Community Health

A main social target of governments, international organizations and the whole world community in the coming decades should be the attainment by all peoples of the world by the year 2000 of a level of health that will permit them to lead a socially and economically productive life. Primary health care is the key to attaining this target as part of development in the spirit of social justice. This declaration was not attained because of HIV and AIDS pandemic which emerged during 1990s. This compromised health systems and every sector was affected and this generally affected our economy. World Health Organization (1978) “Primary Health Care is an essential health care; based on practical, scientifically sound, and socially acceptable method and technology; universally accessible to all in the community through their full participation; at an affordable cost; and geared toward self-reliance and self-determination.

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Some fifty years after WHO defined primary health care, we have yet to fully integrate the vision into practice; thus, to work with or optimize primary health care as defined by the World Health Organization and mitigate or alleviate sub-optimal application of the principles is to understand that a coordinated approach to this complex, multi-faceted, inter-sectorial priority for transforming the health care system can only by explored through an interdisciplinary approach that engages all of the stakeholders in the process (individuals, communities, health care practitioners, decision-makers and policy makers).

Primary Health Care has 5 principles which helps the flow of the department, these principles there are the same worldwide they do not change. So the writer wants to examine those five principles of PHC in relation to Zimbabwean situation. Below are the principles of Primary Health Care; Equitable or Accessibility distribution. This means primary health care should be universally available healthcare delivery regardless of geographic location, and equal distribution. This is for first and most important key to PHC.

Healthcare services must be equally shared by all the people the community irrespective of their race, gender or economic status. This concept helps to shift the accessibility of healthcare from the cities to the rural areas where the most needy and vulnerable groups of the population live. If we go to the rural areas like now we will find that there are no adequate health facilities, there are just clinics owned by district councils that are located so far away from most houses and it will be difficult to get there.

At the clinics there are no adequate resources for all medical requirements compared to the situation in towns where there is a wide range of medical services. Health practitioners there are many trained but they do not want to be deployed in the rural areas because of differences in lifestyles and they prefer going and work outside the country. So there is no equal distribution of primary health care services though people in the rural mostly believe in cultural practices in the healing of diseases or maybe they are still stuck to those practices because the modern approach is not easily accessible for them.

The problem is, this principle is politically sensitive usually people with power who have the least needs wish to allocate resources to themselves. Community/ public participation, It encourages the community to participate in making decisions about their own health, identifying their own health needs and finding solutions to their health problems. Health concerns everyone and everyone has the right and duty to decide about their own lives. Health services is brought accessible for everyone and every person has a right to health facilities but it is up to the person to make a decision whether to utilize the resource or not.

That is why a patient is asked to sign a consent form before an operation, this is a real demonstration that health issues are not dictated on people but it is by choice. Another example is that, in the communities we live there are different people with different cultures and beliefs, for instance people in other apostolic sects which does not go to hospital they will not utilize the resource. Community participation also includes meaningful involvement of the community in planning, implementing and maintaining their health services.

Through the involvement of the community, maximum utilization of local resources, such as manpower, money and materials, can be utilized to fulfill the goals of PHC. Community participate by joining in free discussion of a new venture and in the subsequent decision making. If people are herded by cattle without community involvement it will create a disease of donor dependence which is so difficult to cure. Preventive/ Promotive Approach, involves health promotion which includes all the important issues of health education, nutrition, sanitation, maternal and hild health, and prevention and control of endemic diseases. Through health promotion individuals and families build an understanding of the determinants of health and develop skills to improve and maintain their health and wellbeing. Primary health care will be targeting at health and wellness and expanding opportunities for early identification of risk and prevention of illness. For example, introducing Anti-Retroviral Art to an HIV positive mother to save life and promoting good health for the child we relate this with a saying that says ‘A stitch in time saves nine’.

The focus of PHC is on determining the social and environmental context within which health problems occur, identifying risk and seeking ways to overcome barriers to achieving health. Primary health-care approach supports client empowerment and self-care capacity. Appropriate Technology, it emphasizes on those technologies that are scientifically sound, cost-effective and feasible to be introduced into the community. They are supposed to be adaptable to local needs, and acceptable to those who apply it and for whom it is used.

Technology can refer to the structure and delivery of health services, human resources, medical equipment, pharmaceutical agents or new interventions and techniques. There is a need to ensure that interventions and technologies used in health care are proven to be effective and affordable. Health technology assessment can provide decision-makers with scientific evidence about the technology and the benefit to the patient, or help them determine that the technology would be of benefit, but no more than one that is less expensive.

For example, the Ottawa Ankle Guidelines indicate that for the emergency treatment of ankle injuries, an x-ray is needed only in certain situations (Keogh, Shafi, & Wijetunge, 1998, pp. 341-343). Multisectoral approach / inter-sectorial collaboration. This emphasizes integrated work with other sectors, such as the Ministry of Agriculture and the Ministries of Education, Housing and Water Resources. To be able to improve the health of local people the PHC programme does not stand alone, but also involves other sectors.

For instance, for someone to have good health is supposed to have enough food with proper nutritional value, and other people earn a living from agriculture which will improve the standards of living. Another example, is of housing and water resources will be responsible for allocation of residential stands with proper water and sanitation systems. If we look back in the 20th century during The Public health Phase they observed that things like contaminated food and water and air as well as unsanitary living conditions could promote or reduce the onset and spread of communicable diseases and prevention of diseases is one of PHC principles.

Employment of majority helped that the standards to improve starting from the way they live, the food because of people had employment which helped to make a living In conclusion, Primary health care focuses on individual and community strengths and opportunities for change; maximizes the involvement of the community; includes all relevant sectors but avoids duplication of services; and uses only health technologies that are accessible, acceptable, affordable and appropriate.

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