Primary Health Care PDF

PRIMARY HEALTH CARE DONE BY: DR. MAIS ALKHALILI COMMUNITY MEDICINE SPECIALIST pray for them ‫ادﻋﻮﻟﮭﻢ‬  The Alma-Ata declaration in Kazakhstan in 1978 emerged as a major milestone of the twentieth century in th...

PRIMARY HEALTH CARE DONE BY: DR. MAIS ALKHALILI COMMUNITY MEDICINE SPECIALIST pray for them ‫ادﻋﻮﻟﮭﻢ‬  The Alma-Ata declaration in Kazakhstan in 1978 emerged as a major milestone of the twentieth century in the field of public health, and it identified primary health care as the key to the attainment of the goal of HEALTH FOR ALL. ‫ ﻧﺸﺄ ﻛﻤﻌﻠﻤﺔ رﺋﯿﺴﯿﺔ ﻓﻲ‬1978 ‫أﺗﺎ ﻓﻲ ﻛﺎزاﺧﺴﺘﺎن ﻓﻲ ﻋﺎم‬-‫إﻋﻼن أﻟﻤﺎ‬ ‫ وﻗﺪ ﺣﺪد اﻟﺮﻋﺎﯾﺔ اﻟﺼﺤﯿﺔ‬،‫اﻟﻘﺮن اﻟﻌﺸﺮﯾﻦ ﻓﻲ ﻣﺠﺎل اﻟﺼﺤﺔ اﻟﻌﺎﻣﺔ‬."‫اﻷوﻟﯿﺔ ﻛﻤﻔﺘﺎح ﻟﺘﺤﻘﯿﻖ ھﺪف "اﻟﺼﺤﺔ ﻟﻠﺠﻤﯿﻊ‬  WHAT IS MEANT BY PRIMARY HEALTH CARE (PHC)? ‫(؟‬PHC) ‫ﺼﺪ ﺑﺎﻟﺮﻋﺎﯾﺔ اﻟﺼﺤﯿﺔ اﻷوﻟﯿﺔ‬ َ ‫ﻣﺎ ﯾُﻘ‬ The Declaration of Alma-Ata proposed that primary health care should: ‫أﺗﺎ أﻧﮫ‬-‫ اﻗﺘﺮح إﻋﻼن أﻟﻤﺎ‬ 1. Reflect the economic conditions and sociocultural and political characteristics of the country and its communities..‫ﯾﺠﺐ أن ﺗﻌﻜﺲ اﻟﺮﻋﺎﯾﺔ اﻟﺼﺤﯿﺔ اﻷوﻟﯿﺔ اﻟﻈﺮوف اﻻﻗﺘﺼﺎدﯾﺔ واﻻﺟﺘﻤﺎﻋﯿﺔ واﻟﺜﻘﺎﻓﯿﺔ واﻟﺴﯿﺎﺳﯿﺔ ﻓﻲ اﻟﺒﻠﺪ وﻣﺠﺘﻤﻌﺎﺗﮫ‬ 2. Address the main health problems in the community, providing promotive, preventive, curative, and rehabilitative services accordingly. ‫ وﺗﻘﺪم ﺧﺪﻣﺎت اﻟﺘﻌﺰﯾﺰ اﻟﺼﺤﻲ‬،‫ ﺗﺘﻨﺎول اﻟﺮﻋﺎﯾﺔ اﻟﺼﺤﯿﺔ اﻷوﻟﯿﺔ اﻟﻤﺸﺎﻛﻞ اﻟﺼﺤﯿﺔ اﻟﺮﺋﯿﺴﯿﺔ ﻓﻲ اﻟﻤﺠﺘﻤﻊ‬.‫واﻟﻮﻗﺎﺋﻲ واﻟﻌﻼﺟﻲ واﻟﺘﺄھﯿﻞ وﻓﻘًﺎ ﻟﺬﻟﻚ‬ WHAT IS MEANT BY PRIMARY HEALTH CARE (PHC)? ،‫ﺮﺑﯿﺟﺔﻤاﯿﻟﻊﺤﯿاﻟﻮﻘاﻧﻄﺎﺎﻋتﺎواتﻟﻐوﺬاﺟءﻮاﻧواﻟﺐ اﺼﻟﻨﺘﺎﻨﻤﻋﯿﺔﺔ اوﻟاﻟﻮﺘﻌطﻠﻨﯿﯿﻢﺔ ووااﻟﻹﻤﺳﺠﻜﺘﺎﻤنﻌﯿوﺔا اﻟﻷﻤﻋﺮﻤﺗﺎﺒلﻄاﺔﻟﻌﺑﺎﮭﻣﺎﺔ‬،‫وﺑﺎﺟﮫﻹ اﻟﺿﺨﺎﻓﺔﺼ إﻮﻟﻰصﻗ اﻄﻟﺎﺰعرااﻟﻋﺔﺼ وﺤﺗﺔ‬،‫وﯾﻋﺸﻠﻤﻰﻞ‬.3.‫واﻻﺗﺼﺎﻻت واﻟﻘﻄﺎﻋﺎت اﻷﺧﺮى؛ وﯾﻄﺎﻟﺐ ﺑﺎﻟﺠﮭﻮد اﻟﻤﻨﺴﻘﺔ ﺑﯿﻦ ﺟﻤﯿﻊ ھﺬه اﻟﻘﻄﺎﻋﺎت‬ 3. Involve, in addition to the health sector, all related sectors and aspects of national and community development, in particular agriculture, animal husbandry, food, industry, education, housing, public works, communications and other sectors; and demands the coordinated efforts of all these sectors. 