PFC First Set PDF

# **The Physician as the Healer** ## **Aims** - Differentiate between disease and illness and the physician's role in both. - Apply the physician's roles within the 5 dimensions of health. - Differentiate between the disempowering authoritarian role of a physician and that of mobilizing the patient...

# **The Physician as the Healer** ## **Aims** - Differentiate between disease and illness and the physician's role in both. - Apply the physician's roles within the 5 dimensions of health. - Differentiate between the disempowering authoritarian role of a physician and that of mobilizing the patient's will to live and empowering the patient. - Identify the qualities that every physician requires within the 5 dimensions of health. - **Health** - Complete state of physical/mental... - **Healing** - Restoration to "normal" state. - **Disease** - Condition of the living body (Diagnoses). - **Illness** - Condition of body and mind (Perception of wellbeing). ## **Authoritarian/Traditional Doctor's Role** - Assumption that the doctor knows best. - Acts in patient's best interest, therefore dominates the relationship. ## **Patient-Centred Care** - About treating a person receiving healthcare with dignity. - Including them in their health. ## **5 Dimensions of Health** | Dimension | Description | |---|---| | **Physical** | Absence of disease or illness | | **Mental** | Cognitive ability, memory impacting health | | **Emotional** | Mood and general emotional state | | **Spiritual** | Provides purpose and meaning in a person's life and health. Sense of overall purpose (pleasure, passions, pride). | | **Social** | Making and maintains meaningful relationships | ## **Health Care Competencies** | Competency | | |---|---| | **Scholar** | | | **Professional** | | | **Communicator** | | | **Medical Expert** | | | **Health Advocate** | | | **Leader** | | | **Collaborator** | | ## **What is a Physician** - Health facilitator - Assistant to healing - Communication - Listener - Continuous Learning - Empathy - Advocacy - Collaborator - Leadership ## **Understanding Human Connectedness** **Knowing the Self** - Recognizing ones emotions and assumptions. - Recalling ones own experiences **Witnessing Others' Suffering** **Seeing the Suffering Other** - Recognizing the individuality of suffering - Understanding spirituality/meaning - Acknowledging the life-altering impact of suffering **Understanding Human Connectedness** - Our connected humanity reveals the universality of suffering. **Reflecting on the Impact of Others' Suffering for Self** **Responding to the Suffering Other** - Practicing Compassionate and Supportive Presence. - Sharing presence with the sufferer. - Practicing active listening - Listening for meanings. - Encouraging the voice of the sufferer. - Asking questions. - Acknowledging the impacts of suffering. "A good physician treats the disease. A great physician treats the patient *with* the disease." # **Professional Identity Formation** ## **Values and Roles 1: Becoming a Doctor** > "From the beginning of time, people have tried to heal one another." - The purpose of this session is to demonstrate the professional framework within which roles and identities will develop. - Identify the core and enabling competencies that define a healthcare practitioner. - Evaluate the development of your professional identity within the HPCSA/Afrimed/Canmed guidelines framework. ## **Values** - The beliefs people have especially about what is right/wrong. - The principles that determine how you act. - Indicates how we interact. ## **What are your values?** > "If you are more fortunate than others, build a longer table, not a taller fence." ## **Professions and the Social Compact** - Profession - work that requires a certain amount of training. - Comes with a degree of respect and responsibility. - With that power comes social compact/expectation (eg. To "do no harm"). ## **Privilege and Self-Governance** - "Taking conscious responsibility for the tasks and interests of the profession, if necessary, act in opposition to the state. This is facilitated by the internalisation of a common attitude and understanding of the role of the profession and what constitutes appropriate behaviour." ## **Professional Values** - **Compassion** - Empathy in Action - **Respect** - Honouring Patients' Autonomy - **Integrity** - Honesty and Transparency - **Professionalism** - Excellence in Practice - **Communication** - The Key to Effective Care - **Teamwork** - Collaborating for Patient Care >"Doctors' Values: The Heart of Healthcare By embracing these values, doctors provide high-quality, patient-centred care that honours the trust placed in them." # **HPCSA Core Competencies** ## **I - Role of the Healthcare Practitioner** - As healthcare practitioners, healthcare professionals integrate all of the graduate attribute roles, applying profession-specific knowledge, clinical skills and professional attitudes in their provision of patient/client-centred care. The healthcare practitioner is the central role in the framework of graduate attributes. ## **Points of Reference for Understanding Role** - Batho Pele Principles - HPCSA guidelines. - CANMEDS - Constitution - Bill of Rights - Patient Rights Charter - Pfulandlela Pledge (Written by Wits HS faculty) - WHO > "Consider how these guidelines and others determine/can be used to develop our personal and professional identity." **National Core Standards** **National core standards** | Standard | Description | |---|---| | 1. Patient rights | | | 2. Safety, clinical risk | | | 3. Clinical support | | | 4. Public health services. | | | 5. Leadership & corporate governance | | | 6. Operational management | | | 7. Facilities & infrastructure | | **6 Priorities** | Priority | Description | |---|---| | Patient Safety, Patient Rights: Clinical | 1. Values and attitudes | | | 2. Waiting times | | | 3. Cleanliness | | Facilities & infrastructure: | 3. Cleanliness | | Governance & Care: | 4. Patient safety | | | 5. Infection prevention and control | | Clinical Support Services: | 6. Availability of medicines and supplies | # **Self-Reflection Mandate** > Self-awareness gives you the capacity to learn from your mistakes as well as your successes. - Self-reflection and awareness - Self-care - We cannot help others if we are not whole people ourselves. **Experience-based learning: The SPaRC model** | | | |---|---| | **Support** | Student Organisation | | **Participation** | Patient Serving Clinician | | **Real Patient Learning** | | | **Capability** | Real Learning | <start_of_image> Patient | | | | | **Preparing** | | | **Experiencing** | | | **Reflecting** | | | **Performing** | | # **Ethics of Care** > The purpose of this session is to critique the importance of the culture of a caring environment' with colleagues and peers and by extension an atmosphere of care for persons and families in the community. ## **Aims** - Apply the knowledge of resolving ethical dilemmas through case study scenarios. - Clarify the application of virtue ethics and care ethics in medical practice using case scenarios. ## **Ethics at Large** > "There are many ethical/social theories" - Traditional ethical theories - Utilitarianism and deontology dominate - Society - See as made up of autonomous, rational individuals. - Rules, duties, justice, rights, impartiality, universality, utility, preference satisfaction. - Principalism - Developed as reaction to > "There are 4 main principals doctors must maintain" ## **Autonomy** - The patient/client - Autonomy is Latin for "self-rule" - Imposes an obligation to respect the autonomy of other persons - to respect the decisions made by other people concerning their own lives. - Autonomous consent rests on the principle of human dignity. ## **Beneficence** - Health Professional - Has an obligation to bring about good in all our actions. ## **Non-maleficence** - Health Professional - Have an obligation to act in such a way that we do not harm others/commit a harmful act: "First, do no harm." - An obligation not to inflict harm intentionally. ## **Justice** - Health Professional - We have an obligation to provide others with whatever they are owed or deserve. - We have an obligation to treat all people equally, fairly, and impartially. ## **Principalism** - Autonomy - Beneficence - Justice - General principles across the theories ## **Normative Ethics** - Utilitarianism - Deontology - Virtue ethics - What we ought to do. ## **Care Ethics** - Carol Gilligan - 1960s feminist perspective. - Widely applied in healthcare: nursing, health care, education, international relations, law, and politics. - Normative - Virtue Ethics - The person in traditional ethical theories - independent, isolated, rational, and self-interested. - Care = Understanding of the individual as an interdependent, relational being. - Importance of human relationships and emotion-based virtues such as benevolence, mercy, care, friendship, reconciliation, and sensitivity. ## **Premises** | | Description | |---|---| | **Patient-Centredness** | A human being is essentially dependent on others | | **Interdependency of human existence** | Children dependent upon parents/ elderly dependent on children or carers/disabled persons rely on others | ## **Relationships, Person and Society** | Category | Description | |---|---| | A person is interdependent, integral (emotion, reason, and will), and relational. | | | Traditional gender underpinning | | | The concept of the liberal individual is an abstract, illusory concept. | | | Western culture: the justice view of morality was traditionally cultivated and shared by men. | | ## **Does Care = "Girly"???** - Women have traditionally been taught a different kind of moral outlook that emphasizes solidarity, community, and caring about one's special relationships. - Morality as care ignored or trivialized because women were traditionally in positions of limited power and influence. - **Justice view:** focuses on doing the right thing even if it requires personal cost or sacrificing the interest of those to whom one is close. - **Care view:** We can/ should put the interests of those who are close to us above the interests of complete strangers, and we should cultivate our natural capacity to care for others and ourselves. ## **Criticisms** - Care ethics developed as part of the feminist movement, and feminists have criticized care-based ethics for reinforcing traditional stereotypes of a 'good woman'. Is this still relevant? - Care ethics can promote favouritism which