Health Care Lecture

HEALTH CARE

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Definition of Health Care

Health care, or healthcare, is the prevention, treatment, and management of illness and the

preservation of mental and physical well being

through the services offered by the medical,

nursing, and allied health professions.

Health care embraces all the goods and services designed for your health, including preventive, curative and palliative interventions, whether directed

to individuals or to populations.

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Health Care Process

Definition

A systematic, rational method of planning and

providing health care by identifying a clients actual or potential health care needs,

establishing plans to meet the identified needs

and delivering specific health care interventions

to meet those needs for the purpose of attaining,

maintaining, and promoting optimal

biopsychosocial functioning.

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Health as a Continuum between biological and social factors across the Lifespan

Health From Cells to Society

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Peoples Right to Daily Life

The United Nations (Article 25, 1948) declaration for peoples rights to daily life:

All people have the right to a standard of living adequate for the health and well-being of a person and of ones family, including food, clothing, housing, and medical care, and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age, or lack of livelihood in circumstances beyond ones control.

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Health and IllnessTHE STUDY OF MAN

THE ATOMISTIC APPROACH

Views man as an organism composed of different organ

systems, each system

composed of organs and each

organ made up of tissue cells.

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THE HOLISTIC APPROACH

Stimuli in the environment provide the necessary forces to enable man to demonstrate consciously or unconsciously, the nature of his responses and the subsequent quality of his relationship with his environment.

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THE HOLISTIC APPROACH

It provides a fundamental framework on which one can base his perception or

observation of the total behavior of man in

relation to society.

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MOTIVATION TO OVERCOME HARDSHIP

Motivation may come either from natural or supernatural forces.

Man reasons that it comes naturally to man to suffer for those whom he loves and wishes to protect from pain and suffering.

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MOTIVATION TO OVERCOME HARDSHIP

The other type of motivation may be supernatural wherein one transcends pain

and suffering to a higher place in the hope

of non-material reward.

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Health and Illness

ABRAHAM MASLOWS

HIERARCHY OF NEEDS

The five level of basic needs:

Physiologic needs

Safety and security needs

Love and belonging needs

Self-esteem needs

Self-actualization needs

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Health and Illness

FACTORS AFFECTING HEALTH AND ILLNESS (PEISES)

Physical dimension

Emotional dimension

Intellectual dimension

Socio-cultural dimension

Environmental dimension

Spiritual dimension

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Health and Illness

Physical dimension genetic make-up,develop mental level,race & sex

Emotional dimension- how the mind and body interact to affect body function & respond to body condition

Intellectual dimension- cognitive abilities,educational background & past experiences

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Health and Illness

Socio-cultural dimension- these are health practices & beliefs w/c influences a persons economic, lifestyle,family & culture

Environmental dimension - such as housing, sanitation, climate & pollution

Spiritual dimension- spiritual & religious beliefs and values

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Health and Illness

SOCIAL DETERMINANTS OF HEALTH

- Are the social conditions in which people live which determine their health, illnesses and generally related to social, economic, political and environment circumstances. It greatly influenced collective and personal well-being

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Health and Illness

MODELS OF HEALTH

Medical Model

Health is the state of being free of signs

or symptoms of disease. Illness is the

presence of signs or symptoms of

disease.

Nedra B. Belloc and Lester Breslow 1972

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Health and Illness

MODELS OF HEALTH

Health-Illness Continuum

Health is a constantly changing state,

with high level wellness and death

being on opposite ends of a graduated

scale, or continuum.

J-B. McCann Flynn and P.B. Heffron 1984

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Health and Illness

MODELS OF HEALTH

Role-Performance Model

Health is the ability to perform all those

roles for which one has been socialized.

-Defined with reference to the individuals participation in the social system.

Talcott Parsons, 1964

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Health and IllnessMODELS OF HEALTH

High-Level Wellness

High-level wellness refers to functioning

to ones maximum potential while maintaining balance and purposeful

direction in the environment.

