HEALTH CARE
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Definition of Health Care
Health care, or healthcare, is the prevention, treatment, and management of illness and the
preservation of mental and physical well being
through the services offered by the medical,
nursing, and allied health professions.
Health care embraces all the goods and services designed for your health, including preventive, curative and palliative interventions, whether directed
to individuals or to populations.
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Health Care Process
Definition
A systematic, rational method of planning and
providing health care by identifying a clients actual or potential health care needs,
establishing plans to meet the identified needs
and delivering specific health care interventions
to meet those needs for the purpose of attaining,
maintaining, and promoting optimal
biopsychosocial functioning.
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Health as a Continuum between biological and social factors across the Lifespan
Health From Cells to Society
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Peoples Right to Daily Life
The United Nations (Article 25, 1948) declaration for peoples rights to daily life:
All people have the right to a standard of living adequate for the health and well-being of a person and of ones family, including food, clothing, housing, and medical care, and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age, or lack of livelihood in circumstances beyond ones control.
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Health and IllnessTHE STUDY OF MAN
THE ATOMISTIC APPROACH
Views man as an organism composed of different organ
systems, each system
composed of organs and each
organ made up of tissue cells.
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Health and IllnessTHE STUDY OF MAN
THE HOLISTIC APPROACH
Stimuli in the environment provide the necessary forces to enable man to demonstrate consciously or unconsciously, the nature of his responses and the subsequent quality of his relationship with his environment.
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Health and IllnessTHE STUDY OF MAN
THE HOLISTIC APPROACH
It provides a fundamental framework on which one can base his perception or
observation of the total behavior of man in
relation to society.
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Health and IllnessTHE STUDY OF MAN
MOTIVATION TO OVERCOME HARDSHIP
Motivation may come either from natural or supernatural forces.
Man reasons that it comes naturally to man to suffer for those whom he loves and wishes to protect from pain and suffering.
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Health and IllnessTHE STUDY OF MAN
MOTIVATION TO OVERCOME HARDSHIP
The other type of motivation may be supernatural wherein one transcends pain
and suffering to a higher place in the hope
of non-material reward.
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Health and Illness
ABRAHAM MASLOWS
HIERARCHY OF NEEDS
The five level of basic needs:
Physiologic needs
Safety and security needs
Love and belonging needs
Self-esteem needs
Self-actualization needs
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Health and Illness
FACTORS AFFECTING HEALTH AND ILLNESS (PEISES)
Physical dimension
Emotional dimension
Intellectual dimension
Socio-cultural dimension
Environmental dimension
Spiritual dimension
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Health and Illness
Physical dimension genetic make-up,develop mental level,race & sex
Emotional dimension- how the mind and body interact to affect body function & respond to body condition
Intellectual dimension- cognitive abilities,educational background & past experiences
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Health and Illness
Socio-cultural dimension- these are health practices & beliefs w/c influences a persons economic, lifestyle,family & culture
Environmental dimension - such as housing, sanitation, climate & pollution
Spiritual dimension- spiritual & religious beliefs and values
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Health and Illness
SOCIAL DETERMINANTS OF HEALTH
- Are the social conditions in which people live which determine their health, illnesses and generally related to social, economic, political and environment circumstances. It greatly influenced collective and personal well-being
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Health and Illness
MODELS OF HEALTH
Medical Model
Health is the state of being free of signs
or symptoms of disease. Illness is the
presence of signs or symptoms of
disease.
Nedra B. Belloc and Lester Breslow 1972
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Health and Illness
MODELS OF HEALTH
Health-Illness Continuum
Health is a constantly changing state,
with high level wellness and death
being on opposite ends of a graduated
scale, or continuum.
J-B. McCann Flynn and P.B. Heffron 1984
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Health and Illness
MODELS OF HEALTH
Role-Performance Model
Health is the ability to perform all those
roles for which one has been socialized.
-Defined with reference to the individuals participation in the social system.
Talcott Parsons, 1964
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Health and IllnessMODELS OF HEALTH
High-Level Wellness
High-level wellness refers to functioning
to ones maximum potential while maintaining balance and purposeful
direction in the environment.
Halbert Louis Dunn MD, PhD - 1961
John Travis, 1975
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Health and IllnessMODELS OF HEALTH
World Health Organization
Health is the state of complete physical,
mental, social well-being and not merely
the absence of disease. WHO, 1947
At the first International Conference on Health Promotion in Ottawa,
Canada (1986), the Ottawa Charter for Health Promotion built on the
WHO's concept and further defined health as "a resource for everyday
life ... a positive concept emphasizing social and personal resources,
as well as physical capabilities." Good health enables one to function
independently within a changing environment.
