HEALTH, HEALTH FOR ALL AND

PRIMARY HEALTH CARE

World Health Organization

Regional Office for the Eastern Mediterranean

Community Based Initiatives - Training Manual. Module 2, Unit 2.1 1

 Learning objectives

To give better understanding of:

▪ Concept of health, its dimensions and
determinants
▪ Concepts of health for all and primary health
care
▪ Community health system
▪ Roles of different stakeholders for health.

Community Based Initiatives - Training Manual. Module 2, Unit 2.1 2

 Expected outcome

Participants will:
▪ Understand concept of health and community
based health approaches
▪ Be able to implement multisectoral
interventions for achieving improved health
outcomes.

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 Health

A state of complete physical, mental and

social well-being and not merely the
absence of disease or infirmity
World Health Organization, 1947

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 Health
(Continue ….)

Health has holistic view

▪ Being a multidimensional process, involves
well-being of a person as a whole in relation to
social, political and environmental influences
▪ Focus on living state and equates with
productive and creative life
▪ Links with broader issues of human
development where it plays a vital role in
cohesion, progress, prosperity and
development of a society
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 Health
(Continue ….)

Significance
▪ Fundamental human right.
▪ Worldwide social goal.
▪ Central to QOL and human development.
▪ Essence of a productive life
▪ Intersectoral issue
▪ Integral part of the socioeconomic system

Community Based Initiatives - Training Manual. Module 2, Unit 2.1 6

 Health
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Dimensions

Physical Mental Social

Community Based Initiatives - Training Manual. Module 2, Unit 2.1 7

 Health
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Dimensions:
Physical Social
 Harmony with
▪ Functioning of body
▪ Ability to do daily tasks society
 Involvement with
Mental society
 Social skills
▪ Balance with surroundings
▪ Self- esteem
▪ Know problems and goals
▪ Self control
▪ Faces problems
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 Health
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Determinants

Internal External

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 Health
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Internal determinants
Biological & cognitive
▪ Hereditary factors (Race, sex, age)
▪ Genetic (Diabetes, breast cancer)

Psychological & spiritual

Life stress and anxiety causes mental disorders,
hypertension, heart attack, gastric ulcer

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 Health
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External determinants
▪ Environmental (climate, shelter, air, water )
▪ Socioeconomic (livelihood means)
▪ Occupation (working conditions and insurance )
▪ Welfare services (social support networks )
▪ Food & nutrition (balanced diet, food hygiene )
▪ Culture (traditions, values and beliefs )
▪ Education (illiteracy)

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 Health for all (HFA)

Attainment by all peoples of the

world… of a level of health that can
permit them to lead a socially and
economically productive life
30th World Health Assembly, 1977
--------------------------------------------------------------------
HFA is equity in access to health services
& socio-economic opportunities.
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 Health for all
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HFA could not be achieved due to:

▪ Weak community role,
▪▪ Poor intersect oral actions
Top down approach

▪ Neglecting human development

HFA can be achieved through:
▪ Totality of human needs and Integration
development
▪ Reorienting/ restructuring health care services
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 Primary Health Care

Essential health care based on practical,

scientifically sound and socially acceptable
methods and technology made universally
accessible to individuals and families …
through their full participation and at a cost
the community and country can afford to
maintain at every stage of their
development in the spirit of self-reliance
and self-determination.
WHO 1978
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 Primary Health Care
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Principles
▪ Equity and accessibility
▪ Acceptable technologies
▪ Nation wide coverage and affordable
▪ Self reliance
▪ Cost effective methodologies
▪ Intersectoral coordination
▪ Community participation
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 Primary Health Care
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Components
▪ Health education/prevention of diseases
▪ Food supply and nutrition
▪ Safe drinking water and sanitation
▪ Maternal and child health, family planning
▪ Immunization
▪ Prevention/control of endemic diseases
▪ Treatment of common disease/injuries
▪ Provision of essential drugs
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 Primary Health Care
(Continue ….)

Community health care system

▪ Primary health facility accessible to all
▪ Linking community with health facility
▪ Health promotion/activist groups
▪ Community organizations
▪ Intersect oral coordination
▪ Community involvement in
 Realizing needs/priorities
 Implementation and management

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 Right and responsibilities for
health (Continue ….)

Right for health

Everyone has the right to a standard of living
adequate for the health and well-being of himself
and his family."
Universal declaration of human rights, 1948
----------------------------------------------------------------------------------
Health is one of the fundamental rights of every
human being to enjoy the highest attainable
standard of health.
WHO constitution

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 Right and responsibilities for
health (Continue ….)

Responsibilities for health

▪ Health not a commodity or product that can be
provided, obtained or purchased
▪ Health is outcome of many interrelated actions
undertaken by:
 Individuals
 Families

 Community

 Sate (country)

 International organizations.

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 Right and responsibilities for
health (Continue ….)

Individual responsibilities
▪ Personal hygiene, Healthy habits & HLS
▪ Disease prevention measures
▪ Periodic medical examination
▪ Early reporting for sickness & treatment
▪ Preventing spread of disease
▪ Safe water, healthy food/breast feeding
▪ Improving housing and environment
▪ Family planning
▪ Precautionary measures for risk factors
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 Right and responsibilities for
health (Continue ….)

Community responsibilities
▪ Strengthen local health systems
▪ Utilize and monitor health services
▪ Develop community health workers
▪ Improve sanitation and environment
▪ Restrict factors of ill health
▪ Promote HLS, breastfeeding & family planning
▪ Food safety, adequate water
▪ Health promotion & protection
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 Right and responsibilities for
health (Continue ….)

State responsibilities
▪ Need-oriented policies and strategies
▪ Plan services, seeking partners, mobilize
resources and implement programs
▪ Establish equipped health faculties
▪ Health education, awareness and HRD
▪ Identify health problems and their control
▪ Poverty reduction and QOL
▪ Exchange experiences and collaboration

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 Right and responsibilities for
health (Continue ….)

International responsibilities
▪ Exchange of experiences
▪ Human resources development
▪ Facilitate technical cooperation among
developing countries and agencies
▪ Disseminate information
▪ Financial support & material assistance
▪ Developing models/feasible solutions
▪ Building partnerships and linkages.

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