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    Basic PHC

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    EsidianaUttari
    Primary Health Care (PHC) is the first level of contact with individuals, families, and communities within the national health system. It aims to provide comprehensive, socially appropriate, and universally accessible health care as close to people's

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    Basic PHC

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    EsidianaUttari
    61 views55 pages
    Primary Health Care (PHC) is the first level of contact with individuals, families, and communities within the national health system. It aims to provide comprehensive, socially appropriate, and universally accessible health care as close to people's

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    Primary Health Care (PHC) is the first level of contact with individuals, families, and communities within the national health system. It aims to provide comprehensive, socially appropriate, and universally accessible health care as close to people's

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    61 views55 pages

    Basic PHC

    Uploaded by

    EsidianaUttari
    Primary Health Care (PHC) is the first level of contact with individuals, families, and communities within the national health system. It aims to provide comprehensive, socially appropriate, and universally accessible health care as close to people's

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 55

    Primary Health Care

    Levels of Care
    Primary health care
    Secondary health care
    Tertiary health care

    Primary health care


    The first level of contact between the individual and the health system.
    Essential health care (PHC) is provided.
    A majority of prevailing health problems can be satisfactorily managed.
    The closest to the people.
    Provided by the primary health centers.

    Tingkat kontak pertama antara individu dan sistem kesehatan.


    disediakan Pelayanan kesehatan esensial (PHC) disediakan.
    Mayoritas masalah kesehatan yang berlaku dapat memuaskan dikelola.
    Yang paling dekat dengan rakyat.
    Disediakan oleh pusat-pusat kesehatan primer.

    Secondary health care

    More complex problems are dealt with.


    Comprises curative services
    Provided by the district hospitals
    The 1st referral level
    Tertiary health care

    Offers super-specialist care


    Provided by regional/central level
    institution.
    Provide training programs

    What is Primary Health


    Care?
    PHC is essential health care that is a socially
    appropriate, universally accessible, scientifically sound
    first level care provided by a suitably trained workforce
    supported by integrated referral systems and in a way
    that gives priority to those most in need, maximises
    community and individual self-reliance and
    participation and involves collaboration with other
    sectors. It includes the following:
    health promotion
    illness prevention
    care of the sick
    advocacy
    community development

    PHC adalah pelayanan kesehatan esensial yang merupakan


    sesuai sosial, diakses secara universal, suara ilmiah perawatan
    tingkat pertama yang diberikan oleh tenaga kerja yang terlatih
    didukung oleh sistem rujukan terpadu dan dengan cara yang
    memberikan prioritas kepada mereka yang paling membutuhkan,
    memaksimalkan kemandirian masyarakat dan individu dan
    partisipasi dan melibatkan kolaborasi dengan sektor-sektor
    lainnya. Ini meliputi:
    - promosi kesehatan
    - pencegahan penyakit
    - perawatan sakit
    pembelaan
    pengembangan masyarakat

    Primary Health Care (PHC)

    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 community and the
    country can afford (Alma-Ata, 1978)

    PHC
    Pelayanan kesehatan esensial berdasarkan metode dan teknologi
    praktis, suara ilmiah dan diterima secara sosial membuat diakses
    secara universal untuk individu dan keluarga di masyarakat melalui
    partisipasi penuh mereka dan dengan biaya yang masyarakat dan
    negara mampu

    Primary Health Care


    PHC is the first level of contact with individuals, family &
    community with national health system bringing healthcare as
    close as possible to where people live & work, it constitute the
    first element of continuing health process.

    PHC adalah tingkat pertama kontak dengan


    individu, keluarga & masyarakat dengan sistem
    kesehatan nasional membawa kesehatan
    sedekat mungkin ke mana orang hidup &
    bekerja, itu merupakan elemen pertama dari
    proses yang berkelanjutan kesehatan.

    Primary Health Care


    PHC conceded to be the most peripheral level of the
    health system, this include such institutes as health
    centers, clinics, sub centers, general practitioners offices
    & poly clinics, the name varying from one country to
    another.

    PHC kebobolan menjadi tingkat yang paling


    perifer dari sistem kesehatan, termasuk
    lembaga ini seperti puskesmas, klinik, sub
    pusat, kantor dokter umum & klinik poli, nama
    bervariasi dari satu negara ke negara lain.