4. Promote maximum community participation in the planning, organization, operation and control of primary health care, making fullest use of local, national and other available resources; and to this end develop through appropriate education the ability of communities to participate. ‫ ﯾﺸﺠﻊ ﻋﻠﻰ أﻗﺼﻰ ﻗﺪر ﻣﻤﻜﻦ ﻣﻦ اﻟﻤﺸﺎرﻛﺔ اﻟﻤﺠﺘﻤﻌﯿﺔ ﻓﻲ ﺗﺨﻄﯿﻂ وﺗﻨﻈﯿﻢ وﺗﺸﻐﯿﻞ وﻣﺮاﻗﺒﺔ اﻟﺮﻋﺎﯾﺔ اﻟﺼﺤﯿﺔ‬.4 ،‫ واﺳﺘﻐﻼل أﻗﺼﻰ ﻗﺪر ﻣﻤﻜﻦ ﻣﻦ اﻟﻤﻮارد اﻟﻤﺤﻠﯿﺔ واﻟﻮطﻨﯿﺔ واﻟﻤﻮارد اﻷﺧﺮى اﻟﻤﺘﺎﺣﺔ؛ وﻟﮭﺬا اﻟﻐﺮض‬،‫اﻷوﻟﯿﺔ‬.‫ﯾﺘﻌﯿﻦ ﺗﻄﻮﯾﺮ ﻗﺪرات اﻟﻤﺠﺘﻤﻌﺎت ﻟﻠﻤﺸﺎرﻛﺔ ﻣﻦ ﺧﻼل اﻟﺘﻌﻠﯿﻢ اﻟﻤﻨﺎﺳﺐ‬ WHAT IS MEANT BY PRIMARY HEALTH CARE (PHC)? ‫ ﺗﻔﻀﻲ إﻟﻰ اﻟﺘﺤﺴﯿﻦ اﻟﺘﺪرﯾﺠﻲ‬،‫ أن ﺗﻜﻮن ﻣﺪﻋﻮﻣﺔ ﺑﻨﻈﻢ إﺣﺎﻟﺔ ﻣﺘﻜﺎﻣﻠﺔ وﻋﻤﻠﯿﺔ وﻣﺘﺪاﻋﻤﺔ‬.5.‫ وإﻋﻄﺎء اﻷوﻟﻮﯾﺔ ﻟﻤﻦ ھﻢ ﻓﻲ أﻣﺲ اﻟﺤﺎﺟﺔ إﻟﯿﮭﺎ‬،‫ﻟﻠﺮﻋﺎﯾﺔ اﻟﺼﺤﯿﺔ اﻟﺸﺎﻣﻠﺔ ﻟﻠﺠﻤﯿﻊ‬ 5. Be sustained by integrated, functional and mutually-supportive referral systems, leading to the progressive improvement of comprehensive health care for all, and giving priority to those most in need. 6. Rely on health workers, including physicians, nurses, midwives, auxiliaries and community workers as applicable, as well as traditional practitioners as needed, suitably trained socially and technically to work as a health team and to respond to the expressed health needs of the community. ‫ ﺑﻤﻦ ﻓﯿﮭﻢ اﻷطﺒﺎء واﻟﻤﻤﺮﺿﺎت واﻟﻘﺎﺑﻼت واﻟﻤﻌﺎوﻧﻮن واﻟﻌﺎﻣﻠﻮن‬،‫ اﻻﻋﺘﻤﺎد ﻋﻠﻰ اﻟﻌﺎﻣﻠﯿﻦ اﻟﺼﺤﯿﯿﻦ‬.6 ً‫ اﻟﻤﺪرﺑﻮن اﺟﺘﻤﺎﻋﯿﺎ ً وﺗﻘﻨﯿﺎ ً ﺗﺪرﯾﺒﺎ‬،‫ وﻛﺬﻟﻚ اﻟﻤﻤﺎرﺳﻮن اﻟﺘﻘﻠﯿﺪﯾﻮن ﺣﺴﺐ اﻟﺤﺎﺟﺔ‬،‫اﻟﻤﺠﺘﻤﻌﯿﻮن ﺣﺴﺐ اﻻﻗﺘﻀﺎء‬.‫ﻣﻨﺎﺳﺒﺎ ً ﻟﻠﻌﻤﻞ ﻛﻔﺮﯾﻖ ﺻﺤﻲ واﻻﺳﺘﺠﺎﺑﺔ ﻟﻼﺣﺘﯿﺎﺟﺎت اﻟﺼﺤﯿﺔ اﻟﻤﻌﺮب ﻋﻨﮭﺎ ﻟﻠﻤﺠﺘﻤﻊ اﻟﻤﺤﻠﻲ‬  (‫ )ﻋﻨﺎﺻﺮ‬:‫اﻷﻧﺸﻄﺔ اﻷﺳﺎﺳﯿﺔ ﻟﻠﺠﻨﺔ‬ THE CORE ACTIVITIES OF PHC : (Elements) 1. Education concerning prevailing health problems and the methods of preventing and controlling them..‫ اﻟﺘﺜﻘﯿﻒ ﺑﺸﺄن اﻟﻤﺸﺎﻛﻞ اﻟﺼﺤﯿﺔ اﻟﺴﺎﺋﺪة وأﺳﺎﻟﯿﺐ اﻟﻮﻗﺎﯾﺔ ﻣﻨﮭﺎ وﻣﻜﺎﻓﺤﺘﮭﺎ ھﻢ‬.1 2. Promotion of food supply and proper nutrition. ‫ ﺗﻌﺰﯾﺰ اﻹﻣﺪادات اﻟﻐﺬاﺋﯿﺔ واﻟﺘﻐﺬﯾﺔ اﻟﺴﻠﯿﻤﺔ‬.2 3. An adequate supply of safe water and basic sanitation...‫ ﺗﻮﻓﯿﺮ إﻣﺪادات ﻛﺎﻓﯿﺔ ﻣﻦ اﻟﻤﯿﺎه اﻟﻤﺄﻣﻮﻧﺔ واﻟﻤﺮاﻓﻖ اﻟﺼﺤﯿﺔ اﻷﺳﺎﺳﯿﺔ‬.3 4. Maternal and child health care, including family planning..