Primary Health Care Module 3 Notes PDF

Notes by: JADE F. VILLAR, RN Primary Health Care PRIMARY HEALTH CARE -the first level of contact between the individual and the...

Notes by: JADE F. VILLAR, RN Primary Health Care PRIMARY HEALTH CARE -the first level of contact between the individual and the health system -a practical approach to making health benefits within the reach of all people -an approach to health development, which is carried out through a set of activities and whose ultimate aim is the continuous improvement and maintenance of health status Alma Ata: “PHC 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 Evolution of Primary Health Care and at a cost that the community and country can afford to 1. The WHO has supported the maintain at every stage of their development in the spirit of global implementation of Primary self-reliance and self-determination.” Health Care which started in (Philippines) September 6 to 12, 1978 during the First International Conference Mission: To strengthen the healthcare system by increasing in Primary Health Care in Alma Ata, Russia. opportunities and supporting the conditions wherein *this is an important milestone in the history of public people will manage their own health care. health Concept: Alma Ata Declaration of 1978 Characterized by partnership and empowerment of the people shall permeate as the core strategy in the effective Universal Goal: Health for All by the Year 2000 provision of essential health services that are community 3 Main Objectives: based, accessible, acceptable and sustainable, at a cost, which 1. Promotion of healthy lifestyles the community and the government can afford. 2. Prevention of diseases It is a strategy, which focuses responsibility for health of the 3. Therapy for existing conditions individual, his family and the community. It includes the full participation and active involvement of the community *read : https://iris.who.int/bitstream/handle/10665/347879/WHO- towards the development of self-reliant people, capable of EURO-1978-3938-43697-61471-eng.pdf achieving an acceptable level of health and well-being. It also recognizes the inter-relationship between health and 2. Pres. Ferdinand Marcos signed the overall political, socio-cultural and economic Letter of Instruction (LOI) 949 on development of society. October 19, 1979, a year after the Primary Health Care Conference. 5 Key Elements to achieving the goal for LOI 949: Adoption of Primary Health Care Strategy “Health for All” Promoted participatory management of local health care system Philippines… … the 5 key elements Theme: “Health in the Hands of the People by 2020” Purpose: It is an approach towards the design, without with development, and implementation of programs focusing on health development at community 1. Reducing exclusion and social disparities in health level. (universal coverage) Philippines’ Goal: Health for All Filipinos by the 2. Organizing health services around people’s needs and year 2000 and Health in the Hands of the People by expectations (health service reforms). the year 2020 3. Integrating health into all sectors (public policy *Marcos adapted the PHC strategy because he wanted reforms). an improved state of health and quality of life for all 4. Pursuing collaborative models of policy dialogues people through self-reliance (leadership reforms). 5. Increasing stakeholder participation. Notes by: JADE F. VILLAR, RN Notes by: JADE F. VILLAR, RN Essential Health Services using the acronyms: Key Principles of Primary Health Care ELEMENTS 1. 4A’s of PHC E – Education for Health a. Accessibility – refers to the physical distance of a health -one of the potent methodologies for information dissemination. It facility or the travel time required for people to get the promotes the partnership of both the family members and health needed or desired services. Requires the existence of a workers in the promotion of health as well as prevention of illness facility within reasonable distance from the catchment required by the people are offered in the health care L – Locally Endemic Disease Control facility population or the people it is meant to serve. -control of endemic disease focuses on the prevention of its b. Affordability – it is not only in consideration of the occurrence to reduce morbidity rate individual or family’s capacity to pay for basic health services. Particularly for public health services, it is also E – Expanded program for immunization a matter of whether the community or government can afford these services. -control the occurrence of preventable illnesses especially of children below 6 years old. Immunizations on poliomyelitis, c. Acceptability – means that the health care offered is in measles, tetanus, diphtheria and other preventable disease are consonance with prevailing culture and traditions of the given for free by the government and ongoing program of the DOH population. M – Maternal and Child Health d. Availability – is a question whether the basic health services required by the people are offered in the health -mother and child are the most delicate members of the care facilities. community. So, the protection of the mother and child to illness and other risks would ensure good health for the community. The 2. Support mechanisms goal of Family Planning includes spacing of children and natural or established process brought about to enhance the responsible parenthood quality of life and provides a buffer against adverse life events. Primary healthcare depends on the adequate number E – Essential Drugs and distribution of trained physicians, nurses, community -this focuses on the information campaign on the utilization and health workers, allied health professions, and others working acquisition of drugs. In response to this campaign, the GENERIC as a health team and supported at the local and referral levels. ACT of the Philippines is enacted. It includes the following drugs: 3 major sources: People, Government, Private Sectors Cotrimoxazole, Paracetamol, Amoxycillin, Oresol, Nifedipine, Rifampicin, INH (isoniazid) and Pyrazinamide, Ethambutol, 3. Multi-sectoral approach Streptomycin, Albendazole, Quinine a. To be able to maximize resources we have. b. Capacitate the partnership – to be able to learn with Generics Act of 1988 (RA No. 6675) each other -an act to promote, require and ensure the production of i. Intrasectoral approach (two-way referral an adequate supply, distribution, use and acceptance