    PHC - Alma- Ata


    Declaration:

    In 1978, ministries from 134 countries met at the Alma- Ata


    conference in the former USSR to declare a common mission
    for governments, international organizations & health workers
    worldwide (health for all by the end of year 2000), they
    thus declare the strategy of PHC as the key to realize this
    vision.

    PHC - Alma- Ata


    Declaration:
    They called for urgent & effective local, global efforts to develop
    & implement PHC through out the world particularly in
    developing countries.
    so;
    Primary health care (PHC) became a core policy for the WHO
    with the Alma-Ata Declaration in 1978 and the Health-for-All by
    the Year 2000 Program.

    The commitment to global improvements in health,


    especially for the most disadvantaged populations,
    was renewed in 1998 by the World Health Assembly.
    This led to the Health-for-All for the twenty-first
    Century policy and program, within which the
    commitment to PHC development is restated.

    Philosophy of PHC:
    1-Health is fundamental related to availability &
    distribution of resources (not just health resources
    such as doctors, nurses, medicines) but also by other
    socioeconomic resources such as education, water
    supply, & food supply.

    Philosophy of PHC:

    2-PHC is concerned with equity to ensure that the


    available health & social resources are distributed wisely
    with due consideration for those whose needs are
    greatest.

    Philosophy of PHC:
    3- Health is an integral part of the overall development,
    thus factors which influence health care are social,
    cultural, economic as well as biological & environmental.

    Philosophy of PHC:
    4- To achieve better health, requires much more
    development by people themselves as individuals &
    families, communities in taking action on their own
    behalf adapting health behavior & ensuring healthy
    environment.

    Principles for PHC


    PHC based on the following principles :

    Social equity
    Nation-wide coverage
    Self-reliance
    Inter-sectoral coordination
    Peoples involvement in the planning and
    implementation of health programs

    Principles
    of ofPHC
    The 1978 Declaration
    Alma-Ata proposed a

    set of PRINCIPLES for primary health care. PHC


    should:

    1.Reflect and evolve from the economic conditions and


    socio-cultural and political characteristics of the country
    and its communities, and be based on the application of
    the relevant results of social, biomedical and health
    services research and public health experience
    2. Address the main health problems in the community,
    providing promotive, preventive, curative and
    rehabilitative services accordingly

    3. Involve, in addition to the health sector,


    all related sectors and aspects of national
    and community development, in particular
    agriculture, animal husbandry, food,
    industry, education, housing, public works,
    4. Promote maximum community and
    individual self-reliance and participation in
    the planning, organization, operation and
    control of primary health care, making
    fullest use of local, national and other
    available resources; and to this end develop
    through appropriate education the ability of
    communities to participate

    5. Be sustained by integrated, functional and


    mutually-supportive referral systems, leading to
    the progressive improvement of comprehensive
    health care for all, and giving priority to those
    most in need
    6. Rely, at local and referral levels, on health
    workers, including physicians, nurses, midwives,
    auxiliaries and community workers as
    applicable, as well as traditional practitioners as
    needed, suitably trained socially and technically
    to work as a health team and to respond to the
    expressed health needs of the community.

    Core Activities for PHC


    There is a set of CORE ACTIVITIES,
    which were normally defined nationally
    or locally. According to the 1978
    Declaration of Alma-Ata proposed that
    these activities should include:

    1. Education concerning prevailing health problems and


    the 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

    5. Immunization against the major infectious diseases

    6. Prevention and control of locally endemic diseases

    7. Appropriate treatment of common diseases and injuries

    8. Basic laboratory services and provision of essential


    drugs.

    9. Training of health guides, health workers and health


    assistants.

    10. Referral services

    Mental health
    Physical handicaps
    Health and social care of the elderly

    1.

    WHO Strategies of PHC

    Reducing excess mortality of poor marginalized


    populations:
    PHC must ensure access to health services for the
    most disadvantaged populations, and focus on
    interventions which will directly impact on the major
    causes of mortality, morbidity and disability for
    those populations.

    2. Reducing the leading risk factors to human health:


    PHC, through its preventative and health
    promotion roles, must address those known risk
    factors, which are the major determinants of health
    outcomes for local populations.