Halbert Louis Dunn MD, PhD - 1961

John Travis, 1975

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World Health Organization

Health is the state of complete physical,

mental, social well-being and not merely

the absence of disease. WHO, 1947

At the first International Conference on Health Promotion in Ottawa,

Canada (1986), the Ottawa Charter for Health Promotion built on the

WHO's concept and further defined health as "a resource for everyday

life ... a positive concept emphasizing social and personal resources,

as well as physical capabilities." Good health enables one to function

independently within a changing environment.

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Needs-Fulfillment Model

Health is state in which needs are being

sufficiently met to allow an individual to

function successfully in life with the

ability to achieve the highest possible

potential.

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Health and Illness

STAGES OF ILLNESS BEHAVIOR

Stage 1: Symptom Experience

The person is aware that something is wrong. A person usually recognizes a physical sensation or a limitation in

functioning but does not suspect a

specific diagnosis.

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Health and Illness


Stage 1: Symptom Experience

The persons perception of a symptom includes awareness of a physical change

such as pain, a rash or a lump; evaluation

of this change and a decision that it is a

symptom of an illness, and an emotional

response.

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Health and Illness


Stage 2: Assumption of the Sick Role

If symptoms persist and become severe, clients assume the sick role. At this point the

illness becomes a social phenomenon, and

sick people seek confirmation from their

families and social groups that they are

indeed ill and that they be excused from

normal duties and role expectations.

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Health and Illness


Stage 3: Medical Care Contact

If symptoms persist despite the home remedies, become severe, or require

emergency care, the person is motivated to

seek professional health services. In this

stage the client seeks expert

acknowledgement of the illness as well as

the treatment.

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Health and Illness


Stage 4: Dependent Client Role

The client depends on health care professionals for the relief of

symptoms. The client accepts care,

sympathy and protection from the

demands and stresses of life.

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Health and Illness


Stage 4: Dependent Client Role

A client can adopt the dependent role in a health care institution, at home, or

in a community setting. The client

must also adjust to the disruption of a

daily schedule.

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Health and Illness


Stage 5: Recovery and Rehabilitation

This stage can arrive suddenly, such as when the symptoms appeared. In the

case of chronic illness, the final stage

may involve in an adjustment to a

prolonged reduction in health and

functioning.

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What Determines Health:

Income and social status

Social support networks

Education

Employment & working conditions

Social environments

Physical environments

Personal health practices and coping

Healthy child development

Biology and genetic endowment

Health services

Gender

Culture

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Causes of Chronic Disease

Individual-specific Modifiable Risk Factors

Unhealthy Diet

Physical Activity

Tobacco Use

Socioeconomic, Cultural, and Environmental Determinants

UrbanizationPopulation Aging Globalization

Individual-specific Non-Modifiable Risk Factors

Age

Heredity

Biochemical/Physiological Risk Factors

Raised Blood Pressure

Raised Blood Glucose

Abnormal Blood Lipids

Overweight/Obesity

Main Chronic Diseases

CancerHeart DiseaseStrokeChronic Respiratory DiseasesDiabetes

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Population Impact

Interventions

Source: McKinlay & Marceau (2000). Public health matters. Am J Pub Health, 90, 25-33, p. 29.

Levels of Causation

Organization & Community Interventions

EnvironmentalInfluences

SocialPosition

Social & Cultural Processes

PsychologicalProcesses

Biological & Genetic Factors

Primary & Secondary Prevention

Primary & Secondary Prevention / Treatment

Primary & Secondary Prevention / Treatment

Healthy Public Policy

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Health and IllnessLEVELS OF PREVENTION

Primary Prevention

Providing specific protection against disease to prevent its occurrence is the most desirable form of prevention.

Preventive measures consists of counseling, education and adoption of specific health practices or changes in life style.

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Primary Prevention

Examples:

Mandatory immunization of children belonging to the age range of 0-59

months old to control acute infectious

disease.

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Primary Prevention

Examples:

Minimizing contamination of the work or general environment by asbestos

dust, silicone dust, smoke, chemical

pollutants and excessive noise.

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Primary Prevention(infectious disease)

Primary PreventionPrevention measures before the disease happens.

Methods of Primary Prevention:

Seclusion or avoidancestaying away from infected individuals

Keeping yourself cleanwash hands with antibacterial soaps & shower

Get enough rest

Exercise on a regular basis

Eat Right

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Primary Prevention(noninfectious disease)

Prevention measures before the disease occurs.