violates fairness and impartiality. - Care ethics must address various issues, including how it can integrate traditional ethical values ie justice, etc ## **What Should We Care About** - Chosen a caring profession - looking after needs of others. - Individual and their relationships to their families - Their relationships to us and their communities > "Each patient has their own "village" /baggage." - Our families and our own relationships > "Look after yourself ~" # **Virtue Ethics** - Is not an either/ or with other theories - Virtue ethics: developed by Aristotle and other ancient Greeks. - Quest to understand and live a life of moral character. - Assumes that we acquire virtue through practice. > "PRACTICE MAKES PERFECT?" - By practicing being honest, brave, just, generous, and so on, a person develops an honourable and moral character. - According to Aristotle, by honing virtuous habits, people will make the right choice when faced with ethical challenges. # **Theory of Social Justice** - Equality, equity, rights, participation. - Social justice = the fairness of a society's wealth and resource distribution, as well as the distribution of privileges and opportunities. - Discrimination based on traits like race or gender goes against the principles of social justice, which include human rights, access, participation, and equity. > John Rawls Justice as fairness # **Ethics of Care** > "Ethics of Care encompasses the values and characteristics a (health-care) professional is expected to have, develop, and uphold." ## **Principles** | Principle | Description | |---|---| | Competency | | | Responsibility | | | Advocacy | | | Care | | | Good person | | | Resource Management | | | Social Justice | | > To illustrate the difference among three key moral philosophies, ethicists Mark White and Robert Arp refer to the film The Dark Knight where Batman has the opportunity to kill the Joker. Utilitarians, White and Arp suggest, would endorse killing the Joker. By taking this one life, Batman could save multitudes. Deontologists, on the other hand, would reject killing the Joker simply because it’s wrong to kill. But a virtue ethicist “would highlight the character of the person who kills the Joker. Does Batman want to be the kind of person who takes his enemies’ lives?” No, in fact, he doesn’t (See References). > "Virtue ethics = guide to being a virtuous human being AND for living life without providing specific rules for resolving ethical dilemmas" > "Social justice = the fairness of a society’s wealth and resource distribution, as well as the distribution of privileges and opportunities. Discrimination based on traits like race or gender goes against the principles of social justice, which include human rights, access, participation, and equity. John Rawls Justice as fairness" # **Interprofessional Learning and Practice** **Figure 1. Health and Education Systems** | Category | Description | |---|---| | Local context | Local health needs | | Present & future health workforce | Fragmented health system | | Health & Education systems | Collaborative practice | | | Collaborative practice-ready health workforce | | | Interprofessional education | | Strengthened health system | | | Optimal health services | Improved health outcomes | ## **Aims** - Describe the concept of interprofessional (collaborative) learning. - Categorize the different professionals and their roles within a community-oriented, primary-care practice. **WHO framework for interprofessional practice.** ## **What is Interprofessional Practice?** - A collaborative practice - working with professionals in your profession, outside your profession, and with your patients. - It involves having an understanding of the roles of different professionals. - We need an understanding of everyone's scope of practice. - We should learn about each other, with each other, and from each other. - Healthcare challenges are overcome by effective teamwork. - There is a correlation between effective teamwork and positive patient outcomes. - We need to manage a patient collaboratively. ## **IPP in SA** - Chronic shortage of healthcare workers in our country. - Patients experience long waiting times in queues to collect medication and achieve care. - A delay in referral to the appropriate healthcare professional for triage. - We need a better understanding of where different patients should be referred to. - There is a breakdown of effective communication through the referral process. - There exists poor communication between different healthcare providers. - Lack of collaboration - this is a result of pride, egos, and defensiveness. ## **Benefits of an Interprofessional Team** - Better patient outcome. - Reduced medical errors - you only fill your role - not outside the scope of expertise. - Improves staff relations - less delay to referral process. - Mutual respect for roles and responsibilities. - Improved quality of care. - Enhances job satisfaction. - Improved patient-centeredness. > "In terms of INEQUALITY in SA: An interprofessional team addresses this as you will be able to shift patients to the relevant workers. We open up opportunities as targeted care can be provided." ## **Patient Case Study** > Man who lives alone, smokes and drinks (but not excessively) has