Public Health PPQ 2023-2017 Flashcards
Name five items and justify the inclusion of such items in the form.
Explain five health implications of public health laws. (10)
Protection of patient rights
Concerns the legal aspects of providing preventive, curative, rehabilitative services.
Protection of community health.
Establishment, financing and operation of health care facilities.
Prohibits conduct that is harmful to the health of individual and communities e.g. tobacco control, alcohol, substances abuse.
Resource allocation.
Organization of health services.
Ensures quantity and quality of care.
Differentiate between a health policy and a health law and give an example of each.
Health policy
health law
Health policy can be defined as
the “decisions, plans, + actions that
Are undertaken to achieve specific
Healthcare goals w/in a society
In Latin “Legis” means Law
Law is a system of rules made by an authority of a perticular country or community and must be obeyed.
Legislation is another term
meaning statutory law.
These laws are embodied in writing +
are known as statutes or Acts
These laws have been enacted by
a legislature/the governing body of a country.
Legislation can also mean
the process of making the law.
In SA, the national parliament passes a law.
The lower bodies are
provincial legislation + municipal councils
Explain the importance of understanding the structure and function of the District Health System as physiotherapists. (10)
What is DHS
A vehicle for delivery of the PHC package.
The DHS provides the health sector w/
● a Mx framework that can deliver HC
○ in a cost effective + integrated manner.
DHS is a means to achieve an end.
The end:
● rendering equitable, effective, efficient HC
○ of good quality to ppl in geographic subdivisions.
Includes all health care workers,
● services, + facilities up to +
○ including the district hospital.
&
Function NBNB will def ask
Organisation, planning + Mx
● All planning happens at district office
○ ∴ the approach to DHS needs to be
■ collected for the district office
Financing + resource allocation
● Conditions you see
● The time you use
● The consumables
● If don’t have data will not get resources
● Stats
○ Need to know the right ones to get
Community participation
● Community needs to be involved
○ on what services is available
● Advertise clinic to get community to come into clinic
○ Outreach
● Bottom up approach
● Have community ppl on staff
○ Offers bursary to study in health science
■ ∴ work in province
Intersectoral action
● Not just you in the health department
○ Collaborate with diff sectors
■ Education
■ Transport
■ Water and sanitary
■ Traditional healing
Development of human resources
● Training different people to help
● Community building skills
Explain the importance of the District Health Information System (DHIS) in physiotherapy practice. (4)
While the District Health Information System (DHIS) is likely not designed specifically for physiotherapy practices, it can still hold importance in the field. Here’s how:
- Data collection and reporting: DHIS can be a centralized system for collecting physiotherapy data like patient demographics, treatment details, and outcomes. This helps physiotherapists track their work and contribute to public health data.
- Monitoring and evaluation: By analyzing DHIS data, physiotherapy departments and policymakers can assess the effectiveness of physiotherapy services, identify areas for improvement, and allocate resources efficiently.
- Improved communication: DHIS can facilitate communication between physiotherapists, other healthcare providers, and public health authorities. This can improve patient care coordination and overall healthcare delivery.
- Patient Care: DHIS can support physiotherapy practice by providing a platform to track patient progress and outcomes over time. This data can be used to individualize treatment plans, improve patient communication, and ensure continuity of care.
- Public Health Initiatives: DHIS data can be aggregated to inform public health initiatives related to musculoskeletal health and rehabilitation. Physiotherapists can leverage DHIS to identify physiotherapy needs within the population and advocate for preventative measures.
Overall, DHIS can contribute to better data-driven decision making in physiotherapy practices and the healthcare system as a whole.
Mr Tam, a primary school teacher, was involved in a motor vehicle accident. He sustained a complete L4 spinal cord injury. He is discharged home and he is using a wheelchair. He would like to go back to work.
1.1. outline the management programme using the first five steps in the rehabilitation process. (10)
Prevention -of secondary complications such as development of pressure ulcers from prolonged sitting in wheelchair, contractures which would reduce PROM below NLI
Identification and referral (assessment)
Treatment
Referral
Reorientation and vocational training
Resettlement and integration
Follow-up
Mr Tam, a primary school teacher, was involved in a motor vehicle accident. He sustained a complete L4 spinal cord injury. He is discharged home and he is using a wheelchair. He would like to go back to work.
1.3. describe two components of an ergonomic assessment that can inform Mr Tam’s return to work process. (4)
Worker
assess the worker(patient),
Subjective + objective HX
Risk factors /triggers/posture/
emotions (stress levels)/health
can use the ICF
Workstation (inc. environment-RA)
Workstation design
/Layout/Chair/desk height/keyboard height/working incl. the environment temp/light/noise/clutter /stressful jobs/ interpersonal factors/safety etc.
