Definitions, Principles & Activities of Primary Health Care

DEFINITION OF PRIMARY HEALTH CARE

• Primary Health Care is essential health care made universally accessible to individuals and families in the community by means acceptable to them through their full participation and at a cost that the community and country can afford.

• It is the first level of contact of individuals and the family with the national health system bringing health care as close as possible to where people live and work and establishes the first element of a continuing care process.

ELEMENTS OF PRIMARY HEALTH CARE

1. Education and information concerning prevailing health problems and methods of preventing and controlling them

2. Promotion of food supply and proper nutrition

3. An adequate supply of safe water and basic sanitation

4. Maternal and child health care including family planning

ELEMENTS OF PRIMARY HEALTH CARE

5. Immunization against the major infectious diseases

6. Prevention and control of locally endemic diseases

7. Appropriate treatment of common diseases and injuries

8. Provision of essential drugs

Element No. I :Education concerning prevailing health

problems and methods of preventing and controlling them

• is an essential factor mentioned in Alma-Ata

• People should be educated with this concept in their minds for health practice.

• Also education to make the individual able to think and decide about his health

• Education is based on socio economic conditions, politics, culture and

Element No. 2Promotion of food supply and proper

nutrition• Why there is importance is given to nutrition?

• Nutrition is a basic factor influencing the quality of human life.

• Under nutrition is still one of the greatesthealth hazards.

• Child and maternal malnutrition is widespread.

Element No. 2Promotion of food supply and proper

nutrition

• Community health workers should be responsible: for

A. the promotion of better nutrition.

B. Correction of faulty feeding practices and prevention of infectious diseases which are nutrition related e.g., diarrhea.

Element No .3An adequate supply of safe water and

basic sanitation

• the foremost (principle) in primary health care is: Safe, adequate and accessible supplies of water together with proper sanitation.

• What is the main objectives of this PHC elements? And by what?

1. to prevent diseases and 2. improve the quality of life and well-being of

population • By:1. promoting personal and community hygiene, ensuring

the availability of safe water supply and sanitation facilities through independent community action and

2. also by associating water supply and sanitation with other health and / or development programs.

Element No. 4Maternal and child health care including family

planning

• aims at:

• promoting and protecting the health of children and women of childbearing age,

• Why:

1. so that all children have the possibility for healthy growth and development

2. and so that the reproductive life of women is compatible with a state of health and well-being.

What are the care included in MCH/FP?

• MCH/FP care includes at least five main functions:

1. Antenatal care

2. Delivery care

3. Postnatal care

4. Child care

5. family planning care

Element No. 5Immunization against the major

infectious diseases

• What does immunization program is initiated? And by what? And How?

• reduce morbidity and mortality

• by providing immunization against the major killers of children

• For which diseases does developing world gave priority?

is usually given to the following diseases.

a) Diphtheria

b) Whooping cough

c) Tetanus

d)Measles and Rubella

e) Poliomyelitis

f) Tuberculosis

g) Hepatitis B

h) Mumps

i) Pneumococcal.

When does immunization is given?

• In addition children are protected in the first year of life. Also tetanus immunization is given for pregnant mothers.

Element No. 6Prevention and control of locally endemic

diseasesA. Malaria

• In the past malaria was one of the major health problems in Oman.

• National Malaria Eradication Programme (NMEP) was initiated in ALSharquiyagovernorates as a pilot in 1990 with main objectives of stopping local transmission and eliminate the reservoir of infected cases.

Element No. 6Prevention and control of locally endemic

diseasesA. Malaria

• Strategies applied were: vector control, mainly larviciding, and early case detection and prompt radical treatment.

Element No. 7Appropriate treatment of common

diseases and injuries

• A. Diarrheal diseases

• B. Common accidents in the home

A. Diarrheal Disease

• Prevention of diarrheal morbidity and mortality is a vital part of national strategies of PHC. Diarrheal disease control itself includes three main functions (objectives) namely:

a. Diagnosis of diarrheal disease

b. Provision of appropriate treatment (plan A, plan B, plan C)

c. Management of outbreaks of diarrheal diseases and its prevention

A. Diarrheal Disease

• How to achieve these objectives?

• In order to achieve the above objectives support is required in terms of appropriate information, appropriate technologies, equipment and supplies, improved communication, supervision and technical support.

B. Common Accidents in the home:

• Accidents are among the highest causes of death in most countries.

• The aim therefore must be:1. not only to provide first aid on the spot and adequate

treatment at the appropriate level of care, but 2. also to prevent the occurrence of similar accidents in the

future and 3. provide programs for active rehabilitation of disabled

persons, children as well as adults.• Three types of home accidents have been chosen as

examples, namely;• a) Cuts b) Burns & Scalds c) Poisoning

B. Common Accidents in the home:

• Three types of home accidents have been chosen as examples, namely;

a) Cuts

b) b) Burns & Scalds

c) c) Poisoning

Element No. 8: Provision of essential drugs

• aims at making these drugs available to all over the country at all times.

How to make drugs available to all over the country at all times?

• by instituting an efficient system of drug acquisition , storage, distribution, and utilization.

• To achieve this, all persons concerned with primary health care should participate actively in the management of drugs at their own level.

How to make drugs available to all over the country at all times?

• Is there any relation between availability of drugs at one center and in any other center in the county?

• Yes, Drug management in primary health care is an integral part of the overall drug management plan for a country wide health system.

Objectives of Primary Health Care in Oman

1. Provision of an accessible, comprehensive as well as specialized PHC service to the community.

2. Advanced capacity building to the health professionals in leadership, management and clinical skills.

3. Implementing PHC policies.

4. To strengthen the screening in Primary Health Care through defaulter tracing and early detection of diseases and its management among above 40 years.

5. Implementing effective and accredited CPD training Program for PHC workers.

The FIVE Principles of Primary Health Care

A. Universal coverage of the population with care provided according to need:

• This is the call of fairness. No one should be left out, no matter how poor or how remote. It means the "ALL" in Health for All

B. Services should be promotive, preventive, curative and rehabilitative:

• Services should not be only curative but also should be promotive to the population's understanding of health and healthy style of life, and reach toward the root causes of diseases with preventive emphasis. Treatment of illness and rehabilitation are important as wel

C. Services should be effective, culturally acceptable, affordable and manageable

Services must be effective. Cultural acceptability and effectiveness are mutually dependent services must be affordable in local terms as governmental resources are limited

• D. Community should be involved to promote self-reliance

• The community should be actively involved in the process of defining health problems and needs, developing and implementing solutions and evaluating programs.

E. Approaches to health should be related to other sectors of development

• Actions should be taken to deal with causes of ill health. Education for literacy , clean water and sanitation, improved housing, ecological sustainability, building of roads or waterways, income supplementation, enhancing roles for women, more effective marketing of products. All these have a substantial impact on health

Quality Assurance

• Improvement and Patient Safety Program in PHC in Oman

• Vision

• provide a health service that is accessible, acceptable, efficient, effective and safe that is continuously evaluated and improved.

Why does Quality assurance is important?

• Quality assurance is important because it: leads to increase and irrationalized expenses of health services, users' dissatisfaction as well as high rates of medication and medical errors.

What does ministry of health do in relation to quality assurance?

• The Ministry of health has adopted a Total Quality Strategy to establish and maintain Quality Management systems in Health Care Institutions.

What does effective implementation of quality systems requires?

• The effective implementation of quality systems requires joint work between all health care workers in one side and different community sectors on the other side.

Thank You