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1、rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,1,PRIMARY HEALTH CARE,By Dr Naseer Alam Tariq,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,2,Health,Health is a fundamental human rightState responsibility for the health of its peopleNational Govt all over the worl
2、d are striving to expand and improve their health care servicesThe current situation isUrban orientedMostly curative in natureAccessible to a small part of population,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,3,Health,Health is a state of complete physical, mental and social w
3、ellbeing and not merely absence of disease or infirmity (WHO Definition of Health 1948),rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,4,Primary Health Care,At the international level, the Universal Declaration of Human Rights established a breakthrough in 1948, by stating in Artic
4、le 25: “Everyone has the right to a standard of living adequate for the health and wellbeing of himself and his family” The preamble to the WHO Constitution also affirms that it is one of the fundamental rights of every human being to enjoy “The highest attainable standard of health”,rimaryHealthCar
5、ehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,5,Primary Health Care,Increasing importance given to social justice and equity, recognition of the crucial role of community participation, changing ideas about the nature of health and development, the importance of political will called for new app
6、roaches to make medicine in the service of humanity more effective.,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,6,Primary Health Care,Against the above background, the 30th World health Assembly resolved in May 1977 at Almata , that “the main social target of governments and WHO
7、 in the coming decades should beThe attainment by all citizens of the world by the year 2000 of a level of health that will permit them to lead a socially and economically productive life”This culminated in the international objective of HEALTH FOR ALL by the year 2000 as the social goal of all gove
8、rnments.,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,7,Primary Health Care,The joint WHO UNICEF international conference in 1978 at Alma Ata (USSR) the governments of 134 countries and many voluntary agencies called for a revolutionary approach to health care.Declaring that “The
9、 existing gross inequality in the health status of people particularly between developed and developing countries as well as within countries is politically, socially and economically unacceptable”,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,8,Primary Health Care,Health for all
10、means that health is to be brought within the reach of every one in a given community. It implies the removal of obstacles to health that is to say the elimination of MalnutritionIgnoranceDiseaseContaminated water supplyUnhygienic housing etcIt depends on continued progress in medicine and public he
11、alth.,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,9,Alma Ata Declaration called on all governments to formulate national policies, strategies and plans of action to launch and sustain primary health care as part of a national health system.It is left to each country to innovate,
12、 according to its own circumstances to provide primary health careThis was followed by the formulation and adoption of the Global Strategy for Health for all by the 34th World Health Assembly in 1981.Primary Health care got off to a good start in many countries with the theme “Health for All by 2000
13、 AD”,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,10,Primary Health Care,Primary Health Care is a new approach to health care, which integrates at the community level all the factors required for improving the health status of the population.,rimaryHealthCarehowMedLecturesMedical
14、Lecturesand初级卫生保健医学讲座讲座howm,11,Concept of PHC,PHC is for all specially the needyRegardless of social and economic status every individual in the nation must have access to good health careThe services should be acceptable to the community and there must be active involvement of the communityThe heal
15、th services must be effective, preventive, promotive and curativeThe services should form an integral part of the countrys health systemThe programme must be efficient, multi- sectorial because health does not exit in isolation,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,12,Prim
16、ary Health Care,Essential Health care based on practical, scientifically sound, and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the country and community can afford,rimaryHealt
17、hCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,13,Levels of Health Care,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,14,Levels of Health Care,3 level of health care service,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,15,Levels of Health Care,3 level of
18、 health care servicePrimary care levelSecondary care levelTertiary care level,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,16,Levels of Health Care,Primary care levelFirst level of contact of individual, family and community with health systemMost effective and close to the peopl
19、ePHCBHU, RHC, THQClinicsRMOGP,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,17,Levels of Health Care,Secondary care levelHigher level of careMore complex problem are dealt withDHQTHQ Health centersHosp,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,18,Levels of H
20、ealth Care,Tertiary care levelSpecialized health careSpecific facilitiesSpecialized health workersTeaching hosp, Regional hosp Central hosp Specializes hosp AFICAFIDNICVD,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,19,Primary Health Care,PHC is essential health care made univers