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Health and IllnessMODELS OF HEALTH
Needs-Fulfillment Model
Health is state in which needs are being
sufficiently met to allow an individual to
function successfully in life with the
ability to achieve the highest possible
potential.
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Health and Illness
STAGES OF ILLNESS BEHAVIOR
Stage 1: Symptom Experience
The person is aware that something is wrong. A person usually recognizes a physical sensation or a limitation in
functioning but does not suspect a
specific diagnosis.
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Health and Illness
STAGES OF ILLNESS BEHAVIOR
Stage 1: Symptom Experience
The persons perception of a symptom includes awareness of a physical change
such as pain, a rash or a lump; evaluation
of this change and a decision that it is a
symptom of an illness, and an emotional
response.
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Health and Illness
STAGES OF ILLNESS BEHAVIOR
Stage 2: Assumption of the Sick Role
If symptoms persist and become severe, clients assume the sick role. At this point the
illness becomes a social phenomenon, and
sick people seek confirmation from their
families and social groups that they are
indeed ill and that they be excused from
normal duties and role expectations.
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Health and Illness
STAGES OF ILLNESS BEHAVIOR
Stage 3: Medical Care Contact
If symptoms persist despite the home remedies, become severe, or require
emergency care, the person is motivated to
seek professional health services. In this
stage the client seeks expert
acknowledgement of the illness as well as
the treatment.
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Health and Illness
STAGES OF ILLNESS BEHAVIOR
Stage 4: Dependent Client Role
The client depends on health care professionals for the relief of
symptoms. The client accepts care,
sympathy and protection from the
demands and stresses of life.
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Health and Illness
STAGES OF ILLNESS BEHAVIOR
Stage 4: Dependent Client Role
A client can adopt the dependent role in a health care institution, at home, or
in a community setting. The client
must also adjust to the disruption of a
daily schedule.
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Health and Illness
STAGES OF ILLNESS BEHAVIOR
Stage 5: Recovery and Rehabilitation
This stage can arrive suddenly, such as when the symptoms appeared. In the
case of chronic illness, the final stage
may involve in an adjustment to a
prolonged reduction in health and
functioning.
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What Determines Health:
Income and social status
Social support networks
Education
Employment & working conditions
Social environments
Physical environments
Personal health practices and coping
Healthy child development
Biology and genetic endowment
Health services
Gender
Culture
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Causes of Chronic Disease
Individual-specific Modifiable Risk Factors
Unhealthy Diet
Physical Activity
Tobacco Use
Socioeconomic, Cultural, and Environmental Determinants
UrbanizationPopulation Aging Globalization
Individual-specific Non-Modifiable Risk Factors
Age
Heredity
Biochemical/Physiological Risk Factors
Raised Blood Pressure
Raised Blood Glucose
Abnormal Blood Lipids
Overweight/Obesity
Main Chronic Diseases
CancerHeart DiseaseStrokeChronic Respiratory DiseasesDiabetes
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Population Impact
Interventions
Source: McKinlay & Marceau (2000). Public health matters. Am J Pub Health, 90, 25-33, p. 29.
Levels of Causation
Organization & Community Interventions
EnvironmentalInfluences
SocialPosition
Social & Cultural Processes
PsychologicalProcesses
Biological & Genetic Factors
Primary & Secondary Prevention
Primary & Secondary Prevention / Treatment
Primary & Secondary Prevention / Treatment
Healthy Public Policy
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Health and IllnessLEVELS OF PREVENTION
Primary Prevention
Providing specific protection against disease to prevent its occurrence is the most desirable form of prevention.
Preventive measures consists of counseling, education and adoption of specific health practices or changes in life style.
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Health and IllnessLEVELS OF PREVENTION
Primary Prevention
Examples:
Mandatory immunization of children belonging to the age range of 0-59
months old to control acute infectious
disease.
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Health and IllnessLEVELS OF PREVENTION
Primary Prevention
Examples:
Minimizing contamination of the work or general environment by asbestos
dust, silicone dust, smoke, chemical
pollutants and excessive noise.
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Primary Prevention(infectious disease)
Primary PreventionPrevention measures before the disease happens.
Methods of Primary Prevention:
Seclusion or avoidancestaying away from infected individuals
Keeping yourself cleanwash hands with antibacterial soaps & shower
Get enough rest
Exercise on a regular basis
Eat Right
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Primary Prevention(noninfectious disease)
Prevention measures before the disease occurs.
