Subject:- Community

Health Nursing

Topic:- HEALTH PROMOTION AND

PRIMARY HEALTH CARE
PRESENTED BY,
MR. KAILASH NAGAR
ASSIST. PROF.
DEPT. OF COMMUNITY HEALTH NSG.
DINSHA PATEL COLLEGE OF NURSING, NADIAD
 HEALTH PROMOTION
INTRODUCTION:
 A t the beginning of the 20th century, a
new concept, the concept of health
promotion began to take shape. It was
realized that public health had neglected
the citizen as an individual and that state
had a direct responsibility for the health of
the individual.
 INTRODUCTION
CONTT……
 Consequently in addition to disease
control activities, one more goal was
added to public health. I.e. health
promotion of the individual.
 DEFINITION:

 Health promotion is the process of

enabling people to increase control
over and to improve health.” It is
not directed against any particular
disease, but is intended to
strengthen the host through a variety
of approaches (interventions).
 GOALS OF HEALTH
PROMOTION
 T o create environments that allow
all the ability to access all needed
services.
 To equip with the skills to determine
their own health needs.
STRATEGIES OF HEALTH
PROMOTION
1.Building healthy public policy
 Development of smoke free spaces
2. Creating supportive environment
3. Strengthening community Action
 Encouragement to initiate community
groups
 STRATEGIES OF HEALTH
PROMOTION CONTT……
4. Developing personal skills
 HIV/AIDS, Malaria, TB, MCH
5. Reorienting health services
 Reforming of the health sector to
incorporate a department focusing on
adolescent health
 INTERVENTIONS HEALTH
AREA IN
PROMOTION:
 1. Health education
2 . Environmental
modifications
 3 . Nutritional interventions
 4 . Lifestyle and behavioral
changes
 HEALTH
EDUCATION

 This is one of the most cost-effective

interventions. A large number of
diseases could be prevented with little
or no medical intervention if people
were adequately informed about them
and if they were encouraged to take
necessary precautions in time.
 HEALTH EDUCATION
CONTT……
 The targets of educational efforts may
include the general public, patients,
priority groups, health providers,
community leaders and decision-makers.
 ENVIRONMENTAL
MODIFICATION

A comprehensive approach
to health promotion
requires environmental
modifications, such as
provision of safe water;
installation of sanitary
latrines; control of insects
and rodents; improvement
 ENVIRONMENTAL
MODIFICATION
 The history of medicine has shown that
many infectious diseases have been
successfully controlled in many
countries through environmental
modifications.
 NUTRITIONAL INTERVENTIONS
 These comprise food distribution
and nutritional improvement of
vulnerable groups: child feeding
programmes,food fortification;
nutritional education,etc.
 LIFE STYLE AND
BEHAVIOURAL
CHANGES
 The conventional public health
measures or interventions have not
been successful in making in roads
into lifestyle reforms. The action of
prevention in this case, is one of
individual and community
responsibility for health.
 LIFE STYLE AND
BEHAVIOURAL
CHANGES
 Health education is a basic element of all
health activity. It is of paramount
importance in changing the views,
behavior and habits of people.
PRIMARY HEALTH
CARE
 INTRODUCTION:

 Wi t h increasing recognition of the

failure of existing health services to
provide health care, alternative ideas and
methods to provide health care have been
considered and tried. The concept of
primary health care came into limelight in
1978 following an international
conference in Alma-Ata, USSR
 DEFINITION:

Primary health care is the essential health

care
made universally accessible to
individuals and acceptable to them,
through their full
participation and at a cost the
community and the country can afford.
 PURPOSES
 Increase in life expectation.
 Improvement in nutritional
status.
 Provision of basic sanitation.
 Development of manpower and
other resources.
 CARE:

 The Alma-Ata conference outlined 8

essential components of primary health
care.
 Education concerning prevailing health
problems and the methods of preventing and
controlling them.
 Promotion of food supply and proper nutrition
 A n adequate supply of safe water and basic
sanitation.
 Maternal and child health care, including
family planning.
 Immunization against major infectious
diseases.
 Prevention and control of locally
endemic diseases.
 Appropriate treatment of common
diseases and injuries.
 Provision of essential drugs.
CARE:

