Primary Health Care and Community Nursing Practice

Vocabulary practice flashcards covering primary health care principles, epidemiology, community assessment, family-centered nursing, child growth and development, malnutrition management, IMCI guidelines, childhood immunisation schedules, and disability models.

Primary Health Care (PHC)

Essential, person-centred healthcare universally accessible to individuals and families through their full participation and at an affordable cost; it encompasses health promotion, disease prevention, curative care, and rehabilitation, extending from home to hospital guided by social and economic justice.

Primary Care

The initial level of healthcare contact focused predominantly on clinical assessment, individual treatment of acute or chronic illness, and basic service delivery at the community entry point.

Alma-Ata Declaration (Eight Essential Elements)

The foundational 1978 global declaration outlining the core components of Primary Health Care: education concerning prevailing health problems; food supply and proper nutrition; safe water and basic sanitation; maternal and child healthcare including family planning; immunisation against major infectious diseases; prevention and control of locally endemic diseases; appropriate treatment of common diseases and injuries; and provision of essential drugs.

Comprehensive Health Care (Four Main Aspects)

An integrated healthcare delivery model consisting of: promotive care (optimising health and wellness), preventive care (averting disease and complications), curative care (clinical diagnosis and disease treatment), and rehabilitative/palliative care (restoring functional capacity or relieving end-of-life suffering).

Quadruple Burden of Disease (South Africa)

The simultaneous coexistence of four major disease burdens in South Africa: 1) Maternal, neonatal, child health, infectious diseases, and malnutrition; 2) Non-communicable degenerative diseases (e.g., hypertension, diabetes); 3) Trauma, violence, and injuries; and 4) HIV and tuberculosis (TB).

Selective Primary Health Care

An approach to healthcare delivery that restricts interventions to a limited package of high-priority, cost-effective medical procedures targeted at specific diseases and high-risk populations when resources are constrained.

Epidemiology

The scientific study of the distribution, frequency, and determinants of health conditions, diseases, and injuries within human populations, along with the application of this study to control health problems.

Descriptive vs. Analytical Epidemiology

Descriptive epidemiology characterizes health events by person, place, and time (what, who, where, when); analytical epidemiology tests hypotheses to identify specific causes, determinants, and risk factors of diseases (why and how).

Demography

The statistical study of human populations, including their size, geographic distribution, composition (such as age and sex), and structural changes over time through births, deaths, and migration.

Endemic, Epidemic, and Outbreak

Endemic is the constant, expected baseline presence of a disease in a geographic area; epidemic is a sudden increase in the number of cases of a disease clearly above normal baseline expectancy; an outbreak is an epidemic localized to a small, circumscribed geographic area.

Years of Life Lost (YLL) vs. Years Lived with Disability (YLD)

YLL quantifies premature mortality by multiplying deaths by remaining life expectancy at age of death; YLD measures the health loss and reduced quality of life from living with non-fatal disease or injury, weighted by disability severity.

Health-Adjusted Life Expectancy (HALE)

The average number of years that an individual at a given age can expect to live in 'full health,' taking into account years lived in less than ideal health due to disease, injury, or disability.

Health Promotion

The process of enabling individuals and communities to increase control over their lifestyle and environmental determinants to improve their overall physical, mental, and social well-being.

Levels of Illness Prevention

Three tiers of clinical and public health interventions: Primary prevention forestalls the initial development of a disease (e.g., immunisation, healthy diet); Secondary prevention detects disease early before clinical symptoms appear (e.g., screening tests for hypertension); Tertiary prevention reduces disability and complications from established disease (e.g., stroke rehabilitation, diabetic foot care).

Health-Illness Continuum

A conceptual model illustrating health as a dynamic, fluctuating status along a graded scale ranging from optimal high-level wellness on one end, through an asymptomatic midpoint, to severe illness and premature death on the other.

Community Profile

A systematic, comprehensive assessment and description of a community detailing population demographics, geographic boundaries, socioeconomic conditions, environmental infrastructure, disease patterns, and existing formal and informal resources.