Methods of Primary Prevention:
Not Smoking or drinking in excess Eating right Exercise on a regular basis Get enough rest Stress management (Yoga, Tai Chi, Progressive
Muscle Relaxation)
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Health and IllnessLEVELS OF PREVENTION
Secondary Prevention
Consist of organized, direct screening efforts or education of the public to promote early case finding of an individual with disease so that prompt intervention can be instituted to halt pathologic processes and limit disability.
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Health and IllnessLEVELS OF PREVENTION
Secondary Prevention
Early diagnosis of a health problem can decrease the catastrophic effects that
might otherwise result for the individual
and the family from advanced illness
and its many complications.
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Health and IllnessLEVELS OF PREVENTION
Secondary Prevention
Examples:
Public education to promote breast self-examination, use of home kits for
detection of occult blood in stool
specimens and familiarity with the
seven cancer danger signals.
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Warning Signs of Cancer
C Change in bowel or bladder habits;
A A sore that does not heal;
U Unusual bleeding or discharge;
T Thickening or lump in breast or elsewhere;
I Indigestion or difficulty in swallowing;
O Obvious change in wart or mole;
N Nagging cough or hoarseness;
U Unexplained anemia; and
S Sudden unexplained weight loss.
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Health and IllnessLEVELS OF PREVENTION
Secondary Prevention
Examples:
Screening programs for hypertension, diabetes, uterine cancer (Pap smear), breast cancer (examination and mammography), glaucoma and sexually transmitted diseases.
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Secondary Prevention
Secondary PreventionPreventive measures that lead to early diagnosis and prompt
treatment of a disease or injury to limit
disability and prevent a more severe disease.
Methods:
Visit your doctor on a regular basis
Visit your doctor for regular physicals
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Health and IllnessLEVELS OF PREVENTION
Tertiary Prevention
It begins early in the period of recovery from illness and consists of such activities as
consistent and appropriate administration of
medications to optimize therapeutic effects,
moving and positioning to prevent
complications of immobility and passive and
active exercises to prevent disability.
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Health and IllnessLEVELS OF PREVENTION
Tertiary Prevention
Continuing health supervision during rehabilitation to restore an individual to an
optimal level of functioning. Minimizing
residual disability and helping the client to
learn to live productively with limitations
are the goals of tertiary prevention.
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Tertiary Prevention
Tertiary PreventionMeasures aimed at rehabilitation following significant disease.
Methods:
Medications
Chemotherapy
Surgery
Dialysis
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Summary: Levels of Prevention
Primary Prevention - activities prevent a problem before it occurs (e.g., immunization against the
seven childhood illnesses).
Secondary Prevention activities provide early detection and intervention (e.g., screening for
presence of diabetes).
Tertiary Prevention activities correct a disease state and prevent it from further deteriorating (e.g.,
teaching insulin administration in the home).
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Health as a Multifactorial
Phenomenon
FACTORS AFFECTING HEALTH
Political involves ones leadership, how he/she rules,
manages and involves other people in decision making
- protection from exploitative working conditions
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Health as a Multifactorial Phenomenon
FACTORS AFFECTING HEALTH
Political
- expanding access to social security
- creating the circumstances where people
can use their faculties and abilities at the
maximum level in the pursuit of common
goals
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Health as a Multifactorial Phenomenon
FACTORS AFFECTING HEALTH
Cultural
relating to the representation of nonphysical traits, such as values, beliefs, attitudes and customs shared by a group of people and passed from one generation to the next.
practices a customary action usually done to maintain or promote health like use of anting-anting or lucky charms
beliefs a state or habit of mind wherein a group of people place trust into something or a person (Webster)
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Definition of Values
Values are beliefs and things considered important by an individual or a family, such as
freedom, independence, privacy, physical
appearance, money, health and fitness, integrity
and honesty.
Values influence behavior and understanding a populations values leads to better tolerance why they react or respond to issues of health or are
resistant to change, among other facets of
behavior.
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Components of
Culture Roots
Culture refers to the sum total of customs, values, traditions,
art, history and other norms
that are developed, learned
and shared by a specific group
of people.
As these practices are passed down from generation to
generation, they may be
modified with time, knowledge,
acculturation, and lifestyle that
would result in security,
comfort and betterment of well
being.
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Health as a Multifactorial Phenomenon
FACTORS AFFECTING HEALTH
Heredity
the genetic transmission of traits from parents to offspring: genetically determined
(Miller-Keane, 1987)
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Newborn Screening (NBS)
A simple procedure using the heel prick method (a few drops of blood are taken from the babys heel and blotted on a special absorbent filter card, dried for 4 hours and sent to the Newborn Screening Center) to determine if the baby has a congenital metabolic disorder that may lead to mental retardation and even death if left untreated.
