Primary health care   

This article is about an approach to providing universal health care. For the sector of the health care system, see Primary care.  

Public ambulatory care facility in Maracay, Venezuela, providing ambulatory care sensitive conditions for adequate primary health care.

Primary health care, often abbreviated as "PHC", has been defined as "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 the country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination".^[1] In other words, PHC is an approach to health beyond the traditional health care system that focuses on health equity-producing social policy.^[2][3]
This ideal model of health care was adopted in the declaration of the International Conference on Primary Health Care held in Alma Ata in 1978 (known as the "Alma Ata Declaration"), and became a core concept of the World Health Organization's goal of Health for all.^[4] The Alma-Ata Conference mobilized a "Primary Health Care movement" of professionals and institutions, governments and civil society organizations, researchers and grassroots organizations that undertook to tackle the "politically, socially and economically unacceptable" health inequalities in all countries.

History of medicine

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All human societies have medical beliefs that provide explanations for birth, death, and disease. Throughout history, illness has been attributed to witchcraft, demons, astral influence, or the will of the gods. These ideas still retain some power, with faith healing and shrines still used in some places, although the rise of scientific medicine over the past millennium has altered or replaced mysticism in most cases.
The ancient Egyptians had a system of medicine that was very advanced for its time and influenced later medical traditions. The Egyptians and Babylonians both introduced the concepts of diagnosis, prognosis, and medical examination. The Hippocratic Oath, still taken by doctors today, was written in Greece in the 5th century BCE. In the medieval era, surgical practices inherited from the ancient masters were improved and then systematized in Rogerius's The Practice of Surgery. During the Renaissance, understanding of anatomy improved, and the invention of the microscope would later lead to the germ theory of disease. These advancements, along with developments in chemistry, genetics, and lab technology (such as the x-ray) led to modern medicine.

Health care provider

A health care provider is an individual or an institution that provides preventive, curative, promotional or rehabilitative health care services in a systematic way to individuals, families or communities.
An individual health care provider (also known as a health worker) may be a health care professional within medicine, nursing, or a field of allied health. Health care providers may also be a public/community health professional. Institutions (also known as health facilities) include hospitals, clinics, primary care centres, and other service delivery points. The practice of health professionals and operation of health care institutions is typically regulated by national or state/provincial authorities through appropriate regulatory bodies for purposes of quality assurance.^[1] Together, they form part of an overall health care system.

Health system

A health system, also sometimes referred to as health care system or healthcare system is the organization of people, institutions, and resources to deliver health care services to meet the health needs of target populations.
There is a wide variety of health systems around the world, with as many histories and organizational structures as there are nations. In some countries, health system planning is distributed among market participants. In others, there is a concerted effort among governments, trade unions, charities, religious, or other co-ordinated bodies to deliver planned health care services targeted to the populations they serve. However, health care planning has been described as often evolutionary rather than revolutionary.^[1][2]

Health human resources

Health human resources (“HHR”) — also known as “human resources for health” (“HRH”) or “health workforce” — is defined as “all people engaged in actions whose primary intent is to enhance health”, according to the World Health Organization's World Health Report 2006.^[1] Human resources for health are identified as one of the core building blocks of a health system.^[2] They include physicians, nurses, midwives, dentists, allied health professions, community health workers, social health workers and other health care providers, as well as health management and support personnel – those who may not deliver services directly but are essential to effective health system functioning, including health services managers, medical records and health information technicians, health economists, health supply chain managers, medical secretaries, and others.
The field of HRH deals with issues such as planning, development, performance, management, retention, information, and research on human resources for the health care sector. In recent years, raising awareness of the critical role of HRH in strengthening health system performance and improving population health outcomes has placed the health workforce high on the global health agenda.^[3]

