Introduction to health system

• HEALTH CARE

  • Is the various services for the prevention or treatment of illness and injuries

  • The set of services provided by a country or an organization for the treatment of the physically and the mentally ill.
• PRIMARY HEALTH CARE

  • Is about caring for people, rather than simply treating specific diseases or conditions. Is on essential part of health care and its main principles are equity, health promotion and disease prevention, community participation, appropriate health technology and multisectoral approach.
• MAIN AREAS of PHC: • Empowered People and Communities

  • Multisectoral Policy and Action

  • Primary care and essential Public Health functions as the core of the integrated health services
• Differences in PHC depends on: • Needs of the residents

  • Availability of Health care providers • The communities geographic location • Proximity to other health care services in the area.
• DIFFERENT LEVELS OF HEALTH CARE

  • PRIMARY HEALTH CARE

  • SECONDARY HEALTH CARE

  • TERTIARY HEALTH CARE
• PRIMARY HEALTH CARE

  ü The “first” level of contact between the individual and the health system. ü Essential health care (PHC) is provided. ü A majority of prevailing health problems can be satisfactorily managed. ü The closest to the people. ü Provided by the primary health centers
• SECONDARY HEALTH CARE

  ü More complex problems are dealt with. ü Comprises curative services ü Provided by the district hospitals ü The 1st referral level
• TERTIARY HEALTH CARE

  ü Offers super-specialist care ü Provided by regional/central level institution. ü Provide training programs
• PRINCIPLES of PRIMARY HEALTH CARE

  1. Equitable distribution
  2. Community participation
  3. Intersectoral coordination
  4. Appropriate technology
• Equitable distribution

  Health services must be shared equally by all people irrespective of their ability to pay.
• TO ENSURE EQUITY:

  n The population to be served must be known. n The vulnerable groups are to be identified & reached. n The health services (not necessarily health centers) have to be dispersed into:

  l The farthest remote rural areas.

  l The deepest parts of the underserved urban population.

  l The failure to reach the needy & the majority is usually due to limited geographical access.
• The accessibility has to be improved by :

  l Increasing the number of health facilities. l Improving transport conditions. l Organizing outreach services, thus substituting one when the other is not available.
• PHC aims to:

  n Correct imbalance in accessibility

  n Bring health services as near to people's homes as possible.

  n To achieve this, PHC is supported by higher level of health care to which patients can be referred for extended care.
• Community participation

  l Involvement of individuals, families, & communities in promotion of their own health & welfare.

  l There must be a continuing effort to secure meaningful involvement of the community in:

  n Planning

  n Implementation

  n Maintenance of health services

  n Evaluation of health services.

  n Maximum reliance on local resources such as: Manpower, Money and Materials.
• Intersectoral coordination

  l There is an increased realization of the fact that the components of PHC cannot be provided by the health sector alone.
• Appropriate technology

  l TECHNOLOGY that is scientifically sound, adaptable to local needs, & acceptable to those who apply it & those for whom it is used, & that can be maintained by the people themselves in keeping with the principle of self reliance with the resources the community & country can afford.

  
  

  l HEALTH TECHNOLOGIES are needed in:

  ü Diagnostic maneuvers. ü Therapeutic maneuvers.

  
  

  ü Disease prevention.

  ü Disease control.

  ü Health promotion.
• Importance of Health Care System

  ü It facilitate documentation of data, diagnosis, plans, client responses and evaluation.

  ü It evaluates the efficiency and effectiveness of care

  ü It gives directions, guidance, and planning to healthcare

  ü It provide for continuity of care and to reduce omissions

  ü It individualize client participation in care. ü It promotes creativity and flexibility in health care practices.
• HEALTH CARE DELIVERY SYSTEM

  ü refers to the totality of resources that a population or society distributes in the organization and delivery or health services. It also includes all personal and public services performed by individuals or institutions for the purpose of maintaining or restoring health.
• 8 ESSENTIAL COMPONENTS OF HEALTH CARE

  1. Health education concerning prevailing health problems & the methods of preventing & controlling them 2. Promotion of food supply & proper nutrition 3. An adequate supply of safe water & sanitation 4. Maternal & child health care 5. Immunization against major infectious diseases 6. Prevention & control of locally endemic diseases 7. Appropriate treatment of common diseases & injuries 8. Provision of essential drugs
• ELEMENTS OF PRIMARY HEALTH CARE

  1. Education
  2. Water & sanitation
  3. Nutrition
  4. Maternal & child health
  5. Immunization
  6. Prevention of endemic diseases
  7. Treatment
  8. Drug availability
• FIVE COMMON SHORT COMINGS OF HEALTH CARE DELIVERY

  1. Inverse Care

  2. Impoverishing Care.

  3. Fragmented and Fragmenting Care

  4. Unsafe Care

  5. Misdirected Care
• THE BASIC REQUIREMENTS FOR SOUND PHC (THE 8 A’S AND THE 3 C’S)

  ü Appropriateness

  ü Availability

  ü Adequacy

  ü Accessibility

  ü Acceptability

  ü Affordability

  ü Assessability

  ü Accountability

  ü Completeness

  ü Comprehensiveness

  ü Continuity
• STRATEGIES of PHC:

  1. Reducing excess mortality of poor marginalized populations
  2. Reducing the leading risk factors to human health
  3. Developing Sustainable Health Systems
  4. Developing an enabling policy and institutional environment
• Reducing excess mortality of poor marginalized populations

  Ø PHC must ensure access to health services for the most disadvantaged populations, and focus on interventions which will directly impact on the major causes of mortality, morbidity and disability for those populations.
• Reducing the leading risk factors to human health

  Ø PHC, through its preventative and health promotion roles, must address those known risk factors, which are the major determinants of health outcomes for local populations.
• Developing Sustainable Health Systems

  Ø PHC as a component of health systems must develop in ways, which are financially sustainable, supported by political leaders, and supported by the populations served.
• Developing an enabling policy and institutional environment

  Ø PHC policy must be integrated with other policy domains, and play its part in the pursuit of wider social, economic, environmental and development policy.
• GOALS OF HEALTH CARE SYSTEM

  ü Good health

  ü Responsiveness to the expectations of the population ü Fair financial contribution

  ü Health care system in an urban and rural areas