UNIT 5 6 7 8 9 PHC May 2024.pdf

UNIT 5 PRIMARY HEALTH CARE (PHC) Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 1 Getu Teshome(HO, MPH) World Health Organization(WHO) Established in 1948 Major objective- the attainment by all people of the world the highest possible level of health. Goal(1977): of providing health for all by the year 2000. Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 2 Getu Teshome(HO, MPH) WHO The strategy to meet this goal was later deﬁned in the 1978 WHO/UNICEF joint meeting at Alma-Ata. In this meeting it was declared that the PHC strategy is the key to meet the goal of ‘health for all (HFA) by the year 2000’that will permit them to lead socially and economically productive life. Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 3 Getu Teshome(HO, MPH) PHC Deﬁnition An 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 community and country can afford to - maintain at every stage of their development in the spirit of self reliance and self–determination. Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 4 Getu Teshome(HO, MPH) It forms an integral part of the country’s health system and the overall social and economic development of the country. It is the ﬁrst level of contact of individuals, the family and the community with the national health system. Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 5 Getu Teshome(HO, MPH) Certain important terms in deﬁnition of PHC 1. Essential health care provided through PHC is basic and indispensable 2. Practical - appropriate and realistic, Selection of priorities based on resources 3. Scientiﬁcally sound- The strategy we use to implement PHC should be scientiﬁcally explainable and should be understood. - PHC should not entertain quack medicine Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 6 Getu Teshome(HO, MPH) 4. Socially Acceptable Methods and Technology Not every method and technology is acceptable to societies. In order to implement PHC the method and technology we are using should be accepted by the local community. We need to consider the local value, culture and beliefs etc. Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 7 Getu Teshome(HO, MPH) 5. Universally Accessible : the approach is to bring health care as close as possible to where people live and work. Collective expression of political will in the spirit of social equity. Because of the inequitable distribution of the available resources, the services are not reachable (approachable) by all who need them. Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 8 Getu Teshome(HO, MPH) 6. Community involvement Active involvement of people in the planning implementation and control of PHC Individuals and families assume more responsibility for their own health. It was wrongly conceived that health for communities can achieved through the efforts of health workers alone. Health is not a gift that could be given to communities by health professionals. Communities can achieve better health status through their own efforts and the health workers are helping them identify their problems and to point out methods for dealing with the problems. Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 9 Getu Teshome(HO, MPH) 7. Cost that the community or country can afford Health services are expensive because of professional costs and the cost of equipment and capital expenses. PHC demands the use of methods which are cheap or within the cost the community can afford to pay. Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 10 Getu Teshome(HO, MPH) 8. Self reliance and self determinations Implies individuals, families, and community’s initiative in assuring - responsibilities for their own health development Adopting measures that are understandable & accepted by them. Knowing when and for what purpose to turn to others for support and co-operations. Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 11 Getu Teshome(HO, MPH) HFA/2000 mean: The imbalance between town and countryside, rich and poor, becomes less marked. Morbidity and mortality rates are reduced. It will ﬁnally be possible to make a greater contribution through health, to reach country’s economic development. Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 12 Getu Teshome(HO, MPH) The logic of PHC PHC is the call for a partnership in health (both rural and urban). It is not a medical reform but a social reform. Basic needs of food and shelter have always been a local responsibility. Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 13 Getu Teshome(HO, MPH) PRINCIPLES OF PHC: I. Equity: Equitable distribution of services, resources and facilities for the entire population. Give access to the rural and the per-urban poor. Equity means: Equal health, equal access to health care, equal utilization of health care, equal access to health care according to need, equal utilization of health care according to need. Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 14 Getu Teshome(HO, MPH) II. Inter-sectoral approach (collaboration): A joint concern and responsibility of sectors responsible for development in identifying problems, programs and undertaking actions. Promotion of health cannot be attained by a single health sector alone. Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 15 Getu Teshome(HO, MPH) II. Inter-sectoral approach.... Education, income, clean water, improved housing and sanitation, construction of roads and water ways, enhanced role of women have substantial impacts on health. Community can often respond more readily to broad approaches to the problems of development than to than fragmented sector by sector approach. Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 16 Getu Teshome(HO, MPH) III. Community Involvement Community involvement is the process by which individuals and families assume responsibility for the community and develop the capacity to contribute to their and the community’s development. They should not be passive recipients of the service. Everybody should be involved according to his/her ability. Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 17 Getu Teshome(HO, MPH) Important rules to follow in community involvement Do not tell them, but inform them Do not force them, but persuade them Do not make them listeners, but decision makers Involve them in the: Assessment of the situation Identiﬁcation of the problems Setting of priorities and making decisions Planning, implementation, monitoring, evaluation and management programs. Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 18 Getu Teshome(HO, MPH) IV. Appropriate technology for health Methods, procedures, techniques and equipment that are: - Scientiﬁcally valid - Adopted to local needs, acceptable to those who use them and those for whom they are used - Maintained and utilized with resources the community or the country can afford. -Take account of both the health care needs and the socioeconomic context of a country. Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 19 Getu Teshome(HO, MPH) Technology is generally understood to mean the knowledge, skill (soft ware) and hard ware that are used to solve a problem. If the things do not ﬁt the people and places, then these things are unlikely to be helpful in the long run and may well prove to be a disappointment and a waste of resources. Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 20 Getu Teshome(HO, MPH) Criteria of appropriate technology: Effective- It must work and fulﬁl its purpose in the circumstances in which it needs to be used. E.g. Fancy incubators for low-birth weight infants Vs warm cloths Culturally acceptable and valuable - It must ﬁt into the hands, minds and lives of its users and providers. E.g. TBAS Vs TTBAS Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 21 Getu Teshome(HO, MPH) Criteria... Affordable (cost effective): This doesn’t mean that an appropriate technology must always be cheap. Cost effectiveness should be carefully considered and the choice must be an informed one. Locally sustainable- it should not be over dependent on imported skills or supplies for its continuing functioning, maintenance and repair Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 22 Getu Teshome(HO, MPH) Criteria... Possessive of an evolutionary capacity- A technology is highly appropriate if its introduction and acceptance can lead to further beneﬁts Environmentally accountable- The technology should be environmentally harmless or, at least minimally harmful. E.g. Indiscriminate use of pesticides Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 23 Getu Teshome(HO, MPH) Criteria... Measurable- The impact and performance of any technology needs proper and continuing evaluation if it is to be widely recommended. E.g. solar energy. Politically responsible- It may be unwished to alter an existing balance in a way that might be counterproductive. Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 24 Getu Teshome(HO, MPH) V. Emphasis on health promotion and prevention of diseases It sees health as a positive attribute, rather than simply’ the absence of diseases’. One of the important tasks of the planner is to re-address the imbalance in allocation of resources to preventive and curative care, enhancing the role of resources available to prevention and promotion. Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 25 Getu Teshome(HO, MPH) Health promotion Includes all effort that seeks to move people closer to optimal Well- being or higher level of wellness or promotes healthier and happier life. It is the combination of educational and environmental supports for action and condition of living conducive to health. Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 26 Getu Teshome(HO, MPH) Health promotion... It consists of general non-speciﬁc interventions that enhance health and the body’s ability to resist disease. E.g. include improvement of socioeconomic status, provision of adequate food, housing, clothing, education, paid jobs, vocational training old-age pension beneﬁts; emotional and social support, relief of stress. Etc. Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 27 Getu Teshome(HO, MPH) Disease prevention: -Inhibiting the development of a disease before it occurs or if it occurs interrupting or slowing down the progression of diseases. Disease prevention is aimed at stopping the disease process before it starts or preventing further deterioration of a condition that already exist. These preventive services are popularly categorized as: Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 28 Getu Teshome(HO, MPH) - Primary prevention: prevention of an illness before it has a chance to occur e.g. immunization -Secondary prevention: include early detection of actual or potential health problems e.g. screening hypertension. -Tertiary prevention: avoiding farther deterioration of already existing problem. E.g. rehabilitation after stroke Disease control: -Involves all the measures designed to reduce or prevent the incidence, prevalence and consequence of a disease to a level where it cannot be a major public health problem. Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 29 Getu Teshome(HO, MPH) VI. Decentralization Away from the national or central level Bring decision making closer to the communities served. Provide greater efﬁciency in service provision and greater potential for multi- sectoral collaboration at lower service delivery level but, may lead to geographically inequitable in resources availability and technical skill. Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 30 Getu Teshome(HO, MPH) Components or Elements of PHC At its declaration, PHC had the following eight elements 1. Health education 2. Promotion of food supply and proper nutrition 3. Adequate supply of safe water and basic sanitation 4. MCH including FP 5. Expanded Immunization 6. Prevention and control of locally endemic diseases 7. Appropriate Rx of common diseases and injuries 8. Provision of essential drugs Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 31 Getu Teshome(HO, MPH) Components added after Alma-Ata declaration 9. Mental health 10. Oral health 11. Control of ARI 12. Control of HIV/AIDS and other STIs 13. Occupational health 14. Use of traditional medicine Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 32 Getu Teshome(HO, MPH) Status of PHC and Problems encountered in the implementation of PHC in Ethiopia Since 1980, PHC has been the main strategy on which the health policy has been based. Although the implementation of PHC Varies from country to country depending on the political economic and social conditions. Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 33 Getu Teshome(HO, MPH) Contents of PHC activities in Ethiopia include the following: Education concerning the prevailing health problems and methods of preventing and controlling them. Locally endemic diseases prevention and control Expanded program on immunization Maternal and child health, including family planning Essential drugs provision Nutrition, promotion of food supply Treatment of common diseases and injuries Sanitation, as well as adequate and safe water supply Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 34 Getu Teshome(HO, MPH) A review of PHC implementation was attempted in Ethiopia in 1985 revealed the following general achievements: Expansion of health services to the broad masses especially by establishing new health stations and health posts Expansion of EPI MCH/FP Increase in number of health personnel Increased health propaganda attempts to improve the health consciousness of the population PHC committees established at the lowest local administrative level Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 35 Getu Teshome(HO, MPH) Major Problem Encountered Absence of an infrastructure at the district level to implement PHC Difﬁculty in achieving inter-sectoral collaboration Inadequate health service coverage and misdistribution of available health services Inadequate resource allocation Absence of clear guidelines or directives to governmental institutions and mass organization on how to implement PHC Presence of culturally dictated harmful traditional practices or unscientiﬁc beliefs and practices in Ethiopia Absence of sound legal rules to support environmental health activities Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 36 Getu Teshome(HO, MPH) What PHC is not A greater attention to people on deﬁned needs only Meant only for the urban poor and the rural population Integrated as a service of lower quality care Concerns only the developing countries An obstacle to the Development and growth of hospital care Simple health development process that can only be directed by CHWS Reduce academic excellence in health science and technology Arsi University,Public Health Dept, Intro. to PH for Health Ofﬁcer Students By 37 Getu Teshome(HO, MPH) Unit 6 Health systems Traditional health system(group 1 ) History of development of health services in Ethiopia (Group 2) Modern health system (Group 3) Millennium Developmental Goals(Group 4) Organization of health services & health system in Ethiopia (Group 5) Sustainable Developmental Goals (Group 6) Health service coverage and distribution Team approach in health service Health Service Coverage and Distribution Health service distribution is a geographical and demographic allocation/placement or/ and availability of a speciﬁc type of health service(s). It mainly focuses on the geographical availability of the service(s). Health service coverage is the level of availability, accessibility and utilization of a given health service(s) in a speciﬁed population and geographical area. Health Service Coverage and Distribution….. The health service coverage as well as distribution in the country is relatively poor when it is compared to other developing nations. This can be clearly illustrated if one sees the health and health related indicators of the country. Health Service Coverage and Distribution… the health service coverage and distribution, as seen briefly, is inadequate and needed to improve. Some of the indicators used to assess the service coverage and distribution in health include: Contraceptive Coverage EPI Coverage ANC coverage Coverage of TT2 to pregnant women Coverage of TT2 to non pregnant women Post natal service coverage Proportion of deliveries assisted by trained health workers Share of annual health budget Health Service Coverage and Distribution… Coverage of TB prevention and control services Provision of safe and equate water supply Proportion of the population with access to excreta disposal facilities Availability of essential drugs and medical supplies in each health facility Health Service Coverage and Distribution… Drugs prescribed in generic name Per capital expenditure on health Blindness prevalence rate HIV Prevalence rate