Primary Health Care

Us: Waled Amen

Learning objectives• At the end of this session you will able to:1. Shed light on PHC including Sudan situation2. Define health, health care and disease3. Describe dimension of health4. Describe spectrum of health and disease5. Illustrate health indicators6. Appraise health care and analyze its levels.7. To understand characteristics of health care.

International Conference on Primary Health Care held by the World Health Organization (WHO) and UNICEF at Alma-Ata. Since that time, PHC has meant many different things to many different groups.

The term ‘primary health care’ (PHC) gained widespread currency following the 1978.

- a basic human right- essential for satisfaction of basic human needs - to be attained by all people

The constitution of WHO and numerous Health Assembly resolution have reaffirmed that health is:

The PHC in Sudan started in 1977 as expanding preventive health care services. It passed through different stages in its development, then be as a full package of health care services in the recent last years. Sudan is considered the first country in EMRO, that started PHC program.(WHO. Report)

PHC in Sudan

Hans's Definition- adaptationMaslow's definition- satisfaction of physiological needs.

“ Health is a state of complete Physical, mental & social well being & not merely the absence of disease or infirmity”. (WHO)

Recent definition: health is a dynamic state of complete physical, mental & social & spiritual well being & not merely the absence of disease & infirmity.(WHO)

• Physical well being • Mental well being .• Social well being is.

• Spiritual well being: focuses on self, consciousness,

intuition. • Environmental well being• Emotional well being

– Ability to think clearly, reason objectively. A state of balance between the individual and surrounding world.

– Free from internal conflict– Aware about himself– Having a good self control– Coping with stress

Includes perfect body functioning, physical fitness, Activities of Daily Living (ADL), a state in which every cell and every organ is functioning at optimum level, and in perfect harmony with the rest of the body.

Mental dimension

Ability to have satisfying relationships

–Self-efficacy and self-esteem

Social dimension

Appreciation of the external environment and one’s role in caring for it.

Feeling as part of a greater spectrum of existence

Environmental dimension

Positive health

Better health

Freedom from disease

Unrecognized disease

Mild disease

Sever disease

Death

Health Indicators: Indicators of health are

variables used for measurement of community

health progression or deterioration.

Should be valid, i.e., they should actually measure what they are supposed to measure. To be valid, it should be sensitive, i.e., they should be sensitive to changes in the situation concerned and should be specific, i.e., they should reflect changes only in the situation concerned.

Should be reliable or objective, i.e., the answers should be the same if measured by different people in similar circumstances;

Should be feasible, i.e., they should have the ability to obtain data needed.

Should be relevant, i.e., they should contribute to theunderstanding of the phenomenon of

interest.

Classification of indicators

1. Policy indicators2. Services indicators3. Utilization indicators4. Impact indicators

1. Baseline indicators2. Progress indicators3. Evaluation indicators

Mortality indicatorsMorbidity indicators Disability rates Nutritional status indicatorsSocial indicatorsothers

1. Evaluative indicators2. Comparative indicators

Illness is the visible presentation of symptoms

Disease is the underlying defect or malfunction within the organism.Dis (mal), and ease (comfortable, wellness)

Disease may occur without illness. Health and illness are mutually exclusive, but health and disease are not.. Since health and disease may coexist, one cannot construct a continuum to show their relationship. (Terris, 1975)

Disease

Impairment

Disability

Handicap

Invalidity

• Health care is a multitude services provided to individuals, families, or communities by health professions or other for achieving the objectives of promoting, maintaining, monitoring, or restoring health.

Health care

Characteristics of health care

Compassion : feeling of pity about

suffering of others.Conscience : sense of right and

wrong, feel of guilty.

Commitment : seriously take the

responsibilities.Confidence : feeling sure about

ones ability.Competence : do the best to be

done.

1. Primary care level• the first level of contact of individuals,

families, or communities with the national health system.

• Provides essential health care.• Promotive, preventive, and curative care.

2. Secondary care level- The first referral level, deals with more complex problems. Which provides mainly curative and rehabilitative services.- Health facilities level includes hospitals and rehabilitative centers.

3. Tertiary care level•More specialized level such as teaching hospital and specialized hospital.

1. Kamalam.S.2005, Essentials in Community Health Nursing Practice, First edition, New Delhi: Jaypee Borther.

2. Clement.I.2009, Basic Concepts of Community Health Nursing, Second edition, Bengalru: Jaypee Borther.

3. Analysis of the concepts of eight essential elements of PHC. Final report of the international conference on PHC, Alma-Ata,1978. WHO, Geneva,1978.

4. Spradley.B.W. 1996Community Health Nursing concepts and practice, 4th edition. USA:library of congress catologing.

5. Stone.S.C.1998, Comperhensive Community Health Nursing, 5th edition, USA:Nancy. L.coon.

6. Suzan.G.J. PHC Components.NEJM. Accessed on www.nejm.com.2011