UNIT- 2 Health care delivery system.pptx

3rd GNM COMMUNITY HEALTH NURSING -II PPT

1. Unit -2 Health care delivery system a) Health care concept and trends b) Health care services - Public sector, Rural, Urban c) Private sector d) Public Private Partnership (PPP) e) Other agencies f) Indigenous systems of medicine Ayurvedha, yoga, unani, siddha and homeopathy (AYUSH) g) Voluntary health services h) National Health Programmes i ) Nurse role in health care services

2. Health care concept and trends Health care is defined as multiple services rendered to individual ,families, or communities by the agent of health services or professional for the purpose of promoting ,maintaining ,monitoring or restoring health.

3. Trends in health care Comprehensive health care Basic health services Primary health care

4. Levels of health care

5. 1.  Primary Health Care According to alma ata conference defined primary health care as follows, “primary health care is essential health care made universally accessible to individuals and acceptable to them, through their full participation and at cost that the community and country can afford. ”

6. Responsibilities of primary health care Assessing the health level of individual and community Ensuring active participation of community And encouraging the individuals to participate Providing treatment in emergencies and taking care of the general health Referring training and supervision health workers

7. Keeping an eye on the outbreak of disease Providing training and supervision of health workers Coordination with health programs Providing health education on preventive, promotive and curative aspects of health Maintaining the progress of primary health care

8. Health care service

9. Super specialty hospital or institution Super specialty hospital come under this group. In these hospital super specialists of different organs or diseases are trained and patients are also treated. All India institute of medical science is an example of such institute.

10. Health insurance schemes Employee state insurance (ESI) Central government health scheme(CGHS)

11. Other agencies Defence services railways

12. PRIVATE SECTORS In private sectors ,there are specialty hospital, super –specialty hospitals, medical college hospital, dispensaries and health clinics . The people who can afford heavy expenses are taking the facilities of health care from these hospital

13. a. Private hospitals and clinics : Because of mixed economy and globalization ,private hospital are being opened rapidly. From small to large metropolitan cities, their network is spreading. But private hospital ,nursing homes and clinics are mainly therapeutic institution and provide health services to urban population only. To get their services, price is to paid ,hence poor and weaker section cannot get their service.

14. b.private consultation centre With the increasing number of allopathic hospital ,the tendency to start health consultation privately, is increasing doctors. Medical council of India ,and Indian medical association keep professional checks over them. In rural areas, fake doctors often start private clinics and consultation which is a money making.

15. C . mission or religious hospital These hospital are managed by mission ,trust or charitable institutions. In many parts of the country, such hospital and clinics provide medical services either free of cost or at very cheap rate ,to common people. Though they are functioning mainly in urban areas ,they provide health care to rural population also, through camps or community care centres It is worth mentioning that three quarter of indian population live in villages ,but most of the health care system is in the cities.

16. PUBLIC PRIVATE PARTNERSHIP

17. Objective of PPP Improving the health care delivery Monitoring the growth of private sectors and directing it Improving the health management Providing access to essential RCH Exchange of skills Widening The Range Of Services

18. Benefits of PPP Utilizing the existing capacity of health system Creating competition Improving quality choice and availability of RCH Other service to poor Creating synergy between public and private system

19. Condition for success of partnership A clear understanding between the partners about mutual benefits Clear understanding the responsibilities Strong community support Stability of the govt and law Strong management information system Clarity on incentives and penalties

20. Indian system of medicine The indigenous system of medicine is also called as Indian system of medicine Is an ancient system of medicine which practiced in India The practice of indigenous system of medicine provides medical care to the rural population .

21. Indigenous system of medicine [AYUSH] The indigenous systems of medicine form an important part of public system of health care delivery in both rural and urban areas. Services are rendered through out-patient departments, dispensaries and hospitals. Ayurveda Siddha unani homeopathy Yoga naturopathy

22. System has unique treasure for the conversion of metals and minerals as drugs and many infective diseases are treated with the medicines containing specially processed mercury, silver, lead and Sulphur without any side effects. The strength of the Siddha system lies in providing very effective therapy in the case of Psoriasis, Rheumatic disorders, Chronic liver disorders, Benign prostate hypertrophy, bleeding piles, peptic ulcer including various kinds of Dermatological disorders

23. YOGA The concept and practices of Yoga originated in India about several thousands years ago. Yoga Practice is essential for self realization, it is also widely used for management of several diseases. Maharishi Patanjali, "The Father of Yoga“.

