Primary Healthcare Approach - Essay Example

Name: Course: College: Tutor: Date: PRIMARY HEALTHCARE APPROACH Introduction Primary healthcare approach (PHA) to healthcare is considered the most holistic approach that is aimed at providing promotive, preventive, curative, rehabilitative and supportive care (Walsh and Crumbie, 2007; p 79) in a manner that reflects equity in all dimensions. A full definition given by WHO in 1978, "Primary health care seeks to extend the first level of the health system from sick care to the development of health. It seeks to protect and promote the health of defined communities and to address individual problems and populates health at an early stage. Primary health care services involve continuity of care, health promotion and education, integration of prevention with sick care, a concern for population as well as individual health, community involvement and the use of appropriate technology." (UNSW Research Centre for Primary Health Care & Equity CPHCE, 2010; Austin and Boyd, 2006; p46) It is a method of care that is favorable both in emergencies and in normal health conditions, it ensure a full package of care for the patient and his/her family. This study will focus on how the primary healthcare approach can be used to solve healthcare issues in a community setting. This will be based on a case study of a 30 year old refugee from Sudan-Alice, who has been living in Australia for 6 months (see appendix A below). Immediate Actions The case of Alice is a technical one, its not just a community case as many would be but is complexes by the fact that she and her family are refugees on asylum in Australia; there are many complications arising from the displacement aspect itself. The first step would be to carry out a rapid needs assessment which will help in identifying the priority needs hence designing appropriate actions (UNHCR, 2007); this may call for individual assessments and family assessment so as to identify individual and family needs. Using the information given in the case study (in Appendix A) immediate needs include:- 1) a mental burden for both Alice and the family; loss of beloved ones, violent sexual assault, 2) economic burden – Alice is unemployed but she is expected to shoulder all family expenses using a meager government allowance and the son has to walk to and from school each day 3) Cultural shock and loneliness; Alice and her family live away from other members of her community. The 12 year old son is unhappy with his new school, and getting culturally appropriate food is a problem 4) opportunistic infections; the family struggles on several occasions the family with episodes of gastroenteritis. How health promotion and/or illness prevention strategies could be of benefit in assisting the client/family in this scenario After the need assessment, it is clear that Alice and her family need attention and probably the health care nurse will be to focus on health promotion practices. Health promotion involves a range of activities such as health education, prevention and control of disease, maternal and child health care, nutrition among others. Health promotion will enable Alice and her family to develop skills to improve and maintain their health and well being; in this case health promotion will be directed at disease prevention and addressing all round problems including the mental trauma that Alice and her family may be facing. The main threatening disease to Alice and her family is gastroenteritis that has been an on and off episode-this can be an entry point to a long-term and continuity care process. The family can receive treatment for the gastroenteritis and can be educated on how to prepare food properly and hygienically as a tertiary prevention service. The family would also receive nutrition education including how to choose culturally appropriate foods that are locally available and are safe. On maternal and child health care, the nurse in this case will have to do some counseling-or refer Alice to a family counselor- given Alice’s violent encounters during displacement and her husband’s death. The son may also have to go through the counselor since there is evidence that he may be having a problem at the new school; he may be affected by the fact that he has to walk a long distance, he is not used to his new schoolmates and teachers and probably may be discriminated against. She may also need to be educated on various economical projects she can engage in to boost her financial status. Health promotion according to Funnel, Koutoukidis and Lawrence (2008; p69) is a better choice as it promotes social, economic and personal development and also ensure that an individual lives quality life. It is cost effective and a powerful tool; but it cannot be effectively used unless there is high collaboration amongst health care providers and between health care provides and other stakeholders. Therefore the nurse handling Alice’s case will have to seek extensive help from other departments within the health care set-up and outside such as from the son’s school. It is important to tackle this case study from an integrated perspective because it falls under the category of marginalized populations; there is evidence that individuals seeking asylum in countries such UK face discrimination and this trend is widespread in many other countries (Kelley and Stevenson, 2006; p4). The gap between the rich and the poor keeps widening by the day and access to health care is not an exceptional. WHO (2011) statistics show that the difference between the life expectancy of the rich and poor is 40 years. Female headed household fall under the poorest populations and generally women have the worst attention in health care provision especially in reproductive health and childbirth. Given that the family in question shares most of the aspects considered to contribute to low socio-economic status and that the family is considered as refugees, primary health care approach will be the best option; it has been adopted by other care providers to handle refugee cases (RAPH Project) and will ensure efficacy in solving the health oriented problems as well as aim at reducing the inequities that may be in existence. Primary healthcare ensures there is equity in distribution of money, power and resources; each and every community member has a chance to participate in various projects using available community resources, without considering the origin and status of the individual (WHO, 2011; Basavanthappa, 2008; p196-197). Further as indicated in the WHO report, “inequitable access, impoverishing costs, and erosion of trust in health care constitute a threat to social stability.” Hence justification as to why WHO has been advocating for the restoration of the primary healthcare approach into healthcare systems; it has been observed that countries that have embraced the approach invest little in healthcare as compared to those whose healthcare systems are based on other approaches. In addition primary healthcare approach ensures that the preventive aspect of healthcare is capitalized; in the modern world, the biomedical interventions seem to be a priority but WHO observes that embracing the preventative approach will reduce the global disease burden by 70%. Further, primary healthcare will ensure holistic healthcare and not money-oriented treatment whereby healthcare staff is interested in running several tests and complicated procedures to ensure a fat pay whereby those who cannot afford such procedures are left out. The primary healthcare approach seeks to ensure all individuals despite their originality and status in society have access to basic healthcare that is individual centered, affordable and efficient. The approach also gives room for participation of the communities in program roll-out and implementation hence it is owned by the community and ensure more sustainable and continuous care practices. Given the central roles of the primary healthcare approach, there is need for co-jointed efforts. For instance research and academic institutions should ensure they come up with education curricula that are holistic and that prepare the healthcare staff adequately for the rapidly changing and increasing health needs. The governments on the other hand should ensure that they allocate health sectors the right budgetary allocations to be able to take care of the varied patient needs and extend to family needs; emphasis should be laid on the most vulnerable population such as children and reproductive mother. Agencies such as UNHCR need to improve there follow-up on asylum refugees to ensure that they end up in safe and culturally acceptable neighborhoods and probably have the right settings in place such as places of worship and schools. Private stakeholders such as companies and individuals can help raise funds or contribute tangible stuff such as food stuffs, clothes, bedding, residential premises to ensure refugees get a better life. Sectoral and regional integration is one of the factors that are included in Australian primary healthcare strategy (Department of Health and Ageing, 2009-2010) Strategies or services that could be used to help this client/family The strategies that will be applied in the case of this particular family will aim at directly solving the problems identified in the earlier section of “what would be done immediately” and possibly some strategies will aim at providing continued support to the family. Training/education The family in question requires education and training in many perspectives starting with nutrition education. Given that the family is in a new environment where access to culturally acceptable foods is difficult, it may be of great importance to educate the family on how to prepare the most common locally available foods so as to ensure their survival. It will also be important for the family to receive general education on sanitation and the need to cook food well and serve hygienically to prevent it from the regular attacks by gastroenteritis. Education on economic projects such as poultry keeping or starting a small family business will also be vital and probably information on projects that can ensure the family produces its own food such as kitchen and multi-storey gardening. Training on cutting on costs will also be vital such that the family purchases only what they need most and at the fairest prices. Encouraging regular community meetings It is obvious that the family is experiencing a cultural shock and lack the warmth brought about by close traditional social ties such as the family could borrow food or receive gifts from community members during food shortages. Alice and family would also feel safer