Methods of Primary Prevention:

Not Smoking or drinking in excess Eating right Exercise on a regular basis Get enough rest Stress management (Yoga, Tai Chi, Progressive

Muscle Relaxation)

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Secondary Prevention

Consist of organized, direct screening efforts or education of the public to promote early case finding of an individual with disease so that prompt intervention can be instituted to halt pathologic processes and limit disability.

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Early diagnosis of a health problem can decrease the catastrophic effects that

might otherwise result for the individual

and the family from advanced illness

and its many complications.

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Examples:

Public education to promote breast self-examination, use of home kits for

detection of occult blood in stool

specimens and familiarity with the

seven cancer danger signals.

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Warning Signs of Cancer

C Change in bowel or bladder habits;

A A sore that does not heal;

U Unusual bleeding or discharge;

T Thickening or lump in breast or elsewhere;

I Indigestion or difficulty in swallowing;

O Obvious change in wart or mole;

N Nagging cough or hoarseness;

U Unexplained anemia; and

S Sudden unexplained weight loss.

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Examples:

Screening programs for hypertension, diabetes, uterine cancer (Pap smear), breast cancer (examination and mammography), glaucoma and sexually transmitted diseases.

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Secondary PreventionPreventive measures that lead to early diagnosis and prompt

treatment of a disease or injury to limit

disability and prevent a more severe disease.

Methods:

Visit your doctor on a regular basis

Visit your doctor for regular physicals

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Tertiary Prevention

It begins early in the period of recovery from illness and consists of such activities as

consistent and appropriate administration of

medications to optimize therapeutic effects,

moving and positioning to prevent

complications of immobility and passive and

active exercises to prevent disability.

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Tertiary Prevention

Continuing health supervision during rehabilitation to restore an individual to an

optimal level of functioning. Minimizing

residual disability and helping the client to

learn to live productively with limitations

are the goals of tertiary prevention.

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Tertiary Prevention

Tertiary PreventionMeasures aimed at rehabilitation following significant disease.

Methods:

Medications

Chemotherapy

Surgery

Dialysis

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Summary: Levels of Prevention

Primary Prevention - activities prevent a problem before it occurs (e.g., immunization against the

seven childhood illnesses).

Secondary Prevention activities provide early detection and intervention (e.g., screening for

presence of diabetes).

Tertiary Prevention activities correct a disease state and prevent it from further deteriorating (e.g.,

teaching insulin administration in the home).

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Health as a Multifactorial

Phenomenon

FACTORS AFFECTING HEALTH

Political involves ones leadership, how he/she rules,

manages and involves other people in decision making

- protection from exploitative working conditions

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Health as a Multifactorial Phenomenon


Political

- expanding access to social security

- creating the circumstances where people

can use their faculties and abilities at the

maximum level in the pursuit of common

goals

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Cultural

relating to the representation of nonphysical traits, such as values, beliefs, attitudes and customs shared by a group of people and passed from one generation to the next.

practices a customary action usually done to maintain or promote health like use of anting-anting or lucky charms

beliefs a state or habit of mind wherein a group of people place trust into something or a person (Webster)

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Definition of Values

Values are beliefs and things considered important by an individual or a family, such as

freedom, independence, privacy, physical

appearance, money, health and fitness, integrity

and honesty.

Values influence behavior and understanding a populations values leads to better tolerance why they react or respond to issues of health or are

resistant to change, among other facets of

behavior.

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Components of

Culture Roots

Culture refers to the sum total of customs, values, traditions,

art, history and other norms

that are developed, learned

and shared by a specific group

of people.

As these practices are passed down from generation to

generation, they may be

modified with time, knowledge,

acculturation, and lifestyle that

would result in security,

comfort and betterment of well

being.

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Heredity

the genetic transmission of traits from parents to offspring: genetically determined

(Miller-Keane, 1987)

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Newborn Screening (NBS)

A simple procedure using the heel prick method (a few drops of blood are taken from the babys heel and blotted on a special absorbent filter card, dried for 4 hours and sent to the Newborn Screening Center) to determine if the baby has a congenital metabolic disorder that may lead to mental retardation and even death if left untreated.