Health education

Health education is the profession of educating people about health.^[1] Areas within this profession encompass environmental health, physical health, social health, emotional health, intellectual health, and spiritual health.^[2] It can be defined as the principle by which individuals and groups of people learn to behave in a manner conducive to the promotion, maintenance, or restoration of health. However, as there are multiple definitions of health, there are also multiple definitions of health education. The Joint Committee on Health Education and Promotion Terminology of 2001 defined Health Education as "any combination of planned learning experiences based on sound theories that provide individuals, groups, and communities the opportunity to acquire information and the skills needed to make quality health decisions." ^[3] The World Health Organization defined Health Education as "compris[ing] [of] consciously constructed opportunities for learning involving some form of communication designed to improve health literacy, including improving knowledge, and developing life skills which are conducive to individual and community health." ^[4]

Health policy

Health policy

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This article is about policies, plans and strategies across the health care sector. For specific information on health insurance policies, see health insurance.

Health policy can be defined as the "decisions, plans, and actions that are undertaken to achieve specific health care goals within a society."^[1] According to the World Health Organization, an explicit health policy can achieve several things: it defines a vision for the future; it outlines priorities and the expected roles of different groups; and it builds consensus and informs people.^[1]
There are many categories of health policies, including personal health care policy, pharmaceutical policy, and policies related to public health such as vaccination policy, tobacco control policy or breastfeeding promotion policy. They may cover topics of financing and delivery of health care, access to care, quality of care, and health equity.^[2]
There are also many topics in the politics and evidence that can influence the decision of a government, private sector business or other group to adopt a specific policy. Evidence-based policy relies on the use of science and rigorous studies such as randomized controlled trials to identify programs and practices capable of improving policy relevant outcomes. Most political debates surround personal health care policies, especially those that seek to reform health care delivery, and can typically be categorized as either philosophical or economic. Philosophical debates center around questions about individual rights, ethics and government authority, while economic topics include how to maximize the efficiency of health care delivery and minimize costs.
The modern concept of health care involves access to medical professionals from various fields as well as medical technology, such as medications and surgical equipments. It also involves access to the latest information and evidence from research, including medical research and health services research.
In many countries it is left to the individual to gain access to health care goods and services by paying for them directly as out-of-pocket expenses, and to private sector players in the medical and pharmaceutical industries to develop research. Planning and production of health human resources is distributed among labour market participants.
Other countries have an explicit policy to ensure and support access for all of its citizens, to fund health research, and to plan for adequate numbers, distribution and quality of health workers to meet health care goals. Many governments around the world have established universal health care, which takes the burden of health care expenses off of private businesses or individuals through pooling of financial risk. There are a variety of arguments for and against universal health care and related health policies. Health care is an important part of health systems and therefore it often accounts for one of the largest areas of spending for both governments and individuals all over the world. For example, medical debt is now a leading cause of personal bankruptcy in the United States.^[3][4]

Health insurance

Health insurance is insurance against the risk of incurring medical expenses among individuals. By estimating the overall risk of health care expenses among a targeted group, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is available to pay for the health care benefits specified in the insurance agreement. The benefit is administered by a central organization such as a government agency, private business, or not-for-profit entity.^[1]

Environmental protection

Environmental protection is a practice of protecting the environment, on individual, organizational or governmental levels, for the benefit of the natural environment and (or) humans. Due to the pressures of population and technology, the biophysical environment is being degraded, sometimes permanently. This has been recognized, and governments have begun placing restraints on activities that caused environmental degradation. Since the 1960s, activism by the environmental movement has created awareness of the various environmental issues. There is not a full agreement on the extent of the environmental impact of human activity, and protection measures are occasionally criticized.
Academic institutions now offer courses, such as environmental studies, environmental management and environmental engineering, that study the history and methods of environmental protection. Protection of the environment is needed from various human activities. Waste, pollution, loss of biodiversity and the introduction of invasive species are some of the issues relating to environmental

Healthy community

Healthy community design is planning and designing communities that make it easier for people to live healthy lives. Healthy community design offers important benefits:

• Decreases dependence on the automobile by building homes, businesses, schools, churches and parks closer to each other so that people can more easily walk or bike between them.
• Provides opportunities for people to be physically active and socially engaged as part of their daily routine, improving the physical and mental health of its citizens.
• Allows persons, if they choose, to age in place and remain all their lives in a community that reflects their changing lifestyles and changing physical capabilities.

