PRIMARY CARE TO THE HEALTH OF A POPULATION

Essay by Josué M. Pedraza C.

INTRODUCTION

We can say that health is physical, mental and social wellbeing and not merely the absence of disease or infirmity.

In this fact the role of primary care to the health is a very important fact for the wellbeing of the community because this is based mainly on promotion and prevention of diseases, providing the populations means to improve health and increase control over it, through the intervention of the determinants of health and reducing inequality.

This takes place mainly through the following fields: public policy formulation, creating supportive environments for health, strengthening action and community participation, development of healthy personal attitudes and reorienting health services; for their Features The health promotion is a strong intersectoral action that makes the social mobilization required to transform health conditions.

The primary care to the health refers to the kind of care provided at the first point of contact with the health care system.

The primary care to the health was originated with the Declaration of Alma Ata aiming to achieve Health for All by the Year 2000. The principles set out in this Declaration are the essence of what is called comprehensive universal primary care of the health. This is essential health care based on practical methods and technologies, scientifically sound and socially acceptable, available to all individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every single stages of development in a spirit of self-reliance and auto-determination.

A year after the declaration of Alma Alta, Walsh and Warren (1993), raised the strategy of selective PHC (Primary Health Care) as an interim alternative that would allow start implementing PHC. This strategy argued that the best way to improve health was to fight a disease based on cost-effectiveness. Thus, these authors identified four factors to guide the selection of the diseases with the aim of prevention and treatment: prevalence, morbidity, mortality, and viability control (including effectiveness and cost).

This narrow selection of the specific conditions for these populations was designed to improve health statistics, but abandoned the approach of Alma Ata on the social equity and health, based on this approach the concept of comprehensive primary care is created, whose main components are a concern to improve the quality of life, equity and access to care as guiding principles (Lawn et als, 2008).

For some authors, the transformative potential from a selective primary care a comprehensive health care has remained largely untapped (Magnussen et al, 2004). However, there were some important

successes, especially in the 1980s where PHC coverage was increased and health status of the population was considerably improved (Streefland & Chabot, 1990).

The keys to these achievements were related to the political will to meet basic health needs of all citizens, active participation of the population in the effort to achieve this goal by improving social and economic equity (Baum & Sanders, 1995 ).

In September 2003, after 25 years of Alma Ata, PAHO after meeting found that the APS were being considered in America, just as a form of entry to health services, but not as a development strategy to achieve better levels of care.

However, although the objectives were not being fully met, progress was checked in health levels and are able to establish some lessons, and finally goals for the future were established (Montenegro, Girard, Duarte & Oyarzun, 2007).

PRIMARY CARE TO THE HEALTH

Primary Health Care (PHC) is a strategy to ensure health for all and universal and equitable access to medical service system so that its implementation requires competent professionals to perform responsibly in each of its levels of complexity.

Thus, the primary health care is essential health care to all individuals and families in the community can access through acceptable means to them, with their full participation and at an affordable cost to the community and the country. It is the core of the health system of a country and an integral part of overall socio-economic development of the community.

By the way, the Primary Health Care provides a way to organize all health care, from households to hospitals, where prevention is as important as cure, and with resources invested rationally at different levels of care.

The basic principles of Primary Health Care are: the equitable distribution of resources, as all groups in society have the same rights to health, including economic access to services; appropriate technology; primary health care should be based on affordable, ethical and culturally acceptable methods for the individuals and the community, and be appropriate to the conditions that are to be applied; Cooperation between different sectors, collaborating and following common strategies with other sectors whose policies are related to health, such as agriculture, education and housing and community participation that is responsible for encouraging and give opportunity to people actively involved in decisions about their own health and health services for their community.

The Primary Health Care, has sought to encourage community participation in solving health problems and the exercise of the enforcement of law and participation understood as the ability of the population to take effective and dignified part in decisions of health care and the implementation of programs and projects that lead to it.

SOCIAL PARTICIPATION

Participate in health means the sensitizing the community to development programs, voluntary contributions, or their ability to formulate projects to improve the quality of life through health actions. Moreover, since the focus of social policy, constitutes participate expression of democracy and link with development programs.

