Authentic engagement, co-creation and action research
Felicity Goodyear-Smith, Bob Mash in How to Do Primary Care Research, 2018
Primary health care, as defined by the World Health Organization (WHO) in 1978, is essential health care; based on practical, scientifically sound and socially acceptable methods and technology; universally accessible to all in the community through their full participation; at an affordable cost and geared towards self-reliance and self-determination.1 Primary health care shifts the emphasis of health care to the people themselves and their needs, reinforcing and strengthening their own capacity to shape their lives. Thus, as a strategy, primary health care focuses on individual and community strengths (assets) and opportunities for change (needs); maximises the involvement of the community; includes all relevant sectors but avoids duplication of services and uses only health technologies that are accessible, acceptable, affordable and appropriate.2,3
Introduction
Felicity Goodyear-Smith, Bob Mash, Michael Kidd in International Perspectives on Primary Care Research, 2017
In 1978, the World Health Organization issued a declaration at Alma-Ata underlining the international importance of primary care. It stated that primary health care is 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. It forms an integral part both of the country’s health system, of which it is the central function and main focus, and of the overall social and economic development of the community. It is the first level of contact of individuals, the family and community with the national health system bringing health care as close as possible to where people live and work.8
Improving health systems
Michael Kidd, Cynthia Haq, Jan De Maeseneer, Jeffrey Markuns, Hernan Montenegro, Waris Qidwai, Igor Svab, Wim Van Lerberghe, Tiago Villanueva, Charles Boelen, Cynthia Haq, Vincent Hunt, Marc Rivo, Edward Shahady, Margaret Chan in The Contribution of Family Medicine to Improving Health Systems, 2020
The effectiveness and equity of health systems correlate with their orientation toward primary health care. This correlation was demonstrated in a study by Barbara Starfield that measured the health outcomes of 12 Western industrialized nations in relation to the characteristics of their health system policies and practices that reflect primary health care. Lower mortality rates, longer life expectancy, lower expenditures for health care, and the population’s satisfaction with its health system were all associated with a country’s orientation to primary health care. Countries that appropriately supported and delivered primary health care achieved better health outcomes at lower costs.4,29 Further research demonstrated that a greater emphasis on primary care can be expected to lower the costs of care, improve health through access to more appropriate services, and reduce the inequities in the population’s health.41
The role of primary health care in achieving global healthcare goals: Highlighting the potential contribution of occupational therapy
Published in World Federation of Occupational Therapists Bulletin, 2018
Sue Dahl-Popolizio, Sue Doyle, Sabby Wade
The World Health Report 2008 (WHO, 2008) was titled ‘Primary Care- Now more than ever’, identifying the importance of primary care in addressing the growing challenges facing countries and healthcare systems due to increasing NCDs. Primary care has focused on providing person-centred care that is rational, and evidence based, and is designed to anticipate societal and population health changes (WHO, 2008). The nature of the health challenges facing populations has changed. Globalisation has brought changes in how communicable diseases are spread, and urbanisation, lifestyle changes, and increasing commercialisation of food production has brought the increased impact of NCDs on population health (WHO, 2008). Current healthcare systems across the globe were not designed to manage these NCDs and have difficulty with changing direction (WHO, 2008). Primary health care is the ideal setting in which to manage these conditions, located in the person’s community, and able to adapt to local community needs and provide integrated and sustained contact with individuals (WHO, 2008).
Re-thinking performance assessment for primary care: Opinion of the expert panel on effective ways of investing in health
Published in European Journal of General Practice, 2019
Dionne Kringos, Sabina Nuti, Christian Anastasy, Margaret Barry, Liubove Murauskiene, Luigi Siciliani, Jan De Maeseneer
From this definition, eight domains of primary care can be identified, i.e. (1) universal and accessible, (2) integrated, (3) person-centred, (4) comprehensive and community-oriented, (5) services provided by a team of professionals accountable for addressing a large majority of personal health needs (quality), (6) sustained partnership with patients and informal caregivers, in the context of family and community, (7) coordination and (8) continuity of people’s care. Additionally, the domains of (9) primary care organization and (10) human resources need to be added since they are key determinants of the delivery of high quality, efficient and equitable primary care services. Table 1 displays some of the key dimensions of each domain. General practitioners will especially recognize that the central aspects of their professional activities: being responsive for bio-psychosocial needs of patients, building relationships and continuity with patients, coordination of chronic care, and making sure that no one is left behind, are well represented in Table 1.
Perspectives of health workers on annual performance appraisal: A study in primary health care
Published in International Journal of Healthcare Management, 2021
Soheila Majidi, Abbas Daneshkohan, Ehsan Zarei, Tahereh Ashktorab
Primary health care is vital for achieving universal health coverage and ensuring equity in health and social justice [29]. Motivation of PHC workers plays an important role in the health system performance [30], whereas they usually benefit less rewards (in terms of prestige and money) than other health workers. In spite of important role of PHC in achieving UHC, unfortunately PHC services has been paid less attention as compared to curative and rehabilitative services in Iran, as well as in many other countries. PHC workers salary and benefit and their motivation is low. A study conducted by Tabrizi et al. on the status of Iran’s PHC system showed inadequate financial resources and low motivation of human resources as some weaknesses of the system [31]. Furthermore, Nekoei Moghadam et al. in a qualitative study on human resources in Iran’s primary health care system found that poor employee performance evaluation was one of four cause of demotivation among health workers [21]. In such conditions and given economic constraints, intervention in areas such as performance appraisal and supportive supervision are low cost and cost-effective strategies for increasing motivation and improving performance of PHC workers. Studying performance management system and finding areas for improvement is a prerequisite for any intervention in this field.
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