if they lived close to their community members because they would have an identity and probably share the same experiences and therefore encourage each other. Regular meetings and a possible shift of residence by Alice and family to join other Sudanese communities may help alleviate some of the family sufferings. Three most important community resources you would recommend to the client First, the family can utilize community water reserves such as rivers for irrigation and community land to grow subsistent crops; given the high costs of living, the family can save a great deal by reducing money spent on food through increasing own produced foods. Own produced foods will be more acceptable and safer hence reducing chances of contracting the gastroenteritis. If the family ventures into poultry farming, it will have a more balanced diet at their exposure compared to when they have to budget for all food stuffs. Even if they do not keep poultry, at least the cash they save from purchase of other food staffs they produce can be used to purchase high protein foods and fruits. Forests for firewood can also be another helpful resource; the family can use traditional method in cooking to save on electricity bills. Conclusion The primary healthcare approach is a wholesome approach that ensures each and every individual’s needs are catered for and the poor and rich alike receive quality healthcare. Co-jointed efforts between governments, global institutions and agencies, civil societies, research and academic institutions and private stakeholders will ensure its successful integration and use in healthcare systems. It is the responsibility of each and every healthcare staff and other stakeholders that are involved in ensuring the success of healthcare systems to ensure that they play their role in the chain properly. The nurse in the case study in question will have to ensure that the family needs are properly identified, that the principles of the primary healthcare approach; equity, community participation and development, health promotion for prevention, are the core of his/her services to the family. Appendix A: Scenario 1 Alice is a 30 year old refugee from the Sudan. She has 3 children, two girls aged 3 and 5yrs and a 12 year old son who has just started High School. She lost her husband and two other children during civil unrest in her country and has been living in Australia for 6 months; the first two months were in a detention centre. She currently shares a 2 bedroom town-house with her 22 year old cousin, Melody, who has 18 month old twin boys. Alice had a miscarriage just prior to leaving Africa; the pregnancy was the result of violent sexual assaults in a refugee camp.  Alice does not have a job or any skills and has been learning English at a local migrant centre. She has met some other Sudanese women at this centre, but they all live in different areas to her. Alice relies on public transport, but lives 20 minutes walk from the nearest bus. Her only income is a government allowance and she has found it increasingly difficult to manage her finances with the recent rises in cost of living. She struggles to find food that she is familiar with and the family group has had several episodes of gastro-enteritis over summer. Her son has a 40 minute walk to school each day, and he is unhappy at his new school and she has received a letter from the school about his poor attendance.  You are the Community Nurse at the Refugee Health Clinic at the Mater Hospital and have just been discussing some of these issues with Alice when she has presented for follow-up appointment. References Austin, W. and Boyd, A.M (2006). Psychiatric nursing for Canadian practice. Retrieved from http://books.google.co.ke/books 1 May, 2011 Basavanthappa (2008). Community Health Nursing. Retrieved from http://books.google.co.ke/books 1 May, 2011  Department of Health and Ageing (2009-10). Overview: Australia’s First National Primary Health Care Strategy. Retrieved from http://www.health.gov.au/internet/yourhealth/publishing.nsf/Content/report- primaryhealth 1 May, 2011 Funnel, R. Koutoukidis, G. and Lawrence, K. (2008). Tabbner's Nursing Care: Theory and Practice. Retrieved from http://books.google.co.ke/books 1 May, 2011 Kelley, N. and Stevenson, J. (2006). First do no Harm: Denying Healthcare to people whose asylum claims have failed. Retrieved from www.medact.org/content/refugees/Health%20access%20report.pdf 1 May, 2011 Refugees and Primary Health Care (RAPH) Project. Supporting Quality primary Healthcare for your patient of a Refugee Background. Retrieved from www.seagp.org.au/documents/.../RefugeeHealth/RaPH%20promotional 1 May, 2011 UNSW Research Centre for Primary Health Care & Equity CPHCE. (2010). Building Capacity for Primary Health Care: Defining primary Healthcare. Retrieved from www.phcconnect.edu.au/defining_primary_health_care.htm 28 April, 2011 UNHCR (2007). Rapid Needs Assessment (RNA) of Recently Displaced Persons in Kurdistan Region. Retrieved from www.unhcr.org/494771ea2.pdf 1 May, 2011 Walsh, M. and Crumbie, A. (2007). Watson's Clinical Nursing and Related Sciences. Retrieved from http://books.google.co.ke/books 1 May, 2011 WHO (2011). World Health Report calls for return to primary health care approach. Retrieved from www.who.int/mediacentre/news/releases/2008/.../index.html 28 April, 2011 Read More