This essay will discuss the principles of primary health care and its applicability in in Australian Indigenous communities. First it will discuss how and where primary Health Care came about. Secondly, this essay will talk about the social determinants of health and its principles, and the importance of community development and its principles. Finally it will discuss its relevance in Indigenous communities.
The international movement to implement health service delivery that encompassed health promotion strategies. (S Couzos et al 2003) Strategies that examined food supply and nutritional and environmental factors in disease control, and provided for essential drugs and preventative intervention in addition to the delivery of primary medical care as defined by the World Health Organisation(WHO) conference in Alma Ata in 1978 and its subsequent declaration for primary health care.
"The International Conference on Primary Health Care was convened in Alma-Ata, Kazakhstan, in 1978, and was attended by virtually all the member nations of the World Health Organization (WHO) and UNICEF. The Alma-Ata Declaration of 1978 emerged as a major milestone of the twentieth century in the field of public health, and it identified primary health care (PHC) as the key to the attainment of the goal of Health for All (HFA)."
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"Alma-Ata Declaration." Encyclopaedia of Public Health. Ed. Lester Breslow. Gale Cengage, 2002. 26 April 2010 2:30 PM
The following definition was developed by the Australian Primary Health Care Research Institute (APHCRI).
"Primary health care is socially appropriate, universally accessible, scientifically sound, first level care provided by health services and systems with a suitably trained workforce comprised of multidisciplinary teams supported by integrated referral systems in a way that: gives priority to those in need and addresses health inequalities; maximises community and individual self reliance, participation and control; and involves collaboration and partnership with other sectors to promote public health. Comprehensive primary health care includes health promotion, illness prevention, treatment and care of the sick, community development, and advocacy and rehabilitation." (Primary Health Care Readings 2010)
According to Services for Australian Rural and Remote Allied Health - SARRAH, the principles of primary health care are as follows - equity, health promotion, working in teams, collaborating with others, working across the continuum of care, population health
Approach, social determinants of health and consumer and community participation.
(Primary Health Care Readings 2010)
As an idealistic approach to health and health care, primary health care is characterised by an holistic understanding of health as wellbeing, rather than the absence of disease.
Health promotion has been defined by the world health Organisation's 2005 Bangkok Charter for Health Promotion in a Globalize World as
"the process of enabling people to increase control over their health and its determinants, and thereby improve their health". Wikipedia, Health promotion, http://en.wikipedia.org/wiki/Health promotion as of Apr. 26, 2010, 14:03 GMT.
As stated in Social Determinants of Health: The Solid Facts (WHO, 2003):
"Health policy was once thought to be about little more than the provision and funding of medical care: the social determinants of health were discussed only among academics. This is now changing. While medical care can prolong survival and improve prognosis after some serious diseases, more important for the health of the population as a whole are the social and economic conditions that make people ill and in need of medical care in the first place.
Nevertheless, universal access to medical care is clearly one of the social determinants of health." Wikipedia contributors. "Social determinants of health." Wikipedia, The Free Encyclopaedia. Wikipedia, The Free Encyclopaedia, 12 Apr. 2010. Web. 26 Apr. 2010.
The social determinants of health are income and social status, education, health literacy, healthy living conditions, racism, discrimination and culture, early life factors and genetics, lifestyle factors and access to health care. The presence of good health is dependent upon several determinants; health services are important, but equally important is access to housing, education, employment, communication and other services.
Community development principles, according to the Melbourne based Association of Neighbourhood Houses and Learning Centres (ANHLC) is as follows, community participation, community ownership, empowerment, lifelong learning, inclusion, access and equity, social action, advocacy, networking and self help. The health status of communities is both a function of and a reflection of development in those communities. The importance of community control is crucial in Primary Health Care; health services should reflect local needs and involve communities and individuals at all levels of planning and provision of services. Training, development and curriculum design should be based on community needs and priorities. Attitudes, knowledge and skills developed on promoting prevention, intervention healing and rehabilitative health care.
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Community participation and awareness, through education building and consciousness raising on health and health-related issues.
Care needs to be provided in the holistic context by culturally appropriately trained Aboriginal health professionals. This involves technology and working in collaboration with other agencies and services. This involves treatment of prevention of illnesses and management of chronic disease, provision of medication, rehabilitative services, maternal and child health, anti natal and postnatal care, counselling, environmental health and community support services such as school health, transport, advocacy and interesting services which, should me made accessible to communities or as close as possible to where they live. It should encompass prevention, intervention, health promotion, education to encourage participation and access to information, resources and services. The leads to empowerment, self reliance and self determination and development of knowledgeable communities. This is Primary Health Care.