24. In the present days, Yoga Education is being imparted by many Yoga Institutions, Yoga Colleges, Yoga Universities, Yoga Departments in the Universities . Many Yoga Clinics, Yoga Therapy and Training Centers, Preventive Health Care Units of Yoga, Yoga Research Centers etc. have been established in Hospitals, Dispensaries, Medical Institutions.

25. NATUROPATHY Naturopathy is closely related to the nature cure and natural hygiene movement. Is a drug less system of medicine Nature cure for lifestyle disorder

26. Voluntary health services The voluntary health services are provided by many voluntary health agencies in India. The Agencies which provide voluntary health services

27. Function S upplementing the work of govt. agencies Pioneering Education Demonstration Guarding the work of govt. agencies Advancing health legislation

28. 1.INDIAN RED CROSS SOCIETY It was established in 1920. It has 400 branches in India. Executing programmes are, promotion of health, prevention of disease and mitigation of suffering among the people. Activities a) Relief work b) Milk and Medical supplies c) Armed forces d) Maternal and child welfare services e) Family Planning f) Blood Bank and First Aid

29. 2 .INDIAN COUNCIL FOR CHILD WELFAE It was established in 1952 and is affiliated with the International union for Child Welfare. The main objective of the council is to promote the opportunities and facilities for the development of children through legal This tries to ensure the promotion of physical ,social and mental health of children.

30. 3.FAMILY PLANNING ASSOCIATION OF INDIA It was formed in 1949, HQ in Mumbai. Activities This includes conducting the family planning clinics, training of doctors, nurses and social workers for family planning activities or providing information

31. 4 .Other NGOs there are numerous other NGOs some of these are…….. the population council voluntary health association of India All India women's conference Medical association

32. 1.World Health Organization  (WHO) World health organization is a specialized, nonpolitical health agency of united nations with head quarter at Geneva in Switzerland. It came into force on 7 th April 1948 Aim To provide vital health care to each and every human being Eradication of poverty and disease International health agencies

33. Objectives The attainment of highest standard of health by all the individuals The current objectives –health for all Membership any country of the world can be member of WHO

34. Regional organization South east Asia Africa America Europe Western pacific Eastern Mediterranean

35. FUNCTIONs Directing and coordinating health programmes throughout the world Prevention and control of communicable and other specific diseases Promoting environmental health Collection of data for health statistics ,communication and publication of information Helping members countries in their health programmes and development of health services, providing more emphasis on the development in the standard of family health.

36. 2.United Nation Development Programme (UNDP) The united nation development program was established in1966 Objectives To help the poor countries in the development of human and natural resources The UNDP projects- economic and social sector – agriculture, industry, education and science, health, social welfare.

37. 3.Food and Agriculture Organization FAO Formed in 1945 and Headquarters in Rome. its prime concern of food and agriculture organization are: To help nations raise living standards T o improve nutritional status in the all countries T o increase the efficiency of farming, forestry and fisheries To improve status of rural people.

38. 4.International Labor Organization ILO was established in 1919 T o improve the working and living conditions of the working population all over the world. The headquarters of ILO is in Geneva, Switzerland. The main objectives of the ILO is : To improve housing and working condition of workers throughout the world To co-operate in maintaining peace To promote economic and social stability

39. 5.The World Bank The world bank is specialized agency of the united nations It was established in 1944 The head quarters is in Washington It has more than10,000 employees and 100 offices world wide . Objectives To help in raising the standard of living of the underdeveloped countries who are comparatively poor.

40. 6.The United Nations Fund for Population Activities (UNFPA ) Providing assistance to India since 1974. Aim promotes the right of every women ,man and child to enjoy life of health and equal opportunity

41. Function Family planning MCH services Treatment of infertility Prevention of abortion and management Treatment of reproductive tract infection Information, education and counseling on human sexuality and reproductive health

42. 7.CARE (Cooperative for Assistance and Relief Everywhere ) Founded in North America in the wake of the second World War in the year 1945. one of the world’s largest independent, non-profit, non-political international relief and development organization. Objectives To provide food for children in the age group of 6-11 years.

