Test 1- PHC and gerontology Flashcards
Define Health
A state of complete physical, mental and social well-being, not merely the absence of disease or infirmity
What are the dimensions of health
Physical- body shape, size and function
Mental -ability to think clearly and coherently, the ability to make rational judgements
Emotional- the ability to recognise emotions, adapt to and cope with stress and anxiety
Social-the ability to make and sustain relationships with people
Spiritual- religious practices and beliefs
Societal- environmental, working and living conditions, employment, income, social norms and standards
What is community Healthcare
Refers to all the health services that a community can use
Includes personal:(clinics; hospitals)
Non-personal: (water supply, sanitation)
What is community Health
The discipline concerned with the study and improvement of the health characteristics of biological communities
What is community Health Nursing (FBPN)
The field of nursing that is a blend of primary health care and nursing practice
The philosophy of care is based on the believe that care is directed to the individual, family and groups contributes to the healthcare of the population.
The goal to assist the individual, family and community in attaining their highest level (optimum) of holistic health
Contribute to health promotion, education, health talks
Education regarding disease prevention and cure, maintain healthy lifestyle
What is primary healthcare
Essential healthcare that improves health and Makes universal health available to all, especially the poor, through economic and social justice and equity
what is a health system
is a set of components that combine to, support and improve health of a population
Describe a health system of a country
(BAP)
● Broader in scope than a health care system
● All aspects of a nation’s health, including the institutional, material, cultural and human elements of the system
● Primary purpose is to improve health
describe a healthcare system
● The way in which health care is given to the people.
● People and resources involved in the delivering healthcare to individuals.
what are the subdivisions of the healthcare system
- Sector
- Level
- Unit
gives examples of sector as a subdivision of the healthcare system
Public
Private (for profit)
private(not for profit)
gives examples of level as a subdivision of the healthcare system
ward
district
region
province
national
international
gives examples of unit as a subdivision of the healthcare system
Carer
Clinic
Hospital
Contact
Patient
Individual
Community
explain the national healthcare system (sector explained)
The public health care system is funded by government and is open to everybody
The private sector is supported by medical aids , to which individuals contribute at their own expense
Others can also use the service, but they have to pay full fees
Traditional healers are not yet part of the formal health care system
explain the national healthcare system (Levels explained)
Each level of health services(district, provincial and national) provides a different service to the public
NATIONAL DEPARTMENT OF HEALTH:
Do not provide health care services
The legislative body that regulates what services are provided and the way in which this done
PROVINCIAL AND DISTRICT SERVICES:
all have specific services that they carry out for the public
what are the levels that hospitals are named after
1) The first level of care include primary health care clinic, community health centres and district hospitals
2) The second level of care includes regional hospitals
3) The third level of care includes tertiary hospitals
Hospitals can be named according to their areas:- District-; Regional-; National or Specialised hospitals
OR
According to their level such as 1, 2 or 3
what are the levels of care
The point of contact that the individual or population has with the healthcare system
PRIMARY CARE
SECONDARY CARE
TERTIARY CARE
QUATERNARY CARE
what is primary care
The first level of contact with the health system
Can be promotive, preventive and curative interventions
Can be offered by community health worker (community care worker), the healthcare professional, the clinical practitioner or the medical specialist
what is secondary care
Usually at the level of a general hospital for the purpose of curing disease
Usually includes general specialist care
what is tertiary care
Includes advanced specialist care
Associated with medical schools and faculties of health
what is quaternary care
The level at which the most advanced specialist care, such as organ transplant is offered
in what year did PHC begin
1940’s
Explain what the Pholela rural health project
● When starting a new rural health project at Pholela in KZN, the karks came up with a new way of running a health service
● They located the clinic that people can have easy access to it, they also based the services it offered in surveys of the community needs
● the karks considered the culture and the living conditions of the community and then involved the people in their own health issues
● the karks took a wide view of healthcare, focusing not only on curing disease, but also on prevention and promoting health among individuals and communities
● this became known as community oriented health care (COPHC), Which later influenced the primary healthcare approach
● in 1944- karks set up a health centre in pholela, but instead of waiting at the clinic for sick people to arrive, they also trained health workers from the community to make home visits. Each community health worker was given a set of households to look after
● during the visits the health workers collected health info which helped the health centre staff came to understand the health needs of the people
what was the gluckman commission
● Impressed by the karks, henry gluckman who was the minister of health, tried to change the nature of the countrys health services in the early to mid 1940’s
● In an effort to improve the health of all south africans, gluckman commissioned a thorough study of the health services in SA.
● the commissions report identified the following problems that were preventing equal access to health for all.
● the report made some recommendations, which the smuts government agreed to this plan
● 1948 40/400 planned health centres had been set up instead
● instead of forming a central health service to provide equal access for all, the new apartheid laws further divided the services into different racial groups
what is top-down curative approach
aims at curing disease rather than investigating the health needs of the community and the socioeconomic and environmental causes of disease.
what is a bottom up approach
a bottom up approach works with communities to identify their health needs and prevent their health problems.
what are the missionary doctors
● missionary doctors linked to the world council of churches (wcc) began to discover the importance of getting local people and local resources involved in improving health
● the christian medical commission was the first to use the term primary health care to describe this new bottom up approach
● the term “primary healthcare” first appeared in the journal contact published by the wcc in 1970
what are the barefoot doctors
● the barefoot doctors are local farmers chosen by their communities and then given a few months training by doctors from urban hospitals
● they were taught to use simple technology and to combine western and traditional medicine to help their communities
● they then returned to their farms so that they remained a part of their community. this system helped to control epidemics, reduce child deaths and increase life expectancy in china in 1960’s and 1970’s
● the system of the barefoot doctors came to an end in 1990’s. when the chinese government adopted a western hospital-based system of health care.
what is the alma-ata declaration
● during the 1970’s there was a worldwide belief that healthcare services were too expensive and not accessible to all the people in all countries.
