Primary Health Care Essay examples
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Home — Essay Samples — Nursing & Health — Universal Health Care — Primary Health Care
Primary Health Care
- Subject: Nursing & Health
- Category: Health Care
- Essay Topic: Medicare , Universal Health Care
- Words: 1489
- Published: 14 May 2019
- Downloads: 95
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The Importance Of Primary Care
Introduction Primary care can be described as the foundation and pillar of health care. It is the ideal entry point of the health care system, and arguably an area of great influence on an individual’s lifetime experience with health care services. Studies show that patients who utilize primary care have a decreased risk of illness and death (Starfield, Shi & Macinko, 2005). Promoting the role and facilitation of primary care through health policy is a worthwhile endeavor, not just in direct improvement of human health, but also in terms of the financial, social, and environmental aspects related to health care. What is Primary Care? According to the John Hopkins School of Public Health, health policy center, primary care is defined as: “the level of a health services system that provides entry into the system for all new needs and problems, provides person-focused (not disease-oriented) care over time, provides care for all but very uncommon or unusual conditions, and coordinates or integrates care, regardless of where the care is delivered and who provides it. It is the means by which the two main goals of a health services system, optimization and equity of health status, are approached” ("What is primary," 2014). Primary care positively influences the health care system by focusing on preventative medicine first and then, if needed, curative medicine, either by treatment of basic health issues, or the referral to an appropriate specialist. Primary care seeks to promote healthy habits including good nutrition, exercise, proper vaccination against a number of diseases, and avoidance of detrimental activities such as tobacco use, excessive alcohol consumption, and unsafe sexual practices. Primary care also aims to identify ris... ... middle of paper ... ...les and co-payments for approved preventive services and tests that will help Medicare and Medicaid beneficiaries detect disease early, while at a more treatable stage. In addition, reform will make preventive services more accessible for seniors by covering an annual wellness visit that provides a personalized prevention plan for each beneficiary, with no co-payment, coinsurance, or deductible” (Davis, Abrams & Stremekis, 2011). A Beneficial Investment Primary care is arguably the most important area of health services due to its far reaching and powerful impact on the rest of the health care model. What happens (or does not happen) at the primary care level has a great deal of influence on the rest of the system. By prioritizing and emphasizing all aspects of primary care through health policy both in the private and public arenas, all parties stand to benefit.
In this essay, the author
- Explains that the primary care act includes several provisions aimed at increasing access to primary care and improving its role.
- Opines that primary care is arguably the most important area of health services due to its far reaching and powerful impact on the rest of the health care model.
- Explains that primary care is the ideal entry point of the health care system and an area of great influence on an individual’s lifetime experience with health services. promoting the role and facilitation of primary care through health policy is a worthwhile endeavor.
- Defines primary care as the level of a health services system that provides entry into the system for all new needs and problems, provides person-focused (not disease-oriented) care over time, and coordinates or integrates care.
- Explains that primary care providers include family practice physicians, pediatricians, internists, and obstetrician/gynecologists, as well as non-physician medical professionals such as nurse practitioners and physician assistants.
- Argues that the primary care physician shortage issue is rooted in a lack of interest among medical students to choose the field.
- Argues that incentivizing nurse practitioners and physician assistants is an excellent policy goal, since they provide the same level of care as physicians. encouraging health students and undergrad trained health professionals to work towards advanced degrees in these areas is a fiscally advantageous way to reshape the primary health care model.
- explanatory
- argumentative
- Explains that in 2010, the united states took the first tangible step toward universal health care coverage with the legalization of the patient protection and affordable care act of 2010.
- Explains that the new legislation provides insurance coverage for all citizens ensuring access to medical care.
- Explains the cost of health care in the united states is financed through primary sources: corporations, a family or individual, private insurance companies and government programs.
- Argues that the patient protection and affordable care act of 2010 addresses the issues of quality in u.s. health care.
- Opines that the affordable care act is a good first step, but it's not the end of the road.
- Cites the kaiser commission on medicade and the uninsured and the difference health insurance makes.
- Explains that health systems function principally to improve health. each country adopts a specific organizational model that caters to its individual healthcare needs, which are dependent on its history, economy and sociopolitical status.
- Explains that each health system comprises of three levels of care: primary, secondary and tertiary care. the declaration of alma ata defines primary care as the first level of contact of patients with the healthcare system.
- Explains that primary care is outpatient-focused and office setting-based, while secondary and tertiary levels are both inpatient and hospital setting based.
- Explains that the dawson model of regionalized healthcare and the dispersed model are contradictory methods of organizing a health system around these levels.
- Explains that primary care is a priority to improve, maintain and restore health, as pcps not only treat illnesses, but also improve well-being, prevent illness, and support chronic conditions.
- Explains that the dawson model entails an orderly and regulated flow of patients from primary care to higher levels of care.
- Compares the dispersed model adopted by the u.s. to a system with no explicit regionalization; 10.4% of hospital visits in the us were made by gps and family physicians.
- Explains the dispersed model is orientated towards tertiary rather than primary care, with gps constituting only 15.4% of active physicians in patient care in the u.s.
- Explains that in this model, patients do not need pcp referrals to seek secondary and tertiary care, as in new zealand and the u.k.
- Explains that the dawson model adopted by new zealand and the u.k. allows access only to primary care, where gps are usually consulted, whereas the dispersed model allows direct access to any levels of care.
- Explains berman, hsiao, reich, & roberts (2008) define access as a combination of the following factors: (1) physical availability and (2) how easily care can be obtained.
- Explains that a survey conducted by davis et al. (2004) revealed that healthcare in the united states is notably the least accessible.