‫ ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﺗﻨﻈﯿﻢ اﻷﺳﺮة‬،‫ رﻋﺎﯾﺔ ﺻﺤﺔ اﻷم واﻟﻄﻔﻞ‬.4 5. Immunization against the major infectious diseases. ‫ اﻟﺘﺤﺼﯿﻦ ﺿﺪ اﻷﻣﺮاض اﻟﻤﻌﺪﯾﺔ اﻟﺮﺋﯿﺴﯿﺔ‬.5 6. Prevention and control of locally endemic diseases. ‫ اﻟﻮﻗﺎﯾﺔ ﻣﻦ اﻷﻣﺮاض اﻟﻤﺘﻮطﻨﺔ ﻣﺤﻠﯿﺎ وﻣﻜﺎﻓﺤﺘﮫ‬.6. 7. Appropriate treatment of common diseases and injuries. ‫ اﻟﻌﻼج اﻟﻤﻨﺎﺳﺐ ﻟﻸﻣﺮاض واﻹﺻﺎﺑﺎت اﻟﺸﺎﺋﻌﺔ‬.7 8. Provision of essential drugs..‫ﺗﻮﻓﯿﺮ اﻷدوﯾﺔ اﻷﺳﺎﺳﯿﺔ‬ STRATEGIC IMPERATIVES OF PHC IN THE CONTEXT OF THE WHO’S CORPORATE STRATEGY : (GOALS) (‫ )اﻷھﺪاف‬:‫ اﻟﻀﺮورات اﻻﺳﺘﺮاﺗﯿﺠﯿﺔ ﻟﻤﺆﺳﺴﺔ اﻟﺼﺤﺔ اﻟﻨﺒﺎﺗﯿﺔ ﻓﻲ ﺳﯿﺎق اﺳﺘﺮاﺗﯿﺠﯿﺔ اﻟﻤﻨﻈﻤﺔ‬- 1. Reducing excess mortality of poor marginalized populations.‫ اﻟﺤﺪ ﻣﻦ اﻟﻮﻓﯿﺎت اﻟﺰاﺋﺪة ﻟﻠﺴﻜﺎن اﻟﻤﮭﻤﺸﯿﻦ اﻟﻔﻘﺮاء‬2.1 2. Reducing the leading risk factors to human health ‫اﻟﺤﺪ ﻣﻦ ﻋﻮاﻣﻞ اﻟﺨﻄﺮ اﻟﺮﺋﯿﺴﯿﺔ ﻋﻠﻰ ﺻﺤﺔ اﻹﻧﺴﺎن‬ 3. Developing Sustainable Health Systems ‫ ﺗﻄﻮﯾﺮ ﻧﻈﻢ ﺻﺤﯿﺔ ﻣﺴﺘﺪاﻣﺔ‬.3 4. Developing an enabling policy and institutional environment ‫ وﺿﻊ ﺳﯿﺎﺳﺎت وﺑﯿﺌﺔ ﻣﺆﺳﺴﯿﺔ ﺗﻤﻜﯿﻨﯿﺔ‬.4 PRIMARY HEALTH CARE IN A CHANGING WORLD ‫اﻟﺮﻋﺎﯾﺔ اﻟﺼﺤﯿﺔ اﻷوﻟﯿﺔ ﻓﻲ ﻋﺎﻟﻢ ﻣﺘﻐﯿﺮ‬ Changing-1 ‫ﻗﻀﺎﯾﺎ اﻟﺼﺤﺔ‬ 1-Changing health issues :‫اﻟﻌﺐء اﻟﻌﺎﻟﻤﻲ ﻟﻸﻣﺮاض ھﻮ اﻟﺘﺪﻓﻖ‬ ‫ اﻷﻋﺪاء اﻟﻘﺪاﻣﻰ ﻣﺜﻞ اﻟﺴﻞ‬- ‫ﻟﻢ ﯾﺘﻢ ﻛﺴﺐ اﻟﺤﺮب ﺿﺪ اﻷﻣﺮاض اﻟﻤﻌﺪﯾﺔ‬ ‫ واﻷﻣﺮاض اﻟﺠﺪﯾﺪة ﻣﺜﻞ اﻟﻤﺘﻼزﻣﺔ‬،‫واﻟﻤﻼرﯾﺎ ﯾﻜﺘﺴﺒﻮن ﺑﻌﺾ اﻷرض‬ ‫ وﻓﯿﺮوس ﻧﻘﺺ‬،‫اﻟﺘﻨﻔﺴﯿﺔ اﻟﺤﺎدة اﻟﻮﺧﯿﻤﺔ )ﺳﺎرس( ﺗﺠﻠﺐ ﺗﺤﺪﯾﺎت ﺟﺪﯾﺪة‬ The global burden of disease is influx: ‫اﻹﯾﺪز ﻟﮫ ﺗﺄﺛﯿﺮ ﻣﺪﻣﺮ ﻓﻲ اﻟﻌﺪﯾﺪ ﻣﻦ اﻟﺒﻠﺪان )ﺧﺎﺻﺔ ﻓﻲ‬/‫اﻟﻤﻨﺎﻋﺔ اﻟﺒﺸﺮﯾﺔ‬.(‫أﻓﺮﯾﻘﯿﺎ ﺟﻨﻮب اﻟﺼﺤﺮاء‬ The war against communicable diseases has not been won – old enemies such as TB and malaria are gaining some ground, new diseases such as Severe Acute Respiratory Syndrome (SARS) bring new challenges, and HIV/AIDS is having a devastating effect in many countries (especially in Sub-Saharan Africa). Risk factors that lead to both communicable and non-communicable diseases are on the rise, particularly in the poorest countries and communities ‫ﺗﺘﺰاﯾﺪ ﻋﻮاﻣﻞ اﻟﺨﻄﺮ اﻟﻤﺆدﯾﺔ إﻟﻰ اﻷﻣﺮاض اﻟﻤﻌﺪﯾﺔ وﻏﯿﺮ اﻟﻤﻌﺪﯾﺔ‬ ‫ وﻻ ﺳﯿﻤﺎ ﻓﻲ أﻓﻘﺮ اﻟﺒﻠﺪان واﻟﻤﺠﺘﻤﻌﺎت اﻟﻤﺤﻠﯿﺔ‬،‫ﻋﻠﻰ اﻟﺴﻮاء‬  ،‫ وﻋﺪم ﻣﻤﺎرﺳﺔ اﻟﺘﻤﺎرﯾﻦ اﻟﺮﯾﺎﺿﯿﺔ ﺑﺎﻧﺘﻈﺎم‬،‫ ﯾﺆدي اﻻﺳﺘﮭﻼك اﻟﻤﻔﺮط ﻟﻸﻏﺬﯾﺔ اﻟﺪھﻨﯿﺔ واﻟﺴﻜﺮﯾﺔ واﻟﻤﺎﻟﺤﺔ‬ ‫ ﺳﻮاء ﻓﻲ‬،‫واﺳﺘﮭﻼك اﻟﺘﺒﻎ واﻟﻜﺤﻮل إﻟﻰ وﺻﻮل اﻷﻣﺮاض ﻏﯿﺮ اﻟﻤﻌﺪﯾﺔ إﻟﻰ أﺑﻌﺎد وﺑﺎﺋﯿﺔ ﻓﻲ ﺟﻤﯿﻊ أﻧﺤﺎء اﻟﻌﺎﻟﻢ‬.