a stroke and is brought to the ER. > Who do you (as a PHC) call first? > "We should think chronologically — process of referral and levels of care." - Consider receival care (Emergency Department), in the wards, and post-discharge care. - Specialist care and long-term care. - Dental care (dentists, oral hygienist) - smoking, stroke (difficulty feeding), and long-term dental care. - VCT councilor - obtaining HIV status (should be every 3 months). - Social Workers. - Medical aid or financing.. > We should consider an internal medicine specialist before being referred to further specialists - we should consider the chief complaints and complications. # **Ecology of Medical Practice and COPC** > "Community-oriented primary care" > The purpose of this session is to introduce the theories and principles underpinning Community-oriented primary care ## **Aims** - Describe the concept and context ' medical ecology and its significance in the context of health care delivery. - Explore community mapping techniques. - identify the various components of medical ecology, including the interaction between humans, pathogens, and the environment. ## **Medical-Ecological Approaches to Health** - Medical ecology examines the relationships of health to physical, biological, and social environments such as climatic conditions, plants and animals, and population dynamics. - Medical ecology uses evolutionary perspectives to examine the relationship of human' evolved genetic potentials to their health conditions (eg., thrifty genotype, sickle cell anaemia gene's over- dominance in African malaria-endemic area) > Darwinion/evolutionary medicine: Overlap of medicine e evolutionary biology. ## **History of Ecology** - In 1866, Ernst Maeckel, a German biologist, proposed the name ecology for the study of the relationships between organisms and environment, then known as the balance or the economy of nature at that time. - Lamarck In France, and Darwin in England, defended distinct mechanisms for biological evolution. Lamarck accepted the Inheritance of body parts alterations in response to both external physical environmental factors and Internal urges to satisfy new needs and demands. - Darwin laid more emphasis on the natural selection of individual variations and, although recognising the influence of physical factor in evolution, defended the notion that morphological, physiological, and behavioural adaptations gave an organism an edge to survive and to leave viable offspring. ## **Ecological System Theory** - Theoretical contributions of developmental psychologist Urie Bronfenbrenner (1917-2005). He articulated a theory in a series of propositions and hypotheses in his most cited book, The Ecology of Human Development (1979) and further developing it in The Bioecological Model of Human Development. A primary contribution of ecological systems theory was to systemically examine contextual variability in development processes. As the theory evolved, it placed increasing emphasis on the role of the developing person as an active agent in development and on understanding developmental process rather than "social addresses" (e.g. gender, ethnicity)as explanatory mechanisms. **MacroSystem** - Attitudes and ideologies of the culture **ExoSystem** - Industry - Social services - Mass media **MesoSystem** - Family - Peers - School - Church - Health services - Neighbors **MicroSystem** - Individual (sex, age, health, etc.) *"environmental determanism"* - Local politics > Framework for contexts in which individuals develop. # **The Continental Axis Theory** - Prof, Jared Diamond. Guns, Germs and Steel - East - West axis share similar climatic zones as the latitude remains almost constant. - North-South axis confronts with changes in climatic zones (temperature, etc) - Physical barriers (rain forest, swamps, mountain range) prevented the diffusion of domesticable and technology. - Geographic areas offered different resources opportunities. - Suggests that the orientation of a continent's axis significantly influences the diffusion of agriculture, technology, and ideas. The theory distinguishes between continents with primarily east-west axes (like Eurasia) and those with north-south axes (like the Americas and Africa). Diamond argues that these geographical differences contributed to the varying rates of development in human societies, influencing the distribution of wealth and power throughout history. + DISEASE **Factors Underlying the Broadest Pattern of History** **Ultimate Factors** | Factor | Description | |---|---| | East/West axis | | | Many suitable wild species | | | Ease of species spreading | | | Many domesticated plant and animal species | | | Food surpluses, food storage | | | Large, dense, sedentary, stratified societies | | | Technology | | **Proximate Factors** | Factor | Description | |---|---| | Horses | | | Guns, ocean-going ships, swords | | | Steel, writing | | | Political organization | | | Epidemic diseases | | > Helped feed dense societies in which epidemics could maintain them- selves, and partly because the diseases evolved from germs of the domes- tic animals themselves. Jared Diamond, Guns, Germs, Steel ## **Medical Ecology Model** | Category | Description | |---|---| | | Which inspires the future conservation and integration of...