Most babies with metabolic disorders look normal at birth. One will never know that the baby has the disorder until the onset of signs and symptoms and more often ill effects are already irreversible.

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Newborn screening is mandated by

RA 9288 signed by PGMA in April 2004

Newborn screening is ideally done on the 48th72nd hour or at least 24 hours from birth. Some

disorders are not detected if the test is done

earlier than 24 hours. The baby must be

screened again after 2 weeks for more accurate

results.

Babies with positive results should be referred at once to the nearest hospital or specialist for

confirmatory test and further management.

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Disorders Screened in Newborns

Disorder Screened Effect ScreenedEffect if Screened

& Treated

Congenital Hypothyroidism (CH),

Results from lack or absence of thyroid hormone which is

essential to growth of the brain and the body.

Severe Mental

RetardationNormal

Congenital Adrenal Hyperplasia (CAH),

An endocrine disorder that causes severe salt loss,

dehydration and abnormally high levels of male sex

hormone in both boys and girls.

Death Alive and Normal

Galactosemia (GAL),

A condition in which the body is unable to process galactose,

the sugar present in milk.

Death or Cataracts,

Liver/Brain

Damage

Alive and Normal

Phenylketonuria (PKU),

A rare condition in which the baby cannot properly use one of

the building blocks of protein called phenylalanine.

Severe Mental

Retardation/

Brain Damage

Normal

Glucose-6-Phosphate Dehydrogenase Deficiency (G6PD Def),

A condition in which the body lacks the enzyme G6PD.

Severe Anemia,

KernicterusNormal

Source: Department of Health

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Environment

the sum total of all the conditions and elements that make up the surroundings

and influence the development of an

individual (Miller-Keane, 1987)

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Socio-economic

refers to the production activities, distribution and consumption of goods

of an individual

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Health Care Delivery

A PYRAMIDAL HEALTH STRUCTURE

National Health Services Tertiary Health Care

Regional Health Services Secondary Health Care

District Health Services

Rural (Local Hospital) Services

Rural Health Units Primary Health Care

Barangay Health Stations

NationalHealth

Services

Regional/District Health Service

Rural (Local HospitalServices)

Rural Health Units Barangay Health Stations

OVERVIEW OF THE

PHILIPPINE HEALTH SECTOR

THE PHILIPPINE HEALTH CARE

DELIVERY SYSTEM

ORGANIZATION OF THE HEALTH

SYSTEM

Dual health system consisting of the public sector and the private sector

Public Sector

- Largely taxed based financing

- Generally given free at point of service

- Socialized user charges introduced


SYSTEM

Private Sector

- For profit and non-profit providers

- Largely market-oriented

- Paid through users fees at point of

service


SYSTEM

( Public Sector ) Devolution of health services under Local

Government Code of 1991 leading to

fragmentation of health services

DOH as lead agency providing national policies and plans, regulations, standards

and guidelines on health, including tertiary

and specialized health care

LGUs as direct providers of health services, particularly public health programs & primary,

secondary and general tertiary hospital care


SYSTEM

( Private Sector )

For profit and non-profit health providers

- clinics and hospitals

- health insurance

- providers of health products

- research & academic institutions

Individuals, families and communities

- consumers and seekers of health care

- partners in health care

HEALTH CARE FACILITIES

>Local health facilities are poorly-equipped and poorly-staffed;

>Regional and national hospitals are congested

>Health facilities in the public and private sectors are unevenly distributed

>National-local and public-private networking and patient referral systems

are inadequate

THE HEALTH STATUS OF THE

FILIPINOS

DEMOGRAPHIC CHARACTERISTICS

Population growth rate remains high

Half of the population is below 21 years old

Average life expectancy is increasing

Proportion of older persons is growing

GENERAL HEALTH STATUS

Life expectancy at births has increased, with females having longer life expectancy

than males;

IMR and UFMR are declining, but the rate of decline has slowed down;

TFR and MMR are declining, but still one of the highest in Southeast Asia

Large variations in health status among different regions in the country

BURDEN OF DISEASE

Leading causes of morbidity are communicable diseases

Leading causes of mortality are degenerative and other non-

communicable diseases

Double burden of disease places a great toll of the economy

Threat from emerging and resurgent diseases is increasing

UTILIZATION OF HEALTH SERVICES

Fairly widespread use of health facilities in the country with 77 % of households

having used a health facility

Government facilities were most frequented( 39%) compared to private

facilities ( 30 % )

Traditional healers were visited by 8 % of the population

THE VISION, MISSION AND GOALS OF

THE PHILIPPINE HEALTH SECTOR

VISION : Health for all Filipinos

MISSION : To ensure accessibility and

quality of health care to improve the

quality of life of all Filipinos, especially the

poor.