‫اﻟﻤﺠﺘﻤﻌﺎت اﻟﻐﻨﯿﺔ أو اﻟﻨﺎﻣﯿﺔ‬ Excessive consumption of fatty, sugary and salty foods, the failure to take regular exercise, and tobacco and alcohol consumption are resulting in non-communicable diseases reaching epidemic proportions around the world, in both wealthy and developing societies. Many of the most prevalent health problems, whether communicable or non- communicable, whether in physical or mental health, are chronic in nature, They leave the individual (and the family) needing long-term support and care from their communities and the health system. ‫ ﺳﻮاء ﻛﺎﻧﺖ ﻣﻌﺪﯾﺔ أو ﻏﯿﺮ‬،‫واﻟﻌﺪﯾﺪ ﻣﻦ اﻟﻤﺸﺎﻛﻞ اﻟﺼﺤﯿﺔ اﻷﻛﺜﺮ اﻧﺘﺸﺎرا‬.‫ ھﻲ ﻣﺸﺎﻛﻞ ﻣﺰﻣﻨﺔ ﺑﻄﺒﯿﻌﺘﮭﺎ‬،‫ ﺳﻮاء ﻓﻲ اﻟﺼﺤﺔ اﻟﺒﺪﻧﯿﺔ أو اﻟﻌﻘﻠﯿﺔ‬،‫ﻣﻌﺪﯾﺔ‬  ‫ وﺣﻮادث اﻟﻤﺮور ﻋﻠﻰ اﻟﻄﺮق واﻟﻨﺰاع‬،‫ واﻟﻌﻨﻒ ﻓﻲ اﻟﺸﻮارع واﻟﻌﻨﻒ اﻟﻤﻨﺰﻟﻲ‬،‫ﺗﺰﯾﺪ اﻹﺻﺎﺑﺎت ﻓﻲ اﻟﻤﻨﺰل وﻓﻲ ﻣﻜﺎن اﻟﻌﻤﻞ‬ ‫ وﻣﻦ اﻟﻤﺘﻮﻗﻊ أن ﺗﻔﻌﻞ ذﻟﻚ ﺑﺸﻜﻞ ﻣﺘﺰاﯾﺪ ﻓﻲ اﻟﻤﺴﺘﻘﺒﻞ‬،‫اﻟﻤﺴﻠﺢ ﺑﺸﻜﻞ ﻛﺒﯿﺮ ﻣﻦ اﻟﻌﺐء اﻟﻌﺎﻟﻤﻲ ﻟﻸﻣﺮاض‬ Injuries at home and in the workplace, street and domestic violence, road traffic accidents and armed conflict are adding significantly to the global burden of disease, and are expected to do so increasingly in the future As progress is made with providing child and maternal care, and infant mortality rates improve, more children with serious disabilities are surviving and needing lifelong care. ‫ ﯾﻈﻞ ﻋﺪد أﻛﺒﺮ‬،‫ وﺗﺤﺴﻦ ﻣﻌﺪﻻت وﻓﯿﺎت اﻟﺮﺿﻊ‬،‫ﻣﻊ إﺣﺮاز ﺗﻘﺪم ﻓﻲ ﺗﻮﻓﯿﺮ اﻟﺮﻋﺎﯾﺔ ﻟﻸطﻔﺎل واﻷﻣﮭﺎت‬.‫ﻣﻦ اﻷطﻔﺎل ذوي اﻹﻋﺎﻗﺔ اﻟﺨﻄﯿﺮة ﻋﻠﻰ ﻗﯿﺪ اﻟﺤﯿﺎة وﯾﺤﺘﺎﺟﻮن إﻟﻰ رﻋﺎﯾﺔ ﻣﺪى اﻟﺤﯿﺎة‬  Global programs, such as the Polio Eradication Initiative (PEI), will continue to make progress and impact on the pattern of morbidity and mortality. Models to deliver health services and policies will need to be adaptable and flexible to meet the rapidly changing population needs. ‫ ﻓﻲ ﺗﺤﻘﯿﻖ‬،(PEI) ‫ ﻣﺜﻞ ﻣﺒﺎدرة اﻟﻘﻀﺎء ﻋﻠﻰ ﺷﻠﻞ اﻷطﻔﺎل‬،‫ﺳﻮف ﺗﺴﺘﻤﺮ اﻟﺒﺮاﻣﺞ اﻟﻌﺎﻟﻤﯿﺔ‬.‫اﻟﺘﻘﺪم واﻟﺘﺄﺛﯿﺮ ﻋﻠﻰ ﻧﻤﻂ اﻹﺻﺎﺑﺔ ﺑﺎﻷﻣﺮاض واﻟﻮﻓﯿﺎت‬ ‫ ﯾﺠﺐ أن ﺗﻜﻮن ﻧﻤﺎذج ﺗﻘﺪﯾﻢ اﻟﺨﺪﻣﺎت واﻟﺴﯿﺎﺳﺎت اﻟﺼﺤﯿﺔ ﻗﺎﺑﻠﺔ ﻟﻠﺘﻜﯿﻒ وﻣﺮﻧﺔ ﻟﺘﻠﺒﯿﺔ‬.