Primary health care Flashcards
HEALTH CARE SYSTEM
An organization of people, resources, institutions and actions whose
primary intent is to meet the health needs of the people.
- promote
- prevent
- cure
- rehabilitate
Levels of care
Primary care • 1st point of entry/ 1st level of contact with HS • homes, Clinics, Health centers: level 1 (200-250 beds) •Hrs. of operation of clinics (variable 8hrs/some 24hrs ) •Comprehensive range of services: preventive and promotive, curative & rehabilitation, e.g. immunization, family planning, minor trauma • Services are free (except for district hospitals) •By-pass fee
Secondary care- •District hospital •250-500 beds •1st level of referral/services 24hrs •Some specialists - rehab/operating theater/chronic care
Tertiary care •Academic hospitals: (500-1000+ beds) •All specialists •Associated with med schools
Quaternary care
•Highly specialized hospital e.g. tb hospitals/organ transplants
What is Primary health care?
• Essential healthcare made universally
accessible to individuals & acceptable to them
through their full participation and at a cost
the community and country can afford.
• It is an approach to delivering universal health
coverage (NHI strategy).
• Favours the previously disadvantaged – equity.
Key Principles of PHC: 4 A’s and 3 E’s
✓ Available: PHC must include a range of
essential service
✓ Accessible: geographical, architectural,
functional, financial, culturally and
attitudinally, information.
✓ Acceptable: by users.
✓ Appropriate: to the community needs.
✓ Efficient: use of time and resources
✓ Effective: produce desired outcome
✓ Equity: social justice or fairness, distribution of
resource according to need target the most
needy (PWD, children, women)
Strategies for PHC
• Intersectoral collaboration. • Prevention of disease and promotion of health. • Basic infrastructure. • Referral system • Training of auxiliary health workers. • Health education • Community participation and social mobilization, self reliance, empowerment. • Essential drugs, cost-effectiveness.
Role of Physiotherapy in PHC
- Promotive
- Preventative
- Curative
- Rehabilitative
- Consultative
- Research
Promotive role
3 tools identified as core effective HP
• Advocacy: power relations in a vertical direction, speaking on behalf of a
marginalized or disadvantaged
• Enabling: empowerment, education
• Mediation: acting as middle man, relation in a horizontal direction (Ottawa
Charter 1986)
Preventative role
Levels of prevention
1. Primary: Preclinical or pre symptomatic (Health promotion)
• Prevention of disease or injury by controlling the risk
factors. (Before)
• Intervention: Health promotion and specific protection.
2. Secondary: Clinical or symptomatic
• Reduction in consequences of a disease or injury. (During)
• Intervention: Early diagnosis, treatment to limit the
disability.
3. Tertiary: Post clinical or post symptomatic
• Reduction of complications of a disease or injury. (After)
• Intervention: Rehabilitation.
Curative role
• Facilitate quick recover from diseases and injuries of
neuromasculoskeletal and respiratory in nature and
play an essential role in the management of these
conditions.
• Aim of physiotherapy intervention
– Managing pain,
– Improving endurance, mobility, function
– Environmental analysis and adaptation
– Integration of clients into their community
Rehabilitation
• Is a progressive, dynamic goal-oriented and often time
limited process, which enables an individual with
impairment to identify and reach his/her optimal mental,
physical, cognitive and/or social functional level. (WHO,
1999)
• Process of rehabilitation (2nd year work)
– Prevention of disability
– Early identification and referral
– Appropriate management/treatment and restoration of function
– Referral
– Reorientation and vocational training
– Resettlement and Integration
– Follow-up
