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Introduction Definition of PHC 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 country can afford to maintain at every stage of their development in the spirit of self reliance and self determination. Pillars of PHC.

The PHC pillars should be anchored in above definition by using appropriate technology that is scientifically sound and adaptable to local needs and acceptable to those who apply it and for whom it is used in order to be able to conduct Health Promotion activities, involving all important issues of health education, nutrition, Sanitation, maternal and Child health and prevention and control of endemic diseases. Through health promotion, individuals, families and community build an understanding of the determinants of health and develop skills to improve and maintain their health and well being.

These specific pillars are:- 1. EQUITY/ACESSIBILITY 2. COMMUNITY INVOLVEMENT/PARTICIPATION 3. INTERSECTORAL COLLABORATION A brief discussion of each pillar, citing examples. 1. EQUITY (Accessibility) – Equal Distribution A very important pillar in PHC, for good and sustainable health care services must be equally shared by all people of the community irrespective of their race, creed or economic status. This concept in PHC helps to shift the accessibility from major towns and cities to the rural areas where the most needy and vulnerable groups are or live.

Equity implies a fair distribution of health resources & activities for all population groups without discrimination, regarding race, ethnicity, locality or region: for example, this pillar should be taken into account, when deciding on the location of new health facilities, outreach service points, introduction of new health programmes or any charges for services among others. 2. COMMUNITY PARTICIPATION This includes meaningful involvement of the community in planning, implementing, maintaining and monitoring & evaluation of health care services.

Through the involvement of the community, maximum utilization of local resources, such as manpower, money and materials can be utilized efficiently to fulfill the goals of PHC. The community can be involved in the participation of developing Action Work Plans (AWPs) and budget making process for their facility user funds for their local health facilities at level 2 & 3, selection of community health workers (CHWs) & Community Health Committees (CHCs) in the formation of community units, location of Health facilities before construction, during mass health campaigns and mobilization to combat health problems, among other examples.

3. INTERSECTORAL COLLABORATION This pillar is paramount in realizing and improving the health of the people since it endeavors to bringing all departments within the health sector first, i. e. Public Health, Nursing, Clinicians, Pharmacy, Disease surveillance and many others and then working with other stakeholders like Education in developing curricula to include health information e. g.the school health policy and guidelines.

Agriculture for better farming methods to improve food production & security to enhance nutrition, Water on the provision of safe water to prevent water borne diseases, Good housing for better and more hygienic to avoid respiratory related infections, Information and Broadcasting to help create awareness of health concerns and carrying out Health Education through mass media e. t. c, Culture & social services for incorporating PHC into women’s group activities and adult education, Administration & Political elite among others in promoting total and sustainable health care in the community.

Q 2. What are your roles as an Environmental Health Officer in Primary prevention of Diseases? Primary Prevention of diseases Primary prevention can be defined as the upstream approach of disease prevention, i. e. “going upstream”. It looks at the actual cause of diseases within a population, by reducing the risks or threats to health at source. The main goal is to protect healthy people from developing a disease or experiencing an injury in the first place. Primary prevention is highly recommended because it might prevent employing either secondary or tertiary levels.

Some of the interventions of primary prevention practices include:- • Education on good nutrition, the importance of regular exercises and the dangers of using tobacco, alcohol and other drugs. • Conducting regular examinations and screening tests to monitor risk factors for illnesses. • Conducting Immunizations against infectious diseases • Controlling potential hazards at home and at the work place • Education and legislation about proper seat belt and helmet use, among other practices and legislations.

Environmental Health Officer Environmental Health Officer, also known as a Public Health Officer (Inspector) are responsible for carrying out measures for protecting public health, including administering and enforcing legislation related to environmental health and providing support to minimize health and safety hazards. They are involved in a variety of activities, for example inspecting food facilities, investigating public health nuisance and implementing general disease control.

The role of an Environmental Health Officer in Primary Disease Prevention Its evident from the above two definitions that an Environmental Health Officers (EHOs) by virtue of their roles and responsibilities, plays a major role in the primary prevention of diseases since they take care of the activities that are aimed at averting the primary source of disease causation or its associated/predisposing factors. Environmental Health Officers are focused on prevention, consultation, investigation and education of the community regarding health risks and maintaing a safe environment.

EHO bring to the position an understanding of microbiology, risk health assessment, environmental science, as well as skills and knowledge related to the tracking and control of communicable and non communicable diseases, enforcement of legislation related to public health and the environment. EHO in his/her roles works with other departments, agencies and the community groups as well as individual members of the community in protecting public health.

The roles and responsibilities of the EHO help to promote the practices that would majorly avert diseases causation and maintain a healthy population, and they include the following: • Shall regularly conduct focused health education sessions in the community • Shall regularly inspect houses/premises/institutions and advice on health requirements of sanitary facilities, water supply, refuse disposal, light and ventilation, maintenance of a home garden, and ensure that improvements are carried out.

• Shall carry out immunization campaigns/Programmes in the facilities, schools and community targeting certain diseases aimed for eradication or elimination and of public health importance. • Shall investigate cases of communicable diseases, keeps contacts under surveillance and take appropriate actions to prevent further spread of the diseases. • Shall assist in tracing contacts of certain diseases such as Tuberculosis, Leprosy and Sexual Transmitted Infections including HIV & Aids and their defaulters of treatment.

• Shall study the mortality and morbidity statistics of their area and use them to make informed decisions and awareness programmes in the community • Shall enforce laws related to public health and both communicable and non communicable diseases. Q 3. Outline 5 core functions of Public Health Programmes Public Health is a Science and Art of preventing diseases, prolonging life and promoting health through organized efforts and informed choices of society, organizations, public and private, communities and individuals.

This is done through: • Sanitation of the Environment • Control of infections • Education of the individuals in personal and environmental hygiene • Organization of the medical and nursing services for diagnosis and prompt treatment of diseases. • Development of social machinery for individual self empowerment to enable everyone realizes health and longevity. Public Health Programmes- These are specific programmes geared towards reducing diseases incidence, disability and effects of ageing and other physical and mental conditions.

Core Functions as identified by World Health Organization (WHO) • Providing leadership on matters critical to health, and engaging in partnerships with others where joint actions are required. • Setting norms and standards, promoting and monitoring their implementation • Shaping a research agenda and stimulating the generation, translation and dissemination of valuable knowledge and information.

• Articulating ethical and evidence-based policy options • Monitoring the health situation and assessing health trends. REFFERENCES 1. World Health Organization – Declaration of Alma – Ata, Adapted at International Conference on PHC Journal, September 1970 2. Community Health in East Africa Book By Herbert Lobner, SisterJean Lorenz and Willy Okiror Published by AMREF in 1981, 1997 (First Edition ) and Reprinted in 2001 (Second Edition).

3. Development of Primary Health Care in Kenya, Written by Dr. James Maneno – (Edited in 1998) 4. Web Site; http://www-who. int/bullentin/Volumes/86/10/08-03/008/en. 5. Web Site; http://www. iwh. on. ca/wrmb/primary prevention. com, originally adapted from “At Work”, Issue 43, Winter 2006: Institute for Work and Health, Toronto – Japan 6. Web Site; http://www. publichealth. go. ke/health progammes. com

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