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SOCH311
www.endeavour.edu.au
Session 3:
Local and Global Public
Health Perspectives
Department of Social
Sciences
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Session Overview
Primary Health Care
WHO: Health For All
Global burden of disease
Public Health in Australia
Australian burden of disease
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Textbook
Liamputtong, P. (Ed). (2016). Public Health: Local and Global Perspectives.
Cambridge, UK: Cambridge University Press
- Pages 64 -67
Other
Talbot, L. & Verrinder, G. (2014) Promoting Health The primary health care
approach. 5th ed. Sydney: Churchill Livingstone Australia
- Chapter 1- Health promotion in context: primary health care and the new
public health movement. Retrieved from;
http://web.a.ebscohost.com.ezproxy.endeavour.edu.au/ehost/ebookviewer/ebook/bmxlYmtfXzExNTE2OTZfX0FO0?sid
=3efd0aed-f82f-4d3b-90c7-cfef80a458fc@sessionmgr4008&vid=0&format=EB&lpid=lp_1&rid=0
Lin, V., Smith, J. & Fawkes, S. (2015) Public Health Practice in Australia. The
organised effort. 2nd ed. Crows Nest, NSW; Allen & Unwin
- Pages 107 -108
Readings
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Primary Health Care
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Primary Health Care
o Alma- Ata declaration (1978)
• “Health for all by year 2000”
• Core policy for WHO
o PHC is about universal access to fundamental
and affordable health care for individuals and
their families within their community
o Both a strategy and a philosophy
o Underlying values of PHC still attract strong
support internationally WHO (2013) The World Health Report
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Philosophy of PHC
o Universal access to care and coverage on the
basis of need
o Commitment to health equity as part of
development oriented to social justice
o Community participation in defining and
implementing health agendasWHO (2013) The World Health Report
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Principles of PHC
Primary health, as envisaged by the Alma Alta
declaration, is the key to achieving a level of health
that allows people to lead socially and economically
productive lives.
The key principles are:
•Equity
•Social justice
•Empowerment
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Essential services of PHC
o Education regarding prevailing health problems,
prevention and control
o Promotion of food supply and proper nutrition
o Provision of an adequate supply of safe water and basic
sanitation
o Provision of maternal health and child health care,
including family planning
o Immunisation against major infectious diseases
o Prevention and control of local endemic diseases
o Appropriate treatment of disease and injury
o Provision of essential drugsWHO (1978) in Lin, Smith & Fawkes (2014)
8
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Primary Health Care …
o evolves from the conditions and characteristics
of the country and the communities based on the
application of social, biomedical and health
services research and public health experience
o addresses the main health problems in the
community, providing promotive, preventative,
curative and rehabilitative services accordingly
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Primary Health Care is …
o essential health care based on practical,
scientifically sound and socially acceptable
methods and technology
o the first level of contact between individuals the
family and the national health system, bringing
health care as close as possible to where people
live and work, as the first element in a continuing
health care process
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Primary Health Care in Australia
o PHC is the entry level to the health system and,
as such, is usually a person’s first encounter
with the health system.
