04-PHC system and Principles in Saudi Arabia.ppt
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Transcript 04-PHC system and Principles in Saudi Arabia.ppt
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(A)In Developed Countries
*diseases of modernisation.
*over eating &non blalanced diets
*Alcoholism
*Smoking
*overuse of hard drugs
*Worry & distress
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(B) In Developing Countries
*Third did not have access to safe water
*Quarter suffered from malnutrition
*Diarrhoea
*High infant mortality rate 150-250per1000
*High maternal rate 3-15 per 1000
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Generally adverse situation due to:
*In Both Developed and Developing Countries,
there is low access to comprehensive services
*In some countries one out of two see health worker
once/year
*Services were urban based
*Services were curative oriented
*Planning not related to needs
*Absent statistics leading to maldistribution
*No community participation
*Lack of coordination
*Economical deterioration
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Definition of Health
health is the state of complete
physical, mental and social
well being that will permit the
person to become productive
and not only the absence of
disease or infirmity.
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PHC as a Tool for HFA
• Member of WHO & signatory of HFA declaration.
• PHC has become a national strategy development
plan.
• 1980 A Ministerial decree was issued, consolidating
dispensaries, health offices and MCH centers into
PHC centers.
• Health coverage reached 99 % .
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Cardinal Features of PHC(WHO 1978)
PHC is essential health care based on practical,
scientifically & socially acceptable methods &
technology made universally accessible to
individuals & families in the community through
their full participation and a cost that the country
can afford to maintain self-reliance and
self-determination. It forms an integral part of
health system & the overall social & economic
development of the community. First level of
contact, close as possible to people & constitutes
continuing care
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CONCEPT OF COMMON
ILLNESS
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OF THE HEALTH PROBLEMS SEEN IN PHC
400 DISEASES REPRESENT 95%
100 DISEASES REPRESENT 80%
50 DISEASES REPRESENT 60%
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PHC ELEMENTS
(1)Health education
(2)Promotion of nutrition
(3)Environmental sanitation
(4)Maternal and child care
(5)Immunisation
(6)Prevention , control&eradication
(7)Treatment of common diseases
(8)Essential drugs
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Strategies for PHC
1.Expansion and efficiency
2.Better relations with community
3.Comprehensive health care
4.Integration of preventive and curative
5.Promotion of health awareness
6.Coordination with secondary and tertiary care
7.Coordination with academic institutions
8.Multisectorial coordination
9.At risk approach
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According to W. Fabb and J. Fry, good
primary health care must include
the following “As” It must be:
1.
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8.
9.
Available
Accessible
Affordable
Acceptable
Adaptable
Applicable
Attainable
Appropriate
Assessable
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Major Principles
To Achieve HFA
• Each H.C. serves a specific catchment
area.
• Every citizen is tied to a specific H.C.
• Major H.Cs. for Certain No. eg 5-10
centers equipped with essential ancillary
facilities.
• Free services.
• Accessible services with easy reach of
a max. one hour travel.
• Comprehensive & integrated services.
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Major Principles
To Achieve HFA
”cont.”
• Decentralization
through regional PHC
Directorates.
• Consolidation &
strengthening of
national central
programs. (e.g.
malaria, bilharzia..,(
• Promoting health
awareness.
• Adoption of high risk
approach.
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Major Principles
To Achieve HFA ”cont.”
• Training of PHC staff.
• Insurance of community
involvement.
• Effective co-ordination
with
secondary
health care services.
• Co-ordination with other
governmental health
related sectors.
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THE POLICY
DEVELOPED FOR PHC
REMAINS SOUNDLY
BASED. THERE IS
CLEAR EVIDENCE OF
ITS SUCCESS.
Indepth evaluation of PHC ,JOINT MOH AND WhO 1989.
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Ongoing Programs
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Maternal Health .
Acute Respiratory Infection .
Quality Assurance .
Br. Asthma .
Mental Health .
Mini-Clinics .
Supportive Supervision.
Elderly Health .
Essential Drugs List .
Integrated Management of Childhood Illnesses (IMCI)
Computerized Information System .
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PHC& Hospitals in SA
64,114,758
visits
3 visits / Person / Year
83.5 %
PHC Centers
16.5 %
Hospitals
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PHC vs HOSPITAL
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Availability
Accessability
Contact
Triaging
Dr/Pt relationship
Continuity
Preventive measure
Cost effectiveness
Community participation
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IMPACT OF
MCH
Main PHC activity.
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Percent of mothers who received ANC 96 %
% who received 5 or more ANC visits > 80 %
% of births by trained health personnel 96 %
Exclusive breast feeding (1st 4 months) 31.1 %
Newborns with weight <2500gm
5%
Underweight among < 5 Yrs children 14.3 %
Mothers knowledge of birth spacing
91.3 %
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Health systems have several major
components:
• Public health activities
• Primary care
• Specialty care
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Overall, countries that achieve
better health levels
• Are primary care-oriented
• Have more equitable resource distributions
• Have government-provided health services or
health insurance
• Have little or no private health insurance
• Have no or low co-payments for health
services
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Development of FM
1982
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300HCs
No. undergraduate
No. postgraduate
No. commission
No. Family physicians
2008
2000HCs
All university
About 20 program
SCFHS
500 FPs
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Graduate SCFHS-FM2009
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بداية البرنامج
أول دفعة دخلت االمتحان النهائي الكتابي
1/10/1995م
13متدرب
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عدد الخريجين حتى تاريخه
عدد المراكز التدريبية المعترف بـها
خريج 353
28مركز
DIFFICULTIES AND
Challenges
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DIFFICULTIES
• Premises
• Manpower
Quantity
Quality
Breadth
• Training
Basic
Advanced
• Continuing professional development
• Satisfaction
Public
Professionals
• Motivation
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Bad outcome due to accumulation of risk factors
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Healthy
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PROMOTING THE HEALTH
OF THE NATION
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CONCLUSION
1. The implementation the 9 As of PHC
need to be revisited.
2. Future plan to accelerate the process of
QA in all aspects of PHC should be
emphasized including patient safety.
3. Selective training, further leadership
development of PHC staff should be
priority.
4. Health system research within the PHC
activities should be enhanced.
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RECOMMENDATIONS
1. Encourage CME & involvement of
academic institutions.
2. Energize supportive supervision through
QA.
3. Procure training needs.
4. Integration of hospital & HC services
(referral).
Train more trainers as necessary.
Revise & update manuals.
Revision information system & unify registration and reporting through the44
statistical department.
Vision for The New Era
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To emphasize commitment & support for PHC.
To restructure the health care system.
Nationalization of health staff.
To computerize the HIS. In all H.C.
Revitalization of referral system.
To develop an appointment system.
To promote inter-sectoral collaboration.
Primary care doctors operate with smaller lists than
now and spend significantly increased time with each
patient in each consultation.
• To Promote and implement the concept
of patient safety in PHC.
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داعيا ً هللا سبحانه لي ولكم
بدوام الصحة والعافية والرضوان
Thank you for your
kind attention
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