LECTURE 1:

CONCEPT OF HEALTH ,PUBLIC HEALTH AND PRIMARY

HEALTH CARE (PHC)
PBH101
SPRING 2018

Instructor :Dr .Shakina Sultana

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 Health
■ The World Health Organization (WHO) defined health in its
constitution as

“Health is a state of complete physical, mental and social well-

being and not merely the absence of disease or infirmity”.

■ WHO adopted this definition by the International Health Conference,

New York, 1946; Entered into force on 7 April 1948.

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Health is a fundamental human right
■ According to WHO (1946) “…the highest attainable standard of health
as a fundamental right of every human being.”

Understanding health as a human right creates a legal obligation on states,

 to ensure access to timely, acceptable, and affordable health care of
appropriate quality

 as well as to providing for the underlying determinants of health,

such as safe water, sanitation, food, housing, health-related
information and education, and gender equality.
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Dimension of health

■ Major Dimensions of Health

– Physical dimension
– Mental Dimension
– Social Dimension

■ Minor Dimensions of Health

– Spiritual Dimension
– Emotional Dimension
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 Dimension of health(cont.)
Physical dimension‘ the ability to maintain a healthy quality of
life that allows us to get through our daily activities without physical
stress.’ example:

 Good appetite

 Sound sleep

 Smooth, easy and coordinated movement

 All the special senses are intact

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Dimension of health(cont.)
Criteria of a mentally healthy person:
 Positive attitudes toward the self.

 Development—including utilization of abilities,

future orientation, concern with work, and so on.

 Able to resistance to stress and frustration.

 Autonomy, as in self-determination, independent behavior.

 A true perception of reality.

 Environmental adaptation and adjustment, and the capacity to solve problems

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 Dimension of health(cont.)
 Social dimension is the ability to relate to and connect with other people in
our world.

 Our ability to establish and maintain positive relationships

with family, friends and co-workers contributes to our Social Wellness.

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 Dimension of health(cont.)
■ Emotional Dimension: is the ability to understand ourselves and cope
with the challenges life can bring.

 The ability to acknowledge and share feelings of anger, fear, sadness or

stress; hope, love, joy and happiness in a productive manner contributes to
our Emotional Wellness

■ Spiritual Dimension: is the ability to establish peace and harmony in

our lives
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PUBLIC HEALTH

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 In 1920, Charles-Edward Amory Winslow
defined Public Health as

■ “The science and art of preventing disease, prolonging life and promoting
health and efficiency through organized community effort for the
sanitation of the environment, the control of communicable infections, the
education of the individual in personal hygiene, the organization of medical
and nursing services for the early diagnosis and preventive treatment of
disease, and for the development of the social machinery to insure everyone
a standard of living adequate for the maintenance of health, so organizing
these benefits as to enable every citizen to realize his birthright of health and
longevity.“(Soosaar ,2007)

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Historical Development
Rise of modern Public Health:
■ Originated from England’s industrial revolution, generated by mass migration of rural
workers living standards amongst the working population began to worsen, with cramped
and unsanitary urban conditions.

■ Edwin Chadwick's report on The Sanitary Condition of the Labouring Population was
published in 1842. which led to Public Health Act,1848.

■ Reforms included
I. latrinization,
II. building of sewers,
III. regular collection of garbage followed by disposal in a landfill,
IV. provision of clean water
V. draining of standing water to prevent the breeding of mosquitoes. 11
 Historical Development:
Rise of modern Public Health:

■ British doctor John Snow 's identification of a polluted public water well as the
source of an 1854 Cholera outbreak in London. Snow's study was a major event in
the history of public health.
■ With the pioneering work in bacteriology of French chemist Louis Pasteur, and
German scientist Robert Koch, vaccines were invented for remedy at the turn of the
20th century
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 Historical Development

French epidemiologist Paul-louis Simond proved

that plague was carried by fleas on the back of rats.
A child bitten by a flea infected with the Yersinia
pestis bacterium. has caused the bite to become ulcerated

As the prevalence of infectious diseases decreased through the 20th century, public health
began to put more focus on chronic diseases such as cancer and heart disease

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 Role of public health
■ To prevent and manage diseases, injuries and other health conditions
■ To promotion of healthy behavior towards communities and environment.
■ To prevent health problems from re-occurring by:

 Implementing educational programs ,

 Developing policies
 Conducting research.

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Public Health organizations and professionals
Public health plays an important role in disease prevention efforts in both the
developing world and in developed countries, through local health systems
and non –governmental organizations(NGO) .

 Modern public health practice requires multidisciplinary teams of public

health workers and professionals, includes :
Epidemiologists, Biostatisticians, Public health nurses, Midwives and
Environment health officers etc.

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Primary Healthcare (PHC)

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 Primary healthcare (PHC)
■ PHC refers to "essential health care " that is based on "scientifically sound and socially acceptable
methods and technology, which make universal health care accessible to all individuals and families in
a community. It is 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-reliance and self-
determination”

■ This ideal model of healthcare was adopted in the declaration of the International Conference on
Primary Health Care held in Alma Ata, Kazakhstan in 1978 (known as the “Alma Ata Declaration "),
and became a core concept of the World Health Organization's goal of Health for all.

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 Essential Elements of Primary Health Care
(PHC):
There are 8 elements of primary-health care (PHC). That listed below-
 E– Education concerning health problems and the methods of identifying, preventing and
controlling them.

 L– Locally endemic disease prevention and control.

example :African sleeping sickness

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Essential Elements of Primary Health
Care (PHC):
 E– Expanded programme of immunization against major infectious diseases.

 M– Maternal and child health care including family planning.

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Essential Elements of Primary Health
Care (PHC):
 T– Treatment of communicable and non-communicable disease and promotion of
mental health.

 E– Essential drugs arrangement.

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Essential Elements of Primary Health
Care (PHC):
 N– Nutritional food supplement, an adequate supply of safe and basic nutrition.

 S– Safe water and sanitation

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 Home Assignment:

■ What is world health report ? Brief discussion on this .

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Thank you

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