Primary Health Care Model of Integrated Health Care

Primary Health Care Model of Integrated Health Care

The Parable of the LIONS!!

Interpretation of the Parable! • Curative: Meeting the immediate need – Treating people after they get sick • Preventive: Protection – Treating people before they get sick – Prevent entrance of pathogen into body • Promotive: Eliminates the problem – Keep people from getting sick – Eliminate the disease from the community

Comparing the three approaches • Curative • Fill cavities Preventive Brush teeth • Tx diarrhea Boil water • Tx Malaria Mosquito nets Promotive Improve diet Protect water source Kill mosquitoes

Comparing the Models Curative Expense: Income: Felt need: Comm action: Health improved: 4+ 6+ 5+ 0 1+ Prevention 2+ 1+ 2+ 2+ 3+ Promotive 1+ 0 1+ 5+ 5+

Summarizing the Models • Curative – Responds rapidly to felt needs – Effects soon levels off since nothing is done to stop the transmission of disease. • Preventive – Requires more time before producing health improvement (people must change habits) – Offers protection from disease-also levels off

Summerizing-cont’d • Promotive – Requires longest time for health improvement – Community involvement is essential – Must reach people where they live & work. – The only recourse for permanent health improvement in the community.

Integrated Approach • Combines advantages of all models – Meeting the felt needs with curative model – Protecting the community with preventive methods. – Improving the health standards with the promotive aspects. • Ex: Intestinal worms: – Treat seriously ill & all affected: Curative – Teach personal hygiene-hand washing: Prevention – Build & use latrines : Promotion

Why do we have Good health in the U. S. A. • Is it all of our high technology? • Is it the number of highly qualified health professional? • Is it the high-powered antibiotics & vaccines that we have available? • Is it the “state-of-the-art” hospitals? • All of the above • None of the above

The REAL reasons!! • • • A pure water supply A proper sewage disposal system Good environmental sanitation Improved nutrition Control of communicable diseases Better education for the public

Primary Health Care defined • Primary health care is essential h. c. based on practical, scientifically sound & socially acceptable methods & technology, made universally accessible to indiv & families in the community thru full participation & at a cost the community & country can afford to maintain at every stage of development in the spirit of self-reliance & selfdetermination.

Some Prinicples of PHC: • • Available Acceptable Accessible Appropriate

Healthy People 2020 • Process of setting national (USA) health priorities & goals, tracking progress, & evaluating accomplishment of goals for 10 year periods. • Focus – health promotion & disease prevention. • Began in 1979

Healthy People 2020 • Over-arching goals: • Increase the quality & years of healthy life • Eliminating health disparities • Promoting quality of life, healthy development, & healthy behaviors across life stages • Creating social & physical environments that promote good health

Healthy People 2020 Leading Health Indictors • • • Physical activity Tobacco use Responsible sexual behavior Injury and violence Immunization Overweight and obesity Substance abuse Mental health Environmental qualtiy Access to health care

Millennium Development goals: 1. 2. 3. 4. 5. 6. 7. 8. Eradicate extreme poverty & hunger Achieve universal primary education Promote gender equality & empower women Reduce child mortality rates Improve maternal health Combat HIV/AIDS, Malaria, TB …. Ensure environmental sustainability Develop a global partnership for development

Meanwhile in Nations of the South (2/3 of the world!) • Things are going from “bad to worse”! – No public health system in place – Have neither money nor organization to mobilize health services for community. – Increasing population overloads the system – The “tyranny of the urgent” cycle-hi mortality but lack of services (cure centered system) – The “Disease re-cycling Center”!

Great Commission-a relay race • A math quiz! Would you rather have… – A $1, 000/day x 1 mo or a penny a day doubled each day for 30 days? • Penny a day-day #15= $163. 84 • “ -day #20= $5, 242. 88 • “ -day #30= $5, 368, 709. 12 • Multiplication works better than addition. • Carrying out the great commission isn’t just up to us & it isn’t about us-it’s about God!

