PH 052-Essential Public Health Function and Primary Health Care

Course Description:
In this course, students will first define Health before exploring the different concepts of Health that involve clarification on what is Public Health, Health Promotion, Epidemiology, Health Management, Environmental Health, and Nutrition; and differentiate between the “Old” Public Health and the “New” Public Health. This course gives an overview of the eleven (11) Essential Public Health Functions (EPHF) that capture the role of national health authorities (NHA) in public health. Students doing this course are also exposed to the concept, principles and components of Primary Health Care (PHC). The course prepares students to participate in the preliminary assessment of NHA’s performance on the EPHF. It also enhances students’ perception on the fundamental role of PHC in improving the health of people in Pacific communities and in reducing health inequalities between different groups.

• Prerequisite Courses: none

I. LEARNING OUTCOMES

A. PROGRAM LEARNING OUTCOMES (PLOS):

1. Recognize and describe basic health science facts and principles;
2. Discuss the essential public health functions;
3. Describe adult, children and family health issues;
4. Demonstrate an understanding and practice of some generic public health competencies;
5. Demonstrate proper public health skills for public health practice in the community as a junior officer;
6. Demonstrate community and cultural sensitivity in the health care environment;
7. Describe the determinants and problems of adults, children and families;
8. Demonstrate proper cardio-pulmonary resuscitation (CPR) and first aid techniques;
9. Demonstrate ability to make a community diagnosis of the determinants of health in a community;
10. Identify good public health practice;
11. Have had work experience at a public health area/ section.

Course Learning Outcomes (SLOS) - GENERAL

The overall objective of the course is to get students acquainted to the contents and principles of the eleven Essential Public Health Functions. The course also aims at introducing basic concept and components of Primary Health Care. Students will become familiar with the role of PHC in providing people with basic medical services and, at the same time, promoting better health and healthier lifestyle in the Pacific communities. Students will develop a clear understanding of the role of NHA in coordinating EPHF within the country health system. This will form a basic foundation, later on in advanced levels, to build up their leadership and competencies in the assessment and performance of EPHF, and to contribute to the strengthening of effective national public health systems. This course is designed both for community health workers who will be working within the villages of the district centers as well as those who are based in dispensaries in areas where there is no doctor.

Upon the completion of the course, the student with a combined accuracy of 60% should be able to:

1. Define “Public Health”;
2. Describe each of the EPHF in detail;
3. Explain, with examples, the conceptual framework that supports the Essential Public Health Functions (EPHF);
4. Define “Primary Health Care”;
5. Describe and explain basic principles and main components of PHC;
6. List and discuss competently some of the PHC activities in the community.

II. COURSE CONTENT AND SPECIFIC LEARNING OUTCOMES

1. Chapter 1 – Concepts of Health, Public Health and Introduction of 11 EPHF
1. Define “Health”
2. Define “Public Health”; Health Management; Health Promotion; Epidemiology; Environmental Health; Nutrition
3. Discuss how the concept of Public Health has changed in the context of globalization in health in today’s world – Concepts of “old” Public Health and “new” Public Health.
4. Identify the origin and purpose of the Initiative for Public Health in the Americas and the EPHF
5. List the 11 EPHF
2. Chapter 2 – Essential Public Health Functions 1, 2 and 3

   2.1 EPHF 1-Monitoring, Evaluation, and Analysis of Health Status

   1. Define “Health Situational Analysis” (HAS), Monitoring and Evaluation
   2. Purpose of HAS, Monitoring and Evaluation
   3. Describe the Health Fields/Determinants framework used in the health situation analyses
   4. Describe the most common types of HAS, including health profiles, health needs assessment and measuring inequalities in health.
   5. Apply some of the basic concepts of HSA
   6. Describe the most common methods of HSA and their limitations

   2.2 EPHF 2-Public Health Surveillance, Research and Control of Risks and Threats to Public Health

   1. Define Public Health Surveillance (PHS)
   2. Describe the purposes, objectives, characteristics and uses of PHS, research and control of risks and threats to public health
   3. Concepts of “Epidemics” and “Outbreaks”
   4. Describe the principal uses of public health surveillance, especially in relation to early detection of outbreaks and epidemics and immediate response to emergencies.
   5. Discuss the sources of information; steps involved and attributes of Surveillance Systems

   2.3 EPHF 3-Health Promotion

   1. Explain the concept of “Health Promotion”
   2. Discuss why health promotion is important
   3. Describe the five components (according to the Ottawa Charter) of a health promotion strategy
   4. Describe the information required for a situation assessment, i.e. what questions to be asked?
   5. How to conduct a situational assessment in your own community/ country.

3. Chapter 3 – Essential Public Health Functions 4, 5 and 6

   3.1 EPHF 4-Social Participation in Health

   1. Define and discuss concepts of “Social Participation”, such as:
      • Community and citizen participation
      • Social capital
      • Stake holder consultation and collaboration
   2. Assess the state of social participation in your own community/ country by applying EPHF assessment indicators

   3.2 EPHF 5-Development of Policies and Institutional Capacity for Planning and Management in Public Health

   1. Define what “Health Policy” is
   2. Describe what the EPHF on health policy entails
   3. Discuss the role and importance of policy development
   4. Identify key concepts and stages related to the process (including evidence-based policy making and participatory policy making).

   3.3 EPHF 6-Strengthening of Institutional Capacity for Regulation and Enforcement in Public Health

   1. Define “Health Regulation”
   2. Explain the role and importance of health regulation
   3. Describe areas where health regulation is applied
   4. Identify key players in health regulation
   5. Describe, using practical examples, some principle regulatory instruments, their strengths and weaknesses.