THE PRIMARY GOALS OF THE HEALTH

SECTOR

Better Health Outcomes

- Attaining the best average level of health for the entire population and attaining the smallest feasible differences in health status among individuals and groups

More Responsive Health System

- Meeting the peoples expectations of how they should be treated by health providers and the degree by which people are satisfied with the health system

THE PRIMARY GOALS OF THE

HEALTH SECTOR

More Equitable Health care Financing

- Distributing the risk that each individual

faces due to cost of health care according

to the ability to pay rather than to the risk

of illness

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Health Promotion

Public health efforts focus on health promotion and disease prevention.

Health promotion activities enhance resources directed at improving well being,

whereas disease prevention activities

protect people from disease and the

effects of disease.

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Primary Health Care

DEFINITION

Universal Definition

- Essential care based on scientifically sound

and socially acceptable methods and technology

made universally accessible to individuals,

families and communities through their full

participation, at a cost they can afford at any

given stage of development, and with the goal of

self-reliance and self-determination.

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Primary Health Care

GENERAL PRINCIPLES OF PRIMARY HEALTH CARE:

Health and development are interrelated.

Essential health services must be accessible, available, acceptable and affordable.

Genuine peoples participation is essential.

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Primary Health Care

Mission and Goals

Mission: To strengthen the health care system by increasing opportunities and supporting the conditions wherein people will manage their own health care.

Key Strategy to Achieve the Goal:Partnership with and empowerment of the People.Health for All by the Year 2000

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The strategy for achieving healthfor all is based on four (4) basic points:

Use of technology that is scientifically and socially acceptable as well as economically sound.

Political efforts to improve health, thus improving peoples economic and social status.

Cooperation of the health sector with other sectors such as education, agriculture, industry and media.

Community and individual participation.

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Primary Health Care

Mission and Goals

Key Strategy to Achieve the Goal:Partnership with and empowerment of the People.Health for All by the Year 2000

Health in the Hands of the People by the Year 2020Strategy: Advocacy and Social Mobilization

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Primary Health Care

Primary Health Care

H-O-M-E E-L-E-M-E-N-T-S

H - Hospital as a Center of Wellness

O - Oral and Dental Health

M - Mental Health

E - Elderly Care

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Primary Health Care

Primary Health Care E-L-E-M-E-N-T-S

E- Education for Health

L- Local Endemic Disease Prevn & Control

E- Expanded Program on Immunization

M- Maternal and Child Health

E- Essential Drugs

N- Nutrition

T- Treatment of Communicable Diseases

S- Safe Water and Sanitation

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Four Pillars of Safe MotherhoodDOH

Antenatal/Prenatal Care

Emergency OB Care

Clean & Safe Delivery

Family Planning

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Focuses on the promotion

and advocacy of 10

scientifically-proven

medicinal plants endorsed

by DOH.

Lagundi,Yerba Buena,Sambong,Tsaang Gubat,Niyug-niyugan,Bayabas,Akapulko,Ulasimang Bato,BawangAmpalaya.

Herbal Medicine Community-Based Program

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Care Enhancement Qualities

STEPS IN PROBLEM SOLVING

(A-D-P-I-E)

ASSESSMENT: COLLECT DATA

DIAGNOSIS: DEFINE THE PROBLEM

PLAN: SELECT STRATEGIES

IMPLEMENTATION: TAKE ACTION

EVALUATION: EVALUATE RESULTS

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CARATIVE ELEMENTS

Humanistic-altruistic value system

Faith and hope

Sensitivity to self and others

Helping trust relationship

Ability to accept positive and negative expression of feelings

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CARATIVE ELEMENTS

Interpersonal teaching and learning abilities

Personality type

Solid family background

Experience of having been loved and the ability to love

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CARATIVE ELEMENTS

Sense of humor

Relaxed attitude

Open-mindedness

Quick decision making

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HEALTH CARE 2

COMMUNITY ORGANIZING PARTICIPATORY ACTION RESEARCH

(COPAR)

