How to Design & Implement

preventative health care programmes

This website is for those working in health care in developing countries and on emergency health intervention projects. The focus is on preventative health care. This website is for hands-on information only and is strictly for practical application of PHC skills. The information on this site is from my book
“How to Design and Implement Effective Sustainable Preventative Health Care Programmes”.     

  ABOUT PRIMARY HEALTH CARE   

Over time, the term “Primary Health Care” has become very confusing. A study by Haggerty et al.(2007) revealed 25 operational definitions of Primary  Health Care … “but there appears to be some consensus that primary care is the first level of contact of individuals and families with the national health system, bringing health care as close as possible to where people live and work.”  David Morley, Emeritus Professor of Child Health, UK 

Information on this site is based upon the 1978 Alma Ata Declaration and the World Health Organization’s 1999 definition of Public Health.

Alma Ata Declaration 1977
Part VI
 
“Primary health care is 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 participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination. It forms an integral part both of the country's health system, of which it is the central function and main focus, and of the overall social and economic development of the community. It is the first level of contact of individuals, the family and community with the national health system bringing health care as close as possible to where people live and work, and constitutes the first element of a continuing health care process.”

To download full article click link to local file Almaata Declaration en.pdf 

Public Health WHO 1999

“The science and art of preventing disease, prolonging life, and promoting health and efficiency through organized community efforts”  

Progress of Alma Ata 

Access to basic health services was affirmed as a fundamental human right by the Declaration of Alma-Ata in 1978. The reality is that, in 2002, more than 30 years later, many people in resource-poor settings still do not have equitable access to even basic services. In many places this gap is widening.

Almost as soon as the Alma-Ata Conference was over,  PHC was under attack. Politicians and aid experts from developed countries could not accept the core PHC principle that communities in developing countries would have responsibility for planning and implementing their own healthcare services. A new concept of “Selective Primary Health Care” (SPHC)11 advocated providing only PHC interventions that contributed most to reducing child (< 5 years) mortality in developing countries. The advocates of SPHC argued that comprehensive PHC was too idealistic, expensive and unachievable in its goals of achieving total population coverage. By focusing on growth monitoring,  oral rehydration solutions, breastfeeding and immunisation, greater gains in reducing infant mortality rates could be achieved at reduced cost. 

In effect, SPHC took the decision-making power and control central to PHC away from the communities and delivered it to foreign consultants with technical expertise in these specific areas. These technical experts, often employed by the funding agencies, were subject to the policies of their agencies, not the communities. SPHC reintroduced vertical programs at the cost of comprehensive PHC. John J Hall and Richard Taylor  MJA (Medical Journal of Australia)  Vol 178 6 January 2003

To download full article click link to local file The demise of the Alma-Ata Declaration .pdf 

The Aim of this website

  1. To bring the focus of health care back to the people’s entry to the national health system - the Health Centres.   
    Primary Health Care is the first level of contact of individuals, the family and community with the national health system…. constitutes the first element of a continuing health care process. (Alma Ata Declaration VI)

  2. Provide the Health Centre staff with sufficient knowledge and skills to allow for the prevention of illness and for early intervention where necessary.   
    Primary health care relies, at local and referral levels, on health workers, including physicians, nurses, midwives, auxiliaries and community workers as applicable, as well as traditional practitioners as needed, suitably trained socially and technically to work as a health team and to respond to the expressed health needs of the community. (Alma Ata Declaration VII:7)   

  3. Provide practical information on preventative health care to both national staff and aid workers.

Targeted Audience

For the Aid Workers - what did you want or need to know before taking an assignment on a health project?

For the National/IDP/Refugee Staff – what do you want to know in order to keep the people in your communities healthy? (Note: Camps and emergency- generated settlements are communities).    

Write in your questions, problems or solutions. They will be responded to and added, if relevant, to the site for others who may have the same problem. Email leonamcayzer@yahoo.com.au

  COMPONENTS OF PREVENTATIVE HEALTHCARE

   HEALTH SURVEILLANCE OF VULNERABLE GROUPS

Under Five Clinic
PROGRAMME OBJECTIVE
The Under 5 Clinic is designed to:
• Ensure the child is growing well
• Ensure the child is adequately nourished and immunized
• Provide an opportunity for early intervention if the child is ill or not thriving
• Increase the mother’s knowledge and skills in childcare

View Under 5 Clinic Index v-vii
Prenatal Clinic
PROGRAMME OBJECTIVE

The Prenatal Clinic is designed to: 
• To improve the health and outcomes of pregnant women.

View Prenatal Clinic Index vii-viii
Elders & Chronics
PROGRAMME OBJECTIVE

The Elders and Chronics Clinic is designed to:
• To maintain/improve the health and quality of life for the
elderly and those with chronic illness or incapacity.   

View Elders and Chronics Index viii-ix

EDUCATION

As with other programmes, all Health Education Programmes are based upon:

Education

View Education Index iv

About Leona Cayzer

Book Download/Order

"This book has come about from my experiences in both national and international health programmes.

I have been most fortunate in the sequence of my experiences which began with working in the isolated aboriginal communities in Northern Canada with Medical Services Branch of Health and Welfare Canada, now known as First Nations and Inuit Health. Through this work I learned of the organized and effective community preventative health care programmes.

My first two international positions were an integrated rural development project and a project for children with polio. The Project Director was the same for both projects. His was a social view – poverty is the root cause of ill-health. At the field level he emphasized the need of women’s literacy, income generation and community participation.

As a result of these first experiences I have developed an intense interest in preventative health
care in developing countries and recognized the absolute need for education of the health
workers, including the TBAs (and, if possible, the Medicine Man), and the community residents."  
- Leona Cayzer

Write in your questions, problems or solutions. They will be responded to and added, if
relevant, to the site for others who may have the same problem.
Email leonamcayzer@yahoo.com.au 

More about Leona Cayzer »