‫اﻻﺣﺘﯿﺎﺟﺎت اﻟﺴﻜﺎﻧﯿﺔ اﻟﻤﺘﻐﯿﺮة ﺑﺴﺮﻋﺔ‬ 2-CHANGING DEMOGRAPHY ‫ﺗﻐﯿﺮ اﻟﺪﯾﻤﻮﻏﺮاﻓﯿﺎ‬-2 as with the pattern of health issues, the population profiles of countries are changing and will continue to change: ‫ ﻓﺈن اﻟﻤﻼﻣﺢ اﻟﺴﻜﺎﻧﯿﺔ ﻟﻠﺒﻠﺪان ﺗﺘﻐﯿﺮ‬،‫ﻛﻤﺎ ھﻮ اﻟﺤﺎل ﻣﻊ ﻧﻤﻂ اﻟﻘﻀﺎﯾﺎ اﻟﺼﺤﯿﺔ‬ :‫وﺳﻮف ﺗﺴﺘﻤﺮ ﻓﻲ اﻟﺘﻐﯿﯿﺮ‬ - - Overall improvements in diet, sanitation, disease prevention and health care are resulting in increased life expectancy and a general aging of the population with the gap in life expectancy between industrialized and developing countries continuing to close. ‫ﺗﺆدي اﻟﺘﺤﺴﯿﻨﺎت اﻟﻌﺎﻣﺔ ﻓﻲ اﻟﻨﻈﺎم اﻟﻐﺬاﺋﻲ واﻟﺼﺮف اﻟﺼﺤﻲ واﻟﻮﻗﺎﯾﺔ ﻣﻦ اﻷﻣﺮاض واﻟﺮﻋﺎﯾﺔ اﻟﺼﺤﯿﺔ إﻟﻰ‬ ‫زﯾﺎدة ﻣﺘﻮﺳﻂ اﻟﻌﻤﺮ اﻟﻤﺘﻮﻗﻊ وﺷﯿﺨﻮﺧﺔ ﻋﺎﻣﺔ ﻟﻠﺴﻜﺎن ﻣﻊ اﺳﺘﻤﺮار ﺗﻀﯿﯿﻖ اﻟﻔﺠﻮة ﻓﻲ ﻣﺘﻮﺳﻂ اﻟﻌﻤﺮ اﻟﻤﺘﻮﻗﻊ ﺑﯿﻦ‬.‫اﻟﺒﻠﺪان اﻟﺼﻨﺎﻋﯿﺔ واﻟﻨﺎﻣﯿﺔ‬ 3-SOCIAL AND ECONOMIC CHANGE ‫اﻟﺘﻐﯿﺮ اﻻﺟﺘﻤﺎﻋﻲ واﻻﻗﺘﺼﺎدي‬-3 The ways in which the world is changing, in social and economic terms, has major implications for population health, and for health systems..‫ وﻋﻠﻰ اﻟﻨﻈﻢ اﻟﺼﺤﯿﺔ‬،‫ ﻟﮭﺎ آﺛﺎر ﻛﺒﯿﺮة ﻋﻠﻰ ﺻﺤﺔ اﻟﺴﻜﺎن‬،‫ ﻣﻦ اﻟﻨﺎﺣﯿﺘﯿﻦ اﻻﺟﺘﻤﺎﻋﯿﺔ واﻻﻗﺘﺼﺎدﯾﺔ‬،‫ إن اﻟﻄﺮق اﻟﺘﻲ ﯾﺘﻐﯿﺮ ﺑﮭﺎ اﻟﻌﺎﻟﻢ‬ One consequence is that some countries find themselves addressing the health needs of populations whose social conditions range from the most primitive and economically deprived, to the most advanced and affluent. ‫ وﻣﻦ ﺑﯿﻦ اﻟﻌﻮاﻗﺐ اﻟﻤﺘﺮﺗﺒﺔ ﻋﻠﻰ ذﻟﻚ أن ﺑﻌﺾ اﻟﺒﻠﺪان ﺗﺠﺪ ﻧﻔﺴﮭﺎ ﻗﺎدرة ﻋﻠﻰ ﺗﻠﺒﯿﺔ اﻻﺣﺘﯿﺎﺟﺎت اﻟﺼﺤﯿﺔ‬ ً‫ وﺑﯿﻦ اﻷﻛﺜﺮ ﺗﻘﺪﻣﺎ‬،ً ‫ﻟﻠﺴﻜﺎن اﻟﺬﯾﻦ ﺗﺘﺮاوح ظﺮوﻓﮭﻢ اﻻﺟﺘﻤﺎﻋﯿﺔ ﺑﯿﻦ اﻷﻛﺜﺮ ﺑﺪاﺋﯿﺔ وﺣﺮﻣﺎﻧﺎ ً اﻗﺘﺼﺎدﯾﺎ‬.‫وﺛﺮاًء‬  ‫ وﺗﻌﺎطﻲ‬،‫ وﯾﺒﺪو أن ﻣﻦ اﻷﻓﻀﻞ ﺗﻌﻠﻢ ﻋﺎدات ﺗﻌﺎطﻲ اﻟﺘﺒﻎ‬.‫ﻀﺎ ﺗﺄﺛﯿﺮ ﺳﻠﺒﻲ إﻟﻰ ﺣﺪ ﻛﺒﯿﺮ ﻋﻠﻰ ﻧﻤﻂ اﻟﺤﯿﺎة‬ ً ‫ھﺬه اﻟﺘﻐﯿﯿﺮات ﻟﮭﺎ أﯾ‬ ‫ف ﻓﻲ اﻟﻤﺠﺘﻤﻌﺎت اﻟﺤﻀﺮﯾﺔ‬ٍ ‫ وﻋﺪم ﻣﻤﺎرﺳﺔ اﻟﺘﻤﺎرﯾﻦ اﻟﺮﯾﺎﺿﯿﺔ ﺑﺸﻜﻞ ﻛﺎ‬،‫ وﺳﻮء اﻟﺘﻐﺬﯾﺔ‬،‫ وﺗﻌﺎطﻲ اﻟﻤﺨﺪرات‬،‫اﻟﻜﺤﻮل‬.