EPI defaulters Defaulters rates of TB and Leprosy Team approach in health service Team work is coordinated action carried out by two or more individuals jointly(WHO) It implies commonly agreed goals, clear awareness of, and respect for other’s roles and functions It also implies that on the part of each member of the team, adequate human and materials resources, supportive cooperative relationships, open, honest and sensitive communications, and provision for evaluations is practiced Health Team The health team is a group of people who have common goal, determined by the community health needs, to the achievements of which each member of the team contributes, in accordance with his competence and skills and in accordance with the functions of others. Team Approach Team approach is deﬁned as the way that management attempts to bring about balance among the different people concerned. Well developed and efﬁcient teams are those that can quickly evaluate a complex situation and decide how to state the problem, so the members of the team can use their skills to focus on an integrated approach. The success of team’s work depends to a great extent on how well its members work together and with the people they serve. Team Approach ….. Good management can help a team to work together harmoniously and efﬁciently through: - Setting and sharing objectives - Encouraging good personal relations -Distributing tasks - Coordinating the activities of the team - Applying sound organizational principles Team approach is not a recent innovation. Team work has existed for a long time perhaps for hundred of years in many countries. 49 UNIT SEVEN Deﬁnition and applicability of public health subjects taught under public health and Major strategies of improving public health in developing countries Learning objectives At the end of this unit students will be able to: Explain public health courses Mention applicability of Public Heath courses Outline the major strategies of improving public health in developing countries 50 7.1 Epidemiology Origin- Greek roots Greek English equivalent Epi up on Demos population Logia science / study Deﬁnition- it is the study of the frequency , distribution ,and determinants of disease and other health related conditions in human population and the application of this study to the promotion of health and to the control of health problem. 51 7.2 Health service management Rationale for the course 1. Management is universal and essential function in all kinds of organizations 2. Planning and management skills are needed as most health professionals ﬁnd themselves in managerial position without proper orientation and training 3. Proper heath planning and health services management skill is an important tool to bring about change in the health care system, a requirement in most countries of the world. 52 Management Getting things done through people The process of reaching organizational goals by working with and through people and other resources The process composed of interrelated social and technical functions & activities, occurring in a formal organizational setting for the purpose of accomplishing predetermined objectives through the use of human and other resources. The process of planning, organizing, leading/directing and controlling the efforts of organizational members and using all available organizational members and using all available organizational resources to reach predetermined objectives 53 7.3 Biostatistics Statistics is a ﬁeld of study concerned with the collection, organization and summarization of data, and drawing of inferences about a body of data when only part of the data is observed. Applied statistics: Involves applying the method of mathematical statistics to speciﬁc subject areas. Descriptive Statistical method: Is the methodology of effectively collecting, organizing and describing data. Descriptive statistical methods are concerned with collecting, organizing, summarizing, condensing, presenting data into tables, ﬁgures, graphs, charts, diagrams and numbers and this will summarize a body of data with one or two meaningful ﬁgures. 54 Biostat… Inferential statistical method: branch of modern statistics that is most relevant to public health and clinical medicine, most commonly found in research publications and builds up on descriptive statistics. It is concerned with predicting, estimating and generalizing characteristics of the whole based on the characteristics of a part or subset of the whole. The inferences are drawn from particular properties of sample to particular properties of population. 55 Biostat… Inferential Statistics: Includes: 1. Inductive Statistics: The process of drawing conclusion about unknown characteristics of a population, based on sample based study. 2. Predictive Statistics: The process of predicting future based on historical data. Biostatistics (Health statistics): Application of different statistical methods and concepts to biological, medical and public health data (phenomena). Why we study statistics in public health To be an educated consumer of numerical information To understand medical literature, which use statistical numeration 56 7.4- Nutrition What is nutrition? Nutrition is the science of food, the nutrients and other substances in foods, their action in the body, interaction and balance in relation to health and the disease, and the process by which the organisms ingest, digest, absorbs, transports, utilizes and excrete food substances. In addition, it should be considered with the social, cultural and physiological implications of food and eating. Human Nutrition: A scientiﬁc discipline, concerned with the access and utilization of food and nutrients for life, health, growth, development and well-being. 