Primary Healthcare

Question 1

Features of PHC

Answer 1

• Evidence-based care
• Intersectorial (understands influence of non-health related sectors)
• Culturally acceptable
• Accessible technology
• Participatory approach - self-determination/reliance
• Affordable services
• Primary care (subset of PHC)
• More horizontal than vertical approach

Question 2

Neo-colonialism in healthcare

Answer 2

• Medical gaze: separation of the patient’s disease and their identity
• PHC aims to avoid this separation

Question 3

Define selective PHC

Answer 3

Blending (traditional) vertical approaches with horizontal approaches to health care

Question 4

Vertical approaches to healthcare

Answer 4

• “Top-down” approach
• Solve specific health problems efficiently
• Individual-focus
• Cost-effective

Question 5

Horizontal approach

Answer 5

• Comprehensive, treating underlying issues
• Community-focus
• Less cost-effective

Question 6

GOBI-FFF details and meaning

Answer 6

• Selective PHC program
• Implemented by UNICEF
• Aim: reduce child mortality in low-income countries

Growth-monitoring
Oral rehydration
Breast feeding
Immunisation

Family planning
Female education
Food supplementation

Question 7

GOBI-FFF positive and negative outcomes

Answer 7

Positive outcomes
- Immunisation rates rose 20% –> 40% in the first 2 years
- Oral rehydration therapy rose from <1% –> 20%
- Many UNICEF childhood survival targets achieved

Negative outcomes
- Majority of focus on Immunisation and Oral Rehydration Therapy
- No impact on HEALTH SYSTEMS (infrastructure, workforce, supply chains) thus changes were not SUSTAINABLE
- FAILED TO ADDRESS UPSTREAM FACTORS

Question 8

Criticisms of PHC

Answer 8

• Too robust
• Too broad
• Too expensive

Question 9

Major problems with PHC in low income countries

Answer 9

• Shortage of trained staff
• Institutions/governments which limit distribution supplies and information
• Lack of commitment and funding