision of essential health services
that is community based, accessible, acceptable and
sustainable at a cost which the community and the
government can afford.

PHC according to DOH

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The goal of primary health care (PHC) strategy

HEALTH FOR ALL by the year 2000

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means an acceptable level of health for all the people of the world through community and individual self-reliance

HEALTH FOR ALL

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Three objectives of “Health for All” by the year 2000:

Promotion of healthy lifestyles
Prevention of diseases
Therapy for existing conditions

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The Alma Ata Declaration listed eight essential health services
using the acronym _____

ELEMENTS

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Meaning of ELEMENTS

E – Education for health
L – Locally endemic disease control
E – Expanded program for immunization
M – Maternal and child health including responsible parenthood
E – Essential drugs
N – Nutrition
T – treatment of communicable and noncommunicable diseases
S – safe water and sanitation

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Goal of Primary Health Care in The Philippines

“HEALTH FOR ALL FILIPINOS by the year 2000 AND HEALTH IN THE HANDS OF THE PEOPLE by the year 2020”

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An improved state of health and quality of life for all people attained through ______

SELF-RELIANCE

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To strengthen the health care system by increasing opportunities and supporting the conditions wherein people will manage their own health care.

MISSION of PHC

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2 Levels of PHC Workers

Barangay Health Workers
Intermediate Level Health Workers

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trained community
health workers or health auxiliary volunteers or traditional birth attendants or healers.

BARANGAY HEALTH WORKERS

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include the Public Health Nurse, Rural Sanitary Inspector and midwives.

INTERMEDIATE LEVEL HEALTH WORKERS

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The key principles that set PHC apart from the traditional mode of
health care delivery system:

◸ Accessibility, affordability, acceptability and availability
◸ Support mechanisms
◸ Multisectoral approach
◸ Community participation
◸ Equitable distribution of health resources
◸ Appropriate technology

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4As of PHC

ACCESSIBILITY
AFFORDABILITY
ACCEPTABILITY
AVAILABILITY

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refers to the physical distance of a health facility
or the travel time required for people to get the needed or
desired health services.

ACCESSIBILITY

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individual or family’s capacity to pay for basic
health services and whether the community can afford these
services.

AFFORDABILITY

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the health care offered is in consonance with the prevailing culture and traditions of the population

ACCEPTABILITY

the basic health services required by the people are offered in the health care facilities.

AVALABILITY

The resources for essential health services come from three major entities: The people themselves, the government, the private sector – NGOs, socio- civic and faith groups.

SUPPORT MECHANISMS

Key Principles of PHC

1. Support Mechanisms 2. Multi-sectoral Approach 3. Community Participation 4. Equitable Distribution of Health Resources 5. Appropriate Technology

As health and disease are outcomes of multiple interrelated factors, PHC requires communication, cooperation, and collaboration within and among various sectors.

MULTISECTORAL APPROACH

The involvement of specialized agency, private sectors, and public sectors to achieve improved health facilities.

INTERSECTORAL LINKAGES

communication, cooperation, and collaboration within the health sector: among members of the health team and among health agencies

INTRASECTORAL LINKAGES

a process in which community people are engaged and participated in making decisions about their own health.

COMMUNITY PARTICIPATION

PHC advocates for care that is community- based and preventive in orientation.

EQUITABLE DISTRIBUTION OF HEALTH RESOURCES

2 Programs spearheaded by DOH to ensure equitable distribution of manpower to rural areas:

1. Doctor to the Barrios Program (DTTB) 2. Registered Nurses health Enhancement and Local Service (RN HEALS)

deployment of doctors to municipalities that are without doctors for 2 years, offered competitive compensation

Doctor to the Barrios (DTTB) program

Deployment of nurses to unserved, economically depressed municipalities to address the inadequate nursing workforce in rural communities and health facilities

Registered Nurses health Enhancement and Local Service (RN HEALS)

‘’Technology that is scientifically sound, adaptable to local needs and acceptable to those who apply it and to whom it is applied and that can be maintained by people themselves in keeping with the principle of self-reliance with the resources the community and country can afford.’’

APPROPRIATE TECHNOLOGY

using cheaper, scientifically valid and acceptable equipment and techniques.

