Primary Health Care and Community Health Services - Essay Example

Primary Health Care and Community Health Services Introduction Primary Health Care is defined as that essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and the country can afford to maintain at every stage of their development in the spirit of self-determination (Alma Ata, 1978). The concept of Primary Health Care was adopted by the WHO at the Alma Ata conference in 1978. The conference strongly believed that health is a fundamental human right of every individual and the responsibility is upon the Governments to provide adequate health to every one irrespective of the economic or social status. There upon, Primary Health Care has gained lot of importance in all countries world wide. It is the first level of contact of health services to any individual, family or community and is easily accessible. It includes education of health problems, promotion of good nutrition, safe water supply, basic sanitation, maternal and child health care including family planning and immunization, treatment of common diseases and provision of essential drugs. It makes use of local, national and other available resources and relies on health workers, physicians, nurses, midwives, auxillaries, community workers and traditional practitioners to work as a health team and to respond to the expressed health needs of the community. The effectiveness of imparting Primary Health Care is due to its principles- Easy accessibility, Appropriate technology, Community participation, Prevention and health promotion and Intersectoral collaboration. Nurses have a major role to play in Primary Health Care Services. They may work as health visitors or district nurses and contribute a lot to developing neighborhood or community profiles of the populations they serve (Nursing in Primary Health Care). They gather data from patients and care givers through observation, interviews and listening to cues and assess the patient which is a key part of professional practice. Community Health Care Services in Victoria, Australia There are about 100 community health care services in Victorian area, which are located in every local Government area in Victoria and operate from approximately 400 sites. These are aimed to deliver community based model of care, catering to the needs of all individuals of the community. There are services targeted specifically to the needs of those who require additional help like the disabled, the mentally challenged, the old, the children and the women. The services provided are health promotion and prevention, early identification and intervention, assessment and treatment, and coordinated care with other health providers. An over-view of some of the Community Health Services in Victoria, Australia 1. Women’s Health East Women’s Health East (WHE) is a community based, non-profit regional women’s health promotion agency working across the Melbourne Eastern Metropolitan Region. The organization works to improve the health and wellbeing of girls and women. It promotes access to knowledge, skills and services which enable women to make informed choices about their health and well being. The organization believes that health of women is fundamental to health of society. The WHE organization is not only easily accessible to women of that community; it also works to enhance knowledge and research. The goals of various meetings are based on the declaration at Alma-Ata, the World Health Organizations Targets for Health for All document, and the recent debate at the World Health Assembly on intersectoral action for health (Ottawa charter, the Bangkok charter, Women’s Health East Health Promotion Plan). The organization also strives to enforce scientific evidence based health practice (The Solid Facts by Wilkinson and Marmot). The organization collaborates intersectoral health promotion by means of effective partnerships, a mix of interventions and common planning framework and broad range of sector. Various health promotion plans have been implemented. The organization also works on Mental Health, Domestic Violence, Gender and Race discrimination, Personal safety and other such aspects. 2. Eastern Access Community Health (EACH) EACH is an organization that delivers a range of community health services to improve the physical, mental and social well-being of individuals, families and communities in Melbournes eastern suburbs. Other than the medical and psychological help for men and women, the organization also supports children and the disabled. They have pre-school for young kids, Early Child Intervention Programmes for those with development delay, speech therapy and allied aspects for those with speech and hearing defects and child psychology programmes. The organization also runs a Well Womens Clinic, a General Practice Clinic for young people aged between 12 to 25 years and a Family Relationship Centre to deal with problems within families. There is also help for those youngsters who are at risk of homelessness. For those with mental health problems, there are various rehabilitation and recreation programmes organized by EACH. There are disability services provided for the assistance of those with physical or mental disability and their care givers. The organization helps in providing employment so that the disabled can lead an independent living. There is also a counseling group to take of those involved in violence and crime and other illegal activities. For the old, there are various recreation programmes, physiotherapy and dietics. EACH aims at health promotion and community development. 3. Villa Maria Villa Maria, formerly known as Catholic Braille Writers Association, caters to the needs of the disabled and the old age with a vision to create a compassionate community and a mission to provide quality services and life enhancing opportunities for older people and people with disabilities. There are programmes for early intervention for the disabled, education, support for independent living, accommodation for those in need and respite support services. 4. Statewide Autistic Services Incorporated (SASI) SASI, formerly known as the Victorian Autistic Childrens Association, caters to the needs of those with intellectual disabilities and autism spectrum disorder. The programmes include swimming/hydrotherapy, physiotherapy, vocational training, independent living skills, recreation and leisure health and sensory awareness. 