| | | Which affects the conservation and integration of... | | **Nonhuman Nature (e.g. green space)**| Provides... | | Which affects the distribution of... | | **Environmental Ethics** | Whose instrumental and intrinsic values are partially defined by... | | | Fosters integration of eco-health perspectives that maximizes... | | **Environmental Justice** | | | **Ecosystem Services** | Whose impacts are affected by the principle of... | | | Which can be socially expressed as... | | | Leads to equitable distribution of nature-mediated... | | **Public Health Benefits** | | | **Birds, Guns + Steel** | | | **Jared Diamond** | | | **Interactions of humans, pathogens and the environment.** | | # **Integrative Concepts of Health and Disease by Human Ecological Medicine** - George L Engel (1913-1999): bio-psycho social model (1977) that helps understand health and disease in the context of "psychosomatics". - In parallel, "environmental health" came up, emphasizing the health effects of the physico-chemical environment in order to establish a multi-faceted but integrated theoretical view on health and disease, a human-ecological framework is proposed. - Human ecology, with a view to philosophical anthropology, is concerned with the study of the human-environment relationship and can be characterized as "the ecology of the person". It focuses on the central term "relationship" and its variations, and also offers a theoretical orientation to the multiprofessional practice of clinical work. ## **Human-Environment Relationship and its Variants** - Person-environment relations as a structure of single or double give-take relations, or give-give, or take-take relations, and additional reciprocal rejection relations. - The overall relationship can result in pathogenic imbalances > (e.g. Incan downfall due to swine flu brought by the Spanish). # **Community-Oriented Primary Care (COPC) in SA** > *"Se dibeng's Logic"* | Category| Description | |---|---| | CHD | community health diagnosis | | | | | Access to services | | | | | | Determinants | | | | | | Population| | | | | | Consulting units | | | **Biology** | **Health Status** | | Epidemiology | | | **Morbidity** | **Services** | | **Mortality** | Environment | | **Task** | | | **Job description** | | | **HR** | | | **Equipment & drugs** | | | | **Budget & Planning** | > "There is give and take between both" > **COPC's Qualitative Difference (with the current system) includes the PROCESS OF CARE:** | Category | Description | |---|---| | **Access** | | | **Process of care** | CHD | | **Impact** | | # **Health Analysis by Components** ## **Environment** ### **Natural (Biotic and Abiotic)** ### **Socio-economic (way of life)** ## **Health Services** - Access and coverage - Infrastructure - Personnel - Referral system ## **Biology** - Demography - Life style - Merbidity - Mortality ## **Environment: Natural** - **Assessment method:** inspection - **Secondary source of Info:** not available - **Intersectoral:** not achieved - **Participation:** not achieved - Compacted and eroded soil - Poor forestry resources (low tree density) - Perceived high air pollution - Swamp with high infestation by mosquitoes. - Floods during rainy season. - Stray pigs feeding and roaming around. ## **Environment: Socio-economic** - **Assessment method:** inspection, interview and CHD questionnaire - **Secondary source of Info:** not available - **Intersectoral:** not achieved - **Participation:** mobilization. - Incomplete and poorly maintained roads. - RDP houses architectural design may present a hazard (ventilation, temperature). - Excessive high voltage electricity pylons crossing the area. - Insufficient illumination at night. - Poorly maintained drainage system (swamp and floods areas). - No garbage disposal system in place resulting in build-up of garbage heaps. - No organised intra-community transport system. - No recreational and sport facilities. No leisure areas available. - Chaotic proliferation of informal dwellings and house enlargement for commercial purposes. - ∏ο organised agricultural, manufacturing or industrial activities in the community. - High unemployment and high percentage of population under poverty line. - EPDR = 2.3 (10 supporting 23). - Frequent dysfunctional family structures. - Perceived high incident of crime (no stats). - Civic society fragmented and dysfunctional. - Extremely reticulated and efficient distribution of alcoholic beverages. ## **Biology: Demography** - **Assessment method:** CHD questionnalre - **• Secondary source of info:** poor design and of poor use - **Intersectoral:** not achieved -- **Participation:** not achieved - Population pyramid show: (developing country) - High fertility and mortality - Characteristic infectious diseases mortality pattern. - Low life expectancy - Possible high migrations rate. ## **Biology: Life Style** > *"Way of life" determinants leave little room for alternative improvement in life style* - Perceived very high alcohol consumption - Perceived high tobacco consumption - Perceived high dagga consumption - Limited choices for healthier feeding - Observed prevalent sedentary life amongst adults and specially females - Perceived youth engaging in risky practices (females tavern visits