Posted at 11.03.2018
Keywords: control of endemic diseases, locally endemic diseases
Worldwide, countries are facing various general public health issues but at unequal level. Low and middle-income countries are definitely more experiencing high burden of disease than developed countries (Lopez et al. , 2006).
Public health issues in the world have been around for hundreds of years and to manage them different interventions from differing people have been put in place and also have been improved as time passes depending after new health-related discoveries.
In September 1978, World Health Organisation in collaboration with all the US Children's Account organised the famous International Convention on Primary Professional medical in Alma-Ata, ex - Soviet Union, where 3000 delegates from various nationwide governments and international bodies convened to find new means of dealing with open public health setbacks. This seminar was a landmark in the promotion of society health round the world given the intro of the theme of "Health for many" with the slogan "Health for All by the entire year 2000" (Wooding, Nagaddya & Nakaggwa, 2012).
In the Declaration issued at the end of the seminar, Primary Medical was defined as "essential healthcare based on practical, scientifically sensible and socially suitable methods and technology made universally accessible to individuals and people locally through their full participation and at cost that the city and country are able to keep at every level of the development in the nature of self-reliance and self-determination" (World Health Organisation, 1978).
In this article, with relevant samples, the explicit so this means of this definition will be discussed. Later on, spaces and lessons attracted from the conceptualisation and execution of Primary Healthcare in Rwanda will be recognized. Finally, the relevance of Major Medical care in the Rwandan health system will be evaluated.
The classification of primary healthcare, as it was granted in the Alma-Ata Meeting Declaration, was standard and needed some precisions and common understanding to avoid any misinterpretation.
To fully grasp the explicit so this means of primary medical, as was identified by the planet Health Company, it worth, first of all, to break it into basic terms:
A. 1. Primary medical care as essential and appropriate activities for promoting the fitness of the population
Primary health care is a set of activities targeted at promoting the health status of the populace. Through these activities, prevailing health issues that the community suffer are dealt with properly by providing promotive, preventive, curative and rehabilitative services (World Health Organisation, 1978).
World Health Company (1978) says that the essential services that most important health care would provide were : education on prevailing diseases and the ways of preventing and controlling them; promotion of food resource and proper nutrition; maternal and child healthcare including family planning; sufficient supply of safe water and basic sanitation; immunisation against major infectious diseases; prevention and control of local endemic diseases, appropriate treatment of common diseases and injury; and provision of essential drugs. These services were likely to vary according to the country and community provided their economical and social aspects that they reveal and that they evolve and health system had the social responsibility to avail essential medical care to all (World Health Organisation, 1978).
A. 1. 1. Education on prevailing diseases and the techniques of stopping and managing them
This component of primary healthcare seeks to support personal and community interpersonal development by informing them through education for health. The advancement with their life skills contributes to behaviour change at specific or collective level to be able to tackle health problems prevailing in their community. Also, this activity makes people aware of other factors that determine their overall health like environmental factors, lifestyle and genetics. As a result, people are empowered to possess informed options to possess control over their own health and over those factors identifying their health position.
Various ways are being used ranging from media tools to simple text messages transmitted to individuals or to the community regarding the strategies to fight against common diseases in their neighborhoods (Wooding, Nagaddya & Nakaggwa, 2012). Further, health educational materials can be developed, provided in the universities by those working in education sector to be integrated in health system.
To illustrate this activity locally, the strategies regarding the protection of malaria should include the training on what's malaria, its triggers, signs and symptoms of the disease, treatment and precautionary measures in place.
A. 1. 2. Promotion of food supply and proper nutrition
The Campaign of food source and proper nourishment in the young families and locally generally is a cornerstone in struggling with against ill-health. Under diet and micronutrients deficiencies typically in women in reproductive era and children generally contribute to a global burden of disease (Caulfield & al. , 2006).
A. 1. 3. Maternal and child health including family planning
Maternal and child morbidity and mortality rates, mostly in resource limited countries, remain high and much more action is required to tackle this general population ailment. Women and children's fatalities are related to the complexities which in many cases are preventable and avoidable through collaboration of various stakeholders (Wooding, Nagaddya & Nakaggwa, 2012).
A. 1. 4. Adequate supply of safe normal water and better sanitation
This component of primary healthcare means that population has not only usage of safe and clean drinking water but also to completely clean environment. The role of polluted drinking water and environment in dispersing diseases is known. The supply of safe and sufficient normal water, sanitation and removal of liquid and solid waste play an integral role protecting against diseases transmission (Howard et al. , 2002).
A. 1. 5. Immunisation program against major diseases
Immunisation against major diseases takes on an integral role in avoiding serious contagious diseases largely in children like Tuberculosis, measles, tetanus, whooping cough, etc. Women in reproductive age are also vaccinated for Tetanus.
