Public Health Flashcards

1
Q

What are the roles of physiotherapy and explain them

A

Promotive, Preventative, Rehabilitative, Consultative, Research

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2
Q

What are the 3 key tools for health promotion?

A

Three key tools for health promotion
1. Enablement: empowerment, education, developing personal and other skills
2. Mediation: acting as middle man, inter-sectoral collaboration: Working with other sectors e.g. housing/education/legislature etc. to promote health (relation in a horizontal direction)
3. Advocacy: a process of pushing for change representing/speaking on behalf of a marginalized, vulnerable. Aimed at changing policy/laws/regulatory measures

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3
Q

What are the 3 levels of prevention?

A

Primary prevention: prevention of disease by controlling the risk factor
Secondary prevention: reduction in consequences of a disease by early diagnosis and treatment.
Tertiary prevention: reduction in the complications of a disease through rehabilitation

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4
Q

Explain the hierarchy of risk reduction

A
  1. Eliminate the process: eliminate/remove the hazard – no potential for harm
  2. Substitute substance: replace the hazard - substitute hazardous materials or substances with less harmful alternatives – reduces risk significantly
  3. Segregate (isolate/separate) process: engineered controls - segregate or isolate the hazardous process from workers or the general environment (physical barriers, enclosures etc.)
  4. Insulate process: administrative controls - alter the way people interact with the hazard (safety protocols, procedures, and training to minimize risks associated with the process).
  5. Limit exposure: (personal protective equipment) - only be used after considering more effective strategies
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5
Q

Explain the importance of the District Health Information System (DHIS) in physiotherapy practice

A

Monitoring and Evaluation of Services:
o Enables monitoring and evaluation of rehab services at district level.
o Allows tracking of key performance indicators, (no. patients served, types of conditions) -help identify gaps, assess effectiveness of interventions, and inform improvement efforts within rehabilitation programs.
Resource Allocation and Planning:
o Provides data inform resource allocation and planning for rehab services.
o By analysing data collected through the DHIS, healthcare managers identify areas of high demand, allocate resources strategically, and plan for future service needs.
o Lead more effective utilization of resources and provision of targeted rehabilitation interventions
* Integration with District Health Priorities:
o Allows rehabilitation services to align with district’s health priorities.
o By contributing functional data to DHIS, services can demonstrate impact on population health outcomes (improved abilities, reduced disability, and enhanced quality of life).
o This strengthens visibility and recognition of physiotherapy and rehabilitation as essential components DHS.

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6
Q

What is the difference between the between a HIS and the DHIS

A

Focus
- HIS: Primarily on patients entering a hospital
- DHIS: Extends beyond hospital/health facility
Population Health
- HIS: Cannot provide district-level insights
- DHIS: Provides information on the district population’s health status and the environmental factors affecting their health
Data Source
- HIS: Patient database within the hospital
- DHIS: Includes various sources beyond healthcare facilities
Scope
- HIS: Healthcare data and services
- DHIS: Broader environmental and socio-cultural factors
Target Audience
- HIS: Healthcare providers and hospital administrators
- DHIS: District-level policymakers, health planners and community stakeholders

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7
Q

What are the DHS Functions

A

Organizing, planning, and managing healthcare services (ensuring adequate staffing, managing infrastructure and equipment)
Financing and Resource Allocation (allocation of financial resources based on statistics)
Community Participation ( establishing health committees or forums represent the local population)
Inter-Sectoral Action (collaborates with other sectors such as transport, sanitation, education, and social welfare)
Development of Human Resources: (CPD)

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8
Q

What are the WHO building blocks of a HCS

A
  • Service Delivery: availability, accessibility, quality, and effectiveness of care
  • Health Workforce: skilled healthcare professionals delivering quality care
  • Information: health information systems, data collection, analysis, and dissemination
  • Medical Products, Vaccines & Technologies: access to essential medical products, vaccines, and technologies
  • Financing: the mobilization, allocation, and utilization of financial resources for healthcare
  • Leadership/Governance: the overall governance and stewardship of the health system
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9
Q

