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Dr. Samar AL-Sharif

▪ Senior Lecturer in Community and Family Medicine Department.

▪ Primary Health Care and Health Promotion (MD. MPHC)

References:

1- Primary Health Care Systems and Services.WHO 1997.

2- Primary Care The FutureNHS. June 2005

3- Health in Jordan WHO 2005

4- Population and Family Health SurveyJordan. 2007

- This survey is done every 5 years, its results are obtained 2 years after the survey has been done. - Example: a survey has been done in 2017 and we obtained its results in 2019.- This survey is more accurate than the WHO survery.

5- Population and Family Health SurveyJordan. 2012

6- Population and Family Health SurveyJordan. 2017

7-The World Health Report 2008 Primary Health Care

8-World health statistics 2018: monitoring health for the SDGs, sustainable development goals

9-Department of Statistics , Jordan 2016

What community medicine means?

▪ Community Medicine developed as a branch of medicine distinct from Public Health. By definition, Community medicine is applied to 'healthy' people, customarily by actions affecting large numbers or populations. Its primary objective is prevention of disease and promotion of health.

- The public health’s nucleus is primary health care. - Difference between community medicine and public Health : 1.community medicine= public health + clinical services 2. Public health: part of community medicine (no clinical services) - Any person that has a degree in community medicine can work in public health ( حیحص ریغ سكعلاو )

▪ Community medicine often refers to delivery of family practice led primary care — so actual healthcare delivery services to patients. The provider of such services, at least in the US, can be a physician, osteopath, advanced practice nurse or, in some settings, a physician’s assistant.

- The community health medicine base is primary health care which as we said covers both clincal services and public health .

- Self-esteem is the most important dimension in Emotional well being.

- All systems function together in physical dimension.- Activities of Daily Living (ADL) measure the severity of a disease. **explantion: if a disease becomes more severe the negative effect on daily activities will be increased.

- Mental dimensions:Both psychological and neurological abilities .- Schizophrenia( ةیصخشلا ماصفنا ) is the most affected disease by over thinking, It affects the thinking stream the most.- Depression also affect thinking stream.

- Environmental dimension: is how much you react with your environment.

- No one is 100% healthy but there is something called positive health which claims that someone might be 90% healthy(not completely free of diseases) - Unrecognized disease: is a complex level because patients figure out they might be sick very late

- Many diseases like cancer do not have any clear symptoms in their first stages ,so screening tests and awareness is important in unrecognized diseases .-so screening is important to detect diseases in early stages -Examples of unrecognized diseases : hypertension, depression, cancer)- In severe diseases some symptoms start to appear.

- Idiopathic diseases : diseases with unknown cause.

- Education : As education increases, health increases because education makes the individual more aware of how important health is

Social determinants of health

▪ Income and social status

▪ Stress – control over our life

▪ Early childhood development and education

▪ Employment and work conditions

▪ Social support

▪ Addiction

▪ Physical environment

▪ Exercise and transport

▪ Diet and lifestyle choicesSmith, JD (2007)

- Childhood effects adulthood health in several diseases such as: obesity

- Income is a social class.

- stress greatly affects immunity

Factors affecting health

HEALTH

parenting styles

geographical mobility

family dynamics

social resources

biological factors

family finances

culture

employability

age

gender

McMurray, A. (2003) pg.12 Slide 8

- Geographical mobility : This means that some diseases may increase in regions where temperature is extremely high or extremely low

▪ Declaration of Alma-Ata International Conference on Primary Health Care, Alma-Ata, USSR, 6-12 September 1978

▪ The International Conference on Primary Health Care, meeting in Alma-Ata this twelfth day of September in the year Nineteen hundred and seventy-eight, expressing the need for urgent action by all governments, all health and development workers, and the world community to protect and promote the health of all the people of the world, hereby makes the following

- Meaning that low social class people must br as healthy as high social class people.

ALMA ATA DECLARATION

▪ Health is a fundamental human right and that the attainment of the highest possible level of health is a most important world wide social goal.

▪ The existing gross inequality in the health status of the people particularly between developed and developing countries is politically, socially and economically unacceptable.

▪ Economic and social development, based on a new international economic order is of basic importance to the fullest attainment of health for all.

▪ The people have the right and duty to participate individually and collectively in the planning and implementation of their health care.

▪ Government have a responsibility for the health of their people which can be fulfilled only by the provision of adequate health and social; measures.

▪ All government should formulate national policies, strategies and plans of action to launch and sustain primary health care.

▪ All countries should cooperate in a spirit of partnership and service to ensure PHC for all people.

▪ An acceptable level of health for all the people of the world by the year 2000 can be attained through a further and better use of the world’s resources

GOALS TO BE ACHIEVED BY 2000

▪ Health for All By:

▪ REDUCTION OF IMR

▪ RAISE THE EXPECTATION OF LIFE

▪ REDUCE THE CDR(Crude death rate – the total number of deaths per year per 1,000 people)

▪ REDUCE THE CBR

▪ ACHIEVE A NET REPRODUCTION RATE OF ONE

▪ TO PROVIDE POTABABLE WATER TO ENTIRE RURAL POPULATION

Comprehensive primary health care

– Complete physical, mental and social wellbeing

– Addresses issues of equity and social justice

– Considers the impact of education, housing, food and income

– Acknowledges the value of community development

– Recognises the expertise of individuals over their own health

Talbot and Verinder 2005

Comprehensive Primary Health Care

Acknowledges other factors that contribute to poor health including:

▪ social influences which look at the

– impacts of the key determinants of health which leads to the social determinants of health