and rape) - Perceived high frequency of promiscuous and unprotected sex - Observed hesitation to attending HCT - Observed poor compliance to medical treatments - Perceived poor attention to communal issues - High frequency of un-planned pregnancies # **Primary Health Care as an Approach to Care Delivery** ## **Aims** - Define Primary Health Care (PHC) as an approach to the delivery of primary care. - Locate the centrality of the PHC approach in delivering care in South Africa. - Discuss PHC as part of the global health agenda, considering the importance of Universal Health Coverage. ## **Intro to PHC and the Alma Ata Declaration** - Primary health care is 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. It forms an integral part both of the country's health system, of which it is the central function and main focus, and of the overall social and economic development of the community. It is the first level of contact of individuals, the family and community with the national health system bringing health care as close as possible to where people live and work and constitutes the first element of a continuing health care process. (Section VI, Alma Ata Declaration of 1978) ## **The Alma Ata Declaration** - The landmark event for primary health care was the International Conference on Primary Health Care that took place at Alma-Ata from September 6 to 12, 1978. - Alma-Ara was the capital of the Soviet Republic of Kazakhstan, located in the Asiatic region of the then Soviet Union. - The conference was attended by 3000 delegates from 134 governments and 67 international organizations from all over the world - The conference's main document, the Declaration of Alma-Ata, which was already known by many participants, was approved by acclamation. - The slogan "Health for All by the Year 2000” was coined. - Three key ideas permeate the declaration: - "appropriate technology"; - Lopposition to medical elitism; - And the concept of health as a tool for socioeconomic development. - The primary health care approach became the fundamental means for improving health. ## **What is PHC?** - PHC is both a philosophy of health care and a model for providing services that support health. - Effective PHC is community-based and promotes healthy lifestyles as a pathway to disease and injury prevention. - PHC Provides continuing care and recognizes the importance of the broad determinants of health. - It is an approach to the delivery of health care to ensure people enjoy the highest attainable level of health. - It recognises that health is a human right and takes seriously the principles of equity and social justice. ## **How Should PHC Be Delivered?** - PHC should include: - First Contact Care - Essential services - Disease prevention and health promotion - Accessible care - Affordable care - Acceptable care - Comprehensive care - Continuous care - Co-ordinated care - A community-centered approach to care - Relevant stakeholders > Therefore, pre needs to provide: > - Health promotion services > - Preventive services > - Curative services > - Rehabilitative services | Category | Description | |---|---| | The Supply Side | Health System | | | | | | Approachability | | | Acceptability | | | Availability | | | Affordability | | | Appropriateness | | **Access to Health** | | | The Demand Side | Population Characteristics | | | Ability to perceive | | | Ability to seek | | | Ability to reach | | | Ability to pay | | | Ability to engage | ## **How Can PHC Be Achieved?** - The ultimate goal of primary health care is better health for all. - The WHO has identified five key elements to achieving that goal: - Reducing exclusion and social disparities in health (universal coverage reforms) - health services around people's needs and expectations (service reforms) - Integrating health into all sectors (public policy reforms) - Pursuing collaborative models of policy dialogue (leadership reforms) - Increasing stakeholder participation. ## **Sustainable Development Goals** | Goal | Description | |---|---| | No Poverty | | | Zero Hunger | | | Good health and well-being | | | Quality Education | | | Gender Equality | | | Clean Water and sanitation | | | Affordable and Clean Energy | | | Decent Work and Economic Growth | | | Industry, Innovation and Infrastructure | | | Reduced Inequality | | | Sustainable Cities and Communities | | | Responsible Consumption and Production | | | Climate Action | | | Life below water | | | Life on Land | | | Peace, Justice and Strong Institutions | | | Partnerships for the Goals | | >"Goal 3 speaks directly to health" >"All of these goals can be used to achieve PHC" > "All speak to the determinants of health" # **COPC Tools** > "Community-Oriented Primary Care (COPC) integrates principles of public health and primary care to improve health outcomes at the community level. A core aspect of COPC involves the use of specific tools to systematically assess, analyze, and address health issues." ## **Introduction: Situational Analysis** > "Understand the problem" - Situational analysis is a comprehensive process that assesses the current health status of a community, identifies existing resources and gaps, and determines the factors influencing health outcomes. This tool involves collecting quantitative and