What are the WHO Overall goals/outcomes

A

Improved Health (Level and Equity):
- Level of Health: mortality rate, quality of life
- Equity in Health: Disadvantaged groups equal access (not be left behind in terms of health improvements)
Responsiveness:
- How well meet the expectations of individuals and communities (needs and preferences)
Social and Financial Risk Protection:
- protect individuals and families from the financial risks associated with seeking healthcare.
Improved Efficiency:
- Optimizing resource allocation to achieve the best possible health outcomes with the available resources.

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10
Q

What is a District Health System

A

A comprehensive and cost-effective framework that delivers essential health services, encompassing primary healthcare, health promotion, disease prevention, maternal and child health, immunization, and treatment of common illnesses. It serves as a vehicle for delivering these services and includes all healthcare workers, facilities, and services, up to and including a district hospital, with the ultimate goal of providing equitable, effective, efficient, and high-quality healthcare to people in specific geographic sub-divisions.

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11
Q

What are the 4 streams of primary healthcare re-engineering

A

o Municipal ward-based Primary Health Care Outreach Teams
- House visits
- Basic interventions
- Identification required interventions
o Integrated School Health Program
- Ideally one PHC nurse/school
- Screening, Health education, Health promotion, Curative, Rehabilitative.
o District Clinical Specialist Teams
- Seven-member team per district: Gynaecologist, paediatrician, anaesthetist, family physician, advanced midwife, advanced paediatric nurse, rehab specialist and a primary health care nurse.
o Contracting non-specialist Health Professionals.
- Shortage, contracted on a need basis (paid from the NHI pool of funds).

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12
Q

What is the difference between a green paper and a white paper?

A

o Green paper: a discussion document on policy options or preliminary statement
- Presents a policy proposal or a set of policy options for public discussion and consultation.
- Purpose: to initiate public debate and gather input and feedback from stakeholders, experts, and the general public before finalizing a policy decision.
o White paper: a broad statement of government policy or collated inputs from the public.
- Presents policy decisions or specific proposals for legislation
- Purpose: provide detailed information, analysis, and recommendations on a specific issue or policy area

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13
Q

What is the difference between a law and a policy?

A

Policy refers to the principles, methods, and plans adopted by a government or organization to achieve certain goals.
Law refers to the system of rules and regulations that are binding and enforceable.

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14
Q

What is the difference between a bill and an act?

A

A bill represents a proposed piece of legislation that is currently under examination by a legislative body.
Acts are fully enforceable laws that can carry penalties for non-compliance.

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14
Q

Outline the 10 steps in the legislation process

A
  1. Drafting by the Ministry: Legislation is drafted by the minister and department, with input from key stakeholders like MINMEC (Ministers and Members of the Executive Council).
  2. Public Comment: The draft bill is published in the Government Gazette, allowing the public to provide feedback within a specified period.
  3. Revisions: The draft bill is revised based on the received comments.
  4. Cabinet Review: The draft bill is presented to the cabinet for consideration of its principles.
  5. Legal Certification: State law advisers review and certify the draft bill.
  6. Introduction in Parliament: The draft bill is introduced in either the national assembly or the national council of provinces.
  7. Committee Review: The relevant committee examines the bill, gathers evidence, and may amend it. They vote on the bill and submit a report to their respective house.
  8. House Debate: The committee’s report is debated in the house where the bill was initially tabled. If approved, it moves to the other house, following a similar procedure.
  9. Presidential Approval: After approval by both houses, the bill is sent to the State President for their assent.
  10. Publication and Becoming Law: Once the State President assents, the Act is published in the Government Gazette, becoming the law of the land.
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15
Q

What are the criteria for conducting a screening program?

