SAS 15-16: PRIMARY HEALTH CARE

primary health care (PHC)

considered as a practical approach to the effective provision of essential health services

covers the majority of a person’s health needs as shown in this image above from womb to tomb

are community based, accessible, acceptable, and sustainable, at a cost which the community and the government can afford.

history of primary health care (PHC)

the event was co-hosted by WHO and UNICEF

WHO defined essential health care as universally acceptable and affordable, involving community participation

in May 1977, the 30th World Health Assembly adopted a resolution targeting global health attainment for all by the year 2000

the conference saw participation from 134 leaders globally, emphasizing the need for urgent action to protect and promote global health

the International Conference on Primary Health Care (PHC) occurred in Alma Ata, Kazakhstan from September 6-12, 1978resulting in the Declaration of Alma-Ata

contents of the declaration of Alma-Ata

Health is a fundamental human right, requiring action across various social and economic sectors

Gross health inequality between developed and developing countries is politically, socially, and economically unacceptable

Economic and social development aligned with a New International Economic Order is crucial for achieving universal health and reducing health disparity

People have the right to participate in their health care planning and implementation

Governments are responsible for ensuring the health of their populations through adequate health and social measures

Primary health care is crucial to health systems, integrating health care into social and economic development

Successful implementation requires collaboration across sectors, community participation, referral systems, and a trained health workforce

Governments must develop national policies and strategies for establishing and maintaining primary health care

Collaboration among countries is essential to guarantee primary health care for everyone

Reallocating global resources currently spent on military conflicts towards social and economic development, particularly primary health care, can achieve an acceptable level of health by 2000.

elements of primary health care

nutrition

treatment

education

immunization

drug availability

water and sanitation

maternal and child health

prevention of endemic disease

5 key elements to achieve WHO goals —> better health

increasing stakeholder participation

integrating health into all sectors (public policy reforms)

pursuing collaborative models of policy dialogue (leadership reforms)

reducing exclusion and social disparities in health (universal coverage reforms)

organizing health services around people’s needs and expectations (service delivery reforms)

functions of PHC

medical care

referral services

health education

national heath programs

MCH including family planning

prevention and control diseases

safe water supply and sanitation

collection and reporting of vital statistics

palliation

the relief of symptoms like pain

more related with those persons suffering from cancer and other life-threatening diseases

making the person more comfortable and improves his/her quality of life, but does not cure the disease

attributes of PHC

affordability

coordination

adaptability

acceptable

community based

first point of contact

essential health care

universally accessible

principles of PHC

accessibility

health promotion

public participation

appropriate technology

inter-sectoral cooperation

five types of care

curative

promotive

preventive

rehabilitative

supportive / palliative

rationale of PHC was established due to:

magnitude of health problems

increasing cost of medical care

inadequate and unequal distribution of health resources

isolation of health care activities from other development activities.

objectives of PHC

improvement in basic sanitation

favorable population growth structure

improvement in the level of health care of the community

development of the capability of the community aimed at self-reliance

reduction in the prevalence of preventable, communicable and other disease

reduction in morbidity and mortality rates especially among infants and children

extension of essential health services with priority given to the underserved sectors

maximizing the contribution of the other sectors for the social and economic development of the community.

Declaration of Astana

attracted 2,000 delegates from 120 countries

WHO and UNICEF to implement the declaration

Alma-Ata Declaration 40th Anniversary Celebration

Kazakhstani Health Minister to direct future PHC initiatives

emphasizes primary health care (PHC) for equitable health access

revitalized political commitment and will guide UN General Assembly's 2019 Universal Health Coverage (UHC) discussions

acknowledges ongoing health challenges, especially for marginalized groups

held in Kazakhstan on October 25-26, 2018, co-hosted by WHO, UNICEF, and Kazakhstan

4 key areas Declaration of Astana

empowering communities

making bold political choices for health

building sustainable primary health care

aligning stakeholder support with national policies and strategies.

4 reforms to improve the delivery of PHC

universal coverage reforms (UCR)

service delivery reforms (SDR)

public policy reforms (PPR)

leadership reforms

universal coverage reforms (UCR)

this aims at diminishing exclusion and social disparities in health

primarily by moving towards universal access and social health protection

will ensure that health systems contribute to health equity, social justice and the end of exclusion

service delivery reforms (SDR)

reorganize health services as primary care, around people’s needs and expectations

so as to make them more socially relevant and more responsive to the changing world while producing better outcomes.

public policy reforms (PPR)

will secure healthier communities

by integrating public health actions with primary care and by pursuing healthy public policies across sectors

leadership reforms

replace disproportionate reliance on command and control on one hand, and laissez-faire disengagement of the state on the other, by the inclusive, participatory, negotiation-based leadership required by the complexity of contemporary health systems

WHO supports countries in this area by:

strengthening oral health systems as part of primary healthcare without financial burden

accelerating phase-down of dental amalgam in accordance with Minamata Convention on Mercury

reinforcing oral health information systems and integrated surveillance with other non-communicable diseases

building capacity and technical assistance for population-based strategies to reduce sugar consumption, control tobacco use, and promote fluoride-containing toothpaste

minamata convention on mercury

highlights the importance of controlling mercury, a widely used metal

aimed to protect human health and environment from mercury's adverse effects

adopted in Geneva on October 10, 2013, and entered into force on August 16, 2017

key provisions of minamata convention on mercury

a ban on new mercury mines

phase-out of existing mercury mines

regulation of artisanal and small-scale gold mining

control measures for emissions to air and water releases

reduction of mercury use in specific products and processes

guidelines for the interim storage and disposal of mercury waste

addressing sites contaminated by mercury and associated health concerns.

laissez-faire

french term of ‘leave alone’ ‘let you do’

this leader type will give the least possible guidance to his/her subordinates

it is a leadership style that will allow group members to make the decisions for the organization or company since the leader will not exert effort to do something