APPROPRIATE TECHNOLOGY

The Traditional and Alternative Medicine Act of 1997

RA 8423

The sum total of knowledge, skills, and practice on health care, not necessarily explicable in the context of modern, scientific philosophical framework, but recognized by the people to help maintain and improve their health towards the wholeness of their being, the community and society, and their interrelations based on culture, history, heritage and consciousness. (eg. Herbal medicines)

TRADITIONAL MEDICINE

RA 8423

TRADITIONAL AND ALTERNATIVE MEDICINE ACT OF 1997

The person who signed RA 8423 into law

Secretary of Health: Juan Flavier

This created the Philippine Institute of Traditional and Alternative Health Care, which is tasked to promote and advocate the use of traditional and alternative health care modalities through scientific research and product development.

RA 8423

Through community participation and cohesiveness of people’s organization they can generate support for health care through social mobilization, networking and mobilization of local resources.

SELF-RELIANCE

This ensures empowerment and that empowerment can only be facilitated if the administrative structure provides local level political structures with more substantive responsibilities for development initiators. This also facilities proper allocation of budgetary resources.

DECENTRALIZATION

Barriers of Community Involvement

▪ Lack of motivation ▪ Attitude ▪ Resistance to change ▪ Dependence on the part of community people ▪ Lack of managerial skills

Elements of PHC

1. Education for Health 2. Locally Endemic Disease Control 3. Expanded Program on Immunization 4. Maternal and Child Health and Family Planning 5. Environmental Sanitation and Promotion of Safe Water Supply 6. Nutrition and Promotion of Adequate Food Supply 7. Treatment of Communicable Diseases and Common Illness 8. Supply of Essential Drugs

Is one of the potent methodologies for information dissemination. It promotes the partnership of both the family members and health workers in the promotion of health as well as prevention of illness.

Education for Health

The control of endemic disease focuses on the prevention of its occurrence to reduce morbidity rate. Example Malaria Control and Schistosomiasis Control

LOCALLY ENDEMIC DISEASE CONTROL

This program exists to control the occurrence of preventable illnesses especially of children below 6 years old. Immunizations on poliomyelitis, measles, tetanus, diphtheria and other preventable disease are given for free by the government and ongoing program of the DOH

Expanded Program on Immunization

The mother and child are the most delicate members of the community. So the protection of the mother and child to illness and other risks would ensure good health for the community. The goal of Family Planning includes spacing of children and responsible parenthood.

Maternal and Child Health and Family Planning

Is defined as the study of all factors in the man’s environment, which exercise or may exercise deleterious effect on his well-being and survival.

Environmental Sanitation

Is a basic need for life and one factor in man’s environment.

WATER

One basic need of the family is food. And if food is properly prepared then one may be assured healthy family. There are many food resources found in the communities but because of faulty preparation and lack of knowledge regarding proper food planning, Malnutrition is one of the problems that we have in the country.

NUTRITION & PROMOTION OF ADEQUATE FOOD SUPPLY

The diseases spread through direct contact pose a great risk to those who can be infected. Tuberculosis is one of the communicable diseases continuously occupies the top ten causes of death. Most communicable diseases are also preventable. The Government focuses on the prevention, control and treatment of these illnesses.

Treatment of Communicable Diseases and Common Illness

This focuses on the information campaign on the utilization and acquisition of drugs.

Supply of Essential Drugs

Drugs included in GENERIC ACT of The Philippines:

COTRIMOXAZOLE PARACETAMOL AMOXYCILLIN ORESOL NIFEDIPINE RIFAMPICIN INH (ISONIAZID) PYRAZINAMIDE ETHMABUTOL STREPTOMYCIN ALBENDAZOLE QUININE

Four Cornerstones/Pillars in Primary Health Care

1. Active Community Participation 2. Intra and Inter-sectoral Linkages 3. Use of Appropriate Technology 4. Support mechanism made available

T/F: Primary Health Care integrates preventive, promotive, curative, rehabilitative and palliative health care services.

TRUE

Works with large population groups as well as with individual patients to promote health and understand the risks of disease, injury, disability and death.

PREVENTIVE MEDICINE SPECIALISTS

“Actions aimed at eradicating, eliminating, or minimizing the impact of disease and disability."