Most babies with metabolic disorders look normal at birth. One will never know that the baby has the disorder until the onset of signs and symptoms and more often ill effects are already irreversible.
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Newborn screening is mandated by
RA 9288 signed by PGMA in April 2004
Newborn screening is ideally done on the 48th72nd hour or at least 24 hours from birth. Some
disorders are not detected if the test is done
earlier than 24 hours. The baby must be
screened again after 2 weeks for more accurate
results.
Babies with positive results should be referred at once to the nearest hospital or specialist for
confirmatory test and further management.
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Disorders Screened in Newborns
Disorder Screened Effect ScreenedEffect if Screened
& Treated
Congenital Hypothyroidism (CH),
Results from lack or absence of thyroid hormone which is
essential to growth of the brain and the body.
Severe Mental
RetardationNormal
Congenital Adrenal Hyperplasia (CAH),
An endocrine disorder that causes severe salt loss,
dehydration and abnormally high levels of male sex
hormone in both boys and girls.
Death Alive and Normal
Galactosemia (GAL),
A condition in which the body is unable to process galactose,
the sugar present in milk.
Death or Cataracts,
Liver/Brain
Damage
Alive and Normal
Phenylketonuria (PKU),
A rare condition in which the baby cannot properly use one of
the building blocks of protein called phenylalanine.
Severe Mental
Retardation/
Brain Damage
Normal
Glucose-6-Phosphate Dehydrogenase Deficiency (G6PD Def),
A condition in which the body lacks the enzyme G6PD.
Severe Anemia,
KernicterusNormal
Source: Department of Health
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Health as a Multifactorial Phenomenon
FACTORS AFFECTING HEALTH
Environment
the sum total of all the conditions and elements that make up the surroundings
and influence the development of an
individual (Miller-Keane, 1987)
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Health as a Multifactorial Phenomenon
FACTORS AFFECTING HEALTH
Socio-economic
refers to the production activities, distribution and consumption of goods
of an individual
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Health Care Delivery
A PYRAMIDAL HEALTH STRUCTURE
National Health Services Tertiary Health Care
Regional Health Services Secondary Health Care
District Health Services
Rural (Local Hospital) Services
Rural Health Units Primary Health Care
Barangay Health Stations
NationalHealth
Services
Regional/District Health Service
Rural (Local HospitalServices)
Rural Health Units Barangay Health Stations
OVERVIEW OF THE
PHILIPPINE HEALTH SECTOR
THE PHILIPPINE HEALTH CARE
DELIVERY SYSTEM
ORGANIZATION OF THE HEALTH
SYSTEM
Dual health system consisting of the public sector and the private sector
Public Sector
- Largely taxed based financing
- Generally given free at point of service
- Socialized user charges introduced
ORGANIZATION OF THE HEALTH
SYSTEM
Private Sector
- For profit and non-profit providers
- Largely market-oriented
- Paid through users fees at point of
service
ORGANIZATION OF THE HEALTH
SYSTEM
( Public Sector ) Devolution of health services under Local
Government Code of 1991 leading to
fragmentation of health services
DOH as lead agency providing national policies and plans, regulations, standards
and guidelines on health, including tertiary
and specialized health care
LGUs as direct providers of health services, particularly public health programs & primary,
secondary and general tertiary hospital care
ORGANIZATION OF THE HEALTH
SYSTEM
( Private Sector )
For profit and non-profit health providers
- clinics and hospitals
- health insurance
- providers of health products
- research & academic institutions
Individuals, families and communities
- consumers and seekers of health care
- partners in health care
HEALTH CARE FACILITIES
>Local health facilities are poorly-equipped and poorly-staffed;
>Regional and national hospitals are congested
>Health facilities in the public and private sectors are unevenly distributed
>National-local and public-private networking and patient referral systems
are inadequate
THE HEALTH STATUS OF THE
FILIPINOS
DEMOGRAPHIC CHARACTERISTICS
Population growth rate remains high
Half of the population is below 21 years old
Average life expectancy is increasing
Proportion of older persons is growing
GENERAL HEALTH STATUS
Life expectancy at births has increased, with females having longer life expectancy
than males;
IMR and UFMR are declining, but the rate of decline has slowed down;
TFR and MMR are declining, but still one of the highest in Southeast Asia
Large variations in health status among different regions in the country
BURDEN OF DISEASE
Leading causes of morbidity are communicable diseases
Leading causes of mortality are degenerative and other non-
communicable diseases
Double burden of disease places a great toll of the economy
Threat from emerging and resurgent diseases is increasing
UTILIZATION OF HEALTH SERVICES
Fairly widespread use of health facilities in the country with 77 % of households
having used a health facility
Government facilities were most frequented( 39%) compared to private
facilities ( 30 % )
Traditional healers were visited by 8 % of the population
THE VISION, MISSION AND GOALS OF
THE PHILIPPINE HEALTH SECTOR
VISION : Health for all Filipinos
MISSION : To ensure accessibility and
quality of health care to improve the
quality of life of all Filipinos, especially the
poor.