‫ وھﻲ ﺗﺰرع ﻛﻞ ﺑﺬور وﺑﺎء اﻷﻣﺮاض ﻏﯿﺮ اﻟﻤﻌﺪﯾﺔ‬،‫اﻟﻤﺤﺮوﻣﺔ‬ These changes also have a largely negative effect on lifestyle. The habits of tobacco use, alcohol abuse, drug abuse, poor diet and insufficient exercise seem best learnt in deprived urban communities, and sow all the seeds of the non-communicable disease epidemic. The speed of industrialization and urbanization can leave health systems, and especially primary health care, struggling to adapt infrastructures and capacity to meet new needs. ‫ وﺧﺎﺻﺔ اﻟﺮﻋﺎﯾﺔ اﻟﺼﺤﯿﺔ‬،‫ ﯾﻤﻜﻦ ﻟﺴﺮﻋﺔ اﻟﺘﺼﻨﯿﻊ واﻟﺘﻮﺳﻊ اﻟﺤﻀﺮي أن ﺗﺠﻌﻞ اﻟﻨﻈﻢ اﻟﺼﺤﯿﺔ‬.‫ ﺗﻜﺎﻓﺢ ﻣﻦ أﺟﻞ ﺗﻜﯿﯿﻒ اﻟﺒﻨﯿﺔ اﻟﺘﺤﺘﯿﺔ واﻟﻘﺪرة ﻋﻠﻰ ﺗﻠﺒﯿﺔ اﻻﺣﺘﯿﺎﺟﺎت اﻟﺠﺪﯾﺪة‬،‫اﻷوﻟﯿﺔ‬ Globalization of the world economy, and the development of open markets, have an equally dramatic impact on health and health systems: :‫ ﻟﮭﻤﺎ ﺗﺄﺛﯿﺮ ﻛﺒﯿﺮ ﺑﻨﻔﺲ اﻟﻘﺪر ﻋﻠﻰ اﻟﺼﺤﺔ واﻟﻨﻈﻢ اﻟﺼﺤﯿﺔ‬،‫ وﺗﻄﻮﯾﺮ اﻷﺳﻮاق اﻟﻤﻔﺘﻮﺣﺔ‬،‫إن ﻋﻮﻟﻤﺔ اﻻﻗﺘﺼﺎد اﻟﻌﺎﻟﻤﻲ‬ -The resulting increases in population mobility can lead to the rapid transfer of communicable diseases for example SARS ‫ اﻟﺰﯾﺎدات اﻟﻨﺎﺗﺠﺔ ﻓﻲ ﺣﺮﻛﺔ اﻟﺴﻜﺎن ﯾﻤﻜﻦ أن ﺗﺆدي إﻟﻰ اﻻﻧﺘﻘﺎل اﻟﺴﺮﯾﻊ ﻟﻸﻣﺮاض اﻟﻤﻌﺪﯾﺔ ﻣﺜﻞ اﻟﺴﺎرس‬- -The resulting - increases in the marketing of public health risks such as tobacco, alcohol, and unhealthy diets are leading to the dramatic increase in non-communicable diseases a ‫ﺗﺆدي اﻟﺰﯾﺎدات اﻟﻨﺎﺗﺠﺔ ﻓﻲ ﺗﺴﻮﯾﻖ اﻟﻤﺨﺎطﺮ ﻋﻠﻰ اﻟﺼﺤﺔ اﻟﻌﺎﻣﺔ ﻣﺜﻞ اﻟﺘﺒﻎ واﻟﻜﺤﻮل واﻷﻧﻈﻤﺔ اﻟﻐﺬاﺋﯿﺔ ﻏﯿﺮ اﻟﺼﺤﯿﺔ إﻟﻰ‬ ‫زﯾﺎدة ﻛﺒﯿﺮة ﻓﻲ اﻷﻣﺮاض ﻏﯿﺮ اﻟﻤﻌﺪﯾﺔ‬ 17  e Jordan is Upper Middle Income country Occupies an area of approximately 92,300 km with a total population of 10 Millions , out of them 6.6 millions are Jordanians.( 2015 census). Population : 34.3% < 14 years 62% at the age 15-64 years and ( 3.7%) ≥ 65 years Average Life expectancy ( 73.5 year) S ⑤ HHH : Higher health council JMC :Jordan Medical Council JNC Jordan Nursing Council FDA Food Drug Administration JPD Joint Procurement Directorate HPC Higher Population Council  JORDAN’S NATIONAL HEALTH GOALS 20 National agenda &6 Jordan hospitals in - I Health Service Delivery In Jordan ~ 700 HC Village PHC & CPHC Ministry of Health 32 Hospitals Public Royal Medical Service 1 PHC A 16 Hospitals Teaching Institutions 1 PHC Snapshot 2 Hospitals of 66 Hospitals service Private 2,600 Clinics delivery 1,900 diagnostic and other sectors in King Hussein Cancer Center Non-Profit and International Jordan 23 UNRWA & UNHCR clinics 44 NGO and Charity clinics Total Number of Hospitals 116 ‫ﻧﻘﺎط اﻟﻘﻮة‬ 2018 SWOT ANALYSIS 2018 Swot OFAnalysis THE JORDAN Of The Jordan HEALTHHealth SYSTEM System ‫اﻟﻘﯿﺎدة اﻟﺪاﻋﻤﺔ‬ ‫ اﻹﻧﺠﺎزات ﻓﻲ‬.