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

segufta.dilshad@northsouth.eduCell# 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