TOPIC 6

• Public Health


  The science and art of preventing disease, prolonging life and promoting health and efficiency through organized community effort
• The mission of Public Health is to 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
  • Secondary
  • Tertiary
• Determinants of Health

  • Social and economic environment
  • Physical environment
  • Individual characteristics and behaviors
• Primary 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 the community or the country can afford to maintain at every stage of their development in the spirit of self-reliance and self determination

  
• Four Pillars in Primary Health Care

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

  
• 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
• Universal Health Care


  All Filipinos are automatically included in the National Health Insurance Program (NHIP)
• Dimensions of Universal Health Care Coverage

  • Population coverage
  • Service coverage
  • Financial Coverage

  
• Types and Composition of Health Care Provider Networks

  • Public – Provide-wide or City-wide Health System
  • Private
  • Mix

  
• Contributors to the National Health Insurance Program

  • Direct contributors
  • Indirect contributors
• 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

  
• Primary Health Care Facilities

  rural health units, their sub-centers, chest clinics, malaria eradication units, and schistosomiasis control units; puericulture centers, tuberculosis clinics, private clinics, clinics operated by large industrial firms, community hospitals, health centers and other health facilities
• Village of Grassroot Health Workers

  - first contacts •

  • curative and preventive
  • Community health worker, volunteers or traditional birth attendants
• Intermediate Level Health Workers

  • First source; provide support
  • Attends to health problems
  • Medical practitioners, nurses, midwives
• First Line Hospital Personnel

  • Establish close contact; back up health service
  • Physician with specialty, nurses, dentists, pharmacists and other health professionals
• Service coverage: Health care packages (population-based / individual based)
• Direct contributors

  • Members with capacity to pay premiums, or those gainfully employed or self-earning professionals or workers
• • Indirect contributors
  • Those whose PhilHealth premiums are subsidized by the government
• 8 elements of PHC

  E- education

  L - locally

  E - essential

  M -Maternal

  E - Expanded

  N - nutrition

  T- treatment

  S- sanitation
• Secondary Health Care Facilities

  • non-departmentalized hospitals including emergency and regional hospitals
• Tertiary Health Care Facilities

  • medical centers and large hospitals
• 1977 – WHO members, International Conference on Primary Health Care in Alma Ata, Kazakhstan
• Resolution - 20th Word Health Assembly
• “ the main social targets of governments and WHO in the coming decades should be the attainment by all citizens of the world by year 2000 of a level of health that will permit them to lead a socially and economically productive life”
• Alma Ata Declaration of 1978

  “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 the community or the country can afford to maintain at every stage of their development in the spirit of self-reliance and self determination
• Institute of Medicine, 1988 “The Future of Public Health”
• Regardless of type, HCPNs are composed of

  (1) primary care provider networks (PCPNs) that serve as the initial point of contact and navigator of patients;

  (2) and hospitals that deliver secondary and tertiary general health care services.
• Community Participation

  • is a planned process whereby local groups are clarifying and expressing their own needs and objectives and taking collective action to meet them."
• Multi-sectoral Linkages

  promote flow of information, ideas and integration in achievement of shared objectives
• Appropriate Health Technology

  Methods, Procedures, Techniques and Equipment that are:

  ✓ Scientifically valid

  ✓ Adapted to local needs

  ✓ Acceptable to users and recipients

  ✓ Maintainable with local resources
• Appropriate Technology

  practical, effective and socially acceptable technologies that are accessible, affordable by community and national health systems, encourage self-reliance, and result from participatory processes.
• Support Systems

  1. Training and HR development

  2. Health education and promotion

  3. Supervision and guidance

  4. Monitoring and evaluation

  5. Logistics/financial support

  6. Restructuring of infrastructure and organization