qualitative data to create a detailed picture of the community's health landscape. > "Key components of situational analysis include:" - Demographic Assessment: Examining the population structure, including age, gender, ethnicity, and socioeconomic status. - Health Status Evaluation: Reviewing morbidity and mortality data to identify prevalent health issues and trends. - Resource Inventory: Cataloging available healthcare facilities, workforce, and other resources within the community. - Environmental Scan: Identifying social, economic, and environmental factors impacting health. > "The situational analysis provides a foundation for evidence-based decision-making, helping healthcare providers to prioritize interventions and allocate resources effectively" ## **LISA Tool** > "Understand the stakeholders" - The LISA tool is a strategic framework designed to analyze and understand the interactions between the locality, institutions, stakeholders, and activities within a community. It emphasizes a holistic approach to community health by considering the interconnectedness of various elements. | Category | Description | |---|---| | Locality | Examines the geographical, cultural, and socioeconomic characteristics of the community. | | Institution | Focuses on the roles and capacities of healthcare institutions and other organizations within the community. | | Stakeholders | Identifies key stakeholders, including community members, healthcare providers, policymakers, and other relevant parties. | | Activity | Analyzes the ongoing health activities, programs, and interventions in the community. | > "The LISA tool helps to identify gaps and opportunities for collaboration, ensuring that health interventions are contextually appropriate and culturally sensitive. By understanding the dynamics within a community, healthcare providers can design and implement more effective and sustainable health programs." ## **SWOT Tool** > "Understand internal and external factors" - The SWOT tool is a strategic planning method used to evaluate the Strengths, Weaknesses, Opportunities, and Threats related to a specific project, organization, or community health initiative. It provides a structured framework for identifying internal and external factors that can impact the success of health interventions. | Category | Description | |---|---| | **Strengths** | Internal attributes that contribute to the success of the health initiative, such as skilled healthcare providers, robust infrastructure, or strong community engagement. | | **Weaknesses** | Internal limitations or challenges that hinder progress, such as limited funding, inadequate facilities, or lack of trained personnel. | | **Opportunities** | External factors that could be leveraged to enhance the health initiative, including funding opportunities, technological advancements, or partnerships with other organizations. | | **Threats** | External factors that pose risks or challenges, such as policy changes, economic downturns, or emerging health threats. | > "By conducting a SWOT analysis, healthcare providers can develop strategic plans that capitalize on strengths and opportunities while addressing weaknesses and mitigating threats. This tool is essential for adaptive and resilient community health planning. " # **People in the PFC Space** > "The purpose of this session is to deepen students' understanding of the healthcare system, enhance their communication skills, and encourage reflection on their professional development. You will be introduced to the People in the PFC space." ## **Aims** - Review the importance of patient-centeredness in HCP interactions. Students will be able to describe the healthcare experience from a patient's perspective, identifying key challenges and positive interactions within the healthcare system. - Appraise Communication Skills from both an HCP and a patient perspective. Students will appraise the need for improved communication skills in the engagement between patients and healthcare providers: showing empathy, active listening, and understanding of diverse communication styles. - Analyze Healthcare Delivery: Students will analyze the roles and interactions between different healthcare professionals in patient care, highlighting the importance of interprofessional collaboration for effective healthcare delivery. - Reflect on Personal and Professional Development: Students will reflect on their own attitudes and assumptions about patient care and professional roles, identifying areas for personal growth and development in their future practice as healthcare providers. # **Stakeholders in PFC** ## **Government Bodies** - **National department of Health (NDOH):** - Formulates national health policies, strategies, and guidelines. - Oversees the overall implementation and monitoring of health services. - Provides funding and resources to provincial health departments. - **Provincial Health Departments:** - Implement national health policies at the provincial level. - Manage healthcare facilities and services within their respective provinces. - Allocate and manage provincial health budgets. - **Local Municipalities:** - Ensure the provision of primary healthcare services at the local level. - Operate local clinics and health centers. -