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COMMUNITY

A social group determined by geographic boundaries and/or common values and

interests

Members know and interact with each other

Functions within a particular social structure and exhibits and creates

norms, values and social institutions

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COMMUNITY

Classification

Urban

Rural

Rurban

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URBAN

High density

Socially heterogeneous population and a complex structure, non-agricultural

occupations

Complex interpersonal social relations

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RURAL

Small and the occupation of the people is usually farming, fishing and food

gathering

Primary group relation, well-knit and high degree of group feeling

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RURBAN

Rural families continuously

migrate to the

metropolis

forming

communities of

urban poor

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HEALTH INDICATORS

Birth

Death

Marriages

Migration

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BIRTH

A coming into being; the act or process of being born.

Crude Birth Rate is only a rough measure of fertility in a population since it

makes use of midyear population as its

denominator.

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DEATH

The cessation of all physical and chemical processes that occurs in all living things.

Crude Death Rate is only a rough measure of mortality because death rates

are largely influenced by age and sex

composition of the population.

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MARRIAGE

The institution whereby a man and a woman are

joined in a special kind of

social and legal

dependence for the

purpose of founding and

maintaining a family.

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MIGRATION

The transfer of one individual from one locality to another.

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Community Health Care

Development Process (COPAR)

Approaches to Community

Development

1. Welfare Approach

2. Modernization Approach

3. Transformatory/

Participatory Approach

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Welfare Approach

- The immediate and/or spontaneous

response to ameliorate the

manifestation of poverty, especially on

the personal level.

- Assumes that poverty is God-given;

destined, hence the poor should accept

their condition since they will receive

their just reward in heaven.

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Welfare Approach

- Believes that poverty is caused by bad luck,

natural disasters and certain circumstances

which are beyond the control of people.

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Modernization Approach

- Also referred to as project development

approach.

- Introduces whatever resources are lacking

in a given community.

- Also considered a national strategy which

adopts the western mode of technological

development.

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Modernization Approach

- Assumes that development consists of

abandoning the traditional methods of

doing things and must adopt the

technology of industrial countries.

- Believes that poverty is due to lack of

education; lack of resources such as

capital and technology.

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Transformatory/Participatory

Approach

- The process of empowering/

transforming the poor and the oppressed

sectors of society so that they can

pursue a more just and humane society.

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Transformatory/Participatory

Approach

- Assumes that poverty is not God-given, rather it is rooted in the historical past and is maintained by the oppressive structure in society

- Believes that poverty is caused by prevalence of exploitation, oppression, domination and other unjust structure

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Community Health Care

Development Process (COPAR)

Phases

1. Pre-entry Phase

2. Entry Phase

3. Organization-Building Phase

4. Community Action Phase

5. Sustenance and Strengthening Phase

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Pre-Entry Phase

- The initial phase of the organizing

process where the community organizer

looks for community to serve or help.

- Considered the simplest phase in terms

of actual outputs, activities, strategies

and time spent for it.

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Pre-Entry Phase

Activities:

Designing a plan for community development including all its activities and

strategies for care/ development.

Community consultations/dialogues

Designing criteria for the selection of site.

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Pre-Entry Phase

Activities:

Site selection

Preliminary Social Investigation

Networking with local government units, NGOs and others

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Entry Phase

- Sometimes called the social preparation phase as the activities done here includes the sensitization of the people on the critical events in their life, motivating them to share their dreams and ideas on how to manage their concerns and eventually mobilizing them to take collective action on these.

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Entry Phase

Guidelines:

1. Recognize the role of local authorities

by paying them visits to inform them of

their presence and activities.

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Entry Phase

Guidelines:

2. Appearance, speech, behavior and

lifestyle should be in keeping with those

of the community residents without

disregard of their being role models.

3. Avoid raising the consciousness of the

community residents; adopt a low-key

profile.