57 7.5 Health education Health education- is the part of public health that is concerned with promoting health behaviour. A person s behaviour may be the main cause of a ' health problem, but it can also be the main solution. Through health education we help people understand their behaviour and how it affects their health and encourages people to make their own choices for a healthy life but we do not force them to change. Health education is a combination of learning experiences designed to facilitate voluntary actions conducive to health 58 7.6 Environmental health The aspect of public health that is concerned with those forms of life, substances , forces and conditions in the surroundings of man that may exert an influence on human health and well- being. The application of environmental sciences and engineering principles to the control , modiﬁcation , or adaptation of physical, chemical, and biological factors of the environment in the interest of man's health, comfort and social well- being. Environmental Health is the prevention of diseases and promotion of health by eliminating or controlling the environmental factors which forms links in disease transmission. 59 7.7 Reproductive health (RH): The ICPD (International Conference of Population and Development) deﬁne RH as ‘’RH is a state of complete physical, mental and social well being and not merely absence of disease or inﬁrmity, in all matters relating to the reproductive system and to its function and process.’’ " Reproductive health implies that people are able to satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do ‘’. 60 RH… Implies to the condition women and men have the right To be informed about safe, effective, affordable and acceptable method of family planning of their choice. Access to appropriate health care services that will enable women to go safely through pregnancy, childbirth and provide couples with the best chance of having a healthy infant 61 7.8. Health Economics Economics is the study of how individuals and societies allocate their limited resources in attempts to satisfy their unlimited wants. Economics is the science of choice-It studies how people choose to use scarce productive resources that have alternative uses to produce various commodities and to distribute these goods to various members of the society for their consumption. 62 Health economics….. hHealth economics is the application of economic theories, concepts and techniques to the Health System. Health Economics _ encompasses the full range of two- way casual relations between the health status of individuals and groups and their economic activities…production, distribution and exchange Health economics is a theoretical framework to help health care professionals, health care decision makers, or governments, to make choices on how to make the best use of limited health resources 63 7.9. Ecology Ecology is the study of organisms in relation to the surroundings (environment) in which they live. It is also the study of the interactions between living organisms and their environment. Human ecology is the study of the interactions between humans with one another, with other living things, and with their environment in general. 64 7.10. Research Methodology Research is a quest for knowledge through diligent search or investigation or experimentation aimed at the discovery and interpretation of new knowledge or information. – Research is an approach in obtaining a solution for a speciﬁc problem. – Research is necessary to generate new knowledge and technologies to deal with major unresolved health problems. – Research is essential for guiding action. – Research is necessary to identify priority problems design and evaluate policies and programs 65 Research…. Research is systematic collection, analysis and interpretation of data to generate new knowledge and answer a certain question or solve a problem. Research is a scientiﬁc inquiry aimed at learning new facts, testing ideas, etc. Research is a human activity based on intellectual application in the investigation of matter. Research must be systematic and follow a series of steps and a rigid standard protocol: scientiﬁc method. 66 Major strategies of improving public health in developing countries Establishing policies and strategies to promote social equity in health Community based information Improving learning and educational out comes Improving availability, access and acceptability of health services Improving the quality of Health care Select major risk factors, global and regional burden of disease Access to sanitation These remain priorities, although non communicable diseases and injuries are increasingly important in the poor countries 67 Unit Eight Indicators of health status of a population Learning objectives At the end of this unit students will be able to: Deﬁne Indicators Describe the health status indicators Discuss types of indicators Mention criteria's of indicators List some health status indicators 68 Community indicators are measurements of a community’s economic and social well-being. It is comparison that begins to give meaning to data. An indicator is an index + a cut-off point. E. g. W F A (Weight for age) < 60% = is indicator of severe malnutrition 69 But even more than a report card on how well we are doing, indicators help us to navigate. They provide insights into how the different aspects of our social structure interact. We can see how closely tied are welfare reform and child care. 70 They tell us whether we are improving, declining, or remaining stable. Tracking health status using such indicators provides information on changing or emerging trends. In general health status can identify where interventions have improved the health of a population or where interventions may be needed. Example- Exploring causative factors and preventive measures 71 As deﬁned by WHO health status of a population can be measured by a wide range of factors/indicators/ such as Birth and death rate Morbidity and mortality rate from speciﬁc disease Life expectancy Quality of life Risk factors Financing of health care Health coverage and many other factors 72 Indicators: Come in Several Flavours There are several ways to put statistical indicators into context. Some of them are the followings. 