Health care of the community

Dr Jayaramachandran SAssistant Professor

Dept. of Community MedicineMGMC & RI

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Recap Primary health care

Primary health care in India

Health care delivery

Health status & health problems

Health care of the community

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The student shall be able to

List the MDGs related to health and comment on it’s current status

Define Health for all

Enumerate the strategies for Health for all by 2000

Plan healthcare services

List the basic resources for providing health care

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Millennium Development Goals (MDGs)

MDGs

8 goals18

targets 48

indicators

Goal 1

Eradicate Poverty and hunger

Target 1 : Halve hunger, between 1990 and 2015, the proportion of people whose income is less than 1 dollar a day.

Target 2 :Halve between 1990 and 2015, the proportion of people who suffer from hunger.

Goal 1

• Prevalence of underweight children (under 5 years of age)

• Proportion of population below minimum level of dietary energy consumption.(3)

Indicators

Goal 2

Universal primary education

Target 3 : Ensure that, by 2015, children everywhere, boys and girls

alike, will be able to complete a full course of primary education.

Goal 3

Promote gender equality and empower women

Target 4 : Eliminate gender disparity in primary and secondary education, preferably by 2005, and to all levels of education no later than 2015.

Goal 4

Reduction of child mortality

Target 5 : Reduce under 5 mortality by two- third.

Indicators : – Under 5 mortality rate– Infant mortality rate % of 1 year old children immunized

against measles.

Goal 5

Improve maternal health

Target 6 : Reduce maternal mortality by three quarters.

Indicators : – Proportion of births attended by skilled health personnel – Maternal mortality ratio

Goal 6

Combat HIV/AIDS, malaria and other diseases

Target 7 : Have halted by 2015 and begun to reverse the spread of HIV/AIDS.

Indicators :– HIV prevalence among 15-24 year old pregnant women.– Condom use rate out of total prevalence of contraceptive

use rate.– Number of children orphaned by HIV/AIDS.

Goal 6

Target 8 : Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases.

Indicators : • Prevalence and death rates associated with malaria.• Proportion of population in malaria risk areas using effective

malaria prevention and treatment measures.• Prevalence and death rate associated with tuberculosis.• Proportion of tuberculosis cases detected and cured under

directly observed treatment short course.

Goal 7

Ensure environmental sustainability

Target 9 :Integrate the principles of sustainable development into country policies and programs and reverse the loss of environmental resources.

Target 10 :

Halve, by 2015,the proportion of people without sustainable access to safe drinking water and basic sanitation.

Goal 7

Improve sanitationIndicator

Proportion of urban population with access to improved sanitation.

Reverse loss of resources :Indicator

Proportion of population using solid(biomass and coal)fuels.

Goal 7

Target 11 :By 2020,to have achieved a significant improvement in the lives of at least 100 million slum dwellers.

Indicator:Proportion of population with sustainable access to an improved water source, urban and rural.

Goal 8

Development of a global partnership for development

Target 17 : In cooperation with pharmaceutical companies, provide

access to affordable, essential drugs in developing countries.

IndicatorProportion of population with access to affordable essential drugs on a sustainable basis.

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Health for all

• “Attainment of a level of health that will enable every individual to lead a socially and economically productive life”

• WHO – 30th WHA (1977)

• Alma – Ata conference (1978)

• Health for all (1981) – strategy by WHO

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Strategies for Health for all by 2000

• 12 indicators – WHO :eg – Min. life expectancy

• Report of the study group on “Health for all – an alternative strategy”

• Report of the working group on “Health for all by 2000 AD”

• National Health Policy (1983) – Govt. of India

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Goals to be achieved by 2000 AD

↓ IMR 125 (1978) to < 60

↑ expectation of life at birth from 52 to 64 years

↓ CRD from 14 /1000 to 9 / 1000 population

↓ CBR from 33 /1000 to 21/1000 population

NRR = 1

Provide portable water to entire rural population

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How health care service be?

8 A’s• Appropriateness• Availability • Adequacy• Accessibility• Acceptability• Affordability• Accessibility• Accountability

3 C’s• Completeness• Comprehensiveness• Continuity

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Resources ?

Health man power Money and material Time

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Any questions???

List the MDGs related to health and comment on it’s current status

Define Health for all

Enumerate the strategies for Health for all by 2000

List the basic resources for providing health care

How will you Plan healthcare services ?

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Next class on 04.03.2016 Indian Public Health Standards

Voluntary Health agencies in India

Health insurance