of system) – communication, cooperation and drugs and medicines identified by their generic names. collaboration within the health sectors. ii. Intersectoral linkages – between the health N – Nutrition sector and other sectors like education, agriculture and local government offices. -one basic need of the family is food. There are many food resources found in the communities but because of faulty 4. Community participation preparation and lack of knowledge regarding proper food -involvement of the community in planning, planning, malnutrition is one of the problems that we have in the implementing and maintaining their health services. country. Through the involvement of the community, maximum T – Treatment of communicable and utilization of local resources, such as manpower, noncommunicable diseases money and materials, can be utilized to fulfill the goals of PHC. Resources: Manpower, Money, Material -the diseases spread through direct contact pose a great risk to those who can be infected. But, most communicable diseases are 5. Equitable distribution of health resources. also preventable. The government focuses on the prevention, -this is the first and most important key to PHC. control and treatment of these illnesses. Healthcare services must be equally shared by all the people of the community irrespective of their race, S – Safe water and Environmental Sanitation creed or economic status. This concept helps to shift the -safe water and good environmental sanitation are necessary for accessibility of healthcare from the cities to the rural basic promotion of healthy lifestyle. Both should be maintained as areas where the most needy and vulnerable groups of it contributes to the overall health of a person. the population live. Notes by: JADE F. VILLAR, RN Notes by: JADE F. VILLAR, RN 6. Appropriate Technology - Appropriate healthcare technologies are an important UNIVERSAL HEALTH CARE strategy for improving the availability and accessibility of healthcare services. This means methods, procedures, WHO: defined UHC as “ensuring that all people have access to techniques, and equipment that are: needed health services (including prevention, promotion, treatment, a. Scientifically valid, rehabilitation, and palliation) of sufficient quality to be effective b. Adapted to local needs, while also ensuring that the use of these services does not expose the c. Acceptable to users and recipients, user the financial hardship.” d. Maintainable with local resources. -UHC also referred to as Kalusugan Pangkalahatan (KP), is the LEVELS OF PREVENTION “provision to every Filipino of the highest possible quality of health care that is accessible, efficient, equitably distributed, adequately funded, fairly financed, and appropriately used by an informed and empowered public”. -the Aquino administration puts it as the availability and accessibility of health services and necessities for all Filipinos RA 11223: basically, automatically enrolls all Filipino citizens in the national Health Insurance Program (PHILHEALTH) and prescribes complementary reforms in the health system “mandates the institutionalization of health technology assessment (HTA) as a fair and transparent priority setting mechanism that shall be recommendatory to the DOH and PhilHealth for the development of policies and programs, regulation, and the determination of a range of entitlements such as drugs, medicines, pharmaceutical products, other devices, procedures and services.”  December 12, 2012, the resolution on global health and foreign policy recommended to include universal health coverage in the discussions on the post-2015 development agenda in the context of global health challenges.  September 25, 2015, the resolution on Transforming our world: the 2030 Agenda for Sustainable Development adopted the target of universal health coverage by 2030  December 12 2017, the UN passed a resolution on global health and foreign policy: addressing the health of the most vulnerable for an inclusive society  February 20, 2019, President Rodrigo Duterte signed the Universal Health Care Act into law. Goal of UHC: to ensure everyone receives the health services they need without facing financial hardships Objectives OF UHC: a. Progressively realize universal health care in the country through a systemic approach and clear delineation of roles of key agencies and *primary: wala pang sakit, goal is to prevent illness and promote health stakeholders towards better performance in the (1st: education, 2nd: vaccination) health system; and *secondary: existing na yung sakit, goal is to diagnose and treat early b. Ensure that all Filipinos are guaranteed equitable *tertiary: chronic illness, goal to prevent complications/ for rehabilitation access to quality and affordable health care goods and services, and protected against financial risk. gets mo na?! Notes by: JADE F. VILLAR, RN Notes by: JADE F. VILLAR, RN Thrusts of UHC: a. Financial risk protection through expansion in enrollment and benefit delivery of the National Health Insurance Program (NHIP); b. Improved access to quality hospitals and health care facilities; and c. Attainment of health-related Millennium Development Goals (MDGs). Financial Risk Protection Protection from the financial impacts of health care is attained by making any Filipino eligible to enroll, to know their entitlements and responsibilities, to avail of health services, and to be reimbursed by PhilHealth with regard to health care expenditures. Improved Access to Quality Hospitals and Health Care Facilities Achieved in a number of creative approaches: 1. First, the quality of government-owned and operated hospitals and health facilities is to be upgraded to accommodate larger capacity, to attend to all types of emergencies, and to handle non-communicable diseases. 2. The Health Facility Enhancement Program (HFEP) shall provide funds to improve facility preparedness for trauma and other emergencies. 3. Financial efforts shall be provided to allow immediate rehabilitation and construction of critical health facilities. Attainment of Health Related MDGs Further efforts and additional resources are to be applied on public health programs to reduce maternal and child mortality, morbidity and mortality from Tuberculosis and Malaria, and incidence of HIV/AIDS. Localities shall be prepared for the emerging disease trends, as well as the prevention and control of non-communicable diseases. -------end------ Notes by: JADE F. VILLAR, RN