II.

Community Health and Development Concepts, Principles and Strategies

 Primary Health Care Approach
o Primary health care (PHC)
 Addresses the majority of a person's health needs throughout their lifetime.
This includes physical, mental and social well-being and it is people-centered
rather than disease-centered.
 PHC is a whole-of-society approach that includes health promotion, disease
prevention, treatment, rehabilitation and palliative care.
o Definition
 Primary health care is essential health care made universally accessible to
individuals and acceptable to them, through their full participation and at a cost
that the community and country can afford
 Levels of Care
o Primary Health Care
o Secondary Health Care
o Tertiary Health Care
 Components of Primary Health Care
o Public Education
 Public education is the first, and one of the most essential, component of
primary health care.
 By educating the public on the prevention and control of health problems, and
encouraging participation, the World Health Organization works to keep disease
from spreading on a personal level
o Proper Nutrition
 Nutrition is another essential component of health care. WHO works to prevent
malnutrition and starvation and to prevent many diseases and afflictions.
o Clean Water and Sanitation
 A supply of clean, safe drinking water, and basic sanitation measures regarding
trash, sewage and water cleanliness can significantly improve the health of a
population, reducing and even eliminating many preventable diseases.
o Maternal & Child Health Care
 Ensuring comprehensive and adequate health care to children and to mothers,
both expecting and otherwise, is another essential element of primary health
care. By caring for those who are at the greatest risk of health problems, WHO
helps future generations have a chance to thrive and contribute to globally.
Sometimes, care for these individuals involves adequate counselling on family
planning and safe sex.
o Immunization
 By administering global immunizations, WHO works to wipe out major
infectious diseases, greatly improving overall health globally.
o Local Disease Control
  Prevention and control of local diseases is critical to promoting primary health
care in a population. Many diseases vary based on location. Taking these
diseases into account and initiating measures to prevent them are key factors in
efforts to reduce infection rates.
o Drug Provision
 By providing essential drugs to those who need them, such as antibiotics to
those with infections, caregivers can help prevent disease from escalating. This
makes the community safer, as there is less chance for diseases to be passed
along.
o Accessible Treatment
 Another important component of primary health care is access to appropriate
medical care for the treatment of diseases and injuries.
 By treating disease and injury right away, caregivers can help avoid
complications and the expense of later, more extensive, medical treatment.
 LEGAL BASES OF PHC lN THE PHILLIPINES.
o October 19, 1979 - Letter of instruction (LOI) 949, the legal basis of PHI: was signed by
Pres. Ferdinand E. Marcos, which adopted PHc as an approach towards the design,
development and implementation of programs focusing on health development at
community level.
 Health Promotion
o Health promotion is the process of enabling people to increase control over, and to
improve their health. Health Promotion Glossary, 1998
 Concept of Health Promotion (as embodied in the Ottawa Charter, November 1986)
o The Ottawa Charter for Health Promotion
 The first international Conference on Health Promotion, meeting in Ottawa this
21st day of November 1986, hereby presents this “CHARTER for action to
achieve Health for All by the year 2000 and beyond.”
 Strategies for promoting Health- What strategies help to promote the health of individuals?
o Health promotion approaches and strategies
 Health promotion is aimed at improving the health of an individual or
community or changing behaviour that may have a negative influence on health.
Health promotion approaches and strategies range from individually focused
interventions (such as posters providing positive health messages) through to
the Development of a national health promoting policy (such as the National
Mental Health Strategy).
o Health Promotion Strategies
 1. Build healthy public policy
 2. Create supportive environments
 3. Strengthen community action
 4. Develop personal skills
 5. Reorient health services
 Examples of Theories/Models of Health Promotion: Fender, Bandura, Green
o Health Belief Model
 Focus on individual beliefs about health conditions, which predict individual
health-related behaviors. The model defines the key factors that influence
health behaviors as an:
 1) individual’s perceived threat to sickness or disease (perceived
susceptibility),
 2) belief of consequence (perceived severity),
 3) potential positive benefits of action (perceived benefits) perceived
borders to action,
 4) exposure to factors that prompt action (cues to action), and
confidence In ability to succeed (self-efficacy).
o Pender’s Model
 Focuses on three areas:
 1) individual characteristics and experiences,
 2) behaviour-specific cognitions and affect, and behavioural outcomes.
 The theory notes that each person has unique personal characteristics and
experiences that affect subsequent actions.
o Albert Bandura’s Social Cognitive Theory
 it is a learning theory based on the ideas that people learn by watching what
others do, and that human thought processes are central to understanding
personality.
 The Nurse-Client Relationship in the care of the individual and family in the community setting.
o The nurse-client relationship is an interaction between a nurse and "client" (patient).
o Aimed : Enhancing the well-being of the client, who may be an individual, a family, a
group, or a community.
 Summary: Community health promotion illustrates the empowerment of individual People so
that they can participate on their own health promotion.