● as a result the USSR government hosted an international conference on PHC at alma-ata in september 1978
● the concept of PHC was an approach to healthcare that came into existance after the conference, which was organised by the united nations children fund (UNICEF)
● primary healthcare was accepted by the member countries of the WHO as the key to achieve the goal of “health for all” through a national health system that puts people at the centre of healthcare
● the alma-ata declaration emphasizes that everyone should have access to healthcare and everyone should be involved in it.
what is comprehensive approach
to health care is holistic, taking into account physical, social, psychological, economic, political and environmental wellbeing and being comprehensive in care, it includes a preventive, promotive, curative, rehabilitative, palliative and protective to health care.
define primary healthcare
is essential health care that improves health and makes universal health care available to all, especially the poor, through economic and social justice and equity.
what are socioeconomic conditions
are the conditions of people, including housing, sanitation, access to water, employment and food security.
define structural factors
are circumstances in the area where people live that can affect their health.
what is self worth
refers to an individual’s ideas about how they value themselves
what is public health
(population health) is the science of protecting the safety and improving the health of populations
what is burden of disease
is the major cause of ill health in a country
what is mortality
is death due to a particular condition
what is life expectancy
is the average expected lifespan of a person in a society
what is morbidity
to the rate of disease in a population
what are social determinants of health
are the social and economic factors or conditions such as poverty that influence health.
define wellbeing
is living a favourable, good and satisfactory life.
what are epidemics
are a higher than expected level of a disease in a population
what is palliative care
refers to comprehensive and holistic end-of-life care
what is rehabilitation
refers to the implementation of interventions towards health. these can be medical, educational, vocational, psychosocial or community based interventions
what does inter-disiplinary mean
means to involve several different academic or professional specialties working together, not just doctors and nurses
what are health indicators
are numbers used to measure change over time. they are used to give an indication or measurement of the health of the people living within an area and the impact of these services on the people who use them.
what are expenditure on health per capita
refers to the amount of money spent on health per person in the province in 2014
what does medical scheme coverage
refers to the population that has medical aid cover.
what are the principles of an ideal clinic (ED CP IC AT)
EQUITABLE DISTRIBUTION: health services must be equally by all people irrespective of their ability to pay
COMMUNITY PARTICIPATION: an ongoing effort to foster meaningful involvement of the community in the planning, implementation and maintenance of health services
INTERSECTORAL COORDINATION: involvement of all related sectors and non-governmental organisations (NGOs)
APPROPRIATE TECHNOLOGY: this must be inline with resources that the community and the country can afford
what are the characteristics of primary health care (spencer plays cricket carefully since in December in winter)
● Address the socio-economic causes of poor health
● Make provision for basic health needs, i.e. organising health services around people’s needs and expectations
● Should encourage community empowerment i.e. ensuring that people are able to manage resources that are available to them
● Should provide a comprehensive quality healthcare,
-including promotive,
-preventive,
-curative,
-rehabilitative and
-palliative services
● Should foster the spirit of concerned and accountable health worker practice
● Should prioritised disadvantaged individuals and groups to ensure that health care is accessible, equitable and affordable to all
● Should recognise the importance of integrated service provision from primary to tertiary levels of care within a coherent healthcare system
● Should promote interdisciplinary, multi-professional and intersectoral collaborative teamwork and other stakeholder participation for effective service delivery
what are the 8 minumum core components of PHC
(EFWMIPTP)
1) Education concerning prevailing health problems and methods of preventing and controlling them
2) Promotion of food supply and proper nutrition
3) An adequate supply of safe water and basic sanitation
4) Maternal and child healthcare, including family planning
5) Immunisation against the major infectious diseases
6) Prevention and control of locally endemic diseases
7) Appropriate treatment of common diseases and injuries
8) Provisions of essential drugs
what is the 10 point strategic plan
- Provision of strategic leadership and creation of a social compact for better health outcomes
- Implementation of NHI
- Improving the quality of health services
- Overhauling the health care system and improving its management
- Improving human resources management, planning and development
- Revitalisation of infrastructure
- Accelerated implementation of HIV & AIDS and Sexually Transmitted infections National strategic Plan 2007 - 11 and increased focus on TB and other communicable diseases
- Mass mobilisation for better health for the population
- Review of the drug policy and
- Strengthening research and development.
what is the aim of re-engineering PHC
The re-engineering of Primary Health Care (PHC) aims to increase access of health services to the general public and to improve the quality of health services in general.
what are the 3 streams/aspects of phc reengineering
Community ward based PHC outreach teams
Strengthening of school health services
Institution of district-based clinical specialist teams, with focus on improving maternal and child health
describe PHC Package stream 1
New primary health care package(NHI):
-Community based services
-Increased emphasis on promotive, preventive services at household level
-Includes: oral, hearing, vision, rehabilitative
-School health services
-Aligned with District Hospital package
-Effective referral system
-Appropriate emergency and planned patient transport
describe PHC Package stream 2
-School Health Policy adopted in2003
-Implementation has been very limited due to resource constraints
-Minister of Health and the Minister of Basic Education are responsible
-Package includes reproductive health services and integrates HCT
describe PHC Package stream 3
-To address the unacceptably high infant, child and maternal mortality in most of our districts -National Health Council decided:
-Every district should be supported by a team consisting of:
Gynaecologist, Paediatrician, Anaesthetist, Family physician, advanced midwife, Primary health care nurse
