Primary health care E. Vermeulen. Definition of primary health care. Primary Health Care as defined by the World Health Organization in 1978 is: Essential.

Primary health careE. Vermeulen

Definition of primary health care.Primary Health Care as defined by theWorld Health Organization in 1978 is: Essential health care; based on practical,scientifically sound, and socially acceptablemethod and technology; universallyaccessible to all in the community throughtheir full participation; at an affordable

cost;and geared toward self-reliance and selfdetermination.

Eight essential components for PHC:

1.Education for the identification and prevention /control of prevailing health challenges2. Proper food supplies and nutrition; adequate supplyof safe water and basic sanitation3. Maternal and child care, including family planning4. Immunization against the major infectious diseases5. Prevention and control of locally endemic diseases6. Appropriate treatment of common diseases using

appropriate technology7. Promotion of mental, emotional and spiritual health8. Provision of essential drugs (WHO & UNICEF, 1978).

Basic conditions/terms for effective PHCFairAcceptableAffordableAccessibleEffective

Definition of rehabilitationA goal-orientated and time limited

process aimed at enabling an impaired person to reach an optimum mental, physical and/or social functional level, thus providing him/her with the tools to change his/her life. It can involve measures intended to compensate for a loss of function or a functional limitation and other measures intended to facilitate social adjustment or readjustment.

Community Based RehabilitationCommunity-based rehabilitation (CBR) focuses onenhancing the quality of life for people withdisabilities and their families, meeting basic needsand ensuring inclusion and participation. CBR wasinitiated in the mid-1980s but has evolved tobecome a multi-sectoral strategy that empowerspersons with disabilities to access and benefit fromeducation, employment, health and social services. CBRis implemented through the combined efforts of peoplewith disabilities, their families, organizations andcommunities, relevant government and non-government

health,education, vocational, social and other services.(WHO)

Levels of the National Health System

First (entry) level - Clinics

ClinicsManned by qualified primary

healthcare nursing personnel, physiotherapists and/or other rehabilitation personnel.

Second level – community health centres

Community health centres

manned by doctors, nursing personnel, pharmacists, physiotherapists and/or other rehabilitation personnel. Maternity services are usually available at these centers.

Third level – District Hospitals

District hospitalsManned by doctors, nursing

personnel, dentists, social worker/s, dieticians, physiotherapists and/or other rehabilitation personnel. Emergency care is usually available here.

Fourth level – Regional hospitals

• The first step to more specialised service and long term patient care.

Fifth level – Tertiary Hospitals

Tertiary hospitals providing the most specialised

medical services, such as heart-, brain-, abdominal-, pediatric-, obstetric- or spinal surgeries and the like.

Care provided by physiotherapists at al levels of PHCPromotive carePreventative careCurative/therapeutic careRehabilitative care

Promotive carePromote health care at all levelsEducation programmes directed

at achieving and maintaining healthy living, efficient function and optimal quality of life.

Promotive care is also directed at the maintenance of optimal health in the already diseased or disabled.

Examples......

Preventative careTYPES OF PREVENTION:Primary prevention: prevention

of disease in a susceptible or potentially susceptible population through specific measures such as general health promotion efforts.

Secondary prevention: efforts to decrease the duration of illness, severity of disease through early diagnosis and prompt intervention

Preventative care cont’dTertiary prevention: includes

efforts to decrease the degree of disability and promote rehabilitation and restoration of function in patients with chronic and irreversible diseases

Examples of each type of prevention?

Curative/therapeutic careAssess and treat

musculoskeletal, respiratory and neurological conditions.

Examples....

Rehabilitative careIntervention measures taken to

implement treatment, self management and educational programmes breaking the chain of impairment, disability or handicap.

Restoration of optimal physical and functional independence.