21、ally accessible to individuals and families in the community by means acceptable to them, through their full participation and at a cost that the community and country can afford,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,20,PRINCIPLES OF PRIMARY HEALTH CARE,rimaryHealthCarehow
22、MedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,21,PRINCIPLES OF PRIMARY HEALTH CARE,EquityCommunity ParticipationIntersectoral CoordinationAppropriate Technology,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,22,Equity/Equitable Distribution,The first key principle in primary health
23、 care strategy is equity or equitable distribution of health servicesHealth services must be shared equally by all people irrespective of their ability to pay and all( rich or poor, urban or rural) must have access to health serviceshealth services are mainly in townsInaccessibility to majority of p
24、opulation Social injustice Availability -Insurance/NHS,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,23,Community Participation,Overall responsibility is of the StateThe involvement of individuals, families, and communities in promotion of their own health and welfare is an essent
25、ial ingredient of primary health carePHC coverage cannot be achieved without the involvement of community in planning, implementation and maintenance of health services Polio. FP,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,24,Intersectoral CoordinationDeclaration of Alma Ata sta
26、tes that PHC involves in addition to the health sector all related sectors and aspects of national and community development, in particular education, agriculture, animal husbandry, food, industry, education, housing, public works, communicationTo achieve cooperation planning at country level is req
27、uired to involve all sectors,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,25,Appropriate TechnologyTechnology that is scientifically sound, adaptable to the local needs, and acceptable to those who apply it and those for whom it is used and can be maintained by the people themsel
28、ves with the resources of the community and country can afford luxurious hospitals, costly equipments 80:20,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,26,Essential Component / Elements,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,27,Essential Component / Ele
29、ments,1. Education concerning prevailing health problems and the methods of identifying, preventing and controlling them2.Promotion of food supply and proper nutrition, an adequate supply of safe water and basic sanitation3.Maternal and child health care including family planning4.Immunization again
30、st major infectious diseases,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,28,Essential component / Elements,5. Prevention and control of locally endemic diseases6. Treatment of common diseases and injuries7.Promotion of mental health8. Provision of essential drugs,rimaryHealthCar
31、ehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,29,Millennium Development Goals,MDG,s place health at the heart of development and represent commitments by governments throughout the world to reduce poverty and hunger and to tackle ill health,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医
32、学讲座讲座howm,30,Millennium Development Goals,Eradicate extreme poverty and hungerAchieve universal primary educationPromote gender equityImprove maternal healthReduce child mortalityCombat HIV/AIDS, malaria, and other communicable diseasesEnsure environmental sustainabilityDevelop global partnership fo
33、r development,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,31,Primary Health Care in Pakistan,Basic Health Unit (BHU) Total BHUs 5374BHU serve a population of 5,000-10,000Services provided at BHU areMCH services, childcare, immunization, diarrheal diseases, malarial control, chil
34、d spacing, mental and school health serviceRural Health Centre (RHC)Total No 5955-10 BHU are linked with RHC25 beds, laboratory, X-ray, minor surgery ,dentalDispensaries4842MCH Centers909,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,32,Primary Health Care in Pakistan,Tehsil Hospi
35、tal50-100 bedded hosplaboratory, X-ray, surgery ,dental, specDistrict Headquarters hospital 100-200 bedded hosplaboratory, X-ray, surgery ,dental, all spec,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,33,Primary Health Care in Pakistan,Hospital 972Doctors153567Dental Surg 11740,r
36、imaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,34,Medical/ Dental Colleges,MedicalDentalPublic 38 10Private 50 27Total 88 37G Total125,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,35,Medical Per Addition in 2011-12,Doctor4300Dentist 450Nurses 3000Paramedics 4500,
37、rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,36,PHYSICIAN,A physician is a person who, having been regularly admitted to a medical school, duly recognized in the country in which it is located, has successfully completed the prescribed courses of studies in medicine and has acqui
38、red the requisite qualification to be legally licensed to practice medicine (comprising prevention, diagnosis, treatment and rehabilitation) using independent judgment to promote community and individual health WHO 1972,rimaryHealthCarehowMedLecturesMedicalLecturesand初级卫生保健医学讲座讲座howm,37,HOSPITAL,Hospital is a residential establishment which provides short-term and long-term medical care consisting of observational, diagnostic, therapeutic and rehabilitative services for persons suffering or suspected to be suffering from a disease or injury and for parturient WHO 1963,