- Explains that while healthcare in the u.s. is generally more physically available, it is less effective available. high costs of healthcare have deterred many from seeking required medical care, while in new zealand and the uk, low costs have allowed greater accessibility.
- Explains that regionalized health systems in new zealand and the u.k. are state-owned and provide universal coverage funded predominantly through taxation.
- Explains that the dispersed u.s. model is privately owned and funded by individuals and/or employers through the purchase of private health insurance.
- Explains that the dominance of specialists and low numbers of pcps in the u.s. dispersed model has resulted in higher healthcare costs.
- Compares the u.k. and new zealand, which had the lowest rates, since they provided the most comprehensive coverage with few or no patient costs.
- Explains that access to healthcare in the united states is restricted by long waiting times compared to new zealand and the u.k.
- Argues that the u.s. dispersed model has resulted in high costs due to low government funding and focus on specialized care. new zealand and the uk have been more successful in attaining accessibility in healthcare.
- Concludes that different organization and focus of health system produces different outcomes.
- Describes the advantages and disadvantages of restructuring a health care system to be more focused on primary care services.
- Explains that barr, cumming, daubé, gerring, martin, and mcdonald, j. (2013). new zealand health system review.
- Explains berman, hsiao, reich, and roberts, getting health reform right: a guide to improving performance and equity.
- Explains blick, g., and mays, n. how can primary health care contribute better to health system sustainability?
- Explains how health care is organized, in understanding health policy: a clinical approach, published by mcgraw-hill medical.
- Summarizes the british medical association's 2012 uk medical workforce briefing.
- Cites burt, c. w., and hing, e. u.s. department of health and human services, centers for disease control and prevention.
- Explains that having more primary care doctors cut health spending growth? health affairs, 28(5), 1327-1335.
- States cullen, a., & whiteford, c. (2012). the new zealand medical workforce in 2012.
- Cites davis, k, doty, m, huynh, p. t., osborn, r, peugh, j, schoen, c, & zapert.
- Explains the declaration of alma-ata and the report of the international conference on primary health care, which was held in ussr.
- Explains that ambulatory care provided by office-based specialists in the united states.
- Cites french, s., healy, j. & old, a. (2001). health care systems in transition: new zealand.
- Explains gillies, a. (2003). what makes a good healthcare system?: comparisons, values, drivers.
- Explains haneline, meeker, and jones and bartlett publishers, inc.'s introduction to public health for chiropractors.
- Explains that harrison, a. (2012). the english health care system, 2012.
- Explains isaac, r. (2011), improving the targeting of co-payments in primary care.
- Explains that generalist medicine and the u.s. health care system.
- Explains king, a. (2000). the future shape of primary health care. a discussion document.
- Explains that king, a., 2001, primary health care strategy, wellington, new zealand.
- Explains kronenfeld's view on the changing federal role in u.s. health care policy.
- Explains reid, t. r. (2010). the healing of america: a global quest for better, cheaper, and fairer health care.
- Cites sanders, j., and gaydos (eds. ), "financing and organization of national health systems".
- Explains shi, l., and singh, d. delivering health care in america : a systems approach.
- Describes the who's world health report 2000 health systems : improving performance. geneva, switzerland.
- Opines that access to preventive health care should not be definable as one of life’s luxuries, yet that is what is coming to be for the approximately 50 million americans who have no health insurance.
- Explains that countries with universal health plans, like japan and germany, have better life expectancy rates, spend less on health care, and have more than double the number of its citizens insured.
- Opines that access to primary care could make all the difference in what we as a country spend on healthcare for those who cannot afford it.
- Explains that the emergency room has become the new primary care facility for the millions of uninsured in the united states.
- Explains that children in the united states are also suffering because of the lack of universal health care coverage.
- Opines that the united states is better than this and we need to get this figured out. people are dying because they don’t have adequate access to primary healthcare.
- Explains that uninsured people fare worse than those who have insurance when diagnosed with cancer. the prohibitive costs of screening tests are keeping people from seeking these services—sometimes even if they do have health insurance.
- Argues that the universal health plan should separate access to primary care from the rest of the proposed plan.
- Opines that it is imperative that the united states find a plan that will work to provide preventive care services to every american that wants it.
- Cites galbraith, a. a, ross-degnan, d., soumerai, s. b, kleinman, k, rosenthal, m.
- Compares health status and health care utilization among children in rhode island, 2007: comparing children with public and private insurance.
- Explains stephens, ledlow, and turka's views on the right to health care.
- Explains that the patient-centered medical home (pcmh) is a model of primary care, where patients are treated with respect, compassion, and trusting relationships with providers and staff.
- Explains that there has been controversy on whether or not the patient-centered medical home is effective in improving patient care.
- Concludes that improving primary care is the pillar to achieving the triple aim outcomes. stronger evaluations are needed to clarify and target the model.
- Explains that they tested the philosophy of the patient centered medical home model by reviewing data of 70007 children without special needs. they used logistic regression for complex sample surveys to model each result with the medical home.
- Concludes that their study provided evidence that the medical home is beneficial to health care utilization, child health, and health-promoting behavior outcomes in children without special needs.
- Analyzes rosenthal's article, the medical home: growing evidence to support a new approach to primary care.
- Explains that team-directed medical practice is also considered a medical home principle in this article.
- Explains that whole-person orientation is the personal physician or provider upholds responsibility for all of the patient’s health care needs and organizes care with other professionals. clinical excellence is augmented by information technology into medical practice.
- Opines that evidence-based medicine and decision-making support tools should be put into practice and technology for information that has potential to support patient care, performance measurement, patient education, and communication.