Work routine/processe- task/work, job practices)/frequency/workload/work routine
(HOW /WHEN /HOW OFTEN…YOU CAN ASK + OBSERVE)
Mr Tam, a primary school teacher, was involved in a motor vehicle accident. He sustained a complete L4 spinal cord injury. He is discharged home and he is using a wheelchair. He would like to go back to work.
identify two possible hazards and related risks that Mr Tam might experience at his workplace. (4)
Uneven paving
Wet bathroom floors
Steep incline ramps increasing propulsion and speed
Stigmatisation
Mr Tam, a primary school teacher, was involved in a motor vehicle accident. He sustained a complete L4 spinal cord injury. He is discharged home and he is using a wheelchair. He would like to go back to work.
demonstrate how you can apply three functions of management when developing the vocational rehabilitation program. (6)
- PLANNING
-organizational goals, idx ways to achieve
-the goal identifying resources needed
Different types of plans:
-Purposes
=missions-objectives-strategies-policies-procedures-rules programme-budgets
-Planning matrix
=different from the planning cycle
=Like this in test dont do cycle do matrix
18 marks(planning matrix)
- LEADERSHIP
-directing the resources, influencing/motivating the workers
3.ACTIVITIES/ACTIONS
-Coordinate/CONTROL/COMMUNICATION
-making sure the organisation is on track, performance appraisal,
- EVALUATION
based on the objectives
- BUDGET
for the activities
- ORGANIZING
Identification + allocation of
-activities, resources, defining
-work duties, organisational structure
Mr Tam, a primary school teacher, was involved in a motor vehicle accident. He sustained a complete L4 spinal cord injury. He is discharged home and he is using a wheelchair. He would like to go back to work.
Explain the implications of the Occupational Health and Safety Act (85 of 1993) on physiotherapy practice. (10)
-To provide for health + safety of
-persons at work + to protect the public from
-hazards arising from the workplace.
Health implications:,
-Protection of pt rights
-Concerns the legal aspects of providing preventive, curative, rehabilitative services.
-Protection of community health.
-Establishment, financing + operation of healthcare facilities.
-prohibits conduct that is harmful to the health of individual + communities e.g. tobacco control, alcohol, substance abuse.
-Resource allocation.
-Organisation of health services.
-Ensures quantity + quality of care.
-Authorizes programmes + services that promote the health of individual + communities e.g. Fluoridation water, Health Promotion, housing
-Regulates the production of resources for health care.
-Regulates the production of health care e.g. building hospital, regulation-private hospital.
-Provides for the social financing of health e.g. Medical Scheme Act, Social health insurance.
-Authorises surveillance over quality of care e.g. Regulation-profession ,
You are placed at Themba clinic in the Sedibeng district for your community service year. You have been treating many nurses for lower back pain.
1.1 You decide to conduct an ergonomic assessment. Outline the components of the ergonomic assessment that you should address. (9)
- Worker: past medical/ surgical history. diagnoses & risk factors for comorbidities such as HPT/ Diabetes. A full physical exam of the worker must be done to assess for potential body impairments.
- Workstation and environment: ward size, type of hospital beds (electronic vs manual crank system),
- Work routine: The type of work the patient does must be assessed in detail from the activities done, to the duration of a workday, the amount of physical and mental labour required in a shift
You are placed at Themba clinic in the Sedibeng district for your community service year. You have been treating many nurses for lower back pain.
1.2 Explain three roles of physiotherapy in occupational health. (6)
- Preventative
- Promotive
- Curative
- Consultative
- Rehabilitative
- Research based
1.3 Using a planning matrix, plan how you should address one hazard. (6)
- Problem
Nurses at the clinic are at high risk of having low back pain (LBP) - OBJECTIVES
-Screen nurses in the clinic for Low Back Pain in 2 weeks
-Implement an intervention addressing low back pain management for nurses in the clinic in 2 weeks
- ACTIVITIES
-Identify a ward that has nurses who have never received screening for LBP
-Ask for permission from matron to conduct screening in the identified ward and implement an intervention programme addressing the findings
-Identify an appropriate screening tool (specific and sensitive)to utilise in the screening process
4.RESOURCES
-paper
-Printer
-Pens
-Venue
- EVALUATION
-how many nurses benefited from the intervention
-using the numeric pain scale/faces pain scale to determine how much the intervention decreased their pain.
Discuss two ethical issues you need to consider when conducting a screening programme and how you should manage them. (4)
Failure to inform- results of screening
Failure to intervene
screening with n o intention to treat
Privacy and dignity
Permission/consent
Failure to follow up
Define a district health system. (2)
This is a vehicle for delivery of the primary health care package. It provides the health sector with a management framework that can deliver health care in a cost effective and integrated manner.
Achieves an end: rendering equitable, effective, efficient health care of good quality to people in geographic subdivisions
Includes all health care workers, services and facilities up to and including district hospital.
Name the public health policy underpinning the district health system. (1)
Alma ata declaration, 1978- The Declaration of Alma-Ata was endorsed at the Alma-Ata conference, jointly convened by WHO and UNICEF, that focused world attention on primary health care as the key to achieving an acceptable level of health throughout the world.