Five Functions of a Community

The essential structural tasks executed by a community: 1) Production, distribution, and consumption of goods and services; 2) Socialisation (passing down values and norms); 3) Social control (maintaining order and adherence to norms); 4) Social interparticipation (community involvement and cohesion); and 5) Mutual support (collective caregiving and crisis assistance).

Invited Spaces vs. Claimed Spaces

In community participation, invited spaces are formal consultative opportunities created by government or institutional authorities (e.g., Clinic Committees, Hospital Boards, OHSC); claimed spaces are grassroots platforms organized directly by community members to advocate for rights and accountability (e.g., social audits, public campaigns, social movements).

CESESMA Model of Empowerment

A theoretical framework characterizing empowerment through the dynamic interaction of three interlinked components: personal attitude (recognizing one's self-esteem and capacity to act), capability (possessing necessary skills, knowledge, and autonomy), and conditions/opportunities (supportive social, parental, and organizational environments).

Community Diagnosis

The systematic identification, quantification, and prioritization of population-level health problems, risk factors, and resource deficiencies within a specific community, serving as the basis for collective action.

Family Systems Theory

A conceptual model viewing the family as an open, interdependent emotional and functional unit, where any disruption, stressor, or illness affecting an individual member inevitably reverberates through and alters the entire family system.

Structural-Functional Theory

A family assessment framework that evaluates how a family's internal organization, power hierarchy, communication patterns, and boundaries support the psychological, physical, and developmental functions of its members.

Genogram

A multi-generational visual diagram (typically three generations) mapping family tree structure, biological relationships, vital life milestones (births, marriages, deaths), and major chronic or hereditary illnesses.

Ecomap

A visual assessment tool illustrating the family unit at its centre and outlining the flow, nature, and strength of energy and relationships connecting the family to external community systems, services, and support networks.

Family APGAR Questionnaire

A five-item rapid screening questionnaire used to evaluate an individual's satisfaction with family functioning across five parameters: Adaptation (resource sharing), Partnership (mutual problem-solving), Growth (emotional development), Affection (emotional sharing), and Resolve (commitment of time and space), scored from $0$ to $2$ per item.

First-Time Household Entry Process

The sequential eight-step protocol followed by community health nurses entering a home: 1) Entry (respectful introduction); 2) Identification (identifying occupants and issues); 3) Prioritisation (determining urgent concerns); 4) Referral (linking with outside aid); 5) Care & Education (immediate actions); 6) Reporting (documentation); 7) Self-care (provider safety); and 8) Planning (arranging follow-up).

Growth Monitoring

The regular, sequential measurement and charting of a child's physical growth parameters (weight, length/height, head circumference) to track velocity, detect early faltering, and guide clinical interventions.

Length vs. Height Measurement

Length is measured recumbently with the child lying flat on an infant measuring board (stadiometer) for children under $2$ years; height is measured vertically with the child standing barefoot against a flat vertical wall or stadiometer for children aged $2$ years and older.

Head Circumference (Occipitofrontal Circumference)

The measurement of the greatest distance around the head across the occipital prominence and supraorbital ridges; averages $35\,\text{cm}$ ($32\text{--}38\,\text{cm}$) at birth, increases by approximately $1\,\text{cm/month}$ during the first year, and is measured routinely at birth, $14$ weeks, and $12$ months.

Mid-Upper Arm Circumference (MUAC)

A rapid anthropometric screening method measuring the circumference at the midpoint between the acromion of the left shoulder and the olecranon of the elbow, taken with a non-stretch insertion tape while the arm hangs relaxed.

MUAC Malnutrition Classification Cut-Offs

Standard clinical thresholds for children aged $6\,\text{months}$ to $5\,\text{years}$: red ($< 11.5\,\text{cm}$) indicates Severe Acute Malnutrition (SAM, requires urgent hospital referral); yellow ($11.5\text{--}12.5\,\text{cm}$) indicates Moderate Acute Malnutrition (MAM); green ($\ge 12.5\,\text{cm}$) indicates No Acute Malnutrition (NAM).