THE PRIMARY GOALS OF THE HEALTH
SECTOR
Better Health Outcomes
- Attaining the best average level of health for the entire population and attaining the smallest feasible differences in health status among individuals and groups
More Responsive Health System
- Meeting the peoples expectations of how they should be treated by health providers and the degree by which people are satisfied with the health system
THE PRIMARY GOALS OF THE
HEALTH SECTOR
More Equitable Health care Financing
- Distributing the risk that each individual
faces due to cost of health care according
to the ability to pay rather than to the risk
of illness
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Health Promotion
Public health efforts focus on health promotion and disease prevention.
Health promotion activities enhance resources directed at improving well being,
whereas disease prevention activities
protect people from disease and the
effects of disease.
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Primary Health Care
DEFINITION
Universal Definition
- Essential care based on scientifically sound
and socially acceptable methods and technology
made universally accessible to individuals,
families and communities through their full
participation, at a cost they can afford at any
given stage of development, and with the goal of
self-reliance and self-determination.
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Primary Health Care
GENERAL PRINCIPLES OF PRIMARY HEALTH CARE:
Health and development are interrelated.
Essential health services must be accessible, available, acceptable and affordable.
Genuine peoples participation is essential.
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Primary Health Care
Mission and Goals
Mission: To strengthen the health care system by increasing opportunities and supporting the conditions wherein people will manage their own health care.
Key Strategy to Achieve the Goal:Partnership with and empowerment of the People.Health for All by the Year 2000
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The strategy for achieving healthfor all is based on four (4) basic points:
Use of technology that is scientifically and socially acceptable as well as economically sound.
Political efforts to improve health, thus improving peoples economic and social status.
Cooperation of the health sector with other sectors such as education, agriculture, industry and media.
Community and individual participation.
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Primary Health Care
Mission and Goals
Key Strategy to Achieve the Goal:Partnership with and empowerment of the People.Health for All by the Year 2000
Health in the Hands of the People by the Year 2020Strategy: Advocacy and Social Mobilization
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Primary Health Care
Primary Health Care
H-O-M-E E-L-E-M-E-N-T-S
H - Hospital as a Center of Wellness
O - Oral and Dental Health
M - Mental Health
E - Elderly Care
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Primary Health Care
Primary Health Care E-L-E-M-E-N-T-S
E- Education for Health
L- Local Endemic Disease Prevn & Control
E- Expanded Program on Immunization
M- Maternal and Child Health
E- Essential Drugs
N- Nutrition
T- Treatment of Communicable Diseases
S- Safe Water and Sanitation
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Four Pillars of Safe MotherhoodDOH
Antenatal/Prenatal Care
Emergency OB Care
Clean & Safe Delivery
Family Planning
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Focuses on the promotion
and advocacy of 10
scientifically-proven
medicinal plants endorsed
by DOH.
Lagundi,Yerba Buena,Sambong,Tsaang Gubat,Niyug-niyugan,Bayabas,Akapulko,Ulasimang Bato,BawangAmpalaya.