‫اﻋﺘﻤﺎد اﻟﺨﻄﻂ اﻟﻤﺴﺘﻘﺒﻠﯿﺔ اﻟﻄﻤﻮﺣﺔ‬.‫ﻣﺠﺎل اﻟﺮﻋﺎﯾﺔ اﻟﺼﺤﯿﺔ اﻷوﻟﯿﺔ‬ Strengths Weaknesses ‫ﺗﻐﻄﯿﺔ واﺳﻌﺔ ﻣﺮاﻛﺰ اﻟﺮﻋﺎﯾﺔ اﻟﺼﺤﯿﺔ اﻷوﻟﯿﺔ‬ ‫ﻧﻘﺎط اﻟﻀﻌﻒ‬ ‫واﻟﻤﺴﺘﺸﻔﯿﺎت ﻣﺮاﻛﺰ ﺻﺤﯿﺔ ﻣﯿﺴﻮرة اﻟﺘﻜﻠﻔﺔ وﯾﻤﻜﻦ‬ ‫ اﻟﺘﺮوﯾﺞ ﻟﺨﺪﻣﺎت وزارة‬Promoting the MOH’s services Supportive leadership ‫ﺻﻮل إﻟﯿﮭﺎ ﺗﻮاﻓﺮ اﻟﺘﻘﻨﯿﺎت اﻟﻄﺒﯿﺔ اﻟﺠﺪﯾﺪة‬ ‫اﻟﻮ‬ ‫اﻟﺼﺤﺔ‬ ‫إدارة اﻟﻤﻮارد اﻟﺒﺸﺮﯾﺔ‬ HR management Adoption of ambitious future plans. ‫إدارة اﻟﻤﻌﻠﻮﻣﺎت اﻹدارة‬ Achievements in PHC area. Information management ‫اﻟﻤﺎﻟﯿﺔ اﻟﻤﺮاﻗﺒﺔ وﺿﻤﺎن‬ Wide coverage PHCC and hospitals ‫اﻟﺠﻮدة ھﺠﺮة اﻷدﻣﻐﺔ‬ Financial management.‫ ﻟﻤﻘﺪﻣﻲ اﻟﺨﺪﻣﺎت‬Monitoring and quality assurance Affordable and accessible HC Availability of new medical technologies Brain drain of providers. Source – HHC 2018 ‫ﻓﺮص‬ ‫اﻟﺘﺰام ﺳﯿﺎﺳﻲ‬ Opportunities ‫اﻟﺘﮭﺪﯾﺪات‬ Threats ‫أﻋﻠﻰ‬ ‫ارﺗﻔﺎع ﻣﻌﺪل اﻟﻨﻤﻮ‬ ‫اﻟﺘﻮﺳﻊ اﻟﻮاﺳﻊ‬ ‫اﻟﺴﻜﺎﻧﻲ‬ Higher political commitment ‫زﯾﺎدة ﺷﯿﺨﻮﺧﺔ اﻟﺴﻜﺎن‬ High population growth rate ‫ﻓﻲ ﺧﺪﻣﺎت‬ ‫ﻟﺮﻋﺎﯾﺔ اﻟﺼﺤﯿﺔ‬Wide ‫ا‬ expansion of healthcare services ‫اﻟﮭﺠﺮة اﻟﻘﺴﺮﯾﺔ‬ Increase in ageing population ‫اﻟﺒﺮاﻣﺞ اﻟﻮطﻨﯿﺔ‬ ‫ﻟﻠﺠﻨﺴﯿﺎت اﻷﺧﺮى زﯾﺎدة‬ ‫اﻟﺪاﻋﻤﺔ اﻟﻨﮭﺞ‬ Supportive national programs ‫اﻟﻔﻘﺮ واﻟﺒﻄﺎﻟﺔ‬ Forced migration of other nationalities ‫اﻟﻤﺘﻌﺪد‬ Multisectoral approach ‫ﻧﻘﺺ اﻟﺘﻨﺴﯿﻖ ﺑﯿﻦ‬ Increase in poverty and unemployment ‫اﻟﻘﻄﺎﻋﺎت‬ Advanced communication technology ‫ زﯾﺎدة ﻋﻮاﻣﻞ‬.‫اﻟﻘﻄﺎﻋﺎت‬Lack of coordination between H.sectors ‫ﺗﻜﻨﻮﻟﻮﺟﯿﺎ‬ ‫ﺧﻄﺮ اﻹﺻﺎﺑﺔ‬ ‫اﻻﺗﺼﺎﻻت‬ ‫ﺑﺎﻷﻣﺮاض ﻏﯿﺮ اﻟﺴﺎرﯾﺔ‬ Increase in risk factors for NCD  Di Jordan’s Demographic And Health Indicators Indicator 2018 2022 Population 10309000 11302000 Crude Birth Rate ( Per 1000 pop.) 22.3 18.1 Total Fertility Rate 2.7 2.7 Family size 4.8 4.8 Crude Death Rate Per 1000 pop. 6 6 Infant Mortality Rate per 1000 live births 17 17 Maternal Mortality Rate Per 10000 births 19 38.5 Average Life Expectancy ( years) 