PHC_part 1_.ppsx
- 1. Dr. Amol Koshti MD (Ayu) Associate Professor Department of Swasthavritta SSAC Kalol
- 3. Health care It is defined as multiple services rendered to individuals, families or communities by the agents of health services or professionals for the purpose of promoting, maintaining, monitoring or restoring health
- 4. Levels of Health Care Tertiary level Secondary level Primary level
- 5. Three tier system • Primary health center • Sub-center Primary • Community health center • Taluka hospitals secondary • District hospitals • Medical college hospitals • Apex hospitals - AIIMS Tertiary
- 6. Primary level of Health Care Grass root level Direct contact Services are provided by PHC, sub centers, Village health guides, Anganwadi workers & trained Dais Individuals Health system
- 7. Secondary level of Health Care Health services by Specialist doctors More complex problems are taken care off Also serve as FIRST REFERRAL UNITS
- 8. Tertiary level of Health Care Health services by Specialist & super specialist doctors Services are provided by Apex hospitals (AIIMS), Medical College Hospitals
- 10. Definition Primary health care is defined as an essential health care made universally accessible to individuals and acceptable to them, through their full participation and at a cost the community or country can afford
- 11. Attributes Essential health care Means basic, essential services Universally accessible Should be reachable to all segments of population Acceptable Services are provided in such a way that people should accept them Community participation Active participation of people of the community
- 12. Attributes Affordability Services must be Cost effective Adaptability Services should be flexible to suit given situations Availability Round the clock presence of services Appropriateness Should be relevant to the needs and demands of people
- 13. Attributes Closeness Availability of services at individual door steps Continuity Services provided from womb to tomb Comprehensiveness Services should be preventive, promotive, curative and rehabilitative to community Co-ordinativeness Services require co-operation of various health related departments
- 14. Elements of Primary Health Care Education concerning prevailing health problems and methods of identifying, preventing and controlling them Promotion of food supply and proper nutrition Adequate supply of safe water and basic sanitation Maternal and child health care including family planning
- 15. Immunization against the major infectious diseases Prevention and control of locally endemic diseases Proper treatment of common diseases Provision of essential drugs Elements of Primary Health Care
- 16. Principles of Primary Health Care Equitable distribution Community participation Intersectoral co-ordination Appropriate technology
- 17. Equitable distribution PHC services should be provided to all people irrespective of caste, creed, community, rich- poor It’s the “Key principle” of PHC services
- 18. Community participation By the people – Of the people – For the people Health providers are selected locally, trained locally and provide service locally
- 19. Advantages of Community participation Cost effective Better Acceptance Greater commitment of people results in success of health care services Health awareness becomes integral part of village life Health workers get greater support for their activities Less dependence on government Quality of health care improves
- 21. Appropriate technology Simple Scientifically sound Practically adaptable Culturally acceptable Economically cheaper Operationally convenient
- 22. Organizational framework of health care systems 1. Public health sector A. Primary health care a. Primary health centers b. Sub-centers B. Hospitals a. Community health center/ Taluka hospitals b. District hospitals c. Apex hospitals/ medical college hospitals C. Other agencies a. Employees’ state insurance hospitals b. Central govt. health schemes c. Railway hospitals d. Defence hospitals
- 23. Organizational framework of health care systems 2. Private sector A. Private hospitals, polyclinics, nursing homes B. GP Clinics 3. Indigenous systems of medicine A. Ayurveda B. Yoga C. Unani D. Siddha E. homeopathy 4. Voluntary health agencies 5. National health programmes
- 24. Primary Health Care WHO’s global target: HEALTH FOR ALL BY 2000 AD
- 25. Primary health care Village level Village health guide Dais Anganwadi worker Sub center level PHC level
- 26. Three tier system Village level Sub-center level PHC level
- 27. Village level Grass root level Not by medical personnel but by Non medical personnel such as village health guide, traditional birth attendant (Dais) & Anganwadi workers
- 28. Village level Village health guide scheme Training of local Dais ICDS Scheme - Anganwadi worker (AWW)
- 30. Village health guide scheme Launched on 2nd October 1977 1986 govt. of India – Male health guide replaced by Female health guide
- 31. Village health guide (VHG) Non governmental, Voluntary worker for health One VHG for each village/ 1000 population She must be permanent, local resident of village Must be literate to read write & maintain records Must be acceptable to all sections of society Must be willing to do community health work for 2-3 hr/day
- 32. VHG is given training for 3 months on basic aspects of health such as personal hygiene, sanitation, health education, first aid, ORT etc Stipend – Rs. 200 /month After training she is awarded with certificate and given a manual describing her responsibilities and a medical kit
- 33. Duties of VHG Guides village people on health Creates awareness on family welfare services, immunization , sanitation, personal hygiene, use of ORT etc
- 35. Training of local Dais Importance Age old practice of conducting delivery by dais is prevalent Their skills are acceptable by people Not only rural but some urban people also take their help Female health worker may not be available always to conduct delivery in her area About 90% deliveries are normal and do not require services of specialist Dais can be trained locally in PHCs Their training can improve the quality of MCH services This helps in community participation
- 36. Dais are trained for 1 month with stipend of Rs 300/- During training she must conduct at least 2 deliveries under guidance After training she is given certificate and maternity kit Maternity kit Sterile gauze , Cotton, Clean blade Sterile thread, bowl, soap, Antiseptic lotion, Plastic sheet, tincture iodine, enema-can
- 37. Training on Anatomy of reproductive system Physiology of pregnancy & labor Observation of danger signals Conducting delivery by observing five cleans Five cleans – Clean hands Clean surface Clean blade Clean ligature Clean cord clamp
- 38. Integrated Child Development Services
- 40. Anganwadi worker (AWW) Local lady Studied upto 10th standard 1 for 1000 population To provide basic health services mainly to mothers (antenatal, postnatal) and children below 6 yr age Trained for 4 months in various aspects of health , nutrition & child development
- 41. Duties of Anganwadi worker Preparing & serving supplementary food Growth monitoring of children Health & nutrition education to mothers Non formal education to children in the form of toys, play, songs etc Referral services Maintains records