PREVENTION

consists of actions and measures that inhibit the emergence of risk factors in the form of environmental, economic, social, and behavioral conditions and cultural patterns of living etc.

PRIMORDIAL PREVENTION

It is the prevention of the emergence or development of risk factors in countries or population groups in which they have not yet appeared

PRIMORDIAL PREVENTION

Main intervention in primordial prevention

INDIVIDUAL & MASS EDUCATION

Levels of Preventive Care

1. Primordial 2. Primary 3. Secondary 4. Tertiary

can be defined as the action taken prior to the onset of disease, which removes the possibility that the disease will ever occur.

PRIMARY PREVENTION

Primary prevention may be accomplished by measures of _______

HEALTH PROMOTION & SPECIFIC PROTECTION

The WHO has recommended the following approaches for the primary prevention of chronic diseases where the risk factors are established:

A. POPULATION (MASS) STRATEGY B. HIGH-RISK STRATEGY

is directed at the whole population irrespective of individual risk levels.

POPULATION STRATEGY

aims to bring preventive care to individuals at special risk.

HIGH-RISK STRATEGY

"A preventive measure which brings much benefit to the population often offers little to each participating individual"

PREVENTION PARADOX

It is defined as “ action which halts the progress of a disease at its incipient stage and prevents complications.”

SECONDARY PREVENTION

The specific interventions are: early diagnosis (e.g. screening tests, and case finding programs) and adequate treatment.

SECONDARY PREVENTION

It is used when the disease process has advanced beyond its early stages.

TERTIARY PREVENTION

It is defined as “all the measures available to reduce or limit impairments and disabilities, and to promote the patients’ adjustment to irremediable conditions.”

TERTIARY PREVENTION

Intervention that should be accomplished in the stage of tertiary prevention are:

DISABILITY, LIMITATION, REHABILITATION

“any loss or abnormality of psychological, physiological or anatomical structure or function.”

IMPAIRMENT

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

DISABILITY

Termed as “a disadvantage for a given individual, resulting from animpairment or disability, that limits or prevents the fulfillment of a role in the community that is normal (depending on age, sex, and social and cultural factors) for that individual.”

HANDICAP

Describes ongoing operations aimed at reducing: – The incidence of disease – The duration of disease and consequently the risk of transmission – The effects of disease, including both the physical and psychosocial complications – The financial burden to the community.

CONTROL

“the combined and coordinated use of medical, social, educational, and vocational measures for training and retraining the individual to the highest possible level of functional ability.”

REHABILITATION

Screening is the process to detect among healthy people disorders or risk factors of which they are unaware

SCREENING

“The PRESUMPTIVE identification of UNRECOGNIZED disease or defect by the application of tests, exams or other procedures which can be applied RAPIDLY to sort out apparently well persons who PROBABLY have a disease from those who PROBABLY do not”

SCREENING

Factors appropriate for screening

* Important health problem * High prevalence * Natural history understood * Long latent period * Early detection improves prognosis

Evaluation of a screening program

* Reliability * Feasibility * Validity * Performance * Effectiveness

the consistency of results when the screening program is repeated on the same persons under the same conditions.

RELIABILITY

The acceptability and cost effectiveness that it can be done

FEASIBILITY

The state of being true or acceptable and the accuracy. Classified into (1) Sensitivity and (2) Specificity

VALIDITY

Probability to test positive among truly affected

SENSITIVITY

Probability to test negative among truly unaffected

SPECIFICITY

Universal Health Care Act

RA 11223

Universal Health Care (UHC) is also referred to as ______

Kalusugan Pangkalahatan (KP)

Means that all people have access to the health services they need, when and where they need them, without financial hardship.

UNIVERSAL HEALTH COVERAGE

It is a government mandate aiming to ensure that every Filipino shall receive affordable and quality health benefits. This involves providing adequate resources – health human resources, health facilities, and health financing.

KALUSUGAN PANGKALAHATAN (KP)

Types of Screening

* Mass * Multiple or multiphasic * Targeted * Case‐finding or opportunistic

RA 11223

UNIVERSAL HEALTH CARE ACT

is the “provision to every Filipino of the highest possible quality of health care that is accessible, efficient, equitably distributed, adequately funded, fairly financed, and appropriately used by an informed and empowered public”

KALUSUGAN PANGKALAHATAN