4. Chapter 4 – Essential Public Health Functions 7, 8 and 9

   4.1 EPHF 7-Evaluations and Promotion of Equitable Access to Necessary Health Services

   1. Define “Equity” in relation to access to health care
   2. Discuss why equity is important
   3. Explain on what the basis is of the concepts and definitions of equity in access to health care

   4.2 EPHF 8-Human Resource Development and Training in Public Health

   1. Explain what Human Resource in Health (HRH) means?
   2. Describe major functions Human Resource Development (HRD) entails, including staffing; education and training; performance management; working condition
   3. Discuss the challenges that each HRH function may face in their performance.
   4. Propose and discuss ways to resolve those challenges.

   4.3 EPHF 9-Quality Assurance in Personal and Population-based Health Services

   1. Define “Quality Assurance”
   2. What does quality assurance public health include?
   3. List and describe the three categories of quality assurance activities that quality assurance consist
   4. Discuss why quality assurance is important
   5. Describe the assessment framework and tools for quality assurance
   6. Apply the basic quality improvement tools

5. Chapter 5 – Essential Public Health Functions 10 and 11

   5.1 EPHF 10-Research in Public Health

   1. Define the concept of health research
   2. Clarify the importance of the link between health research and health policy
   3. Discuss why a health research system approach is important
   4. Describe the goals and functions of health research system
   5. Indicate which different sectors contribute and benefit from health research

   5.2 EPHF 11-Reduction of the Impact of Emergencies and Disasters in Health

   1. Describe the Emergencies/Disaster EPHF in detail;
   2. Explain the relationship of this function to the other functions
   3. Discuss the importance of this function as a vital component for the development of an appropriate public health infrastructure
   4. Define hazards, vulnerability, and risk
   5. The importance of upgrade and advance technical knowledge about the causes and consequences of disasters and emergencies to communities and health services facilities
   6. Identify prevention, mitigation, preparedness and response approaches and vital tools applicable to the health sector
   7. The role of an appropriate and complete national disaster plan

6. Chapter 6 – Primary Health Care concept and practice
   1. a) Define “Primary Health Care”.
   2. Define “Community Health Worker” (CHW)
   3. Describe and discuss the role of CHWs in the community
   4. Discuss the content of the Alma Ata Declaration.
   5. Describe the themes leading to the Alma Ata Declaration.
   6. List and discuss the principles of PHC.
   7. Describe using practical examples of the main components of PHC
   8. List some main PHC activities taking place in your community, i.e. a broad range of health and preventative services, including health education, counseling, disease prevention and screening.
   9. Define and compare General PHC and Elective PHC in terms of their advantages and disadvantages.
   10. Discuss using practical examples on what might be obstacles to the implementation of PHC in community.
   11. Propose solutions to overcome those emerged obstacles.
   12. Write up a concise report on the filed visit to a PHC facility: discuss the findings in terms of its infrastructure, supply-equipment, staffing, function, activities and mode of delivery.

III. TEXTBOOKS

1. Selected materials on Essential Public Health Functions, produced by the World Bank Institute
2. Mathur JS. (2008) Comprehensive Textbook on Community Medicine. CBS Publishers and Distributors. (ISBN-13: 978-8123915920)

IV. REFERENCE MATERIALS

1. Turnock BJ. (2009) Public Health: What Is It and How It Works. Jones and Bartlett.
2. Scutchfield FD., Keck CW. (2002). Principles of Public Health Practice, 2nd Edition. Delmar Cengage Learning.
3. Park K. (2000) Park’s Textbook of Preventive and Social Medicine. 16th Edition. Ms Banarsidas Bhanot.
4. WHO materials on PHC

V. REQUIRED COURSE MATERIALS

Prescribed textbook and reference materials

VI. INSTRUCTIONAL MATERIALS/ EQUIPMENT AND COST FOR THE COLLEGE:

There is no special instructional material/ equipment required for this course. There will be a visit to a PHC facility; required logistic support for which will be advised accordingly.

VII. METHODS OF INSTRUCTION:

1. Lectures: in-class lectures.
2. Tutorials: review and revise learning objectives; discuss outcomes of group activities assigned after lectures.
3. Field visit: visits to a PHC facility, such as community health centre (CHC), nursing station, maternal and child health (MCH) clinic, or community dispensary, are designed with the aim to expose students to a real setting where people come for basic medical services. This also includes introduction on its infrastructure, supply-equipment, staffing, basic functions and their mode of delivery.

VIII. EVALUATION

1. Grading scheme: there are two components Formative and Summative assessment.
   
   • Formative Assessment: This type of assessment assesses how a student progresses in class. With feedback from the Instructor, the student would be able to answer these questions: Am I doing well in class? What have I missed? What should I concentrate more on? This assessment will be in the form of tests/ quizzes with or without prior notice.
   • Summative Assessment: This type of assessment means that the marks you get out of it contribute towards your final grades. For this course, this assessment consists of the following:
   1. Continuous Assessment (60%): comprises 2 written Tests and a Report of the visit to a PHC facility. Each of these contributes 20% to the total course assessment.
   2. Final Exam (40%): a 3-hour written paper, done at the end of the course.

   The Assessment is illustrated in the following diagram:

   
2. Grading System

   Grade	Percentage	Outcome
   A	90-100%	Superior
   B	80-89%	Above Average
   C	70-79%	Average
   D	60-69%	Passing
   F	Below 60&	Failure

IX. CREDIT BY EXAMINATION:

NONE

X. ATTENDANCE POLICY:

As per College Policy

XI. ACADEMIC HONESTY POLICY:

As per college Policy