Social and Primary Health Care Services PDF

Social and Primary Health Care Services MSc. Nour Nabil Abd-Alqader, Collage of Pharmacy, Jerash University Public Health Health “ a state of complete physical, mental and social wellbeing rather than the mere absence of disease or infirmity” Public Health “The scie...

Social and Primary Health Care Services MSc. Nour Nabil Abd-Alqader, Collage of Pharmacy, Jerash University Public Health Health “ a state of complete physical, mental and social wellbeing rather than the mere absence of disease or infirmity” Public Health “The science and art of preventing a disease, prolonging life and promoting health through the organized efforts of society” Table of contents 0 0 0 0 1 2 3 4 Components, Health Care Concept of principles Referral in services for PHC and elements PHC PHC in of PHC Jordan  Concept of PHC "essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination.“ Declaration of Alma Ata 1978  Concept of PHC "PHC is a whole-of-society approach to health that aims at ensuring the highest possible level of health and well-being and their equitable distribution by focusing on people’s needs and as early as possible along the continuum from health promotion and disease prevention to treatment, rehabilitation and palliative care, and as close as feasible to people’s everyday environment..“ Declaration of Astana 2018 Essential: It meets the actual health needs of the community. It is comprehensive including preventive, treatment, rehabilitation and palliative care. It has a continuous inherent of the population starting from womb (intrauterine life) until the end of life. Public Health Pyramid Programs that comprises interventions to Tertiary stop/slow restorative and intensive interventions disease progression Programs Secondary targeting those such as interrupting with early negative health behavior (early interventions) identified problems to alleviate it and Programs targeting Primary (Universal) prevent escalation the entire population such as education and awareness campaign for prevention and skill building. Principles of PHC Acceptabilit accessibilit Equity y y Community Multi-sectorial Appropriate participation approach Technology Equity Definition: it is the absence of avoidable difference among groups of people, whether those groups are defined socially, economically, demographically, or geographically. Equitability in PHC means: “universal access to health services irrespective of differences”. Equitability in distribution includes investing more resources in areas with the most demand. Higher risk groups have higher priority. How to ensure equity? 1. Increase the number of health centers to cover all the population of the community. 2. Disperse health services into the most remote rural areas and under-served urban ones. 3. Improve the means of transportation. 4. Determine the population to the served in the catchment area of the PHC centers and identify the vulnerable groups to be reached through organized out-reach services. Acceptability Definition: the extent to which people delivering or receiving a healthcare intervention consider it to be appropriate, based on anticipated or experienced cognitive and emotional responses to the intervention. Acceptability could be political, economical or culture sensitive (social). Accessibility 1. Physical accessibility. The availability of good health services within reasonable reach of those who need them and of opening hours, appointment systems and other aspects of service organization and delivery that allow people to obtain the services when they need them. 2. Economic accessibility (affordability). It is a measure of people’s ability to pay for services without financial hardship. It takes into account not only the price of the health services but also indirect and opportunity costs (e.g. transportation cost). It is influenced by the health financing system and by Accessibility 3. Informational accessibility. The right to seek, receive and impart information and ideas concerning health issues. This right should not impair personal health data from being treated with confidentiality. Community participation The involvement of individuals, families and communities in promotion of their own health and welfare is an essential ingredient of primary health care. PHC coverage cannot be achieved without the involvement of community in planning, implementation and maintenance of health services Community participation Financial supply to cover the cost of some activates of the PHC (equipment, drugs, audiovisual aids, furniture). Through adopting healthful behaviors, people can participate in prevention of communicable diseases and non-communicable disease. Appropriate utilization of health services especially maternity care, child care, reporting of births and deaths. Benefit of Community participation 1) People are more likely to accept preventive health care. 2) Increase health awareness of the population. 3) Community participation is an additional resource to those provided by government so decreases the burden on the government. 4) It is considered a great support to health care workers. Appropriate Technology Technology that is scientifically sound, adaptable to the local needs, and acceptable to those who apply it and those for whom it is used and can be maintained by the people themselves with the resources of the community and country can afford. Appropriate Technology : examples Simple safe water measures: Educating the mother to boil water: specially for children and babies less than 5 years of age, chlorination of wells and water containers. ORS instead of IV fluids Breast feeding in spacing between pregnancies Multi-sectorial collaboration In addition to health sectors, all related sectors and aspects of national and community development, in particular education, agriculture, food, industry, education, housing, public works and communication. To achieve cooperation, planning at country level is required to involve all sectors. Multi-sectorial collaboration: Examples Role of Ministry of Education in schools of Health. The social sector playing roles in controlling social determinants behind health problems (divorce, violence, unemployment) The role of Ministry of Agriculture in food production. Team approach PHC needs a variety of personnel mainly medical, paramedical and non-medical. The team is a group of persons with different levels of knowledge, experience and skills who work together to provide comprehensive services to the individuals, families and community. Who provides PHC? 1. Medical personnel: one or more physician for each center or unit, and a dentist in some centers. 2. Paramedical personnel: nurses, nurse midwives, health visitors, and technicians 3. Health related personnel: persons from health-related sectors available in the catchment area of the PHC center (social workers, sanitarians, food inspectors) 4. Community members including religious leaders and school-teachers. Elements of PHC Preventive: 1. Health education regarding preventing health problems and preventive and control measures. 2. Promotion of food supply and proper nutrition. 3. Provision of comprehensive maternal and child health services and family planning. 4. Immunization of children. 5. Environmental sanitation. 6. Prevention and control of communicable locally endemic diseases Elements of PHC Curative: 1. Treatment of common diseases and injuries. 2. Provision of adequate drugs. Elements of PHC Health gains since the introduction of PHC Decrease both infant and under five mortality. Increase life expectancy for males and females. Increase vaccination coverage. Slight improvement in the environmental conditions. To be continued ….