73.5 73.3 Most of the Health Indicators Improved over the last 10 years * Total Health Care Expenditure : 2.2 Billion JD (2015) Private Sector Public Sector 32% - 65% (723.267.115 ‫أﻧﻔﺎق اﻟﻘطﺎع اﻟﺧﺎص‬ JD) ‫أﻧﻔﺎق اﻟﻘطﺎع اﻟﻌﺎم‬ (1.460.833.812 JD) Charities and NGOs 3% (65.1010.940 JD)  Health Insurance In Jordan (2015) Civil Insurance Program (CIP) University 28.6% - Royal Medical Hospitals Insurance ·so: Services 1.7% 68% Insurance 25.6% of Jordanians are Estimated Duplication Private insured by any 5-7% Insurance kind Others Companies 1.7% 8.4% ofUNWRA Health insurance 1.7% Source –DOS 2015  Jordan as Medical Destination Landmarks of medical achievements in Jordan First Open Heart Surgery 1970 First Kidney Transplant 1972 First Laparoscopic Surgery 1973 First Heart Transplant 1985 Curative First born IVF baby 1987 First Bone Marrow transplant 1995 First liver Transplant 2004  E-Health Care 2015 The government signed a five-year framework agreement with the Electronic Health Solutions Company ( EHS) to regulate the implementation of the e-health programme “Hakeem” at the national level. ‫وﻗﻌﺖ اﻟﺤﻜﻮﻣﺔ اﺗﻔﺎﻗﯿﺔ إطﺎرﯾﺔ ﻣﺪﺗﮭﺎ ﺧﻤﺲ ﺳﻨﻮات ﻣﻊ ﺷﺮﻛﺔ‬ ‫( ﻟﺘﻨﻈﯿﻢ ﺗﻨﻔﯿﺬ ﺑﺮﻧﺎﻣﺞ‬EHS) ‫اﻟﺤﻠﻮل اﻟﺼﺤﯿﺔ اﻹﻟﻜﺘﺮوﻧﯿﺔ‬ ‫اﻟﺼﺤﺔ اﻹﻟﻜﺘﺮوﻧﯿﺔ "ﺣﻜﯿﻢ" ﻋﻠﻰ اﻟﻤﺴﺘﻮى اﻟﻮطﻨﻲ‬.‫ﻣﺴﺘﻮى‬ Is a key government program aiming to ensure the accountability of the health care system. The e-health system operates the storage, retrieval and update the electronic health records of patients from the participating health care facilities in Jordan. Currently, there are (20 ) MOH hospitals , ( 11 ) RMS hospitals connected to the system. In addition, there are 143 MOH health centers connected to the system. ‫ يعمل نظام الصحة اإللكتروني على تخزين واسترجاع وتحديث السجالت الصحية اإللكترونية من املرضى من مرافق‬.‫ هو برنامج حكومي رئيسي يهدف إلى ضمان مساءلة نظام الرعاية الصحية‬.‫الرعاية الصحية املشاركة في األردن‬ ً ‫ مركًزا صحًيا تابًعا لوزارة الصحة متص‬143 ‫ هناك‬،‫ باإلضافة إلى ذلك‬.‫ متصلة بالنظام‬RMS ‫( مستشفى‬11)‫ و‬،‫( مستشفى تابعة لوزارة الصحة‬20) ً ‫ويوجد حاليا‬.‫ال بالنظام‬ Thank you