o It includes a broad range of activities and
services, from health promotion and prevention,
to treatment and management of acute and
chronic conditions. (AIHW, 2016)
PHC is both a level, and an approach to care
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Primary health care in Australia
Fig 4.1 Overview of the Australian PHC within the broader
healthcare system (adapted form AIHW, 2014)
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WHO and Primary Health Care
Revitalised PHC as a key approach to Universal Health
Coverage (Health For All)
o World Health report (2008) PHC (Now More Than Ever)
o World Health Report (2013) Research for Universal
Health Coverage
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WHO and Primary Health Care
Identified 5 key areas in which to achieve PHC:
o Reduction of social/geographic/economic
isolation and exclusion through health reform
o Service delivery around specific health needs
o Integration of health into all sectors of societies
o Dialogue in collaboration with others for
leadership reform
o Increase in Stakeholder participation
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Health Systems based on PHC
o build on the Alma-Ata principles- equity,
universal access, community participation, and
inter-sectoral approaches
o take account of broader population health
issues, reflecting and reinforcing public health
functions
o create the conditions for effective provision of
services to poor and excluded groups
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Health Systems based on PHC
o organize integrated and seamless care, linking
prevention, acute care and chronic care across
all components of the health system
o continuously evaluate and strive to improve
performance
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Selective & Comprehensive PHC
Selectiveo Emphasis on disease and
equity, social justice and
empowerment issues ignored
o Non-medical interventions
discounted
o Community development
devalued
o People as experts in their own
lives disregarded
Comprehensiveo Inter-sectoral
o SDH considered in all policies
o Social justice underpins policy
o Equity embedded in policy
o Community empowered to
participate in decision-making
o Evidenced based decisions
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A health system based on PHC will …
o Reduce exclusion and social disparities in health
(universal coverage)
o Organise health services around people’s needs
and expectations( collaborative service delivery)
o Integrate health into all sectors (public policy)
o Pursue collaborative models of policy dialogue
(leadership) and
o increase stakeholder participation(WHO, 2008)
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Primary Health Care &
Social Determinants of Health
Both prioritise:
• Health equity
• A broad view of health
• Multi-sectoral action
• Participation and empowerment of communities
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Primary Health Care &
Social Determinants of Health
Both discourses are intertwined and vital to
advancing health equity
o Action to address SDH
o Restructuring health systems based on PHC
= Health for All
Social Determinants
of Health
Primary Health
Care
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WHO: Health For All
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Health for All
WHO goal of achieving
Health for All
o Human rights are at the
heart of WHO’s
mandate
o Universal Health
Coverage (Health for
All)
o Gender, equity and
human rights
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Health and Human Rights
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Health and Human Rights
“Health is a social, economic and political issue
and above all, a fundamental human right.
Inequality, poverty, exploitation, violence and
injustice are at the root of ill-health.”
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Health For All
o UN Sustainable
Development Goals
2030
o Builds on success of
the Millennium
Development Goals
2000 - 2015
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WHO: Health For All
_____________
Global burden of disease
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Global Burden of Disease
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Global Life Expectancy
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Threats and challenges to global
health
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Threats and challenges to global
health
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Public Health in Australia
_____________
Burden of disease
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Public Health in Australia
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Australia’s
leading causes
of death 2016
Public Health in Australia
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My Healthy Communities… reporting local information, driving better outcomes
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Public Health in Australia
National Health Priority Areas
o 8 key targets because of their contribution to the
burden of disease in Australia
National Strategic Framework for Chronic
Conditions
o Chronic conditions are the leading cause of
illness, disability and death in Australia
o http://www.myhealthycommunities.gov.au/our-
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Public Health in Australia
o Close the Gap campaign
o National Tobacco Strategy
o Cancer Control
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Australia National Preventative Strategy
Seven strategies and four targets
to advance population health in
Australia
• Halt obesity
• Reduce daily smoking
to ≤ 9%
• Reduce harmful
drinking by 30%
• Contribute to ‘Close
the Gap’ for Australian
indigenous
populations
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Programs managed as Public
Health in Australia
Immunisation, HIV/AIDS and communicable
diseases control
Surveillance, epidemiology and PH laboratories
Environmental health and food
safety
Health promotion-tobacco, diet,
physical activity, cancer prevention, injury prevention
DrugsWomen's cancer
screening
Maternal and child health
Disaster management
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Public Health organisations in
Australia
Includes:
o Governments- local, State & Federal
o General Practitioners
o Other health services
o NGOs- Cancer Council & Heart
Foundation
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Threats and challenges to Public
Health in Australia
Includes:
o Non-Communicable health issues –
Cardiovascular disease; Diabetes; Obesity;
Cancers; Dementia
o Ageing: a 21st century public health challenge?
o Mental Health
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Threats and challenges to
Public Health in Australia
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Complementary Medicine in
Australian Public Healtho Within PHAA
• Evidence, Research and Policy in Complementary
Medicine (ERPICM) Special Interest Group
• Health Promotion Special Interest Group
• Political Economy of Health Special Interest Group
• International Health Special Interest Group
o Australian Research Centre in Complementary and
Integrative Medicine (ARCCIM)
o National Institute of Complementary Medicines (NICM)
o The National Health and Medical Research Council
(NHMRC)
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WHO Traditional Medicine
Strategy
The goals of the strategy are to support
Member States in:
o harnessing the potential contribution
of TM to health, wellness and people
centred health care;
o promoting the safe and effective use
of TM by regulating, researching and
integrating TM products,
practitioners and practice into health
systems, where appropriateWHO Traditional Medicine Strategy 2014-2023 p. 11
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