L4: PRIMARY HEALTH CARE Flashcards
A joint WHO-UNICEF international conference was held in 1978 in Alma Ata (USSR)
ALMA-ATA CONFERENCE
How many countries were part of the Alma-Ata Conference?
134 countries
The conference jointly called for a ______ to the health
care.
REVOLUTIONARY APPROACH
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
the concept of Primary Health Care (PHC) came into existence globally in 1978 because of:
ALMA-ATA CONFERENCE
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
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
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
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
The goal of primary health care (PHC) strategy
HEALTH FOR ALL by the year 2000
means an acceptable level of health for all the people of the world through community and individual self-reliance
HEALTH FOR ALL
Three objectives of “Health for All” by the year 2000:
- Promotion of healthy lifestyles
- Prevention of diseases
- Therapy for existing conditions
The Alma Ata Declaration listed eight essential health services
using the acronym _____
ELEMENTS
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
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”
An improved state of health and quality of life for all people attained through ______
SELF-RELIANCE
To strengthen the health care system by increasing opportunities and supporting the conditions wherein people will manage their own health care.
MISSION of PHC
2 Levels of PHC Workers
- Barangay Health Workers
- Intermediate Level Health Workers
trained community
health workers or health auxiliary volunteers or traditional birth attendants or healers.
BARANGAY HEALTH WORKERS
include the Public Health Nurse, Rural Sanitary Inspector and midwives.
INTERMEDIATE LEVEL HEALTH WORKERS
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
4As of PHC
ACCESSIBILITY
AFFORDABILITY
ACCEPTABILITY
AVAILABILITY
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
individual or family’s capacity to pay for basic
health services and whether the community can afford these
services.
AFFORDABILITY
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
- Support Mechanisms
- Multi-sectoral Approach
- Community Participation
- Equitable Distribution of Health Resources
- 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:
- Doctor to the Barrios Program (DTTB)
- 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
- Education for Health
- Locally Endemic Disease Control
- Expanded Program on Immunization
- Maternal and Child Health and Family Planning
- Environmental Sanitation and Promotion of Safe Water Supply
- Nutrition and Promotion of Adequate Food Supply
- Treatment of Communicable Diseases and Common Illness
- 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
- Active Community Participation
- Intra and Inter-sectoral Linkages
- Use of Appropriate Technology
- 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
- Primordial
- Primary
- Secondary
- 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
