Expanding Primary Health Care Sam Adjei NHIA 10th

Transcript:Expanding Primary Health Care Sam Adjei NHIA 10th:
Expanding Primary Health Care Sam Adjei NHIA 10th Anniversary Conference Outline Introduction Definitions of PHC Global evolution of PHC Goal, objectives and strategies Ghana’s organization of PHC Package of services Financing of services Assessing performance Moving forwards Introduction Evolution of health delivery systems 20yr cycle 1957- Basic health care Emphasis on infrastructure 1977/78- Health for All based on PHC Emphasis on rapid expansion of services 1997- Health sector Reforms and SWAP Health systems strengthnening and MDGs 2015- Post MDG Definition and global commitment Many definitions of PHC – here is the JLN’s “The provision of outpatient non-secondary and non-tertiary preventive and curative care, with a particular focus on ensuring the quality delivery of health interventions prioritized by both countries and the global health community against the highest disease burdens” Global commitments to PHC repeated over time, but not realized in practice Countries still continue to struggle with issues of organizational structures, demand, and financing of primary health care     Ghana experience Goals, organization Goal, objectives and strategies of Ghana PHC Goal: Maximise total life of Ghanaians Objectives: 1) Achieve basic and primary health care for 80 of people 2) Effectively attack the diseases problems that contribute 80 of morbidity and mortality Strategies: Improve accessibility-coverage of services Improve quality of PHC Improve and strengthen management capacity to support to the primary level Organization of care NATIONAL Policy -MOH GHS POLICY - MOH AND GHS TERTIARY CARE REGIONAL LEVEL STRATEGY TRANSLATION -RHMT SECONDARY CARE -REGIONAL HOSPITALS DISTRICT LEVEL PRIMARY HEALTH CARE 1ST REFERAL HOSPITAL District level organization The community level was problematic: there was little evidence that their training and deployment effectively affected morbidity and mortality. The MOH therefore took a decision to replace them with trained staff. Hence the Community-based Health Planning and Services-CHPS Initiative which uses CHO. What is CHPS Stands for Community-based Health Planning Services Involves relocating a CHN (CHO) into community with defined population (zone) Works with volunteers Supported by community through CHC Has a set of functions to perform Supervised by sub district team Community Health Care District Health Management Team Clinical Determinants Track Social Determinants Track CHPS Compound Health Centres District Hospitals Ref Ref Ref Ref M&L Planning, M&E Service & Surveillance Sub-district health management team Services/priority interventions Health services-for PHC in 1978 education concerning prevailing health problems and the methods of preventing and controlling promotion of food supply and proper nutrition; adequate