Herbal Medicine Community-Based Program
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Care Enhancement Qualities
STEPS IN PROBLEM SOLVING
(A-D-P-I-E)
ASSESSMENT: COLLECT DATA
DIAGNOSIS: DEFINE THE PROBLEM
PLAN: SELECT STRATEGIES
IMPLEMENTATION: TAKE ACTION
EVALUATION: EVALUATE RESULTS
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Care Enhancement Qualities
CARATIVE ELEMENTS
Humanistic-altruistic value system
Faith and hope
Sensitivity to self and others
Helping trust relationship
Ability to accept positive and negative expression of feelings
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Care Enhancement Qualities
CARATIVE ELEMENTS
Interpersonal teaching and learning abilities
Personality type
Solid family background
Experience of having been loved and the ability to love
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Care Enhancement Qualities
CARATIVE ELEMENTS
Sense of humor
Relaxed attitude
Open-mindedness
Quick decision making
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HEALTH CARE 2
COMMUNITY ORGANIZING PARTICIPATORY ACTION RESEARCH
(COPAR)
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COMMUNITY
A social group determined by geographic boundaries and/or common values and
interests
Members know and interact with each other
Functions within a particular social structure and exhibits and creates
norms, values and social institutions
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COMMUNITY
Classification
Urban
Rural
Rurban
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URBAN
High density
Socially heterogeneous population and a complex structure, non-agricultural
occupations
Complex interpersonal social relations
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RURAL
Small and the occupation of the people is usually farming, fishing and food
gathering
Primary group relation, well-knit and high degree of group feeling
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RURBAN
Rural families continuously
migrate to the
metropolis
forming
communities of
urban poor
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HEALTH INDICATORS
Birth
Death
Marriages
Migration
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BIRTH
A coming into being; the act or process of being born.
Crude Birth Rate is only a rough measure of fertility in a population since it
makes use of midyear population as its
denominator.
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DEATH
The cessation of all physical and chemical processes that occurs in all living things.
Crude Death Rate is only a rough measure of mortality because death rates
are largely influenced by age and sex
composition of the population.
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MARRIAGE
The institution whereby a man and a woman are
joined in a special kind of
social and legal
dependence for the
purpose of founding and
maintaining a family.
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MIGRATION
The transfer of one individual from one locality to another.
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Community Health Care
Development Process (COPAR)
Approaches to Community
Development
1. Welfare Approach
2. Modernization Approach
3. Transformatory/
Participatory Approach
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Welfare Approach
- The immediate and/or spontaneous
response to ameliorate the
manifestation of poverty, especially on
the personal level.
- Assumes that poverty is God-given;
destined, hence the poor should accept
their condition since they will receive
their just reward in heaven.
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Welfare Approach
- Believes that poverty is caused by bad luck,
natural disasters and certain circumstances
which are beyond the control of people.
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Modernization Approach
- Also referred to as project development
approach.
- Introduces whatever resources are lacking
in a given community.
- Also considered a national strategy which
adopts the western mode of technological
development.
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Modernization Approach
- Assumes that development consists of
abandoning the traditional methods of
doing things and must adopt the
technology of industrial countries.
- Believes that poverty is due to lack of
education; lack of resources such as
capital and technology.
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Transformatory/Participatory
Approach
- The process of empowering/
transforming the poor and the oppressed
sectors of society so that they can
pursue a more just and humane society.
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Transformatory/Participatory
Approach
- Assumes that poverty is not God-given, rather it is rooted in the historical past and is maintained by the oppressive structure in society
- Believes that poverty is caused by prevalence of exploitation, oppression, domination and other unjust structure
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Community Health Care
Development Process (COPAR)
Phases
1. Pre-entry Phase
2. Entry Phase
3. Organization-Building Phase
4. Community Action Phase
5. Sustenance and Strengthening Phase
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Pre-Entry Phase
- The initial phase of the organizing
process where the community organizer
looks for community to serve or help.
- Considered the simplest phase in terms
of actual outputs, activities, strategies
and time spent for it.
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Pre-Entry Phase
Activities:
Designing a plan for community development including all its activities and
strategies for care/ development.
Community consultations/dialogues
Designing criteria for the selection of site.
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Pre-Entry Phase
Activities:
Site selection
Preliminary Social Investigation
Networking with local government units, NGOs and others
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Entry Phase
- Sometimes called the social preparation phase as the activities done here includes the sensitization of the people on the critical events in their life, motivating them to share their dreams and ideas on how to manage their concerns and eventually mobilizing them to take collective action on these.
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Entry Phase
Guidelines:
1. Recognize the role of local authorities
by paying them visits to inform them of
their presence and activities.
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Entry Phase
Guidelines:
2. Appearance, speech, behavior and
lifestyle should be in keeping with those
of the community residents without
disregard of their being role models.
3. Avoid raising the consciousness of the
community residents; adopt a low-key
profile.
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Entry Phase
Activities:
Integration with the community
Sensitization of the community/information campaigns
Continuing social investigation
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Entry Phase
Activities:
Core group formation
- Development of criteria for selection of
CG members
- Defining the role/functions/tasks of the
CG
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Entry Phase
Activities:
Coordination/Dialogue/Consultation with other community organizations
Self Awareness and Leadership Training/ Action planning
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Organization-Building Phase
- Entails the formation of more formal
structures and the inclusion of more formal
procedures of planning, implementing and
evaluating community wide activities
- It is at this phase where the organized
leaders or groups are being given training
to develop their AKS in managing their
own concerns/programs.
