CONCEPT OF

PUBLIC HEALTH,
PRIMARY HEALTH CARE
Course Instructor : Dr. Nadira Sultana Kakoly (NSK)
Assistant Professor, Department of Public Health
School of Health and Life Sciences
North South University
Nadira.Kakoly@northsouth.edu
CONTENT

•Concept and objectives of Public Health

•History and Phases of Public Health
•Public Health functions, achievements and
challenges
•Primary Health care
PUBLIC HEALTH
Concept and Definition of Public Health

• Concept of health has changed from individual to world-wide social goal. As a result,
efforts have been made to improve the general status of people’s health

• Compared to the era before public health, death from contagious disease has decreased
a lot, people have improved health status with better nutrition, safer environment and
more knowledge about health
DEFINITION OF PUBLIC HEALTH

“The science and art of preventing

disease, prolonging life and
promoting health and efficiency
through organized community
efforts”
Winslow, 1920
John Snow and Public Health approaches
• Identification of the problem (What is the problem) - John Snow identified the
Cholera epidemic
• Identification of the cause (What is the reason) - John Snow identified the
source of infection
• Evaluation of intervention (What works) - Realized that the exposure needs to
stopped
• Implementation (How to do it) - He uprooted the tube-well
History of Public Health
John Snow and Broad Street
cholera outbreak in 1854
 PHASES OF PUBLIC HEALTH
Name of Phase Duration What started Efforts Result

Disease control 1880 – 1920 Increased death from Sanitary legislation and Death from
phase communicable disease, reforming communicable
unhealthy environment disease decrease

Health 1921 – 1960 Industrial age, poor Health programs and Improvement of
Promotion general health of people, initiatives (mostly taken by general health
phase decreased productivity state)

Social 1961 – 1980 Increased burden of non- Identify risk factors, Not yet achieved the
Engineering communicable disease change in social and targets
phase behavioral aspects
Health for All 1981 - 2000 Inequity in health Effort to reduce inequality Not yet achieved the
phase services and health status and achieve health for all targets
in low-income and high- through Primary health
income countries care
Public Health vs Clinical Medicine
Criteria Public Health Clinical Medicine

Through organized community Through interception of disease

How they do it
effort process

Coverage Entire community Patients

Emphasis Prevention Treatment

Who does it Public Health practitioner Medical professional

Public Health Problems Varies From Country To Country
USA
• Alcohol-related harms
• Healthcare-associated
infections
• Heart disease and stroke
• AIDS
• Obesity
• Prescription drug overdose
• Mental Health Issues
BANGLADESH
• Respiratory infections & Pneumonia
• Dengue
• Diarrhea and water-borne diseases
• Nutrition deficiency
• Maternal and child health
• Non-communicable disease
• Road safety
• Tuberculosis
• Mental Health Issues & Substance abuse
problems
• Neglected tropical disease
Public Health accomplishments and workforce
• Safe water and sanitation

• Vaccination

• Improved maternal and child health

• Family planning

• Infectious disease control

• Safer and healthier foods

• Safer roads and safer workplace

• Control of tobacco and other drugs

Three Core Functions of Public Health

• Systematically collect, analyze and make

Assessment available information on healthy communities

Assurance • Ensure provision of services to those in need

Policy • Promote the use of a scientific knowledge

Development base in policy and decision making
TEN
ESSENTIAL
PUBLIC
HEALTH
SERVICES
PRIMARY HEALTH CARE
Primary Health Care – History

In 1978, an international conference was held in Alma-Ata, Kazakhstan, where world

leaders endorsed “Health for All” to be achieved by 2000. The Conference stressed
the importance of community participation in the planning and implementation of
their health care. It also advocated the use of scientifically, socially and economically
sounds technologies. In order to attain these targets Primary Health Care (PHC)
was taken as the appropriate method
Primary Health Care – Definition

Essential health care based on practical, scientifically sound, and socially

acceptable methods and technology made universally accessible to individuals
and families in the community through their full participations 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
Importance and Characteristics of PHC

• Closer to the people, takes care of most • Evidence based

common health problems
• Affordable
• Approach - Preventative measures and
encouraging self-care recommendations • Accessible

• Primary health care also provide access to • Socially acceptable (to ensure
the secondary and tertiary health care community participation)
system (Referral)
Essential components of PHC
• Health education
• Immunization for preventable diseases
• Treatment of common infection
• Prevention and control of endemic disease
• Provision of essential drug
• Maternal and child health and Family Planning
• Adequate supply of safe water and basic sanitation
• Food supply and proper nutrition
Examples of PHC facilities in Bangladesh
► Community clinics

► Union health and family welfare

center, Union sub-centers

► Upazilla Health Complex

► UPHCP – PHC centers and mini-

clinics/satellite clinics
THANK YOU
Any QUESTION ?