Stunting vs. Wasting

Stunting is a low height-for-age indicator reflecting chronic, long-term cumulative nutritional deprivation; wasting is a low weight-for-height indicator reflecting acute, severe, short-term body mass loss.

Kwashiorkor vs. Marasmus

Marasmus results from severe energy/calorie starvation leading to generalized muscle wasting, emaciation, loss of subcutaneous fat, and an 'old-man' face without oedema; Kwashiorkor results primarily from acute protein deficiency characterized by bilateral pitting oedema, moon face, hepatomegaly with fatty liver, distended abdomen, and flaky paint dermatosis.

WHO Ten Steps for Management of Severe Malnutrition

A standardized clinical protocol divided into a Stabilisation Phase (Days 1–7: treat/prevent hypoglycaemia, hypothermia, dehydration, electrolyte imbalance, infection, correct micronutrients without iron, and start cautious feeding) and a Rehabilitation Phase (Weeks 2–6: achieve catch-up growth, add iron, provide emotional/sensory stimulation, and prepare for discharge).

General Danger Signs (IMCI Child Aged 2 Months to 5 Years)

Four critical signs requiring urgent hospital referral during pediatric IMCI triage: 1) Inability to drink or breastfeed; 2) Vomiting everything; 3) Convulsions during the present illness; and 4) Lethargy or unconsciousness.

Danger Signs in Young Infants (IMCI Birth up to 2 Months)

Clinical red flags indicating severe illness or possible serious bacterial infection: convulsions, apnoea, severe chest indrawing, grunting or nasal flaring, bulging fontanelle, fever ($\ge 37.5^\circ\text{C}$) or hypothermia ($< 35.5^\circ\text{C}$), lethargy or moving only when stimulated, umbilicus red or draining pus extending to skin, multiple skin pustules, and jaundice within 24 hours of birth or yellow palms and soles.

Signs of Good Breastfeeding Attachment

Four observable physical signs verifying effective infant latching: 1) The baby's chin touches the mother's breast; 2) The mouth is wide open; 3) The lower lip is curled outward; and 4) More areola is visible above the baby's upper lip than below the lower lip.

Expanded Programme on Immunisation (EPI)

A dedicated public health programme designed to control, eliminate, or eradicate target infectious diseases through systematic scheduled vaccinations across infancy, childhood, and adolescence.

EPI Target Diseases (Viral vs. Bacterial)

EPI protects against viral diseases (poliomyelitis, rotavirus diarrhea, measles, mumps, rubella, hepatitis B, human papillomavirus) and bacterial diseases (tuberculosis, diphtheria, tetanus, pertussis, Haemophilus influenzae type b, Streptococcus pneumoniae).

Medical Model vs. Social Model of Disability

The Medical Model views disability as an intrinsic physiological defect or biological problem residing in the individual that requires curative medical adjustment by professionals; the Social Model defines disability as the social oppression, exclusion, and environmental barriers imposed by society on people with impairments.

Impairment vs. Activity Limitation vs. Participation Restriction

Impairment is a loss or abnormality in body structure or physiological function; activity limitation is a difficulty an individual encounters in executing a specific task (e.g., walking, self-care); participation restriction represents problems an individual experiences in involvement in life situations due to societal barriers.

Community-Based Rehabilitation (CBR)

A multisectoral primary healthcare strategy implemented within community settings to provide rehabilitation, equalization of opportunities, poverty reduction, and social inclusion for people with disabilities through collective local action.

Cycle of Disability and Poverty

A bidirectional sociological phenomenon (Yeo & Moore) wherein physical impairment and discrimination produce exclusion from education, healthcare, and employment, causing income poverty, which subsequently breeds malnutrition, hazardous living conditions, and increased risk of further impairment.