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Organization-Building Phase
Activities:
Community meetings to draw up guidelines for the organization of the
CHO
Election of officers
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Organization-Building Phase
Activities:
Development of management systems and procedures, including delineation of
the roles, functions and tasks of officers
and members of the CHO
Team building/Action Reflection Action (ARA)
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Organization-Building Phase
Activities:
Working out legal requirements for the establishment of the CHO
Organization of working committees/task groups (e.g. education and training,
membership of committees)
Training of the CHO Officers/community leaders
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Community Action Phase
Activities:
Organization and training of community health workers
- Development of criteria for the selection of
CHWs
- Selection of CHWs
- Training of CHWs
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Community Action Phase
Activities:
Setting up of linkages/network referral systems
Initial identification and implementation of resource mobilization schemes
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Sustenance and Strengthening
Phase
- Occurs when the community
organization has already been
established and the community
members are actively participating
in community-wide undertakings
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Sustenance and Strengthening
Phase
- The different committees set-up in the
organization-building phase are already
expected to be functioning by way of
planning, implementing and evaluating
their own programs with the overall
guidance from the community wide
organization.
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Sustenance and Strengthening
Phase
Strategies:
- Education and training
- Networking and linkaging
- Conduct of mobilization on health and
development concerns
- Implementation of livelihood projects
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Sustenance and Strengthening
Phase
Strategies:
- Formulation and ratification of
constitutions and by-laws
- Identification and development of
secondary leaders
- Setting up and institutionalization of
financing scheme for community health
program/activities
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Sustenance and Strengthening
Phase
Strategies:
- Development and implementation of
viable management systems and
procedures, committees, continuing
education/training of leaders, CHWs,
community residents
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Sustenance and Strengthening
Phase
Strategies:
- Continuing education and upgrading of
community leaders, CHWs and CHO
members
- Development of medium/long term
community health and development
plans.
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Critical Steps in Building
Peoples Organization
1. Integration
a. Immerse himself in the poor community
b. Understand deeply the culture,
economy, leaders, history, rhythms and
lifestyle in the community
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Critical Steps in Building
Peoples Organization
2. Social Investigation
- A systematic process of collecting,
collating, analyzing data to draw a
clear picture of the community
- Also known as community study
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Critical Steps in Building
Peoples Organization
3. Tentative Program Planning
A community organizer choose one
issue to work on in order to begin
organizing the people.
4. Groundwork
Going around and motivating the people
on one on one basis to do something on
the issue that has been chosen.
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Critical Steps in Building
Peoples Organization
5. The Meeting
People collectively ratifying what they
have already decided individually. It
gives the people the collective power
and confidence. Problems and issues
are discussed.
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Critical Steps in Building
Peoples Organization
6. Role Play
Means to act out the meeting that will
take place between the leaders of the
people and the government
representative.
- It is a way of training the people to
anticipate what will happen and prepare
themselves for such eventuality.
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Critical Steps in Building
Peoples Organization
7. Mobilization or action
Actual experience of the people in confronting the powerful and the actual exercise of people power.
8. Evaluation
The people reviewing steps 1-7 to determine whether they were successful or not in their objectives.
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Critical Steps in Building
Peoples Organization
9. Reflection
- Dealing with deeper, on-going
concerns to look at the positive values
CO is trying to build in the organization
- Gives the people time to reflect on the
stark reality of life compared to the
ideal.
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Critical Steps in Building
Peoples Organization
10. Organization
- The peoples organization is the result of many successive and similar actions
of the people.
- A final organization is set up with
elected officers and supporting
members.
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Community Health Worker
One who provides basic community health
care services for promotion of health,
prevention of illness, simple treatment and
rehabilitation.
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Qualities of a Health Worker
a. Open accepts need for joint planning and decision relative to health care in a
particular situation not resistant to
change.
b. Tactful one who presides over an assembly, meeting or discussion in a
subtle manner; does not embarrass but
gives constructive criticisms.
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Qualities of a Health Worker
c. Coordinator brings into consonance or harmony the communitys health care activity.
d. Objective unbiased and fair in decision-making.
e. Good listener always available for the participant to voice out their sentiments
and needs.
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Qualities of a Health Worker
f. Efficient knowledge about everything relevant to his practice; has the
necessary skills expected of him
g. Flexible able to cope with different situations
h. Critical thinker decides on what has been analyzed
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Functions of a Health Worker
1. Community Health Service Provider
Carries out health services contributing to the promotion of health, prevention
of illness, early treatment of illnesses
and rehabilitation.