- Concludes that patient-centered medical home and diabetes are being used nationwide. the shift toward a pcmh and its practice differs among the different demonstration projects.
- Opines that the evidence provided by these articles proves the pcmh model indeed improves patient care, as well as reducing errors, and increasing satisfaction.
- Opines that the current healthcare system is dysfunctional and projected spending will increase every year, putting an unbelievable strain on our fragile economy. the shortage of primary care doctors is inevitable because of limited income, lesser prestige, and fewer opportunities.
- Explains that most of us have always looked up to primary care physicians for almost all of our healthcare needs. they intimately know our medical history and have a general concern for our wellbeing.
- Opines that the current set-up does not give them the rewards they properly deserve; the prospect of a limited income is completely unavoidable.
- Explains that the push for electronic medical records has left many primary care doctors oblivious on what to do.
- Explains that the disinterest of medical students to pursue this specialty is another setback for primary care practice. the implosion of pseudo doctors into the medical field makes the competition tougher for doctors.
- Analyzes how the current system gives more financial rewards to other medical specialties, resulting in fewer opportunities for primary care physicians. radiologists have more earning potential than a family medicine practitioner.
- Explains that emtala, enacted by the u.s. congress in 1986, requires hospitals and ambulance services to provide emergency medical care regardless of legal status or ability to pay.
- Opines that every american will be at the losing end if the shortage of primary care doctors continues. their policy makers will not understand the predicament of the average citizen.
- Explains that primary care in the united states has been in a state of neglect or underfunded for long. the affordable care act (aca) tries to address some of these issues.
- Explains that the united states has been slow in addressing the need for an effective primary care health care system due to special interest groups or the lack of political will to take on this challenge.
- Explains that the aca promotes the use of electronic health records (ehrs) in order to facilitate the submission and payment of medicare and medicaid bills.
- Opines that the aca tries to address the issues of push back and/or slow adoption through incentives for adoptions of ehrs systems as well as increases in medicaid and medicare payments.
- Opines that investments in the maintenance and development of the primary care workforce are important, citing a 2013 study by the health resources and services administration.
- Opines that the hrsa report projected the demand for primary care physicians to grow by about 14% outpacing the projected supply, resulting in a projected shortage of 20,400 physicians in 2014.
- Explains schuster, mark a, elizabeth a mcglynn, and robert h brook. "how good is the quality of health care in the united states?"
- Explains that the current healthcare reformation is a contentious matter that promises to transform the way americans view an already complex healthcare system.
- Explains that the american nurses association defines the fnp as one who is educationally prepared to assume responsibility and accountability for health promotion and/or maintenance as well as the assessment, diagnosis, and management of patient problems.
- Argues that substituting higher-paid physicians with less-educated and lower-paying nurses will result in a cost effective solution to the increasing shortage of primary care physicians.
- Explains that nurses are champions in adapting to change and identifying creative measures to help modify their practice. delegation of physician care to fnps will lead to better use of resources. sacrificing nursing values cannot be tolerated.
- Cites agosta, l., 'patient satisfaction with nurse practitioner-delivered primary healthcare services'.
- Explains that nurse practitioners are a relatively new concept within the american healthcare system. loretta ford, rn, and dr. henry silver introduced the first informal training program for nurses at the university of colorado.
- Argues that fnps are not all satisfied with their developing role as a primary care provider.
- Cites the american nurses association's consensus model for aprn regulation: licensure, accreditation, certification & education.
- Explains that physicians must be aware of the responsibilities of social justice and cultural sensitivity in the treatment of patients.
- Explains that cost-effective analysis is a large component of social responsibility studies in the context of health care. it is important for physicians to view it through the eyes of social responsibility if people from other cultures and the poor are to be heard.
- Opines that the responsibility for cultural awareness falls on the shoulders of the physician, patient, nurse, hospital, and all medical personal.
- Explains that justice is imperative to cultural sensitivity and social responsibility in general. retributive justice focuses on blame and encouragement of competitive and individualistic values.
- Explains how a physician can use the theory of restorative justice to implement cultural sensitivity by removing incentives for physicians who join their organization.
- Explains that health maintenance organizations play a critical role in the institutionalization of medicine, and how the shift to institutionalized medicine affects the physician/patient relationship.
- Opines that it is important to have access to studies on cost-effective analysis in order to allow voices from all different social classes and cultural backgrounds be heard.
- Cites lambrew, jeanne m., russell, louise, and russell on the role of cost-effectiveness analysis in health and medicine.
- Explains that the relationship between healthcare and social care systems results in difficulties in moving money between them. most health services are not user-centered and are designed and delivered according to traditional systems of care.
- Explains that the us healthcare system is rooted in the private sector, which directly funds 56% of the expenditures through private health insurance, household expenses, and copays.
- Explains that the united states healthcare system has many weaknesses, such as fragmentation, duplication of tests, and unplanned hospitalizations.
- Explains that a patient centered medical home (pcmh) could integrate patient care. a pcmh would integrate primary care and specialists into improve care coordination, safety and quality.
- Explains that physicians and hospitals are paid with a fragmented and confusing mix of public and private payments.
- Explains that an accountable care organization (aca) could provide physicians with continuity of reimbursement and incentives to manage costs, especially high cost cases and administrative costs.
- Argues that malpractice costs are another failing of the american healthcare system, and that physicians must have the security to practice medicine and put patients first.
- Opines that removing the barrier physicians feel from lawsuits will allow physicians to put the patient first in medical care.
- Explains that paper medical records are inefficient and do not allow providers to effectively share information and communicate. computerization eliminates errors caused by poor penmanship and makes ordering more efficient.