5. The Maroondah Addictions Recovery Project (MARP) MARP is a non-profit community based organization dedicated to rehabilitate those involved in substance abuse. There are both residential programs and out-patient support groups. The group’s mission is to provide a range of services in a safe, caring and harmonious environment which nurtures personal growth so as to fulfill the diverse needs of people who wish to develop and maintain an alternative lifestyle to that of alcoholism/addiction. Discussion Primary Health Care is imparted through various community health services. The service organizations cater to the various health needs of various individuals and families in the communities. The success of these services lies in the primary care principles adopted. Easy accessibity, health promotion and prevention, education, intersectoral collaboration, early detection and intervention and coordination with secondary and tertiary care centers are essential components of primary health care. Nurses have a major role to play in primary health care. In a study by Haddad and Umlauf, nurses acknowledged their responsibility to provide health activities and they believed that they were better suited than physicians to do so (Haddad 1998). Of late, there is increasing importance to individual based services like service for women, for children, for the old and for the disabled. The awareness of the need for gender-based health practice is increasing world wide. Some heath issues are specific to women like diseases of the reproductive tract, pregnancy, female specific cancers (breast, cervical and uterine), sexual health issues (family planning, protection against sexually transmitted diseases, abortion) and menopause (may require hormone replacement therapy). Some problems are more common and significant in women than in men like autoimmune diseases (multiple sclerosis, lupus, and fibromyalgia), arthritis, osteoporosis, urinary incontinence, depression, Alzheimers disease and domestic violence. Why these differences occur due to gender is not known. Probably, lack of integrated and comprehensive models of care for women,  disparities in access to care, societal factors like poverty, transportation, child care, stress and other priorities like taking care of children or parents probably add to these gender related health differences (Johnson n.d). The Ottawa Charter was conducted for Health Promotion and is cited internationally as an appropriate conceptual framework for healthcare service delivery. The charter has suggested strategies for nurses for optimal community health care. Personal skill development, creating supportive environment, strengthening community action, building public health policy and re-orienting services in the interest of health can be used as tools by nurses for comprehensive community health care (Cusack 1997). In a study by Willison (2005), on integrating alternative medicine with primary health care, has suggested that public health could play a pivotal role in enhancing chronic disease management and this can be done by aiding the common goals shared between primary health care and complementary and alternative medicine. One of the essential components of primary health care model is community participation and utilization of community workers (CHWs). Of course the efficiency of CHWs is dependent on their training and community support. A study by Quillan (n.d) on CHWs in Honduras has shown that approximately 80% of local health problems can be managed by well trained CHWs. Health promotion and disease prevention form the keystone of Primary Health Care. There is a need for current understanding of the most effective approaches to maintaining health. There is a need for research in the fields of self-management, symptom management and care-giving so as to improve the quality of life (NINR). The current concepts of strategies for health promotion are based on ecological model which aims at a social environmental approach to health and health intervention. This model assumes that age, gender, race, ethnicity and socioeconomic differences shape the context in which individuals function and therefore directly and indirectly influence health risks and resources (Smedly 2000). The WHO has identified health education (in collaboration with education sector), community action (with effective partnerships with the district health system, intersectoral partnerships), institutional strengthening at district level and local advocacy as effective strategies for health promotion (WHO). Conclusion Primary Health Care is necessary for imparting optimal health services to one and all in a country irrespective of social or economic status. The Government, in collaboration with various community services is able to do this. The primary role in Primary Health Care is that of a nurse who is the first level of contact to the patient. The nurse may even take up the role of a health visitor or that of a community health worker. The services provided by these community health organizations vary from general practice to target-services like child care, care of disabled, etc. There is actually further need for research especially in the field of self management, symptom management and care-giving and many organizations and nursing institutions are aiming at this. References Areas of research emphasis, National Institute of Nursing Research (NINR) http://www.ninr.nih.gov/NR/rdonlyres/F85C02CA-1EE3-40F7-BDA4-3901F2284E96/0/StrategicAreasofResearchEmphasis.pdf [Cited: 19 July 2007]. Cusack, L., Smith, M., and Byrnes, T., June 1997. Innovations in community health nursing: Examples from practice. International Journal of Nursing Practice, 3(2), pp.133-136. Declaration of Alma Ata, World Health organization, 1978 http://www.who.int/hpr/NPH/docs/declaration_almaata.pdf. [Cited: 19 July 2007] Eastern Access Community Health - EACH www.each.com.au [Cited 18 July 2007] Eastlynn (CROYDON) (SASI) www.sasi.org.au/www/10/1001127/displayarticle/1001366.html [Cited 18 July 2007] Haddad, L.G., and Umlauf, M.G., October 1998. Views of health promotion among primary health care nurses and midwives in Jordan. Health Care For Women International, 19(6), pp. 515-528. Johnson, P.A., Health Care 101: Womens Health www.brighamandwomens.org/ConnorsCenter/images/HealthCare101.pp [Cited 19 July 2007]. Maternal and Newborn Health, World Health Organization (WHO) http://www.who.int/reproductive-health/publications/RHR_03_11/rhr_03_11_chap2.en.html [Cited 19 July 2007]. Maroondah Addictions Recovery Project (MARP) www.marp.com.au [Cited 19 July 2007]. Ross, F. and Mackenzie, A., 1996. Nursing in Primary Health Care: Policy and Practice. London: Routledge. Smedley, B. D., and Syme, S. L., 2000. Promoting Health-Intervention Strategies from Social and Behavioral Research. National Academies Press. Quillan, J.P., n.d. Community Health Workers and Primary Health Care in Honduras. Journal of the American Academy of Nurse Practitioners, 5 (5) pp. 219–225. Villa Maria Aged & Community Services www.villamaria.com.au [Cited 18 July 2007] Willison, K. D., March 2005. Integrating Complementary and Alternative Medicine with Primary Health Care through Public Health to Improve Chronic Disease Management. Journal of Complementary and Integrative Medicine 2(1): Review articles Womens Health East. www.whe.org.au. [Cited: 18 July 2007] Read More