For Primary Health Care, social participation is the right and ability of the population to participate effectively and responsibly in the decisions of health care and its implementation. This participation is partly a condition for exercising freedom, democracy, social control over public action, and therefore, for equity.

It is essential to ensure effectiveness and satisfaction which is a desirable end in Practicing Self condition. Policies to promote participation have been inserted into health systems in various stages of development and meet the social, economic and political contexts of societies that adopt them, where the focus is based on the needs of the community, bringing health services to the population, increasing system efficiency and providing solutions adapted to local needs.

For Primary health Care, the participation of the community imply an active process that generate socially accepted health practices, and prioritize their contribution to achieving self-reliance and self-management in health. And so the participation of the community is considered as a means and an end in itself.

Overall, participation becomes a principle and element of the Primary care of the health and one of the essential functions of public health, defined as reinforcement of the power of citizens to change their own lifestyles and become an active part of the process aimed at developing healthy behaviors and environments so that influence decisions that affect their health and access to adequate health services.

It is closely linked to strengthening the building of intersectoral partnerships with civil society to allow use of all human capital and material resources available to improve the state of health of the population and promote environments that foster healthy lifestyles.

There are two important components Participation: Collective and individual.

A) The Collective is represented by the Associations of users, Community Involvement Committees, by participation in the ethics committees of public institutions and place community representation on the boards of directors of insurers and service institutions health.

B) Individual is represented in the control exercised by the user through the offices of customer service.

From this perspective, social participation in health is understood as exercise of these skills the duties and rights of the individual to be directed towards the conservation of personal, family and community health and contribute to the planning, management, evaluation and oversight in health services. However, in practice participation is down to individual service request given the barriers that these institutions presented to the user; few of them know the mechanisms of participation and the way to access them, remains a rigid exercise of power from institutions that do not promote attitudes of trust

and tolerance to the proposals and demands of the community. For this reason, participation leads to recognize the capacity of achieving users as the first step in building trust and reciprocity. Given a community that looks askance participation of institutions; and the fulfillment of commitments is a first step.

BENEFITS OF A HEALTH SYSTEM BASED ON PRIMARY HEALTH CARE:

a) Allows access to health to all individuals and populations, promoting and preventing health action in advance through basic health services on the basis of the principles of solidarity and participation of individuals as they have with the possibility to decide about their own health.

b) Seeking equality in health services for all citizens prioritizing prevention and promoting it through reduced costs and better utilization of facilities to offer a better quality of life.

c) Equality of citizens of a population in terms of access and provision of health services.

d) Allows for more efficient use of resources, given that prioritizes most basic and powerful performance, encouraging the use of basic health services, implementing a rational use of them, generating a reduction in costs, an increase in performance and improved quality of life. Especially in developing countries an imminent increase in the effectiveness of health services and a reduction in child mortality among other benefits derived from the implementation of the principles of PHC is presented.

e) Promotes a range of services adapted to the needs of the population through a decentralization of resources that allows, through citizen participation, the system adapts to the specific needs of each community.

f) Guided by values of equity, solidarity and human rights, puts citizens the power to decide about their own health. Besides democratization that implies, this improves the legitimacy of the health system, generating greater self-reliance, promoting healthy lifestyles, changing habits and behaviors of health care.

g) This calls for a positive conception of health that goes beyond the treatment of disease, directly affecting the quality of life of people.

h) Allows removal of economic, geographical and cultural barriers.

CONCLUSION

We can conclude by saying that the Primary Health Care, has a lot of chances to progress in all countries. And now more than ever, because there are opportunities to start changing health systems and convert them into primary health care in all countries.

The difficulties differ in countries with different income levels, but there are aspects that must be taken into account; more money is spent on health than ever and have more knowledge to address global health challenges, including better medical technology.

Currently it is also recognized that threats and opportunities in health are common throughout the world.

Aid is important for some countries, but the vast majority of health spending comes from domestic sources. Thus, most countries have the capacity to start moving towards the benefits of primary health care and benefit from capacity.

In short, the strategy of Primary Health Care consciously applied within the parameters and considerations that over the years have implemented the World Health Organization, governments, the World Bank, UNICEF and other authorities on the subject, can achieve break the barriers of inequity in care and lead to fulfill the purpose of a rational extension of coverage.

BIBLIOGRAPHY

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