- Explains that an ehr costs between $50,000 and $70,000 per physician in an organization. it disrupts existing workflow and causes a temporary slowdown in patient flow.
- Explains that the us healthcare system has a profound problem with approximately 46 million people uninsured.
- Opines that the affordable care act (aca) is the best solution to the uninsured problem in american healthcare.
- Opines that their training in informatics will allow healthcare providers to provide quality and caring treatments. they want to use the data to improve the delivery and effectiveness of the healthcare system.
- Cites baltic, s., rebitzer, j. b. and votruba, m. e.
- Explains that cms (2014). national health expenditures 2012 highlights retrieved from website: http://www.cms.gov
- Explains that the uninsured and the affordability of health insurance coverage. elhauge, e. (2010). the fragmentation of u.s. healthcare.
- Cites hermer, l d., and howard, b. on defensive medicine, cost containment and reform.
- Describes the benefits and drawbacks of electronic health record systems.
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- Health economics
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Essay On Primary Health Care
Type of paper: Essay
Topic: Sociology , Health , Workplace , Medicine , Marketing , Food , Pharmacy , Nursing
Words: 2000
Published: 11/13/2019
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Introduction
Primary health care refers to the medical care that a patient receives on the very first interaction with any system that provides health care. This medical care is provided by a nurse, a doctor or anybody with ideal medical practice. Nurses working in primary health care have general medical training or have been trained to do general work in any doctor‘s room. Other than having a certificate of medical practice such nurses would also require a certificate in basic life support. This paper examines the roles of various service providers in Primary Health Care and further illustrates their general contribution to the overall service delivery in PHC.
The Role of a Nurse in Primary Health Care
The nurse in PHC is held with the responsibility of helping the doctor on various outpatient services. Other related medical roles of a nurse in primary health care include provision of patient care. This is done through activities such as reading vital signs and noting vital symptoms prior to examination by a physician (Worth, 2001, 257-266). A nurse in PHC can also assist patients on telephone by scheduling their appointments or referring them for related emergency services. Such nurses may also oversee the roles of non medical staff within their areas of work. These services may extend to provision of answers related to patient bills and insurance. With the increase in patient numbers and needs, the roles of nurses in PHC may subsequently increase.
Additional roles of a nurse in PHC include liaising with various insurance companies in order to ensure absolute cover of the patient’s medical costs. Other roles may entail the preparation of patient’s prescription. This can also entail working with pharmacists to ensure that the patient’s prescriptions are prepared in good time. Nurses in PHC may also be required to provide both emotional and physical support to the patient. It’s also upon these nurses to help in the elaboration of instructions and prescriptions (Worth, 2001, 257-266).
The Role of a Doctor in Primary Health Care and How they Relate to the General Work in Primary Health Care A doctor’s visit in primary health care is very vital. This is regardless of the fact that sometimes very little time is spent in PHC. This is an aspect that undermines the development of any meaningful relationships among such doctors and the staff in the PHC. The doctors’ main role is to see patients that have been booked for examination by nurses (Sommers, Martem, Barbaccia &Randolph, 2000). Other roles include teaching the staff in PHC, team work development and enhancing communication. The roles of a doctor in PHC are highly impaired by the limited time available on the schedule of the visits. Their roles are also undermined by improper patient scheduling and the lack of appropriate facilities in the clinics to meet the patients’ diagnostic and general medical care. Their role in assisting primary health care nurses is also impaired by improper referral criteria. Improvement of service provision in PHC would highly be determined by proper scheduling of doctor’s visits and clear communication. Service provision in PHC can also be highly improved with ideal training of nurses by doctors on the same (Sommers, Martem, Barbaccia & Randolph, 2000).
Patients also highly benefit from doctor’s services in PHC. Among them is reduction of travelling costs. Visiting doctors help to cut down the costs that the patients would have incurred in looking for the doctors. Patients also benefit from the comprehensive care they receive on such visits. This also entails resolving undifferentiated problems. Sometimes the clinic does benefit from visiting doctors especially if they bring along their all equipments. Doctors can also benefit the clinic by bringing additional drugs (Sommers, Martem, Barbaccia &Randolph, 2000). Doctors can also help in diagnosis of disease conditions that are difficult. To the hospital, the doctors’ role in PHC helps in reduction of the number of referrals which subsequently help in reducing congestion of patients in hospitals.
How Doctors may Negatively Impact on the Role of Nurses in Primary Health Care
Sometimes visiting doctors would have a tendency of blaming the nurses especially with regard to how they do their work. This is highly related to how they schedule patients and refer them to the doctor. This reduces the nurse’s motivation since some doctors may openly indicate that the nurses do not really know their work which is undermining. Some doctors may also undermine nurses in front of their patients (Cohen, Colantonio & Vernich, 2002, 184-188).The service provision in PHC may also be affected if the patient is tossed around between the nurse and the doctor. This is common if the doctors do not have time to see the patients (Sommers, Martem, Barbaccia &Randolph, 2000).Other doctors may have a tendency of giving a negative feedback about the work done by the nurses. Service provision can also be impaired by the doctors’ lack of understanding of the rules of the clinic. These negative aspects highly demoralizes the nurse and negatively impacts on general service delivery.
The Roles of a Physiotherapist in Primary Health Care and their Impact on General Service Provision in PHC
With regard to general service provision, physiotherapists reduce the work load for other service providers in patient care. This is because patients can be discharged early and subsequently referred to physiotherapists. Their role in preventive health care is also an added advantage to both individuals and other service providers (Glendenning, 2003, 139-151). This is offered through their knowledge on exercises and the entire musculoskeletal system. Various lifestyle diseases can best be managed through change of lifestyles. Such advice can best be offered by physiotherapists unlike other service providers that may never have time to sit and talk with the patients (Carson, Dunbar Chenall & Baile, 2007).Their roles extend to post operative care where they offer advice on exercise and general mobility. Physiotherapists greatly relieve other service providers in PHC by offering services that these service providers especially nurses and doctors may not have time to do (Glendenning, 2003, 139-151).