43. CARE in India Anemia control project Integrated nutrition and health project Improving women's health project Child survival project Improved health care for adolescent girls project Family spacing project

44. 8.Danish international development agency Established on 1963 Focused area of development Green growth Social progress Stability and protection Human right and democracy FUNCTIONS Eradication of poverty Provides support to NGOs

45. 9.UNICEF (UNITED NATIONS INTERNATIONAL CHILDREN’S EMERGENCY FUND)    UNICEF was established in 1946 as United Nations International Children’s Emergency Fund. To deliver post war relief to children, later renamed as United Nations Children Fund The main aim to improving the quality of life for children and mother. The headquarters of UNICEF are at New York in USA and regional office for South East Asia is established at New Delhi in India.

46. ACTIVITIES OF UNICEF a) Health b ) Nutrition c ) Education d) Water supply e) Social welfare

47. STRATEGRY BY UNICEF   UNICEF is promoting a campaign known  GOBI  campaign to encourage “Child Health.” G - for growth charts to better monitor child development  O -for oral rehydration to treat all mild and moderate dehydration B- for breast feeding I -for immunization against measles, diphtheria polio, pertussis, tetanus and tuberculosis.

48. 10.European commission It was established in1951 as the nine member “high authority” under president . Represent the interest of the European as whole. Functions It proposes laws for adoption It makes proposals to meet the obligations

49. 11.International red cross It was founded by Henry Dunant, a young Swiss businessman, who when travelling through North Italy in 1859. The Red Cross is a non-political non-official international humanitarian organization devoted to the service of mankind in peace and war. It was started in 7 th  August 1859 to help the neglected thousands of the wounded and dying soldiers.   Later in the work of the Red Cross was extended to other programme which would prevent human suffering. These comprise service to armed forces, disaster service, first aid and nursing, health education and maternity and child welfare services

50. 12.USAID United state agency for international development It was created in 1961. A USAID mission operate in NEWDELHI FUNCTIONS Malaria eradication Nursing and medical education Health education and nutrition Water supply and sanitation Control of communicable diseases Family planning

51. 13.UNESCO United Nations Educational Scientific And Cultural Organization  UNESCO came into being on 4 th  Nov 1946. The main objectives…… Education social and human science cultural ,communication information

52. National Programmes

53. The national health programs have been launched by the central government of India . The Health programme were focusing communicable disease, nutrition, environmental issues, population control, rural health and non communicable diseases introduced recently. Many of the programmes were revised as per need of time. many other agencies have been providing technical and material assistance in the implementation of these programmes.

54. Aim of National Health Programmes Improve health of country Healthy mother = Healthy child Better pregnancy care Better newborn care Eliminate vaccine preventable diseases Target malnutrition Population control

55. Programmes for Communicable Diseases National Vector Borne Diseases Control Programme (NVBDCP) Revised National Tuberculosis Control Programme National Leprosy Eradication Programme National AIDS Control Programme Universal Immunization Programme National Guinea worm Eradication Programme Yaws Control Programme Integrated Disease Surveillance Programme

56. Programmes for Non Communicable Diseases National Cancer Control Program National Mental Health Program National Diabetes Control Program National Program for Control and treatment of Occupational Diseases National Program for Control of Blindness National program for control of diabetes, cardiovascular disease and stroke National program for prevention and control of deafness

57. National Nutritional Programs Integrated Child Development Services Scheme Midday Meal Programme Special Nutrition Programme (SNP) National Nutritional Anemia Prophylaxis Programme National Iodine Deficiency Disorders Control Programme

58. 1.National ARI Program Acute respiratory infection control programme was implemented 1992 as part of CSSM programme. AIM To reduced the mortality rate in children To reduce hospital admission To provide in time treatment of hospitalization cases.

59. 2. NATIONAL ANTI-MALARIA PROGRAMME (NAMP) The National Malaria Control Programme was implemented in the State from 1953 to 1958. With the success achieved the programme was converted in to eradication programme from 1958. The programme is monitored by the Joint Director Of Health Services (Malaria), located at Pune.

60. OBJECTIVES: To reduce period of sickness and to prevent deaths due to Malaria To maintain industrial and agricultural progress

61. Methods to control malaria Mass spraying Surveillance Treatment of cases

62. 3.National filarial control programme NFCP was launched in 1995 The strategies include  a)    Vector Control b)    Detection and treatment of filarial cases c)    Delimitation of endemic areas.

