LECTURE 1: CONCEPTS OF HEALTH, PUBLIC HEALTH AND PRIMARY HEALTH CARE (PHC)
Segufta Dilshad (SgD), MDS, EMPHCourse Instructor
Introduction to Public Health (PBH 101) Department of Public Health
School of Health and Life SciencesNorth South University
Spring 2017
[email protected]# 01711638208
What is Health?
“Health is a state of complete physical, mental andsocial wellbeing and not merely an absence of diseaseor infirmity”-World Health Organization, 1948
The ability to lead a socially and economicallyproductive life
Dimensions of Health
Major Dimensions of Health
Physical Dimension
Mental Dimension
Social Dimension
Minor Dimensions of Health
Spiritual Dimension
Emotional Dimension
Physical Dimension
Ability of human body to function properly
Signs of Good Physical Health:
Good complexion
Clear skin
Bright eyes
Good appetite
Sound sleep
Regular activity of bowels and bladder
Smooth, easy and coordinated movement
All the senses are intact
Mental Dimension
A state of balance between the individual and the surrounding world.
Criteria of a Mentally Healthy Person:
Is free from internal conflict
Is well adjusted
Has a strong sense of self-esteem
Knows himself/herself, his/her needs, problems and goals
Knows his/her strength and weakness
Has good self-control
Faces problems and tries to solve them intelligently
Social Dimension
Ability to interact with others
Criteria of a Social Person:
Interact with people and be receptive to their ideas with an open mind.
Accept and understand diverse cultural norms.
Build networks among different kinds of people.
Adopt a positive self-image.
Enhance interpersonal communication skills.
Emotional Dimension
Ability to cope, adjust and adapt
Criteria of Emotionally Established Person:
Setting realistic goals.
Explore every opportunity with an open mind.
Be aware of the demands and expectations others have from you.
A positive outlook, especially when dealing with conflicts.
Spiritual Dimension
Spiritual health refers to our personal beliefs and values and to seek meaning and purpose of life.
Activities for spiritual awareness and growth are Meditation, Prayer, Visualization, Stretching, Yoga etc.
Qualities of Spiritually Healthy Person:
Hope
Positive outlook
Acceptance of death
Forgiveness
Self-acceptance
Commitment
Clear values
Peace
Self-esteem
Philosophy of Health
Health is a fundamental human right
Health is inter-sectoral
Health is an integral part of development
Health and its maintenance is a major social investment
National Govt all over the world are working to expand and improve
their health care services
The current situation is
Urban oriented
Mostly curative focus
Changing diseases patterns
Emerging new infections
Public Health
Public Health is the art and science of protecting and improving the health of a community through an organized and systematic effort that includes education, assurance of the provision of health services and protection of the public from exposures that will cause harm.
According to World Health Organization (WHO),
“Public health refers to all organized measures (whether
public or private) to prevent disease, promote health, and prolong life among the population as a whole.”
Public Health and Global Health
Public health is concerned with protecting the health of entire populations. These populations can be as small as a local neighborhood, or as big as an entire country or region of the world.
Global health is the health problems, issues and concerns that exceeds national boundaries.
Public Health Issues
Public Health Enemy Number One: Tobacco
Public Health Threat number two: Poor Diet & Physical Inactivity
Environmental issues –Clean water, Clean air, sound, Safe food & Drugs
Injuries
Maternal & child health as social problem
Aging population, Non Communicable Diseases; like - Diabetes and heart disease
Emergency Responses
Public Health Research and solutions
Sexually transmitted infections in young women
Violence against women
TB, Malaria, Diarrhea, HIV/AIDS
Public Health Campaigns
Vaccination and control of infectious diseases
Motor-vehicle safety
Safer workplaces
Safer and healthier foods
Safe drinking water
Healthier mothers and babies and access to family planning
Decline in deaths from coronary heart disease and stroke
Recognition of tobacco use as a health hazard
Healthy life
Objectives of Public Health
Prevention of diseases
Prolongation of life
Promote quality of life and wellbeing
Promote productive life
Elevation of the standard of living
Features Public Health Clinical Medicine
Objective • To prevent diseases, prolong life and promote health & efficiency through an organized community effort
• To prevent diseases, prolong life and promote health & efficiency through interception of diseases process
Coverage • Services offered to entire population of a country
• Services offered to groups of individuals and individuals within these groups
Emphasis • Stress placed on both personal and interpersonal measures of direct and indirect nature
• Greater stress placed on personal level measures of direct nature
Functionaries • Well-organized health teams lead by Public health experts
• Health professionals working individuals or in groups
Overlap • When practiced in group level, it approaches preventive medicine
• When practiced of mass scale, it becomes public health
Operation • Deals with control, elimination and eradication of national health problems at national level
• Deals with risk-intervention procedures in a variety of special clinics
Differentiations between Public Health and Clinical Medicine
Opportunities for a Public Health Professional/Expert
Government agencies, such as Ministry of Health, Centers for Disease Control and Prevention (CDC), Food and Drug Administration or the Environmental Protection Agency
Many international NGO’s i.e.: WHO, USAID, UNDP, UNFPA etc
Some research institution i.e.: ICDDRB
Health care organizations, such as hospital systems and long-term care facilities.
Private sector companies, such as health insurers and pharmaceutical companies.
Colleges and universities, such as schools of public health or medicine.
As an researcher
How Health Services Organized? orLevel of Care in Health System
Health systems are generally organized into three levels of care:
Primary Care
Secondary Care
Tertiary Care
Levels of Health Care
Primary Care Level
The “First” level of contact between individual, family and community with health system
Most effective and close to the people
Essential health care is provided.
The closest to the people.
Provided by the primary health centers, Community Clinics.
General Practitioner, village doctor
Levels of Health Care
Secondary Care Level
More complex problems are dealt with.
Comprises curative services
Provided by the district hospitals
The 1st referral level
Levels of Health Care
Tertiary Care Level
Offers super-specialist care
Provided by regional/central level institution.
Provide training programs
Specialized health care- Bangladesh Sheikh Mujib Medical University (BSMMU), Dhaka Medical College (DMC)
Specific private facilities- Square Hospital, United hospital, Apollo hospital, Green Life Hospital etc.
Specializes hospitals-
Children Hospital
National Heart Institute
TB Hospital
Primary Health Care (PHC)
Primary healthcare (PHC) refers to "essential health care" that is based on scientifically sound and socially acceptable methods and technology, which make universal health care accessible to all individuals and families in a community.
Health System Challenges:
How to cope with an aging population and increasing amount of non communicable disease
The quality of governance
The number, quality and distribution of health care personnel
The mobilization of sufficient financial resources for the health sector
How to provide health care at an appropriate level of quality
How to ensure access to and equtable provision of services
The creation of mechanisms to provide the poor with protection from the costs of health services
Lessons Learned
There are strong link between health, human development, productivity and economic development
Health status determined by a variety of factors, including income, education, knowledge of healthy behavior, social status, sex, genetic makeup, and access to health care services
There are enormous progress in improvement of health status over the last fifty years.
Till the progress in health status has been very uneven and enormous disparities.
Countries do not need to be high income to enjoy good health status.
Health status determined by an individuals and families own knowledge of health hygiene. People and communities have tremendous abilities to enhance their own health status.
We should think the health of All.
THANK YOU