The Roles of a Pharmacist in Primary Health Care
The primary role of a Pharmacist is centered on dispensing drugs. This basically points to the management of medication in the entire medical care. Among the roles in primary health care include; jointly working with physicians in order to effectively manage the medication needs of patients. To patients, pharmacists provide advice on cost effective medication. To other service providers especially nurses and doctors, pharmacists provide information on the compliance of patients to medication (Cohen, Colantonio & Vernich, 2002, 184-188). Some pharmacists may extend their services in PHC to visiting patients in their homes to provide more information on medication. This may also entail provision of advice to patients previously treated on the use of injectable medication at home. Pharmacists may also provide care directly to small ailments. A vital role of pharmacists in PHC is monitoring the expected side effects of medication administered to patients. For the nurse and the doctors in PHC, the pharmacist offers vital assistance by advising patients on how to take their medication and what to possibly do in the event of a complication. This greatly relieves the other service providers (Taylor, Boyd &Krueger, 2003, 1123-1129).
The Role of Social Workers in PHC and their General Contribution to Service Provision in Primary Health Care
Social workers offer coordinated communication that is essential in general patient care. In primary health care, social workers closely liaise with the patients and their families in order to provide all the relevant information needed to make proper connections (Banyard & Hampshaw, 2002, 24-25).They also help patients and members of the community to identify ideal medical links and connections of importance such as educational facilities and other social amenities. Their role extends further to the provision of counseling services on a variety of related problems. They also offer support to individuals and their families during distress as a result of the disease condition. With regard to helping other service providers in PHC, social workers coordinate transition points in social amenities (Banyard & Hampshaw, 2002, 24-25). These services include relocation of patients, and placement. Their role in support of general service provision in PHC is thus extended to advocacy to community and home care services, provision of counseling, referrals to alternative community health care services and consultation with the rest of the service providers in PHC (Globerman, White & McDonald, 2002, 274-283).This basically relieves the other service providers especially the nurse off additional responsibilities.
The Role of Indigenous Social Workers in Primary Health Care and their Contribution to General Service Provision in PHC
The indigenous health worker plays a vital role in Primary health Care. This is offered through partnering with non indigenous service providers especially the nurse in order to foster complementary skills (Glagow& Yates, 2004, 327-659). This is more felt through enhancing communication skills by acting as interpreters. This is geared at decreasing cultural differences. Such workers also increase educational opportunities to the community members and also provide cultural mentorship. The services provided by indigenous health workers foster both emotional and social support that is required for the healing process of the patient. These workers highly help in general service provision especially with regard to preventive medication where they offer health education to the members of the community in the native language (Tsuyuki, Johnson &Teo, 2002, 1149-1155). This is an aspect that can greatly relieve the nurse if she or he cannot speak the native language.
The provision of ideal services in primary health care is highly fostered by the roles played by the various service providers. The nurse in primary health care is held with a number of responsibilities ranging from initial examination to patient care and referral. The roles of other service providers including doctors, physiotherapists and social workers are jointly coordinated in a way that each individual service provider is of help to the other. The general service provision in primary health care is thus a combination of the roles played by various service providers. How each of the roles is played determines the type of service provided in general.
Banyard, J & Hampshaw, D, Primary Care. Social Skills. Health Service Journal, 112 (5820), 2002: 24-25. Carson, B, Dunbar, T, Chenall, R & Baile, D, 2007, Social determinants of Indigenous health Allen and Unwin Sydney Australia. Cohen, C, Colantonio, A & Vernich, L, Positive Aspects of Care giving: Rounding out the Caregiver experience. International Journal of Geriatric Psychiatry, 17, 2, 2002: 184-188. Glagow P, &Yates B. Proactive Asthma Care in Childhood; General practice Based Randomized Controlled Trial. British Medical Journal, 2004: 327, 659. Glenndinning, C., “Breaking down barriers: Integrating Health and Care Services for Older People in England”, Health Policy 65 (2003) 139-151. Globerman, J, White, J. & McDonald, G. Social Work in Restructuring Hospitals: Program Management Five Years Later. Health and Social Work 27(4): (2002):274-283. Sommers, L., Marten, K., Barbaccia, J., Randolph, J, “Physician, Nurse, and Social Worker Collaboration in Primary Care for Chronically Ill Seniors”, Archives of Internal Medicine.2000; 160(12): 1825-33. Taylor T, Byrd C & Krueger K. Improving primary care in Rural Alabama with a pharmacy initiative. AJHP 2003 60 (11):1123-1129. Tsuyuki, T, Johnson, J & Teo, K et al. A randomized trial of the effect of community pharmacist intervention on cholesterol risk management. Arch Intern Med 2002; 162: 1149-1155. Worth, A., Assessment of the Needs of Older People by District Nurses and Social Workers: A changing Culture? Journal of Interprofessional Care, 2001. 15 (3): 257-266.
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Primary Health Care and Nursing
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Primary Health Care: Issues and Challenges
Introduction.