List three characteristics of a primary level of care within a district health system. (3)
First point of entry to health system
Includes clinics/CHCs,/homes
Operating hours vary from 8-24 hours
Capacity of 200-250 beds
Services are free, except for district hospitals
Offers a wide and comprehensive range of services
Outline the four streams on which primary health care will be re-engineered according to the National Health Insurance. (4)
Municipal Ward based Primary Health Care outreach teams
Integrated school health program
District clinical specialist teams
Contracting non-specialist health professionals
Differentiate between a white paper and a green paper policy document. (2)
Green paper: document of discussion of policy options or preliminary statement that allows for public comment
White paper: a document of policy from the government with collated opinions of the public. Broad statement of government policy or collated inputs from the public.
Outline three aspects of the importance of public health laws. (3)
To ensure that a person knows how to act in society
It regulates and ensures that everyone follows the rules and laws
Made to treat every person as equal and so that that no one can consider themselves above the law based on social standing
The public can be aware of the intention of the government society
The public can measure the achievements made by the government
Helps to respond to the needs of society.
You are working as a community service therapist at Siloam hospital. You have been
tasked to train the community health workers.
1.1 Using a teaching and learning plan explain to the community health workers what the role of physiotherapy in mental health is. (16)
1.subject area and time allocation
-Introduction (1 min)
-Objectives (2 min)
-Ice-breaker (2 min)
-Ground rules (1 min)
-Baseline knowledge (2 min)
-Role of physiotherapy in mental health (10 min)
-Evaluation (3 min)
-Conclusion (1 min)
- objective: To educate the audience about the role of physiotherapy in mental health
- key content
Roles of physio:
-Promotive, Preventative, Curative, Consultative, Rehabilitative, Research based.
Physical activity
-Physical activity is a public health priority Especially important for patients with MHD Patients with MHD less likely to be physically active Greater risk of chronic health conditions
-Poorer QoL
-Physical activity as effective as anti-depressant medication.
-Chronic pain management
-Mind-body
- teaching method
- teaching aid
- evaluation
Explain two characteristics of an adult learner that you need to consider during your
health education. (4)
Autonomous
Goal orientated
Bring life experiences to learning
Relevancy oriented
Practical
Need for respect
Discuss the relationship between a district health system and primary health care. (10)
A district health system is a vehicle to provide/deliver primary health care, and provides the health sector with a management framework that delivers healthcare in a cost effective and integrated manner. It includes all healthcare workers, services and facilities up to and including the district hospitals. Primary health care is the first level of contact for any formal healthcare system and is a component of the district health system. It brings health close to where people live and work in a way which is accessible and acceptable to them at a cost the community can afford. District health system determines the resources and finances allocated for primary health care within the district.
State two pillars/building blocks of the health system and justify the importance of these
building blocks in improving health outcomes. (4)
Building blocks
Financing
Information
Access to Medical products, vaccines and technologies
leadership/governance
Health workforce
Service delivery
Mr Bean, a computer analyst, has been involved in a motor vehicle accident and he
sustained an L3 spinal cord injury lesion. He is discharged and independent in his activities
of daily living and using a wheelchair for mobility. He would like to go back to work.
1.1 Outline the rehabilitation programme for Mr Bean using the first three steps of the
rehabilitation process. (7)
Rehab process:
Prevention: primary, secondary and tertiary
Identification and referral: screening/occupational health/ergonomic risk assessment
Treatment: intervention
Referral
Reorientation and vocational training
Resettlement and integration
Follow up
Mr Bean, a computer analyst, has been involved in a motor vehicle accident and he
sustained an L3 spinal cord injury lesion. He is discharged and independent in his activities
of daily living and using a wheelchair for mobility. He would like to go back to work.
Mr Bean is at risk for developing secondary complications. The physiotherapist decides to screen him for secondary complications. Explain the terms sensitivity and specificity of a screening tool. (4)
Sensitivity refers to how good the tool is at identifying people with the condition, in this case the secondary complications.
Specificity refers to the tool’s ability to exclude people without the condition- secondary complications.
Mr Bean, a computer analyst, has been involved in a motor vehicle accident and he sustained an L3 spinal cord injury lesion. He is discharged and independent in his activities of daily living and using a wheelchair for mobility. He would like to go back to work.
Explain the health-promoting role of physiotherapy to Mr Bean’s manager. (9)
Key tools of health promotion:
Enablement: education, empower
Mediation: middle-man
Advocacy: changing policy to allow Mr Bean to return to work, be reintegrated and attend work.
Explain the rationale for developing a District Health Information System. (10)
-Provide comprehensive, timely, reliable and good quality routine evidence for tacking and improving health service delivery.
-Support improved district health management and planning.
-Improve the health status of the community through having objective information on which to base decisions.
-Monitoring and evaluation of district services.
-Facility based info will not meet requirements of the District health information system.
