Principles of Primary Health Care
Primary health care refers to the vital health care that is made accessible at a cost a country and community that can afford, with methods that are practical, scientifically sound and socially acceptable”. (Alma Ata Declaration 1978). The main focus of PHC approach is on inhibiting illness and supporting health. The ultimate aim of primary health care is the accomplishment of better health services for all. The focus of this assignment is discussions on the following, the implementation of equitable distribution, community participation, intersectoral coordination and appropriate technology; the strengths of the above mentioned and the impact it has on the provision of care to clients who access services offered at the Samabula medical Area (McMurray A, 2007).
Mission of Samabula health center is to provide quality services to the community to ensure that the health status is improved with effective and efficient health care service delivery through the availability of medical supplies, consumables and man power. Samabula health centre looks after a population of 17,398 where 6680 is of Fijian of Indian descent, 1824 is of Fijian of other descent and 8894 is of I-Taukei. Equitable distribution generally means universal excess to health services irrespective of the ability to pay. Accessibilities makes sure that every individual gets better excess to services which are cheap and provides equality amongst others. This doesn’t mean that people have to be rich in order to get this services as this is to all the people. Lack of equitable distribution means that some people do not even get a decent basic minimal of care while some population have a concentrated health service. Equitable distribution is implemented by providing care to the community members equally regardless of age, gender, cultural ethnicity, caste, colour and social class. For example in Samabula health centre the zone nurses visits homes, they do NCD screenings, immunization administration, maternal child health clinic, conduct shift clinic(outreach programs), health educations in preschool ; primary schools and HPV vaccine administration. People of this community does not feel neglected as they have equal access to the health care. There is equal utilisation of health services provided by the nurses to the people in the community. The school health team provides services to the schools in the community, whereby they also go to rural schools where they conduct assessment to find out about their health status this is done because most of the rural schools are left out as they are far from the health centres, hospitals and nursing stations (WHO, 2004). One of the positive outcome of visiting the burevasanga primary school by the school team (year 2 students of FSN and the zone nurses) was that there was no cases of scabies which was done this week of 18th October 2018 where as last year there was many cases of scabies.
Community participation includes all the vital resources in promoting health and addressing of health issues at the grass roots level. Health promotion is helping of the community to lead a life of a healthy person. Community participation is when individual Fijian citizens accept responsibility of their own health and their community health that they live in. It is when an individual comes to know the health issues and problems of the community, ways and methods of overcoming it (MacDonald J, 1993). For example the community participation is when the zone nurses go out to the community to create awareness that’s where the community members come together to participate like in cleaning up campaigns. The zone nurses organize fun days for the community where they can come together and participate with each other. Programs are also organized to celebrate health days to make the members of community aware that they should take care of their health as it is said health is wealth so we should mark health as our very important wealth. Community participation approach is a cost effective to extend a health care system. This is where the people of the community begins to understand their health status and take series of preventive measures. The genuine commitment of nurses and the health care team to community self-help is crucial to the motivation process. Participation increases program acceptance ownership, ensures the program meets local needs and it also reduces costs by using local resources (Harvey D, 2005).
Intersectoral collaboration is joint action taken by health and other government sectors as well as private sectors to improve health of population, through cooperative initiatives, alliance coalitions or partnership. Example literacy improvement is mainly the task of the educational sectors where nurses work closely with health professionals providing effective care. School health programs which may engage health and education sectors, this aims at improving the wellbeing of the children, thus reduces school absenteeism. In regards to provision of basic health infrastructures such as electricity is a PHC strategy that contributes to poverty reduction by providing energy for the manufacturing sectors which generates employment and income. Intersectoral collaboration can lead to reduction of adverse consequences such as in containing air pollution or actively promote health such as in policies for promoting access to quality education or gender equality. This approach was a fundamental tenet of the Alma Ata Declaration, and is one of the four pillars of primary health care as laid out in WHO’s 2008 World Health Report.
Appropriate technology has played a key role in health. Appropriate technology that’s when the health center have enough supple available for the care of the patient for example the ECG machine, vitals, oximeter, glucometer, cardiac monitor, resuscitator, suction unit and wheelchairs vaccinations given in MCH. Like for applications on smart phones used to track and assist patients with condition like diabetes or to enable self-tracking of exercise, blood pressure or other health issues. Appropriate technology is technology that is scientifically sound, adapted to local needs, acceptable to those using it and able to be maintained by people themselves using resources the community and country can afford (Cohen, 1989). The latest program is the Wolbachia program which is done in Fiji collaboration with government and local communities. This is where mosquitoes are released that carry Wolbachia. These mosquitoes reduces the ability of Aedes aegypti mosquitoes to transmit viruses between people. This is done to reduce the risk of Zika, Dengue and Chikungunya and protect communities from mosquito borne diseases (Litia C, 2018)
Some of the strengths from principles of primary health care that I observed was that availability of many health equipment’s has allowed the staffs to provide efficient, affordable and emergency health care. Collaboration of many sectors into provision of proper health care services. E.g. NFA provides ambulances. Collaboration of the health care team internally. With 2 zone nurses, community participation also happens to be one of the strength of the health centre as evident by huge turnouts during home visits. There is always a huge turnout at the health centre daily because the staffs provide care equally regardless of race, ethnicity, religion, etc. As mention on the equitable distribution the zone nurse go to homes as it is hard for some people to come to the health centre, where the nurse educate them and make them aware of what all is happening around. As for Samabula health centre which has a good location whereby may people around Suva can access it w and other places without any difficulty. I have also observed that Primary health care has positive impact on clients, clinic and the environment. Provides a peaceful environment between the clients and the health care team. More patients are willing to come as far as Cunningham ; Nadera (other zones) just to be treated at Samabula Health Centre. Morbidity rate as also remain stable (RHD-54, MEN-C nil) and also mortality.
To sum up, primary health care nursing plays an important part of keeping the clients healthy. This approach is proactive using preventative measures, managing chronic disease and encouraging self-care recommendation. This services decrease delay and increase access to the health centre system, offering better health outcomes. Each primary health care centres has an interdisciplinary health care team that provides a range of services in a single site. This coordinated approach to the health care delivery ensures that client delivery ensures that client receive the right care by the right provider, when and where they need