MIDTERMS

• Public Health


  The science and art of preventing disease, prolonging life and promoting health and efficiency through organized community effort
• Public Health


  An organized community effort to address the public interest in health by applying scientific and technical knowledge to prevent disease and promote health
• Mission of Public Health - ensure conditions that promote the health of the community
• Difference of Public Health vs. Clinical Medicine


  • Focuses on prevention rather than cure
  • Utilizes broad measures to protect large populations and communities not just individual patients
  • Does not rely on specific body of knowledge or expertise but on a combination of science and social approaches
• Levels of Prevention


  • Primary Prevention
  • Secondary Prevention
  • Tertiary Prevention
• Primary Prevention


  Preventing the initial development of a disease

  
• Primary Prevention


  • Immunization, reducing exposure to a risk factor

  
• Secondary Prevention


  Early detection of existing disease to reduce severity and complications

  
• Secondary Prevention


  • Screening for cancer
• Tertiary Prevention


  Reducing the impact of the disease
• Tertiary Prevention


  • Rehabilitation for stroke
• Area of Difference between Clinical/Hospital Health and Community Health


  • Setting/Place of practice and activities
  • Types of patients seen
  • Source of concern/range of services provided
  • Priority concern
  • Unit or focus of care
  • Ultimate goal

  
• Determinants of Health


  • Education access and quality
  • Health care and quality
  • Neighborhood and built environment
  • Social and community context
  • Economic stability

  
• Social Determinants of Health

  • Childhood experiences
  • Housing Education
  • Social support
  • Family income
  • Employment
  • Our communities
  • Access to health services
• Primary Health Care forms part of a country's health care system and the overall socioeconomic development of a community

  
• Primary Health Care is the first level of contact with the national health system and provides health care as close as possible to where people live and work

  
• Four Pillars in Primary Health Care

  • Community participation
  • Inter-sectoral coordination
  • Appropriate technology
  • Support mechanism made available

  
• Community Participation


  A process whereby social groups are supported to crystallise their needs and are assisted to translate them into action
• Multi-sectoral linkages


  Relationships and interactions between tasks, functions, departments and organizations that promote flow of information, ideas and integration in achievement of shared objectives
• Appropriate technology


  Practical, effective and social acceptable technologies that are accessible, affordable by community and national health systems, encourage self-reliance, and result from participatory processes
• Support systems for Primary Health Care

  • Training and HR development
  • Health education and promotion
  • Supervision and guidance
  • Monitoring and evaluation
  • Logistics/financial support
  • Restructuring of infrastructure and organization

  
• Elements/components of Primary Health Care

  • Education about prevailing health problems and methods of preventing and controlling them
  • Prevention and control of locally endemic diseases
  • Provision of essential drugs
  • Maternal and child health care; including family planning
  • Expanded immunization against major infectious diseases
  • Promotion of food supply and proper nutrition
  • Appropriate treatment of common diseases and injuries
  • Adequate supply of safe water and basic sanitation

  
• Levels of Health Care Facilities

  • Primary Health Care Facilities
  • Secondary Health Care Facilities
  • Tertiary Health Care Facilities

  
• Levels of Primary Health Care Workers

  • Village of Grassroot Health Workers
  • Intermediate Level Health Workers
  • First Line Hospital Personnel

  
• Major dimensions of Universal Health Care coverage

  • Population coverage
  • Service coverage
  • Financial Coverage

  
• Types of Health Care Provider Networks based on ownership

  • Public
  • Private
  • Mix

  
• Contributors to the National Health Insurance Program

  • Direct contributors
  • Indirect contributors
• Key Areas of Health Regulation under the UHC Act

  • Safety and quality of health facilities and services
  • Affordability of health services, pharmaceuticals, and medical devices
  • Equity in the development of health facilities and provision of health benefits
• Sources of Funding for Universal Health Care

  • Total incremental sin tax collections
  • 50% of the National Government share from PAGCOR
  • 40% of the Charity Fund, net of documentary Stamp Tax payments and mandatory contribution of PCSO
  • Premium contribution of members
  • Annual appropriations of the DOH
  • National Government subsidy to PhilHealth
  • Supplemental Funding
• Health Financing Functions


  • Revenue Generation
  • Pooling of funds
  • Purchasing of services
• Composition of Health Care Provider Networks

  • Primary care provider networks
  • Hospitals that deliver secondary and tertiary general health care services

  
• Primary Care Policy Framework

  • Primary Health Care Approach
  • People Centered Approach
  • Equity and Fairness

  
• Individual-based Health Services


  • Outpatient Benefit Packages and other Special Benefits
  • Primary Care Benefit Package (Konsulta Package)
  • Inpatient Benefit Packages
  • Z Benefit Packages
• Population-based Health Services


  • Health Promotion
  • Epidemiology and Disease Surveillance
  • Disaster Risk Reduction and Management in Health

  
• Implementation Strategies for Reorienting Health Professions Education Curricula


  • Inclusion of UHC in student orientations, including counseling program that promote careers in public health and primary care
  • Inclusion of primary health care in learning outcomes with focus on public health and primary care to support UHC
  • Conduct of faculty development programs like faculty immersion in primary care facilities aimed at shifting the approach towards prioritizing primary health care over curative or "hospitalist" approach
  • Inclusion of primary care competencies in student internship and immersion program objectives
  • Incorporation of primary health care areas of study in the table of Specifications f the licensure examinations of all health professions
  • Implementation of return service obligations for government scholar's inn priority primary care facilities
• Community Assessment


  An exercise by which a collaborative partnership gathers information on the current strengths, concerns, and conditions of children, families, and the community
• Community Assessment Process


  • Scanning the community to locate existing information
  • Developing a family focus
  • Identifying community assets and the degree to which they are accessible to the people who can benefit from them
  • Analyzing the information obtained through the first three steps
• Program


  A series of coordinated related multiple projects that over extended time intended to achieve a goal
• Project


  Has an established and specific objective, has a defined life span with a beginning and an end, usually the involvement of several departments and professionals, has specific time, cost performance requirements
• Major steps in Planning, Sustaining and Evaluating a Health Promotion Project


  • Identify the issues or health problems in the community
  • Prioritize the issues or health problems to identify the one that the project will address
  • Identify risk factors and set the goal for the project
  • Determine contributing factors and state objectives for the project
  • Determine what strategies will be
  • Develop the action plan for the project
  • Sustain the project or keep the project (or some parts of it) going
  • Evaluate the project