Rationale for the PHC approach • Major barriers to H. C. in the Nations of the South: – Economic: “Diseases of Poverty” – Political: Corrupt gov & greedy dictators – Social: How people treat one another – Cultural: Beliefs affect the whole of life – Educational: High illiteracy rates – Population constraints: Over pop- big problem – Natural disasters & wars – A nation without God

“A Nation Without God” • God repeated instructed and warned Israel to be faithful in following His covenant: – Exodus 19: 5 -6 a – Deuteronomy 4: 5 -9 – Deuteronomy 6: 1 -25 • In The New Covenant we are told how much greater it is than the First covenant: – Book to the Hebrews

“A Nation Without God” • The New Covenant is superior to the First covenant: – Hebrews 1 - Jesus greater than angels – Hebrews 3 – Jesus greater than Moses – Hebrews 4, 5, 7 – Jesus is superior high priest – Hebrews 9 – Worship is superior – Hebrews 10 – Jesus sacrifice superior

“A Nation Without God” • Deuteronomy 7: 6 & 14: 2: “You are a holy nation. The LORD your God has set you apart for himself. He has chosen you to be his special treasure. He chose you out of all of the nations on the face of the earth to be his people. ” • 1 Peter 2: 9: “But God chose you to be his people. You are royal priests. You are a holy nation. You are a people who belong to God. All of this is so that you can sing his praises. He brought you out of darkness into his wonderful light. ”

“A Nation Without God” • I Peter 3: 10 -12: “Whoever would love life and see good days must keep his tongue from evil and his lips from deceitful speech. “He must turn from evil and do good; he must seek peace and pursue it. “For the eyes of the Lord are on the righteous and his ears are attentive to their prayer, but the face of the Lord is against those who do evil”

“A Nation Without God” • Proverbs 14: 34: “Righteousness exalts a nation, but sin is a disgrace to any people. ”

Medicine & Health Choosing the best approach • Western medicine: biomedical model A – Separation of the physical & the spiritual – We cure disease- a “sickness” model – We repair the wounds inflicted by the “lions” but fail to drive these “lions” from the forest. Physical Spiritual

Medicine & Health Choosing the best approach • Holism (Wholism) The model in the Nations of the South: – Life “all in a piece”(person affects the whole) – Health is a community affair. – So what do latrines have to do with disease? Physical Spiritual Social

Holism (Wholism) Model Physical Holism Spiritual Psycho/Social

Biblical View of Health Physical Social Psychological Spiritual

An African View of Health • Quotes from a Ghanaian church leader – “Africans make no distinction between religion & medicine. Most Africans see health as equal to correct relationships - between people… including the natural & supernatural. ” – “Concept of health - far more social than biological. ” – “The tribal concept of health as a function of community. ”

Failing to meet the goal! • Despite investment of billions & great effort by tens of thousands, we still live in a world – increasing global medical crisis – dehumanizing poverty – collapsing ecological systems – stressed social systems • The health care system must be a part of the society & culture of the people we serve.

What have we learned? • The injustice of hi-tech health care for the few & none for the majority of the poor. • Western model often creates dependency. • Health isn’t achieved just by curing disease • The #1 cause of illness & death is poverty. • Health isn’t a package, it’s a process. • People with very little training can solve a majority of the world’s health problems.

A Possible Solution! • Primary Health Care: the training of village health workers is a possible solution to the dilemma that faces the people in the 3 rd world. – There will never be enough highly trained health professionals to care for the masses. – Successful PHC is an “inside job”: Solutions must be put into the hands of the local people.

Implications for the future • The role of the nonprofessional – Promoting health without “formal” training – Anyone can mix ORS • Holistic health care – We don’t treat “diseases” we treat people – Include the spiritual as well as the physical – Health is more than a “medical” matter.

Modeling the Great Physician! • Focus on Health – Prevention rather than simply treatment – Work toward health promotion • Health & Evangelism – Modeling Christ as the “Great Physician” – Demonstrating God’s love to a needy, suffering world.

Conclusion! Health & Evangelism. • The two functions of medical missions: – – To demonstrate God’s love to a needy, suffering world. To help extend Jesus to this suffering world & grow His body. • What is ultimately the most important is how the Christian health worker reflects Jesus Christ. • The fascinating story of medical missions is still being written. The times are changing. So are the characters, the settings, the methods and the opportunities. Yet the plot remains constant: the church through medical missions can serve the needy while making disciples in every nation. • The task is far from over, won’t YOU be a part?

Haitian Floods

Haiti Earthquake January 2010

Poteau Church of Christ Gonaives, Haiti • You are invited to view David Smith's photo album: 1 -25 -2011 - Nan Pol Baptisms Six elders and minister performing great mission work; true vocational missionaries