Concept of Public Health and Primary Health Care (PHC)

A brief description of Public Health (PH) and Primary Health Care (PHC)

1. CONCEPT OF AND Col Zulfiquer Ahmed Amin M Phil, MPH, PGD (Health Economics), MBBS Armed Forces Medical Institute (AFMI)

2. PUBLIC HEALTH

3. Essential Services of PH

4. Public Health Fundamentals 5 Ps of Public Health (expansion from the 3 Ps) Prevention (individual and community-focused) Promotion (voluntary, education, advocacy) Protection (policies/regulations; enforcement) Population-based (communities, groups) New 5 th P: Preparedness (e.g., bioterrorism, natural disasters, pandemics)

5. History of Public Health

6. Early Public Health

7. (1100 to 1453 AD) Disease was viewed as divine punishment for the sins of man

8. -Crusaders ’ noble knights boasted of bathing no more than four times a year. -In marked contrast, the Muslims put a premium on cleanliness and dietary regime. -The ritual cleansing of the body precedes each of the five daily prayers, a requirement that sparked the development of sophisticated public-water projects and ingenious engineering techniques . -Religious law proscribed a number of unhealthy practices, including the consumption of alcohol . -A large collection of sayings and practices ascribed to the Prophet Muhammad, later collated as the The Medicine of the Prophet , provided a general blueprint for healthy living and abstemious behavior . -Arabs translated all available Greek books of science and philosophy , -Teaching hospital, the first built in Damascus in 707 . -The leading Arab philosophers— Avicenna , and Maimonides —were all great physicians.

9. (14th to the 17th century) (1514-1564) (1578-1657) (1624–1689) (1818-65 ) (Early pioneer of antiseptic procedures) (1749-1823 ) P ioneer of smallpox vaccine (1632–1723)

10. (A social reformer) ( Legislating on the sanitary conditions of England and Wales)

11. Phases of Public Health

12. -First phase of public health, following soon after the industrial revolution. - Advocated sanitary action to deal with health problems caused by environmental factors.

13. 2.

14. To establish Health For All by 2000 AD by means of Primary health Care (1980-2000 AD) 4.

15. Health For All

16. (2003) (1983) (1976) (Most frequenting Since 1995)

17. Concepts of

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

19. 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 .

20. Secondary health care More complex problems are dealt with. Comprises curative services Provided by the district hospitals The 1 st referral level Tertiary health care Offers super-specialist care Provided by regional/central level institution. Provide training programs

21. WHAT IS PRIMARY HEALTH CARE

22. There are 8 elements of primary-health care (PHC ): E – Education concerning prevailing health problems and the methods of identifying, preventing and controlling them. L –   Locally endemic disease prevention and control. E –   Expanded program of immunization against major infectious  diseases. M – Maternal and child health care including family planning. E –    Essential drugs arrangement. N – Nutritional food supplement, an adequate supply of safe and basic nutrition. T –    Treatment of communicable and non-communicable disease and promotion of mental health. S –   Safe water and sanitation. Essential Elements of Primary Health Care

23. Attributes of (5 As)

24. PRINCIPLES OF PRIMARY HEALTH CARE EQUITABLE DISTRIBUTION COMMUNITY PARTICIPATION INTERSECTORAL COORDINATION APROPRIATE TECHNOLOGY DECENTRALISATION

25. FIVE COMMON SHORT COMINGS OF HEALTH CARE DELIVERY INVERSE CARE: More inclined to the rich. IMPOVERISHING CARE: Healthcare expenditure makes one poor. FRAGMENTED AND FRAGMENTING CARE: Too much specialties, interfere with COMPREHRNSIVE care. UNSAFE CARE: Hospital Acquired Infection. MISDIRECTED CARE: Less budget for preventive services which can tackle 70% of cases of ill-health.