Appraises health needs and hazards.
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Functions of a Health Worker
2. Facilitator
- Helps plan a comprehensive health
program with the people
- Continuing guidance and supervisory
assistance
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Functions of a Health Worker
3. Health Counselor
- Provides health counseling including
emotional support to individuals, family,
group and community
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Functions of a Health Worker
4. Co-Researcher
- Provides the community with
stimulation necessary for a wider or
more complex study of problems
- Enforce community to do prompt and
intelligent reporting of epidemiological
investigation of diseases
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Functions of a Health Worker
4. Co-Researcher
- Suggest areas that need research
- Participate in planning for the study
and in formulating procedures
- Assist in collecting of data
- Help interpret findings collectively
- Act on the result of the research
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Functions of a Health Worker
5. Member of a Team
- In operating within the team, one must
be willing to listen as well as to
contribute, to teach as well as to learn,
to lead as well as to follow, to share
authority as well as to work under it.
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Functions of a Health Worker
5. Member of a Team
- Helps make multiple services which
the family receives in the course of
health care, coordinated, continuous
and comprehensive.
- Consults with and refers to appropriate
personnel for any other community
service.
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Functions of a Health Worker
6. Health Educator
- One who improves the health of the
people by employing various methods
of scientific procedures to stimulate,
arouse and guide people to healthful
ways of living.
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TRENDS AND ISSUES IN
HEALTH CARE
Changing demographics and cultural diversity
Improving health care delivery system
Technological advances and research
Increasing globalization
Preventing terrorism
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TRENDS AND ISSUES IN
HEALTH CARE
Increasing consumer/client involvement
Outcome management
Increasing the availability of skilled health professionals, especially nurses and physicians (also RNDs)
Improving infrastructure in rural areas
Extending education/outreach programs to remote areas (DDUs)
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WORLD LESSONS LEARNED
ABOUT HEALTH CARE
Healthcare systems vary depending on the development level of a country. But the key to implementation is publicly mandated services (public or private). Such services cannot be few and must include those that accommodate accountability in ensuring universal delivery. Supplementary insurance must be allowed for items not covered in the universal system. )
Source: World Economic Forum 28 Jan 2009
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WORLD LESSONS LEARNED ABOUT HEALTH CARE
Japan has the worlds oldest population. Health and longevity create wealth and, thus, health begets wealth. It is documented that nations that develop a 5-year life expectancy advantage also create a larger GDP. A healthy childhood and adulthood contribute to a more productive old age.
New markets and industries are arising silver industries such as financial services, health, housing and hospitality geared to senior citizens. Longevity needs to be linked to health including cognitive health and lifestyle choices play a major role in health.
Source: World Economic Forum 28 Jan 2009
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WORLD LESSONS LEARNED ABOUT HEALTH CARE
The public health focus is shifting from infections to cardiovascular diseases. Complex new models are necessary to develop better responses and improved health with the primary emphasis on really good primary healthcare and prevention to lower costs.
Prevention increases the healthy years of a persons life. The challenge is creating the incentive for prevention: how can people be encouraged to make healthy choices? Mobilized populations can drive the change.
Finland has an 80% lower incidence of heart disease than 30 years ago due to such incentives.
Source: World Economic Forum 28 Jan 2009
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WORLD LESSONS LEARNED ABOUT HEALTH CARE
Improved nutrition and food security also play a role in health outcomes. Increasingly, governments are willing to come to grips with outcomes and to acknowledge that healthcare providers must be geared to supply intervention
to the most vulnerable people.
Indeed, the World Economic Forum could play an important role in fielding a public-private health initiative or supporting efforts to mine large healthcare databases to unearth previously unsuspected correlations.
Source: World Economic Forum 28 Jan 2009
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WORLD LESSONS LEARNED ABOUT HEALTH CARE
Governments must recognize the health, social and political aspects of a serious influenza pandemic. On all levels whether public or private the mantra remains proper diagnosis, correct intervention and appropriate ways of delivering solutions. But how best to ensure that poorer countries can be prepared to support such efforts?
Many of the poorest including migrant populations and refugees are off the radar and may unwittingly be reservoirs of infectious ailments.
Source: World Economic Forum 28 Jan 2009
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WORLD LESSONS LEARNED ABOUT HEALTH CARE
Alzheimers and dementia are on the increase. New research suggests that they relate to the same causes and could respond to the same preventive measures including physical activity and moderate alcohol intake; but this still awaits thorough investigation. . .
Source: World Economic Forum 28 Jan 2009