Elements Of Primary Health Care

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A process whereby knowledge, attitude, and practice of people are changed to improve individual, family, and community health. Basic health service and every member of the health team shares responsibility in providing health education. A means of improving the health of the people by employing various methods of scientific procedures to show the most healthful ways of living.

Consists of techniques that stimulate, arouse, and guide people to live healthfully.  Sum of activities in which health agencies engage to influence the thinking, motivation, judgment, and action of the people in the community. 

Creating awarenes  Motivation  Decision making action 

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Health education considers the health status of the people. 

Determined by the economic and social conscience of the country

 Health

education is learning

 Process

whereby people learn to improve their personal habits and attitudes and to work responsibly for the improvement of health, conditions in the family, community and nation.

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Health education involves motivation, experience and change in the conduct of thinking Stimulates an active interest in people  Develops and provides experiences for change in people’s attitudes, customs, and habits in relation to health and everyday living. 

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Health education should be recognized as a basic function of all health workers

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Health education takes place in the home, in the school, and the community 

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Learning about health results from a wide variety of contacts between members of the family, between pupils and teachers and mong the community members.

Health education is a cooperative effort 

Health education requires that all categories of health personnel work together in close teamwork with families, groups, and community.

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Health education meets the needs, interests, and problems of the people affected. 

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Health education is achieved by doing. 

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The expressed needs and interest of the people themselves are important motivating influences for intiating individual, family and community activities in solving health problems. It does not only mean understanding the different health facts, buth health education also finds means and ways of carrying out the plans. Obtains community and individual participation in the solution of health problems

Health education is a slow continuous process. 

It is a slow development, not a mushroom growth that evolves constant changes and revisions until onkectoves are achieved.

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Health education makes use of supplementary aids and devices. 

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Health education utilizes community resources 

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These education materials are aids to a cooperative health program and not as a program itslef. Helps verbal instructions It involves the careful evaluation of the different services and resources found in the community concerned with the total health and well being of the people. Both human and natural resources are utilized.

Health education is a creative process 

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There is no single pattern for solving community problems, since problem solving is essentially a creative work. Needs a method and technique different from others with a characteristic of its own. Does not follow a rigid and inflexible pattern.

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Health education helps people attain health through their own efforts. 

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It aims to help people make use of their own efforts and education in improving their conditions of living, lodging, good nutrition and prevention of diseases.

Health education makes careful evaluation of the planning, organization and implementation of all health education programs and activities. 

A long and continuous process like health education itself.

 Interviewing  Counseling  Lecture-discussion  Open

forum  Workshop  Case study  Role play  Symposium  Group work – buzz sessions  Community assembly

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Nominal group technique 

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This technique is a structured variation of small group discussion methods. The process prevents the domination of discussion by a single person, encourages the more passive group members to participate, and results in a set of prioritized solutions or recommendations.

Laboratory training Use of IEC (information, education, communication) materials as leaflets, brochures, comics, handouts, flyers

 Use

of publication  Use of audio-visual aids, bulletin boars, billboards, posters, streamers, radio, TV, overhead/slide projectors, multimedia presentation  Use of IEC support as fans, umbrellas, Tshirts, bookmarks, bags, hats, pens, stationaries, keychains, folder, kits

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Qualities of a Good Health Educator            

Knowledgeable/mastery of subject matter Credible Good listener Can emphatize with others Possess teaching skills Flexible Patience Creative and innovative Effective motivator Ability to rephrase/summarize Encourages group participation Good sense of humor.

 AKA

Bilhariasis; snail fever; swimmer’s itch; katayama fever  Agent: blood fluke  Schistosoma

japonicum – endemic in the

philippines  Schistosoma mansoni  Schistosoma haematobium  Infective stage  cercaria  Intermediate  Oncomelania

host:

quadrasi

 Endemic

in 10 regions, 24 provinces, 183 municipalities and 1,212 barangays  Prevalent in: Region 5 (bicol)  Region 8 (samar and leyte)  Region 11 (davao) 

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Mode of transmission: 

contact with contaminated fresh water

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Signs and symptoms: Diarrhea  Bloody stools  Enlargement of the abdomen  Splenomegaly  hepatomegally  Weakness  Anemia  Hepatitis  liver cirrhosis  ascites and jaundice 

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Diagnosis  Kato

Katz (circumovum precipitate) technique 

Stool exam to diagnose schistosomiasis

 Treatment  Praziquantel

(Biltricide)  drug of choice against all species

Methods of Control 

Preventive Measures: Educate the public in endemic areas regarding mode of transmission and methods of protection  Dispose of feces and rine so that viable eggs will not reach bodies of fresh water containing intermediate snail host.  Improve irrigation and agrigultural practices  reduce snail habitats  Treat snail-breeding sites with molluscicides 

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Prevent exposure to contaminated water Provide water for drinking, bathing and washing clothes from sources free from cercariae or treatment to kill them 

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Treat water with iodine or chlorine, or use paper filters or allow water to stand 48 – 72 hours before use