Primary health care as a concept gained popularity following the 1978 International Conference on Primary Health Care jointly held by WHO and UNICEF at Alma-Ata (World Health Organization, N.d; Bryant, 2002). Although different definitions have been adopted by different people, it is the WHO’s definition that has reclaimed global acceptance which also has been used in numerous literatures. According to UNSW Research Centre for Primary Health Care (2010), World Health Organization (WHO), defined primary health care (PHC) in 1978 during the Alma-Ata declaration as one that seeks to extend the first level of the health system from sick care to the development of health, “protect and promote the health of defined communities and to address individual problems and populate health at an early stage.”
At the conference, PHC was adopted to describe the following components: “education about common health problems and what can be done to prevent and control them; maternal and child health care, including family planning; promotion of proper nutrition; immunization against major infectious diseases; an adequate supply of safe water; basic sanitation; prevention and control of locally endemic diseases; and appropriate treatment for common diseases and injuries” (Martens, 2010, p.1). Since it was adopted PHC has put more emphasis on prevention rather than cure. As the author stress, “it relies on home self-help, community participation, and technology that the people find acceptable, appropriate and affordable where also it combines modern, scientific knowledge and feasible health technology with acceptable, effective traditional healing practices” (Martens, 2010,p.1). Primary health care (PHC) plays a big and vital role in health care systems in many countries of the world (Gunn and Masellis, 2008, p.21).
PHC provides families with cost-effective services that in many cases are located close to home, thereby eliminating costly trips to specialists and hospitals. However, in most cases the coverage and effectiveness of primary care services are limited by insufficient resources and staff, erratic drug supplies and faulty equipment. On a larger scale, the functioning of primary health care has been affected by economic, socio-cultural and political aspects existing in a nation, which have direct influence on the society’s health and social environments. Therefore, this essay will investigate the above factors in accordance to the Declaration of Alma-Ata, assess, and explain the fundamental principles of Primary Health Care, the conditions that resulted into the Declaration of Alma-Ata and the possible reasons for the demise of the PHC movement. Information for the above questions will largely depend on literature review of case studies and journal analysis.
Primary Health Care: philosophy, strategy, or service?
Primary health care is believed to constitute three elements as the WHO definition of the concept may be adopted. First, PHC represents “a philosophical approach to health and health care characterized by a holistic understanding of health as wellbeing, rather than the absence of disease” (Rogers and Veale, 2000, p.11; National Primary Health Care Partnership, N.d). In this perspective, in order to experience good health, various aspects that affect human life must be taken care of, as well as ensuring that the needs of the community are addressed. Hence, “the locus of control is important in PHC; health services should reflect local needs and involve communities and individuals at all levels of planning and provision of services” (Rogers and Veale, 2000, p.11). Moreover, services and technology need to be at low cost that majority can afford after accepting them. Equity is another aspect that in great measure characterizes PHC where health services need to endeavor to address imbalance and prioritize services to the most disadvantaged.
PHC manifests a second element, which is strategic where PHC is seen to involve a set of strategies that are designed purposefully at creating health care, which is in line with the original philosophy. The “strategies include needs based planning of decentralized health services, offering management to local communities” (Rogers and Veale, 2000, p.11), and in this case, it is important to offer training to the communities in order to enhance health awareness, a program that can become successful through collective participation. To this extent, primary health care services require balance between health promotion, preventive care and illness treatment and this can be achieved through use of a team selected from various disciplines such as medical, nursing health, community work, population health, health promotion workers and educators. Therefore, primary health strategies can be summarized to include needs-based planning, decentralized management, education, intersectoral coordination and cooperation, balance between health promotion, prevention and treatment; and multi-disciplinary health workers (Rogers and Veale, 2000, p.11).
PHC also provides services within the first level of health care, thus must be strategically established in areas which are within the reach of the society. At the same time, geographical and financial obstacles, which are most likely to be present may be counteracted through ensuring that the services are easily accessible by all, both in terms of logistics and affordable rates.
On further note, PHC services should be administered through active involvement of diverse stakeholders and should include all the relevant health care services as required by the society. In summary, primary care services constitute the following characteristics: locally based, affordable and accessible, well-integrated, health care teams, health promotion, disease prevention, illness treatment and rehabilitation services (Rogers and Veale, 2000, p.12).
Socio-economic conditions that influence primary health care
Inequality experienced both in social and economic spheres have been described as harmful to the health of any society. “The effects become more harmful especially when the society appears to be diverse, multicultural, overpopulated, and undergoing fast but unequal economic growth” (Deogankar, 2004). Deogankar further notes that there exists unchallenged association between social equality, social integration, and health; and that the impact of social and economic inequality on health is great. Poverty, which is the product of social and economic inequality in society creates a lot of negative effects to health of any given population since almost all indicators of health are in one way or the other influenced by the standards of living in any particular given region (Deogankar 2004).
Amin, Shah and Becker (2010), analyzing the socioeconomic factors and how they influence accessibility to maternal and child health care services in Bangladesh, noted that various factors were responsible for the inadequacy been experienced in using maternal and child health services in most rural areas of developing nations. The factors identified included “the availability, accessibility, and quality of services as well as the characteristics of the users and communities in which the users live” (Amin, Shah and Becker, 2010). Further, these factors could be visible in instances such as distance to health services, cost of services, technical qualifications of health professionals, socioeconomic situation of the people and also the women’s’ independence in household decision making processes (Amin, Shah and Becker, 2010).
Carrying a similar study in Nigeria on the major obstacles to accessing primary health care services, Katung (2001) found out that out of 357 women interviewed, high cost of drugs which constituted 29 per cent, service charges at 19per cent, easy accessible to traditional medicine practitioners at 39per cent and problems in getting transport to a healthy facility at 30per cent. Showing how health and economy are related, Ruger, Jamison and Bloom (2001) observe that health and health care systems interrelate with the economy in many ways. For instance, their findings shows that access to higher incomes by population enables the population to experience health benefits as they are able to purchase food, have adequate sanitation, housing and education and also have incentives for fertility limitation (Ruger, Jamison and Bloom, 2001, p.2).