63. Following measures were taken under this programme Assessing the problem filarial in the areas until now not surveyed Treating diagnosed cases Controlling the disease through anti-larva and anti-parasites Distribution of anti-filarial medicine through PHC diethyl carbamazine citrate drug

64. 4.NATIONAL GUINEA WORM ERADIACTION PROGRAM Government of India launched the National Guinea Worm Eradication Programme in 1983-84 as a centrally sponsored scheme on a 50:50 sharing basis between Centre and States with the objective of eradicating guinea worm disease from the country.

65. 5.NATIONAL LEPROSY ERADICATION PROGRAMME National Leprosy Eradication Program    was launched in 1983 as a continuation of the National Leprosy Control Program of 1955 . Detection of cases and DAPSONE monotherapy

66. Objectives Early detection through active surveillance by the trained health workers Regular treatment of cases by providing Multi-Drug Therapy (MDT) at fixed in or centers a nearby village of moderate to low district health education and public awareness campaigns to remove social stigma attached to the disease. Appropriate medical rehabilitation and leprosy ulcer care services.

67. Major activities Early detection and treatment of leprosy is the major step to prevent transmission of disease in the community and to prevent visible deformities Disability Prevention and Medical Rehabilitation –Reconstructive surgery for deformities, provision of Micro cellular rubber (MCR) chappals, aids & appliances like wheel chairs, crutches, goggles etc These services are provided free of cost Trainings - Medical officers , Health Workers ,Para Medical workers, ASHA workers.

68. Urban leprosy control To address the complex problems in urban areas, the Urban Leprosy control activities are being implemented in urban areas having population size of more than 1 lakh. These activities include MDT & follow up of patient for treatment , providing supportive medicines & dressing material and monitoring & supervision.

69. Nurses have key role in the delivery of health care services to the communities. Health care is a multitude of services rendered to the individuals ,families and communities by the health care professionals for the purpose of promoting, maintaining ,monitoring and restoring health ,so the health services are comprehensive in nature.

70. Role of nurses in health care services Preventive Promotive Protective curative Rehabilitative

71. 1.Preventive It is the prime responsibility of nurses to educate the people on preventive aspects of disease by giving health education on personal hygiene ,sanitation ,nutrition, immunization, adopting health lifestyle and family planning .

72. 2.Promotive service These services includes the process of enabling people to increase control over their health and thereby improve their health. The provide promotive service ,the community health nurse focuses on- Health education Environment modification Nutritional intervention Modification of healthy lifestyle

73. 3.Protective services The aim of protective services is to avoid disease all together and bring awareness among the people regarding health protection and specific protection

74. 4.Curative services Early detection and treatment Mass treatment 5.Rehabilitative services Is defined as the combined and coordinated ,use of medical ,social ,educational and vocational measures for training and retraining the individuals to the highest possible level by functional ability.

75. Role of nurse 1. Planner/Programmer Identifies needs, priorities, and problems of individuals, families, and communities implements nursing plan, program policies, Provides technical assistance to rural health midwives in health matters

76. 2.Provider of Nursing Care Provides direct nursing care to sick or disabled in the home, clinic, school, or workplace Develops the family’s capability to take care of the sick, disabled, or dependent member 3Community Organizer Motivates and enhances community participation in terms of planning, organizing, implementing, and evaluating health services Initiates and participates in community development activities

77. 4.Coordinator of Services Coordinates with individuals, families, and groups for health related services provided by various members of the health team Coordinates nursing program with other health programs like environmental sanitation, health education, dental health, and mental health

78. 5.Trainer/Health Educator Identifies and training needs of the family . Conducts training for the promotion and disease prevention Conducts pre and post-consultation conferences for clinic clients acts as a resource speaker on health and health related services Conducts pre-marital counseling

79. 6.Health Monitor Detects deviation from health of individuals, families, groups, and communities through contacts/visits with them 7.Role Model Provides good example of healthful living to the members of the community 8. Change Agent Motivates changes in health behavior in individuals, families, groups, and communities that also include lifestyle in order to promote and maintain health

80. 9.Recorder/Reporter/Statistician Prepares and submits required reports and records Maintain adequate, accurate, and complete recording and reporting Reviews, validates, consolidates, analyzes, and interprets all records and reports Prepares statistical data/chart and other data presentation

81. 10.Researcher Participates in the conduct of survey studies and researches on nursing and health-related subjects Coordinates with government and non-government organization in the implementation of studies/research