A
  • Diagnosis: Screening programs are most suitable for conditions that are serious, have a high prevalence of cases, and whose natural history is well-understood, with appropriateness varying depending on the disease’s prevalence.
  • Diagnostic Test/Tool: The diagnostic test or tool used in a screening program should be both sensitive (effective at identifying individuals with the disease) and specific (accurate at excluding individuals without the disease). Additionally, it should be simple, cost-effective, safe, and acceptable to the target population and reliable.
16
Q

What is the difference between sensitivity and specificity?

A
  • Sensitivity: how good is the test at finding people with the disease
  • True positive: A true positive test e.g. HIV test
  • Specificity: how good is the test at excluding the people without the disease
  • False-Positive: A positive test in someone who does not have the disease.
  • False-Negative: A negative test in someone who has the disease.
17
Q

What is the difference between a hazard and a risk?

A
  • Hazards: anything having the potential to cause harm/injury/disease/death
    o A situation that poses a level of threat to health/life
  • Risk(consequence): Likelihood/Possibility that the hazard will cause harm/injury/loss/disease/death
    o e.g. Puddle: slipping and falling and fracturing your leg.
18
Q

What are the 3 types of risk assessment?

A
  • Baseline risk assessment: a reference point for future risk assessments to establish a broad overview of the risks and hazards within a specific working environment.
  • Issue-based risk assessment: involves identifying risks in specific tasks processes or activities and developing plans of action to manage the risks. E.g. Nurses transferring patients
  • Continuous risk assessment: involves the continuous monitoring of hazards and risks in the work environment and correcting them immediately in order to minimise the development of future risks and hazards.
19
Q

Explain the hierarchy of risk reduction

A
  1. Eliminate the process: eliminate/remove the hazard – no potential for harm
  2. Substitute substance: replace the hazard - substitute hazardous materials or substances with less harmful alternatives – reduces risk significantly
  3. Segregate (isolate/separate) process: engineered controls - segregate or isolate the hazardous process from workers or the general environment (physical barriers, enclosures etc.)
  4. Insulate process: administrative controls - alter the way people interact with the hazard (safety protocols, procedures, and training to minimize risks associated with the process).
  5. Limit exposure: (personal protective equipment) - only be used after considering more effective strategies
20
Q

What are the components of an ergonomics assessment?

A
  1. Worker: assess the worker(patient)
    a. Subjective and objective history
    b. Risk factors/triggers
    c. Posture
    d. Emotions (stress levels)
    e. Health (make use of ICF)
  2. Workstation (environment-risk assessment)
    a. Workstation design/layout
    i. Chair/desk height
    ii. Keyboard height
    b. Environment temp
    c. Light/noise
    d. Clutter
    e. Interpersonal factors
    f. Safety
  3. Work routine (processes)
    a. Tasks/work
    b. Job practices
    c. Frequency
    d. Workload
    e. Work routine
21
Q

Write a planning matrix for lack of referral from nursing staff

A

Problem
- No referral from the nurses
Objective
- Implement a referral system between the nurses and physiotherapy department by December 2022
Activities
- Set up a meeting with the nurses
- Book a venue
- Discuss the importance of referring patients and types of patients to be referred
-Develop referral system to physiotherapy
Resources
- Paper printing
Evaluation
- Number of patients referred

22
Q

What are the functions (roles) of management

A
  • Planning: sets organizational goals, develops strategies to achieve those goals, and identifies the necessary resources to implement these strategies.
  • Leadership: inspires/motivates employees to work towards the organization’s goals; provides guidance and direction on daily tasks.
  • Activities/actions: decision making, delegation, problem-solving, conflict resolution, monitoring and supervision of tasks
  • Coordinate/control/communication: ensure the organization is on track by coordinating activities, controlling processes, and facilitating effective communication; conduct performance appraisals
  • Evaluation: periodically assesses the effectiveness of strategies and actions in achieving objectives; makes necessary adjustments to improve performance
  • Budget: allocate and manage financial resources to fund the organization’s activities
  • Organizing: identifies and allocates activities and resources, defines work duties for employees, and establishes an organizational structure