Central features and principles of Primary Health Care
There are five identified basic principles of PHC, which include the following.
- Equitable distribution of PHC – this principle articulates that PHC need to be provided to all people in equal amount in the community without discriminating basing on gender, age, caste, color, urban, rural, and social class (Community Health Nursing 2010).
- Community participation in order to achieve PHC – this principle states that the community needs to be given a chance to participate in decision-making process regarding policies to address their health issues. In addition, communities need to be mobilized in finding solutions to complicated social problems and there need to be “mass health campaigns and promotions to battle out health problems” (Student Nurses Community 2009).
- Self-reliance – under this principle, the community is to be empowered in order to generate support for various health programs, community to utilize local available resources, programs to train community leaders and other key management skills to be initiated and establishment of income generating projects, cooperatives and small scale industries (Student Nurses Community 2009).
- Multi-sectional approach – according to this principle, appropriate health for any community cannot be achieved in isolation of interventions that are found only in health sector but it should incorporate other sectors that are equally important in attaining proper community health and self-reliance. The key sectors that can be incorporated include agriculture, irrigation, education, housing, animal husbandry, public works, communication, rural development, industries, and voluntary organizations (Community Health Nursing 2010).
- Utilizing appropriate technology, whereby the principle outlines that technology that a community adopts should be accessible, affordable, and feasible and one that is acceptable by the culture of the community (Community Health Nursing 2010). On the other hand key features of PHC include: primary health care should be an integral part of the country’s health system; the created health system should focus on priority; the methods and technology adopted should be scientifically sound; at the same time the technology and methods adopted should be culturally sensitive; primary health care should favor and promote an element of equity; there should be community participation in provision of basic health; and the primary health care system should be sustainable and self-reliant (Marafa, n.d).
Primary Health Care Movement (PHC)
Context in which the phc movement began.
Prior to 1978 conference there were numerous evidences that the health status of poor people was deteriorating especially those living in rural villages. As such there was an urgent need to reallocate adequate health related expenditure that could be used in providing the necessary, low-cost health services to the poor people in world. Therefore, Declaration of Alma-Ata was adopted after it became evident that there was gross inequality in the health status of the people, more so considering that the gap between the developed and developing nations keeps on widening; however, efforts are necessary to bridge this gap especially in political, social and economic environments. The conviction of the participants was that, ”comprehensive approach whereby primary health care was seen as the key to achieving an acceptable level of health throughout the world in the foreseeable future as a part of social development and I the spirit of social justice” (Anon N.d). At the same time, health of individuals was seen to be a fundamental human right and any effort to achieve the right health was to be the most important world-wide social goal and in realizing it there was need for collaboration of key sectors of economy, social together with the health sector.
Implementation and its demise
During the Alma-Ata conference, access to basic health services was affirmed as key fundamental human right that was not supposed to be denied to any individual. But when evaluation of the Declaration is done today, it is a bitter reality that almost more than 30 years later, many people in developing countries still do not have equitable access to basic health services (Hall and Taylor, 2002, p.1); and in other places, the gap is even widening at an alarming rate. PHC has not realized its goals for a number of reasons that range from the fact that key promoters in first world countries denied to accept the involvement of communities in first-hand decision-making process in health care programs. Also, changes in economic ideology resulted into the replacement of PHC by ‘Health Sector Reforms’ that were largely designed based on forces of the market and the economic benefits of better health (Hall and Taylor 2002, p.1). Further Hall and Taylor (2002) note that as soon as the Alma-Ata conference was over, PHC was under attack whereby “Politicians and aid experts from developed countries could not accept the core PHC principle that communities in developing countries would have responsibility for planning and implementing their own healthcare services.”
According to Stephen Gillam, the PHC failed in its initial stages of formation when early efforts at primary health care expansion I the late 1970s were overtaken in mot parts of the developing world by major factors that included economic crisis, sharp reductions in public spending, political instability and emerging disease (Gillam 2007, p.1). Further, the author observes that the social and political goals of Alma-Ata spurred early ideological opposition hence were never fully accepted in market-oriented, capitalist nations. Moreover, in many health systems, a medical model of primary care dominated by professional stakes resisted attempts to expand community-level health workers with poorer training. “Selective primary health care and packages of low cost interventions such as GOBI-FF(growth monitoring, oral rehydration, breast feeding, immunization, female education, family spacing, food supplements) in some way distorted the spirit of Alma Ata” (Gillam 2007, p.1).
Other factors identified to have hastened the demise of PHC include failure in most nations to provide even limited packages, together with explosion of vertical initiatives to tackle the particular world health problems contributed to death of PHC; geographical and financial inaccessibility. In addition, limited resources, erratic drug supply, and faulty equipment have influenced many countries’ PHC services to be largely limited in their availability, accessibility and even impact (Gillam 2007, p.1).
According to Lawn et al (2008), the major setbacks to the Alma-Ata declaration came from the Cold War politics, which stifled the Alma-Ata momentum. On the same measure during that period the global development policy was largely dominated by neoliberal macroeconomic and social policies, for instances the developing countries had to accept the harsh reality of the structural adjustments programs (SAPs) which resulted to reduction in budget deficits through devaluations of the local currency and cuts to public spending in the sectors of health, education and transport. These policies affected the performance of health systems in negative ways such as inadequate supply, chronic under funding of key public health infrastructure, reductions in the number and quality of health personnel and the worsening access to health care for the poor. These situations denoted negatively to the Alma-Ata goals (Lawn et al. 2008, p.4).
