Public Health Flashcards
What are the roles of physiotherapy and explain them
Promotive, Preventative, Rehabilitative, Consultative, Research
What are the 3 key tools for health promotion?
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
What are the 3 levels of prevention?
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
Explain the hierarchy of risk reduction
- Eliminate the process: eliminate/remove the hazard – no potential for harm
- Substitute substance: replace the hazard - substitute hazardous materials or substances with less harmful alternatives – reduces risk significantly
- Segregate (isolate/separate) process: engineered controls - segregate or isolate the hazardous process from workers or the general environment (physical barriers, enclosures etc.)
- Insulate process: administrative controls - alter the way people interact with the hazard (safety protocols, procedures, and training to minimize risks associated with the process).
- Limit exposure: (personal protective equipment) - only be used after considering more effective strategies
Explain the importance of the District Health Information System (DHIS) in physiotherapy practice
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.
What is the difference between the between a HIS and the DHIS
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
What are the DHS Functions
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)
What are the WHO building blocks of a HCS
- 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
What are the WHO Overall goals/outcomes
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.
What is a District Health System
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.
What are the 4 streams of primary healthcare re-engineering
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).
What is the difference between a green paper and a white paper?
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
What is the difference between a law and a policy?
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.
What is the difference between a bill and an act?
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.
Outline the 10 steps in the legislation process
- 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).
- Public Comment: The draft bill is published in the Government Gazette, allowing the public to provide feedback within a specified period.
- Revisions: The draft bill is revised based on the received comments.
- Cabinet Review: The draft bill is presented to the cabinet for consideration of its principles.
- Legal Certification: State law advisers review and certify the draft bill.
- Introduction in Parliament: The draft bill is introduced in either the national assembly or the national council of provinces.
- 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.
- 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.
- Presidential Approval: After approval by both houses, the bill is sent to the State President for their assent.
- Publication and Becoming Law: Once the State President assents, the Act is published in the Government Gazette, becoming the law of the land.
What are the criteria for conducting a screening program?
- 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.
What is the difference between sensitivity and specificity?
- 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.
What is the difference between a hazard and a risk?
- 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.
What are the 3 types of risk assessment?
- 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.
Explain the hierarchy of risk reduction
- Eliminate the process: eliminate/remove the hazard – no potential for harm
- Substitute substance: replace the hazard - substitute hazardous materials or substances with less harmful alternatives – reduces risk significantly
- Segregate (isolate/separate) process: engineered controls - segregate or isolate the hazardous process from workers or the general environment (physical barriers, enclosures etc.)
- Insulate process: administrative controls - alter the way people interact with the hazard (safety protocols, procedures, and training to minimize risks associated with the process).
- Limit exposure: (personal protective equipment) - only be used after considering more effective strategies
What are the components of an ergonomics assessment?
- 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) - 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 - Work routine (processes)
a. Tasks/work
b. Job practices
c. Frequency
d. Workload
e. Work routine
Write a planning matrix for lack of referral from nursing staff
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
What are the functions (roles) of management
- 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