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Entry Phase

Activities:

Integration with the community

Sensitization of the community/information campaigns

Continuing social investigation

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Entry Phase

Activities:

Core group formation

- Development of criteria for selection of

CG members

- Defining the role/functions/tasks of the

CG

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Entry Phase

Activities:

Coordination/Dialogue/Consultation with other community organizations

Self Awareness and Leadership Training/ Action planning

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Organization-Building Phase

- Entails the formation of more formal

structures and the inclusion of more formal

procedures of planning, implementing and

evaluating community wide activities

- It is at this phase where the organized

leaders or groups are being given training

to develop their AKS in managing their

own concerns/programs.

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Activities:

Community meetings to draw up guidelines for the organization of the

CHO

Election of officers

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Activities:

Development of management systems and procedures, including delineation of

the roles, functions and tasks of officers

and members of the CHO

Team building/Action Reflection Action (ARA)

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Activities:

Working out legal requirements for the establishment of the CHO

Organization of working committees/task groups (e.g. education and training,

membership of committees)

Training of the CHO Officers/community leaders

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Community Action Phase

Activities:

Organization and training of community health workers

- Development of criteria for the selection of

CHWs

- Selection of CHWs

- Training of CHWs

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Community Action Phase

Activities:

Setting up of linkages/network referral systems

Initial identification and implementation of resource mobilization schemes

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Sustenance and Strengthening

Phase

- Occurs when the community

organization has already been

established and the community

members are actively participating

in community-wide undertakings

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Phase

- The different committees set-up in the

organization-building phase are already

expected to be functioning by way of

planning, implementing and evaluating

their own programs with the overall

guidance from the community wide

organization.

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Phase

Strategies:

- Education and training

- Networking and linkaging

- Conduct of mobilization on health and

development concerns

- Implementation of livelihood projects

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Phase

Strategies:

- Formulation and ratification of

constitutions and by-laws

- Identification and development of

secondary leaders

- Setting up and institutionalization of

financing scheme for community health

program/activities

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Phase

Strategies:

- Development and implementation of

viable management systems and

procedures, committees, continuing

education/training of leaders, CHWs,

community residents

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Phase

Strategies:

- Continuing education and upgrading of

community leaders, CHWs and CHO

members

- Development of medium/long term

community health and development

plans.

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Critical Steps in Building

Peoples Organization

1. Integration

a. Immerse himself in the poor community

b. Understand deeply the culture,

economy, leaders, history, rhythms and

lifestyle in the community

Adela



2. Social Investigation

- A systematic process of collecting,

collating, analyzing data to draw a

clear picture of the community

- Also known as community study

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3. Tentative Program Planning

A community organizer choose one

issue to work on in order to begin

organizing the people.

4. Groundwork

Going around and motivating the people

on one on one basis to do something on

the issue that has been chosen.

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5. The Meeting

People collectively ratifying what they

have already decided individually. It

gives the people the collective power

and confidence. Problems and issues

are discussed.

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6. Role Play

Means to act out the meeting that will

take place between the leaders of the

people and the government

representative.

- It is a way of training the people to

anticipate what will happen and prepare

themselves for such eventuality.

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7. Mobilization or action

Actual experience of the people in confronting the powerful and the actual exercise of people power.

8. Evaluation

The people reviewing steps 1-7 to determine whether they were successful or not in their objectives.

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9. Reflection

- Dealing with deeper, on-going

concerns to look at the positive values

CO is trying to build in the organization

- Gives the people time to reflect on the

stark reality of life compared to the

ideal.

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10. Organization

- The peoples organization is the result of many successive and similar actions

of the people.

- A final organization is set up with

elected officers and supporting

members.

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Community Health Worker

One who provides basic community health

care services for promotion of health,

prevention of illness, simple treatment and

rehabilitation.

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Qualities of a Health Worker

a. Open accepts need for joint planning and decision relative to health care in a

particular situation not resistant to

change.

b. Tactful one who presides over an assembly, meeting or discussion in a

subtle manner; does not embarrass but

gives constructive criticisms.

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c. Coordinator brings into consonance or harmony the communitys health care activity.

d. Objective unbiased and fair in decision-making.

e. Good listener always available for the participant to voice out their sentiments

and needs.