    3. Developing Sustainable Health Systems:


    PHC as a component of health systems must develop in
    ways, which are financially sustainable, supported by
    political leaders, and supported by the populations served.
    4, Developing an enabling policy and institutional
    environment:
    PHC policy must be integrated with other policy domains,
    and play its part in the pursuit of wider social, economic,
    environmental and development
    policy.

    Effectiveness of PHC
    services
    Effectiveness of PHC services need two
    components :
    1- Efficient PHC services : quality , resources , health
    system.
    2- Satisfactory utilization of the public for services.

    Requirement of Efficient
    PHC services:
    efficient PHC services must
    be :
    1.
    2.
    3.
    4.
    5.
    6.
    7.

    Accessible
    Acceptable
    Affordable
    Efficient administrative, professional and
    technical procedures.
    Community participation
    Comprehensiveness
    Continuity

    Requirement of Efficient
    PHC services:

    Provided PHC services must be :


    1. Accessible :
    suitable site,
    roads and transport for consumers
    to reach the centers and units .
    2. Acceptable : to the public , when
    convinced with given care .
    3. Affordable :
    On the national and community levels
    : services are planned within
    available resources , including financing .
    To the public who can pay for utilization
    of services when necessary .

    Requirement of Efficient
    PHC services:

    4. Efficient administrative,
    professional and technical
    procedures which include:
    Convenient hours and flow of
    work.
    Satisfactory resources including
    health team.
    Organized referral, feedback and
    follow up system.
    Precise registration, filing and
    statstical procedures.

    Requirement of
    Efficient PHC services:
    5.Community participation :
    Primary heath care requires Peoples

    involvement in the planning and


    implementation of health programs

    Primary health care involve in


    addition to the health sectors , all
    related sectors and aspects of
    national and community development
    in particular , agriculture , food
    industry , education, housing ,
    communications and other sectors
    and need coordination of all these
    sectors

    The Basic Requirements for


    Sound PHC (the 8 As and
    the 3 Cs)
    Appropriateness

    Assessability

    Availability

    Accountability

    Adequacy

    Completeness

    Accessibility

    Comprehensiveness

    Acceptability

    Continuity

    Affordability

    Appropriateness
    Whether the service is needed at all in relation to
    essential human needs, priorities and policies.
    The service has to be properly selected and carried
    out by trained personnel in the proper way.

    Adequacy
    The service proportionate to requirement.
    Sufficient volume of care to meet the need and demand
    of a community

    Affordability
    The cost should be within the means and resources
    of the individual and the country.

    Accessibility
    Reachable, convenient services
    Geographic, economic, cultural accessibility

    Acceptability
    Acceptability of care depends on a variety of factors,
    including satisfactory communication between health
    care providers and the patients, whether the patients
    trust this care, and whether the patients believe in the
    confidentiality and privacy of information shared with the
    providers.

    Availability
    Availability of medical care means that care can be
    obtained whenever people need it.

    Assessability
    Assessebility means that medical care can be readily
    evaluated.

    Accountability
    Accountability implies the feasibility of regular review of
    financial records by certified public accountants.

    Completeness
    Completeness of care requires adequate attention to all
    aspects of a medical problem, including prevention, early
    detection, diagnosis, treatment, follow up measures, and
    rehabilitation.

    Comprehensiveness
    Comprehensiveness of care means that care is provided
    for all types of health problems.

    Continuity
    Continuity of care requires that the management of a
    patients care over time be coordinated among providers.

    To Summarize
    Primary care is an approach that:
    Focuses on the person not the disease, considers all
    determinants of health
    Integrates care when there is more than one problem
    Uses resources to narrow differences

    Forms the basis for other levels of health systems


    Addresses most important problems in the community by
    providing preventive, curative, and rehabilitative services
    Organizes deployment of resources aiming at promoting
    and maintaining health.

    THANK YOU

    References:
    Who . Org.
    ^Jump up to:abcWorld Health Organization.The
    determinants of health.Geneva. Accessed 12 May 2011.
    Jump up^Public Health Agency of Canada.What
    Determines Health?Ottawa. Accessed 12 May 2011.
    ^Jump up to:abcLalonde, Marc."A New Perspective on
    the Health of Canadians."Ottawa: Minister of Supply and
    Services; 1974.

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