1. Baseline If statistical data for an indicator is not available or has not been collected, then a mechanism for collecting this information needs to be put into place. The ﬁrst measurement taken is called a baseline. Subsequent data is then measured against this baseline to determine whether conditions are worsening or whether progress is being made. 73 2. Target Goals A community can use target goals such as those established in the Healthy People 2000 model, where minimum standards for health were identiﬁed and targeted for the year 2000. The current status of the community is then measured against those standards. 3. Trends over Time Another way of measuring progress is by comparing progress over a period of time. Depending upon the information available, the trend may cover one year, four years, or more than a decade. 74 Criteria for Indicators Good indicators should do the following: Reflect fundamentals of long-term community health (In other words, short-term needs should not sacriﬁce the long-term health of the community) Be understood and accepted by the community Understandability :Is it clear enough to be interpreted by the readers? Have interest, Exciting, Compelling and appeal for media. Be statistically measurable on a frequent basis and can be updated with existing and objective data sources: Comparable 75 Criteria… Validity :Does it measure an issue directly related to community outcomes? Availability and timeliness :Is the indicator readily available on an annual basis? Accessible and Affordable indicator Stability (consistency) and reliability (Is it compiled in a systematic and credible way which will be repeated every year) Policy relevance :Does it have relevance for policy decisions? 76 Criteria… Representative :Do the indicators as a group cover important dimensions of the solution area? Measure the condition of assets which are of material importance to the region’s wealth Measure the condition in which there is active public interest Responsiveness :Does the indicator respond quickly and noticeably to change? A Leading Indicator: a predictor of potential problems 77 Unit Nine Professional ethics in public health Learning Objectives At the end of this unit students will be able to: Describe areas of professional ethics in Public Health Deﬁne Ethics 78 Ethics is the branch of philosophy that deals with morality and the distinctions between right and wrong. Ethics makes a study of the tensions that arise among people's values, and it attempts, through applied logic, to set out rules of conduct for each particular class of human action. Because it has its basis in logic rather than in, say, religion, ethics is usually considered more objective than morality. Both ethics and morality, however, attempt to tell people what they ought to do. 79 Public health activities are covered by legal provisions at all levels of government in the contemporary societies. Today, WHO member states formulated and shaped broad policy for their citizens and developed broad programs leading to health protection and promotion. Legal medicine or medical juries’ prudence applies the principles and practices of the different branches of medicine to solve legal questions. Medical ethics is one such principle applied in legal medicine to determine the legal responsibility of health professionals. 80 The objective of health care that is the attainment of the highest possible level of health which is highly dependent, among other things, on the regulation of health service delivery and the application of suitable ethical principles. Medical practice in Ethiopia is governed by ethical principles incorporated in different legislations because of the absence of a separate code of ethics. The purpose of the code of ethics is to serve as a guide to conduct for members. It contains standards of ethical behavior for public health workers in their professional relationships. 81 The code of ethics also incorporates standards of ethical behavior governing personal behavior, particularly when that conduct directly relates to the role and identity of the health care professional. For a group to be accepted as a profession, it must be able to demonstrate that its area of operation has direct relevance to the public interest and that its general conduct takes account of this public interest. 82 Professionals have a prestigious, powerful and trusted place in society and both the public and the law expect high standards of conduct especially where society allows self- regulation The ethical element in professional conduct cannot be ignored and the need for professions to be aware of ethical issues in the way they conduct themselves is an important of their recognition. 83

UNIT 5 6 7 8 9 PHC May 2024.pdf

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