Health

Health is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person‘s mind, body and spirit, usually meaning to be free from illness, injury or pain (as in “good health” or “healthy”).^[1] The World Health Organization (WHO) defined health in its broader sense in 1946 as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”^[2][3] Although this definition has been subject to controversy, in particular as having a lack of operational value and the problem created by use of the word “complete”, it remains the most enduring.^[4][5] Classification systems such as the WHO Family of International Classifications, including the International Classification of Functioning, Disability and Health (ICF) and the International Classification of Diseases (ICD), are commonly used to define and measure the components of health.
The maintenance and promotion of health is achieved through different combination of physical, mental, and social well-being, together sometimes referred to as the “health triangle”.^[6][7] The WHO’s 1986 Ottawa Charter for Health Promotion furthered that health is not just a state, but also “a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities.”^[8]
Systematic activities to prevent or cure health problems and promote good health in humans are delivered by health care providers. Applications with regard to animal health are covered by the veterinary sciences. The term “healthy” is also widely used in the context of many types of non-living organizations and their impacts for the benefit of humans, such as in the sense of healthy communities, healthy cities or healthy environments. In addition to health care interventions and a person’s surroundings, a number of other factors are known to influence the health status of individuals, including their background, lifestyle, and economic and social conditions; these are referred to as “determinants of health”.

Public health

Public health is “the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals” (1920, C.E.A. Winslow).^[1] It is concerned with threats to health based on population health analysis. The population in question can be as small as a handful of people or as large as all the inhabitants of several continents (for instance, in the case of a pandemic). The dimensions of health can encompass “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”, as defined by the United Nations’ World Health Organization.^[2] Public health incorporates the interdisciplinary approaches of epidemiology, biostatistics and health services. Environmental health, community health, behavioral health, health economics, public policyand occupational health are other important subfields.
The focus of public health intervention is to improve health and quality of life through the prevention and treatment of disease and other physical and mental health conditions, through surveillance of cases and the promotion of healthy behaviors. Promotion of hand washing and breastfeeding, delivery of vaccinations, and distribution of condoms to control the spread of sexually transmitted diseases are examples of common public health measures.
Modern public health practice requires multidisciplinary teams of professionals including physicians specialising in public health/community medicine/infectious disease, epidemiologists, biostatisticians, public health nurses, medical microbiologists, environmental health officers, dental hygienists, dietitians and nutritionists, health inspectors, veterinarians, public health engineers, public health lawyers, sociologists, community development workers, communications officers, and others.^[3]

Health care

Health care (or healthcare) is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers. It refers to the work done in providing primary care, secondary care and tertiary care, as well as in public health.
Access to health care varies across countries, groups and individuals, largely influenced by social and economic conditions as well as the health policies in place. Countries and jurisdictions have different policies and plans in relation to the personal and population-based health care goals within their societies. Health care systems are organizations established to meet the health needs of target populations. Their exact configuration varies from country to country. In some countries and jurisdictions, health care planning is distributed among market participants, whereas in others planning is made more centrally among governments or other coordinating bodies. In all cases, according to the World Health Organization (WHO), a well-functioning health care system requires a robust financing mechanism; a well-trained and adequately-paid workforce; reliable information on which to base decisions and policies; and well maintained facilities and logistics to deliver quality medicines and technologies.^[1]
Health care can form a significant part of a country’s economy. In 2008, the health care industry consumed an average of 9.0 percent of the gross domestic product (GDP) across the most developed OECD countries.^[2] The United States (16.0%), France (11.2%), and Switzerland (10.7%) were the top three spenders.
Health care is conventionally regarded as an important determinant in promoting the general health and wellbeing of peoples around the world. An example of this is the worldwide eradication of smallpox in 1980—declared by the WHO as the first disease in human history to be completely eliminated by