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f. Efficient knowledge about everything relevant to his practice; has the

necessary skills expected of him

g. Flexible able to cope with different situations

h. Critical thinker decides on what has been analyzed

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Functions of a Health Worker

1. Community Health Service Provider

Carries out health services contributing to the promotion of health, prevention

of illness, early treatment of illnesses

and rehabilitation.

Appraises health needs and hazards.

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2. Facilitator

- Helps plan a comprehensive health

program with the people

- Continuing guidance and supervisory

assistance

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3. Health Counselor

- Provides health counseling including

emotional support to individuals, family,

group and community

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4. Co-Researcher

- Provides the community with

stimulation necessary for a wider or

more complex study of problems

- Enforce community to do prompt and

intelligent reporting of epidemiological

investigation of diseases

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4. Co-Researcher

- Suggest areas that need research

- Participate in planning for the study

and in formulating procedures

- Assist in collecting of data

- Help interpret findings collectively

- Act on the result of the research

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5. Member of a Team

- In operating within the team, one must

be willing to listen as well as to

contribute, to teach as well as to learn,

to lead as well as to follow, to share

authority as well as to work under it.

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5. Member of a Team

- Helps make multiple services which

the family receives in the course of

health care, coordinated, continuous

and comprehensive.

- Consults with and refers to appropriate

personnel for any other community

service.

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6. Health Educator

- One who improves the health of the

people by employing various methods

of scientific procedures to stimulate,

arouse and guide people to healthful

ways of living.

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TRENDS AND ISSUES IN

HEALTH CARE

Changing demographics and cultural diversity

Improving health care delivery system

Technological advances and research

Increasing globalization

Preventing terrorism

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TRENDS AND ISSUES IN

HEALTH CARE

Increasing consumer/client involvement

Outcome management

Increasing the availability of skilled health professionals, especially nurses and physicians (also RNDs)

Improving infrastructure in rural areas

Extending education/outreach programs to remote areas (DDUs)

Adela

WORLD LESSONS LEARNED

ABOUT HEALTH CARE

Healthcare systems vary depending on the development level of a country. But the key to implementation is publicly mandated services (public or private). Such services cannot be few and must include those that accommodate accountability in ensuring universal delivery. Supplementary insurance must be allowed for items not covered in the universal system. )

Source: World Economic Forum 28 Jan 2009

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WORLD LESSONS LEARNED ABOUT HEALTH CARE

Japan has the worlds oldest population. Health and longevity create wealth and, thus, health begets wealth. It is documented that nations that develop a 5-year life expectancy advantage also create a larger GDP. A healthy childhood and adulthood contribute to a more productive old age.

New markets and industries are arising silver industries such as financial services, health, housing and hospitality geared to senior citizens. Longevity needs to be linked to health including cognitive health and lifestyle choices play a major role in health.


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The public health focus is shifting from infections to cardiovascular diseases. Complex new models are necessary to develop better responses and improved health with the primary emphasis on really good primary healthcare and prevention to lower costs.

Prevention increases the healthy years of a persons life. The challenge is creating the incentive for prevention: how can people be encouraged to make healthy choices? Mobilized populations can drive the change.

Finland has an 80% lower incidence of heart disease than 30 years ago due to such incentives.


Adela


Improved nutrition and food security also play a role in health outcomes. Increasingly, governments are willing to come to grips with outcomes and to acknowledge that healthcare providers must be geared to supply intervention

to the most vulnerable people.

Indeed, the World Economic Forum could play an important role in fielding a public-private health initiative or supporting efforts to mine large healthcare databases to unearth previously unsuspected correlations.


Adela


Governments must recognize the health, social and political aspects of a serious influenza pandemic. On all levels whether public or private the mantra remains proper diagnosis, correct intervention and appropriate ways of delivering solutions. But how best to ensure that poorer countries can be prepared to support such efforts?

Many of the poorest including migrant populations and refugees are off the radar and may unwittingly be reservoirs of infectious ailments.


Adela


Alzheimers and dementia are on the increase. New research suggests that they relate to the same causes and could respond to the same preventive measures including physical activity and moderate alcohol intake; but this still awaits thorough investigation. . .


Health Care Lecture

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