A. 1. 6. Reduction and control of local endemic diseases
Some persisting diseases in a community contribute to the burden of disease and are due to the increasing morbidity and mortality in many countries. Regular screening and appropriate treatment of these diseases done by skilled medical care workforce with appropriate health technology are key to the control of these (Wooding, Nagaddya & Nakaggwa, 2012).
A. 1. 7. Appropriate treatment of common diseases and injuries
This component of primary healthcare handles the treating common diseases and traumas that associates of the city suffer. These diseases include common infectious diseases that prevails in the community, skin lesions anticipated to injuries, attacks or other disease conditions that influence the skin all of which contribute to the burden of disease.
A. 1. 8. Provision of essential drugs
The provision of essential drugs contributes greatly in effective management of common pathological conditions locally. They are associated with an maximum importance in protecting against and dealing with diseases which have a greater effect on lives of a huge number of people throughout the world. "Essential drugs save lives and improve health" (Balkan et al. , 2013).
To achieve its ultimate goal, "which is way better health for everyone", primary medical should be evidence-guided. Major healthcare practice must be predicated on scientifically-proved methods, techniques, accessories and drugs (World Health Company, 1978).
To avert health issues, various methods, techniques, machines and drugs are being used in prevention, medical diagnosis, treatment of diseases and patient rehabilitation after the disease in cared for. Collection of health technology to be used hasn't to be only based on technological evidences but also on its affordability and acceptability in the context of local value, culture and notion (World Health Company, 2011). For instance, primary medical providers should use those healthcare systems that enable clients to have access to high quality, safe and cost-effective healthcare.
All associates of the city should equally and universally get access to health services no matter their social economic standing, religion, making love, age, race, vocabulary or geographic location also to ensure that it's effectively achieved, the idea of equity should be taken under consideration.
The option of health services itself is not the confidence that the primary healthcare would be successful. There are other components to be resolved to ensure that health services made universally accessible are appropriately used by all associates of the city. World Health Organisation (1978) suggested that states federal government should use available resources effectively by increasing the cash allocated for health insurance and firstly giving top priority to the extension of primary professional medical to disadvantaged neighborhoods.
Countries should ensure that all obstacles including social monetary barriers are properly tackled by reducing exclusion and sociable monetary disparities to help those in need to have access to health services.
The participation of neighborhoods in primary medical care care activities sorts an integral part in the health system. Central level should take into consideration the role of neighborhoods that play in key professional medical activities planning process. To achieve this, communities need to be enabled to understand their role, especially in major medical care strategies and in the development process at community level in general, by giving with them the information and the necessary information that they don't have at their level. Once community users grasp the part they play in the national primary health care strategy and in the entire development process at community level, then they have the ability to give their contribution in the formulation of major healthcare programs by examining themselves the health problems that they face in their community, placing priorities, adjusting nationwide answers to their local communities and organising themselves and put in place support and control mechanisms (World Health Organisation, 1978). Also, the potency of primary healthcare depends on the use of means that are affordable and appropriate by both the community and the united states.
The need of participation of other health system components and other industries that donate to general country's communal monetary development is of paramount importance in the execution of primary medical care programs as "health can't be attained by the health sector only" (World Health Organisation, 1978). The linkage between principal healthcare and other sectors in the framework of community development requires a coordinated effort in planning process at the city level. The joined work from various community development stakeholders ends in sort of collaboration which has a greater impact on primary medical.
As an illustration of the above, malnutrition reduction program in less than five should involve community members, health care employees, and agricultural employee as they might have the key information that can help in planning process. Additionally, community associates can actively participate in the execution of some the different parts of the program jointly with other development initiatives from other communal economic development sectors.
The implementation of primary medical care in Rwanda has proved very effective lately. Despite the four years of civil battle and genocide that kept several million of folks dead, a large number of hundreds displaced and health system totally collapsed, Rwanda has made amazing progress in improving the health status of its population (Rodriguez & Samuels, 2011).
The above amazing progress is imputable to various factors including ambitious political will that mostly played out in key. Health sector reforms which included community medical health insurance often called "mutuelle de sant" and an improvement of health services done by giving the incentives to healthcare staff through performance-based funding schemes have also been a cornerstone in the accomplishments of such results. Furthermore, strong leadership, strong health guidelines together with participation of community health personnel in participatory decentralisation and effective coordination of donations from health and development lovers have been implemental in implementation of primary healthcare strategies.
Primary medical care conceptualisation and execution, in Rwanda circumstance, offers great lessons to be learnt for future primary medical initiatives either in Rwanda itself or in other places on the globe generally in resources-limited countries.
Rodriguez and Samuels (2011) highlighted that putting in place a solid control and accountability mechanisms by any means levels, involvement and creation of possession of health services seekers, cooperation of all stakeholders in planning process backed by evidence-based guidelines are more likely to help in achieving the desired benefits of primary medical as it has been shown for Rwanda's experience.
In spite of the above mentioned remarkable achievements that Rwanda has manufactured in implementation of most important healthcare, there continues to be chasm to be addressed.