The declaration of Alma Ata helped to entrench the thought of providing health care as being a sign of enhancing human right, with its goals being to reduce health inequalities especially for the poor people since concerns have been that people affected by poverty are disadvantaged as they live in deplorable conditions. In addition, their economic status cannot allow them to enjoy the benefits of the basic services on offer. Various factors have acted as barrier to the attainment of key goals of the declaration but as the recent trends indicate primary health care goals will be achieved in future if key stakeholders come together and pursue common goals. For instance, what is evident today is the fact that governments, donors, and even private organizations are in a positive way talking about working together and major health agencies who in the past have acted in competition are now grouped together in a new outfit known as Health 8 and from this cooperation and coordination is seen to be increasing. Moreover, funding is gradually increasing and is shifting from selective global funds towards health system strengthening through sector-wide approaches. Therefore, as a result of recent numerous programs and policies, there is wide hope that health care will reach many of the poorest families and this will be achieved more easily by revitalizing the principles of Alma-Ata.
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Primary Care Approach In Health Care
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Health Inequality
The solidity of the health equality shall be implemented by several parties. This includes not only government, political figures or policy makers but also community that play important role as a public health specialist, social activist, and researcher. The key to maintain the health equality can be done by continuously improving the population health and eliminate differences in socioeconomic status, geography, race, and other factors. (1) Health inequality occurs when there is a dissimilarity in distribution of health acquirement between individual or groups that brings considerable drain to their lives. The consequences will be most likely to be severe in people who are less advantageous, experiencing less conducive living condition, poverty-stricken
Free Health Care Persuasive Speech
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Examples Of Injustice In Health Care
There is a common phenomenon in the China that many people treated with inequality and injustice in health care. As as Martin Luther King, Jr.’s saying goes “Of all the forms of inequality, injustice in health care is the most shocking and inhumane”. From my point of view, i firmly agree with this point in that each individual has equal right to enjoy the suitable health care. It is intolerable for the whole society to make the health care injustice as a seriously public health problem. In this essay, some facts about the injustice will be given. Also, the solutions to deal with these problems will be provided so that this public health problem will be resolved in the future.
Social Determinants Of Health Essay
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I picked scenario one, just graduated from college and is beginning a job in a new city. The two things that I would do in order to begin my search is, first thing I would do is ask my co-workers, what medical physician they go to and recommends. The reason is, due to the fact that they will be able to give an honest and non-bias opinion. The second thing I would do is contact my insurance company and ask them what physician in my area accepts my insurance and pay them a visit because it will help me in budgeting wisely.
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Hi Olayink A Case Study
I like that you mentioned that “prevention is better than cure”. Recent statistics reveal that too many people in this country do not have access to preventative health care required to remain healthy and avoid or delay the onset of diseases. A healthy life style helps us to leave a healthy life, reduce the cost of health care, as well as helping to prevent chronic diseases such as heart disease, diabetes and cancer. The key to success for wellness and prevention programs is to make the resources for achieving a healthy lifestyle affordable and accessible to the general population. (Rose, M. 2014).
Cultural Competency In Health
Multiethnic health in Australian health care systems manifest the fundamental values of multiculturalism work inside the framework of health care, with certifying that the training of health professional has a strong and specific emphasis on building cultural competence and effectiveness, that is, the ability to work competently and effectively in a culturally diverse workplace and in encounters with people from different cultural backgrounds to ensure the delivery of best level of healthcare.( Australian Government. The people of Australia. Australia’s Multicultural Policy; 2011.) Cultural competence, (National Health and Medical Research Council. Cultural Competency in health: a guide for policy, partnerships and participation. Canberra:
Health Disparities Analysis
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Essay On Right To Health
Health and its wellbeing is considered as one of the important asset of Human life. Health is one of the basic requirements of human beings. In the present time our country is facing degradation of health. As WHO defines, Health is a state of complete physical, mental and social wellbeing and not merely the absence of disease. Health is the most important factor in national development. Through this definition World Health Organization has helped to move health thinking beyond a limited, medicine and pathology based perspective to the more positive domain of well -being. The right to health is one of the basic rights of human beings. Right to health is a vital right without which no one can exercise one’s basic human rights. In the Indian society right to health is an issue of fundamental importance. The responsibility of protecting and fulfilling the right to health not only lays with medical profession but also with governments public functionaries. The term health has an inter-relationship with aspects such as the provision of a clean living environment, protection against hazardous working conditions, education about disease prevention and social security
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IMAGES
VIDEO
COMMENTS
Part A Primary health care evolves from the economic, cultural, social, and political conditions of a country, and it is described as an essential part of
It is also the most frequent means of healthcare provision that they are exposed to. Therefore, primary healthcare can be defined as the most available
Primary health care is important in any community and it consists of many principles – three of the most important ones being affordable
explanatory essay. The Declaration of Alma Ata (1978) defines primary care as the first level of contact of patients with the healthcare system.
Primary health care refers to the medical care that a patient receives on the very first interaction with any system that provides health care.
The basic principles of the SUS are decentralisation and social participation. The Atenção Primária à Saúde (APS; Primary Health Care) is understood as a
primary care essay, very good mark on it running head: primary health care primary health care essay university of regina cnur 102 primary health care
One of the main objectives of primary health care is to make health services accessible and available to all. The World Health
According to UNSW Research Centre for Primary Health Care (2010), World Health Organization (WHO), defined primary health care (PHC) in 1978
The main focus of this essay will be written about the obstacles or other word the challenges to implementing primary healthcare, what can be done in order to