EQUITABLE DISTRIBUTION:
 The first key principle in the primary
health care strategy is equity or equitable
distribution of health services.
 EQUITABLE DISTRIBUTION
CONTT……
 Health services must be shared equally by
all people irrespective of their ability to
pay, and all must have access to health
services.
 A t present health services are mainly
concentrated in the major towns and cities
resulting in inequality of care to the people in
rural areas.
 EQUITABLE
DISTRIBUTION:
CONTT……
 The worst hit are the poor and the needy
and vulnerable groups of the population in
rural areas and urban slums. This has
been termed as social injustice.
 The failure to reach the majority of the
people is due to inaccessibility.
 EQUITABLE
DISTRIBUTION:
CONTT……
 Primary health care aims to redress this
imbalance by shifting the centre of gravity
of the health care system from cities to the
rural areas and bring these services as near
people’s homes as possible.
 COMMUNITY
PARTICIPATION:
•  The overall responsibility of the central and
state governments, the involvement of
individuals, families, and communities in
promotion of their own health and welfare, is an
essential ingredient of primary health care..
 COMMUNITY
CONTT……
PARTICIPATION

 Countries are now conscious of the fact that

the universal coverage by primary health care
cannot be achieved without the involvement
of the local community
 CONTT……
COMMUNITY PARTICIPATION
 There must be a continuous effort to secure
meaningful involvement of the community in
the planning, implementation and maintenance
of health services, besides maximum reliance
on local resources such as manpower, money
and materials .In short, primary health care
must be built on the principle of community
participation (or involvement).
 CONTT……
COMMUNITY PARTICIPATION
 One approach that has been tried successfully
in India is the use of village health guides and
trained dais.
They are selected by the local community and
trained locally in the delivery of primary health
care to the community they belong, free of
charge .By overcoming cultural and
communication barriers, they provide primary
health care in ways that are acceptable to the
community.
 There is an increasing realization of the fact
that the components of primary health care
INTER SECTORAL
cannot be provided by the health sector alone.
COORDINATION:
 INTER SECTORAL
COORDINATION
CONT…
The declaration of Alma-Ata states, primary
health care involves in addition to the health
sector, all related sectors and aspects of
national and community development,in
particular agriculture, animal husbandry, food,
industry, education,
housing, public works,
communication and other
sectors”
 INTER SECTORAL
COORDINATION
CONTT……
 This requires strong political will to
translate values into action, an important
element in intersectoral approach is
planning –planning with other sectors to
avoid unnecessary duplication of
activities.
 APPROPRIATE TECHNOLOGY:
 Appropriate technology has been defined
as “technology that is scientifically
sound, adaptable to local needs, and
acceptable to those who apply it and for
those for whom it is used, and that can be
maintained by the people themselves in
keeping with the principle of self reliance
with the resources the community and the
country can afford”
 APPROPRIATE
TECHNOLOGY
CONTT……
 The term appropriate is emphasized
because in some countries, large luxurious
hospitals that are totally in appropriate to
the local needs are built, which absorb a
major part of the national health budget,
effectively blocking any improvement in
general health services.
APPROPRIATE
TECHNOLOGY
CONTT……
 This also applies to use of costly
equipment, procedures and techniques
when cheaper, scientifically valid and
acceptable ones are available, viz, oral
rehydration fluid.
 ROLE OF NURSES IN
PRIMARY HEALTH
CARE

 Assessing the health status of

individuals and communities.
 Health Education
 Food Supply And Proper Nutrition
 Water supply and basic sanitation.
 Maternal and Child Health Care including
Family Planning.
 ROLE OF NURSES IN
PRIMARY HEALTH CARE
CONTT……
 Immunization
 Treatments of Minor
ailments.
 Mobilizing
community
involvement.
 Providing integrated health
care including the
treatment of
emergencies and making
referrals.
 RESEARCH STUDY
 Nur se delivered lifestyle interventions in primary health care
to treat chronic disease risk factors associated with obesity: a
systematic review.
 Sargent GM, Forrest LE, Parker RM.
Abstract
 Nurses in primary health care (PHC) provide an increasing
proportion of chronic disease management and preventive
lifestyle advice. The databases MEDLINE, CINAHL,
EMBASE and PsychINFO were searched and the articles were
systematically reviewed for articles describing controlled adult
lifestyle intervention studies delivered by a PHC nurse, in a
PHC setting. (i) no difference of effect when the same
intervention was delivered by a PHC nurse compared to other
health professionals in PHC
 RESEARCH STUDY
(ii)the provision of counselling delivered by a PHC
nurse was more effective than health screening
(iii)counselling based on behaviour change theory
was more effective than the same dose of non-
behavioural counselling when at least three
counselling sessions were delivered
The evidence supports the effectiveness of
lifestyle interventions delivered by nurses in PHC
to affect positive changes on outcomes
associated with the prevention of chronic disease
including: weight, blood pressure, cholesterol,
dietary and physical activity behaviours, patient
satisfaction, readiness for change and quality of