scholarly journals Comprehensive primary health care, not any vertical program needed for UHC

2019 ◽  
Vol 8 (6) ◽  
pp. 2165
Author(s):  
Jayanta Bhattacharya
2017 ◽  
Vol 12 (2) ◽  
pp. 431-440 ◽  
Author(s):  
Antônio Augusto Dall’Agnol Modesto ◽  
Marcia Thereza Couto

Erectile dysfunction (ED) is a common sexual problem and has been attracting growing interest from the field of medicine. The pharmaceutical industry works together with medical associations to popularize the theme, emphasizing individual enhancement and medication, besides reinforcing an idea of a male sexuality defined by the ability to have an erection and penetrate. Patients worried about erection problems search for general practitioners (GPs), frequently without a clear complaint, and a comprehensive primary health care (PHC) must be capable of dealing with these issues considering medicalization and disease mongering. This article discusses how PHC physicians take (and might take) care of men with erection problems, and how users perceive it and search for help in two cities in the State of São Paulo, Brazil. The qualitative research, performed in five PHC services, included semistructured interviews with 16 GPs and 15 adult male users. The adult male users were invited by their doctors during consultations where questions about prostate, ED, or other sexual problems arose. Interviews were transcribed and submitted for content analysis. In addition, the five participating services were observed with help of a specific script. Results indicate that ED is frequently a hidden agenda and that doctors have trouble approaching the problem, usually focusing on the biological aspects. Based on empirical data and literature, this work indicates some measures to qualify the care of men with ED in PHC which includes contemplating users’ questions, respecting their autonomy, avoiding an antidrug stance, and considering drug and nondrug approaches as a continuum of resources.


2021 ◽  
Vol 27 (1) ◽  
pp. 57
Author(s):  
Ailsa Munns

Comprehensive primary health care is integral to meaningful client-centred care, with nurses and midwives central to partnership approaches with individuals, families and communities. A primary health model of antenatal care is needed for Aboriginal and Torres Strait Islander women in rural and remote areas, where complex social determinants of health impact on pregnancy outcomes, early years and lifelong health. Staff experiences from a community midwifery-led antenatal program in a remote Western Australian setting were explored, with the aim of investigating program impacts from health service providers’ perspectives. Interviews with 19 providers, including community midwives, child health nurses, program managers, a liaison officer, doctors and community agency staff, examined elements comprising a culturally safe community antenatal program for Aboriginal and Torres Strait Islander women, exploring program benefits and challenges. Thematic analysis derived five themes: Organisational and Accessibility Factors; Culturally Appropriate Support; Staff Availability and Competencies; Collaboration; and Sustainability. The ability of program staff to work in culturally safe partnerships with clients in collaboration with community agencies was essential to building meaningful and sustainable antenatal strategies. Midwifery primary health care competencies were viewed as a strong enabling factor, with potential to reduce health disparities in accordance with Australian Government and research recommendations.


2010 ◽  
Vol 15 (1) ◽  
Author(s):  
Nomasonto B. Magobe ◽  
Sonya Beukes ◽  
Ann Müller

‘No member of [health] staff should undertake tasks unless they are competent to do so’ is stated in the Comprehensive Primary Health Care Service Package for South Africa (Department of Health 2001)document. In South Africa, primary clinical nurses (PCNs), traditionally known as primary health care nurses (PHCNs), function as ‘frontline providers’ of clinical primary health care (PHC) services within public PHC facilities, which is their extended role. This extended role of registered nurses(set out in section 38A of the Nursing Act 50 of 1978, as amended) demands high clinical competency training by nursing schools and universities.The objectives of the study were to explore and describe the perceptions of both clinical instructors and students, in terms of the reasons for poor clinical competencies. Results established that two main challenges contributed to students’ poor clinical competencies: challenges within the PHC clinical field and challenges within the learning programme (University).OpsommingDie primêre kliniese verpleegkundiges, tradisioneel bekend as primêre gesondheidsorg verpleegkundiges, funksioneer in Suid-Afrika as eerste-linie verskaffers van kliniese primêre gesondheidsorg (PGS) dienste binne die publieke PGS fasiliteite. Dit is hulle uitgebreide rol. Hierdie uitgebreide rol van die verpleegkundige (soos deur Wet op Verpleging,No 50 van 1978, artikel 38A voorgeskryf), vereis opleiding in kliniese vaardighede van hoë gehalte deur verpleegskole en universiteite.Die doelwitte van die navorsing was om die persepsies van beide kliniese dosente en leerders,met betrekking tot die redes vir swak kliniese vaardighede, repektiewelik te verken en te beskryf.Twee temas is deur die resultate as uitdagings (hoof redes) vir die swak vaardighede van leerders aangetoon, naamlik uitdagings in die PGS kliniese praktyk en die uitdagings in die leerprogram (universiteit).


PEDIATRICS ◽  
1981 ◽  
Vol 67 (1) ◽  
pp. 47-52
Author(s):  
Henry K. Silver ◽  
John E. Ott ◽  
Claibourne I. Dungy ◽  
Louis L. Fine ◽  
Virginia M. Moore ◽  
...  

More than 20 studies have been carried out of child health associates to assess their knowledge, training, and practice; their ability to interpret and integrate data; their cognitive knowledge and psychomotor and interpersonal skills; and their competence and effectiveness as primary health care providers. The results of the assessment and evaluation studies of child health associates indicate that they can determine the health status and manage the health care of patients in ambulatory settings and in the newborn nursery with a degree of skill and competence approaching that of pediatricians. Child health associates can provide comprehensive primary health care for more than 90% of children seen in these settings. The high degree of acceptance of child health associates by families and their demonstrated proficiency and cost-effectiveness document that they can be an important source of primary health care for most children.


2007 ◽  
Vol 13 (2) ◽  
pp. 18 ◽  
Author(s):  
John Macdonald

Despite considerable rhetoric, comprehensive primary health care remains largely a matter of a paper exercise. The theory promotes horizontal and vertical integration and the active participation of people in planning. Experience in Australia and elsewhere indicates that what is in place in health services is often primary medical care: the management of the needs of presenting individuals. The arguments for upstream interventions remain valid, bolstered by research on the social determinants of health. Two examples are given of primary health care that attempt to work upstream, before clinical interventions become necessary and illustrate the need for both horizontal and vertical integration. Consequences for policy and training are drawn.


2016 ◽  
Vol 168 ◽  
pp. 43-52 ◽  
Author(s):  
Fran Baum ◽  
Toby Freeman ◽  
David Sanders ◽  
Ronald Labonté ◽  
Angela Lawless ◽  
...  

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