Treat patients in endemic areas to prevent disease progression and to reduce transmission Travelers visiting endemic areas should be advised of the risks and informed about preventive measures

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Control of Patient, Contacts and the Immediate environment 

Report to local health authority in selected endemic areas

 Investigation

of contacts and sources of infection (case finding and surveillance)  Motivate

people in endemic areas to have annual stool examination

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Chronic parasitic infection caused by a nematode parasites Endemic in Regions 5, 8, 11,CARAGA (region XIII), marinduque, sarangani provice Infectious agent: (nematode) Wuchereria brancrofti  Bruglia malayi  Bruglia timori 

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Young and adult Worms lives in the lymphatic vessels and lymph nodes while the microfilariae are usually found in blood

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MOT 

Person to person through bites from an infected female mosquito Aedes poecilius

 Incubation

period: 8 – 16 months

 1.

Signs and Symptoms Asymptomatic Stage      

Presence of microfilariae in the peripheral blood No clinical signs and symptoms Some remain asymptomatic for years and in some instances for life Other progress to acute and chronic stages Microfilariae rate increases with age and then levels off In most endemic areas including the Philippines, men have higher microfilariae rate than women

2. Acute Stage  Lymphadenitis 

Inflammation of the lymph nodes

 Lymphangitis  Inflammation

 In

of the lymph vessels

some cases, the male genitalia is affected leading to funiculitis, epidydimitis, or orchitis

3. Chronic Stage Develop 10 – 15 years from the onset of first attack  Hydrocoele 

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Swelling of the scrotum

 Lymphedema  Temporary

swelling of the upper and lower extremities

 Elephantiasis  Enlargement

nad thickening of the skin of the lower and/or upper extremities, scrotum, breast

 Diagnosis  Physical

examination  History taking  Observation of the major and minor signs and symptoms

 Laboratory  Nocturnal

Examinations

Blood Examination

 Blood

is taken from the patient at night (after 8:00 PM)

 Immunochromatrographic  Rapid

assessment method  Antigen test

Test

 Focus

on the compliance to the prescribed treatment regimen  DIETHYLCARBAMAZINE CITRATE (DEC) or HETRAZAN  Drug

of choice

 Side

effects

 Systemic  Due

to host inflammatory responses to parasites antigen liberated by the rapid death of the microfilariae

 Local  Induced

by death of the microfilaria

 Mass

Treatment

 Distribution

to all population  Dosage: 6 mg/kg body weight taken as a single dose per year

 Surgical

Treatment

 Lymphvenous

 SUPPORTIVE  Observe

anastomosis

CARE FOR FILARIASIS

personal hygeine to avoid superinfection

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PREVENTION AND CONTROL  Vector

control

 Environmental

sanitation  Spraying with insecticides  protect

infdividual and families in endemic areas  use

of mosquito nets  Use of long sleeves, long pants, socks  Application of insect repellants  Screeing of houses  Health education

 Also

known as Ague, black water fever  Produced by intraerythrocytic parasites of the genus Plasmodium  P.

falciparum  P. Vivax  P. Ovale  P. Malariae

 Factors

affectng severity of the disease

 Infecting  P.

species

Falciparum is the most fatal Most common  Found in the Philippines 

 P.

Vivax Second most common  Widely distributed 

 P.

Malariae 

 P.

Third most common

Ovale 

rare

 Magnitude

of parasitemia  Metabolic effects of the parasite  Mode

of Transmission

 Person

to Person through the bite of female Anopheles Mosquito

 Incubation

period: 10 days – 4 weeks

 Diagnosis  Clinical

Method

 Based

on the signs and symptoms of the patient plus a history of his/her having visited a malaria endemic area  Pattern of Disease (cycle is every 48 – 72 hours) Cold Stage  chills  Hot Stage  fever  Wet State  diaphoresis 

 Microscopic

Method (Malarial Smear)

 Examination

of blood semar of the patient  Specimen is taken when patient has fever

 Chemoprophylaxis  Given

to persons going to malaria endemic

area  Chloroquine  chemoprophylaxis

drug of choice  Taken at weekly intervals starting from 1 – 2 weeks before travelling  Given throughout pregnancy

 Prevention B

and Control

– Biological Method

 On-stream

I

clearing

– Insecticides  Treatment

insecticide

C

of mosquito nets/curtains with

– Case Findings  E – Environmental Sanitation and health education  P – Personal Prevention

 Personal

Prevention

 Wearing

of clothing that covers arms and legs in the evening  Avoid outdoor night activities (vector’s peak hours: 9 PM – 3 AM)

C – Chemical Method  L – Larvae eating Fish  E – Environmental Sanitation  A – antimosquito soap (Basisl Cetronella)  N – Neem Trees 

 Blood

Schizonticides

 Drugs

acting on sexual blood stages of the paraside which are responsible for clinical manifestations  Chloroquine  Sufadoxine  Quinine  Tetracycline  quinidine