Primery health care

8/9/2019 Primery health care

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ALMA ATA DECLARATION

The main goal of Governments andWorld Health Organization in the comingdecades should be the attainment by allpeople of the world by the year 2000, a

level of health that would permit them tolead a socially and economicallyproductive life


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Themes Leading toAlma Ata

1. Changing theories of health &development: shift away from GNP(Gross National Product) as measureof development towards recognition of

the need of social development2. Concerns about poverty & populationcontrol

3. Increasing confidence upon alternativeapproaches to medical care model

4. Success of CHWs & associatedimportance on community participation

5. Revival of interest in public health;tackling causes of ill health rather than

symptoms


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B

A B


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D

C D


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F

E F


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H

G H


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I

A J


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L

K

L


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M

M N


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P

O P


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R

Q R


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S

S T


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V

U V


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X

W X


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Y

Y Z


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PRIMARY HEALTH CARE

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 and

at a cost that the community and the country

can afford It forms an integral part of the

country's health system, of which it is the

central function and the main focus, and of the

overall social and economic development of the

community


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PRINCIPLES OF PHC

1. Health Prevention & Promotion

2. Equity

3. Appropriate Technology

4. Community Participation

5. Intersectoral Coordination

6. Decentralization*


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COMPONENTS OF PHC1. Education concerning prevailing health problems &

the methods of preventing & controlling them

2. Promotion of food supply and proper nutrition

3. An adequate supply of safe water and basic

sanitation

4. MCH including FP

5. Immunization against major infectious diseases6. Prevention and control of locally endemic diseases

7. Appropriate treatment of common diseases and

injuries

8. Provision of essential drugs


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PHC: EXTENDED ELEMENTS IN THE 21st CENTURY

1. Expanded options of immunization

2. Reproductive health needs

3. Provision of essential technologies for health

4. Health promotion as defined in Ottawa Charter

and authorized by resolution (WHA 42.44)5. Prevention and control of non-communicable

diseases

6. Food safety and provision of selected food

supplements0


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PHC: Global Targets1.All people in every country will have ready access at least to

essential health care & to first-level referral facilities2. All people will be actively involved in caring for themselves &

their families, as far as they can, in community action for health

3. Communities throughout the world will share governments

responsibility for the health care of their members

4. All governments will assume the overall responsibility for

the health of their people

5. Safe drinking water & sanitation will be available to all

people (Cont )


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PHC:Global Targets (Cont )

6. All people will be passably nourished

7. All children will be immunizes against the major

diseases of childhood

8. Communicable diseases in the developing countries

will be of no greater public health significance in the

year 2000

9. All possible ways will be applied to prevent &

control non-communicable diseases & promote mental

health through influencing the life styles &

controlling the physical & psychological environment

10. Essential drugs will be available to all


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GLOBAL HEALTH TARGETS

1. Health equity: childhood act

2. Survival: MMR, CMR, life expectancy

3. Reverse global trends of five major pandemics

4. remove and eliminate certain diseases

5. Improve access to water, sanitation, food and shelter

6. Measures to promote health7. Develop, implement and monitor national HFA policies

8. Improve access to comprehensive essential, qualityhealth care

9. Implement global and national health information and

observation systems10. Support research for health


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Obstacles totheImplementationofPHC Strategy

1. Misinterpretation of the PHC Concept

2. Misconception that PHC is a 2nd rate

health care for the poor

3. Selective PHC Strategies

4. Resistance to Change

5. Lack of political will6. Centralized Planning & Management

Infrastructure


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SELECTIVE

PRIMARY HEALTH CAREPHC involve that if one cannot afford to

offer universal coverage for even the

most basic of health care, one could

would offer treatment & preventive

strategies for the few diseases

identified as having the greatest threat

to humanity, & which are amenable toprevention / cure at low cost.


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Comprehensive PHC

ADVANTAGES

1.Looks at total healthcare

2.Involvement ofcommunity

3.Covers all elements ofPHC

4.Ensures equitable

distribution ofresources

5.Facilitates effectivereferral system

6.Government goal

DISADVANTAGES

1. More costly toimplement

2. Takes long timeto see impact

3. Long time toprocess

4. Lack ofspecializedtreatment

5. Expensive6. Inefficient

referral system

???-- misuse


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Selective PHC

ADVANTAGES

1.Donor friendly

2.Elimination of selecteddisease

3.Easy to plan & implement

4.Is focused & have moreimpact

5.Easy to manage &measure output

6.Require limited resources7.Improve quality of

services

DISADVANTAGES

1. Disease rather thanhealth oriented

2. Doesnt ensure equity

3. Top down decisionmaking

4. Neglect other

problems5. Leads to outbreak

6. Resources (tight)might not be availablefor urgent needs(emergencies)

7. Less communityinvolvement donorpriority


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Reasons for slow progress

towards HFA (Cont.)

7. Widespread inadequacy of health promotion

activities

8. Weak health information systems and no

baseline data9. Pollution, poor food safety, and lack of safe

water supply and sanitation

10. Rapid demographic and epidemiological

changes11. Inappropriate use of, and allocation of

resources for, high cost technology

12. Natural and man-made disaster


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PHC: FROM ALMA- ATATO21st CENTURY

1. PHC as an approach has provided impetus and

energy to progress towards HFA2. Some progress has been made in ensuring

access to the original eight PHC elements3. PHC remains valid as the point of entry into a

comprehensive health care system

4. Interconnect oral action for health has notbeen fully achieved

5. Reorientation of health services andpersonnel to PHC principles remains elusive

6. Community participation takes time and

dedication by all


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New Trends that Will InfluenceHealth in the 21st Century

1. Widespread absolute and relative poverty2. Demographic changes: aging and growth ofcities

3. Epidemiological changes: continuing highincidence of infectious diseases; increasingincidence of non- communicable diseases,

injuries and violence4. Global environmental threats to human survival5. New technologies: information and

telemedicine services6. Advances in biotechnology

7. Globalization of trade, travel and spread ofvalues and ideas


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GOALS AND TARGETS OF HFA1. An increase in life expectancy and in the

quality of life for all2. Improved quality in health between and

within countries

3. Access for all to sustainable health systems

and services

An initial set of targets will guide the

implementation of the HFA policy and definepriorities for action for the first two decades

of the 21st century


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THE PRINCIPALS OF HEALTH PROMOTION IN THE

OTTAWA CHARTER (1986)

1. Building a healthy public policy

2. Creating supportive environment

3. Developing personal skills

4. Strengthening community action

5. Reorienting health services


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PHC in the 21st Century:Policy Objectives to support thePHC Approach

1. Make health central to development andenhance prospects for intersect oralaction

2. Combat poverty as a reflection of PHCs

concern for social justice3. Promote equity in access to health care

4. Build partnerships to include families,communities and their organizations

5. Reorient health systems towardspromotion of health and prevention ofdisease

u y :


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u y :Some Essential Components

Attach greater emphasis tocomprehensive quality health carethroughout the life span

Ensure equitable access to the originaleight PHC elements

Expand PHC elements in response to

identification of new threats of health,and opportunities to tackle thesethreats


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Essential Health System Functionsthat Complement and Support PHC

Provide sustainable financing of PHC

Invest in human and institutional capacity forhealth

Optimize private and public sector support forPHC through appropriate regulations

Strengthen research to support and advancePHC

Implement global, national and localsurveillance and monitoring systems

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