Primary Health Care: The Basics

In the following sections, information is given and links provided to sites where you should be able to find further information in an understandable form on the following topics:

RH & MCHEPINutritionMalaria
HIV/AIDSOther STDsDiarrhoeaTBLeprosy
Water, Sanitation & WasteHealth EducationAlternatives

For any reader who wants more, there are a huge number of sites on the Web offering quality information – but with language aimed at people with higher education. If you are happy with that level of language then a good starting point is Eldis – go to www.eldis.org/health and check the list of topics at the right of the page.

To consider activities at different levels of care, download "Principles and Practice of PHC" from this site; look at Part Two 5.2.

Reproductive Health (RH) and Mother & Child Health (MCH)

blue-bullet For an outline of actvities plus a discussion, download "Principles and Practice of PHC" from this site and read 1.3. & 2.2.

blue-bullet "A Book for Midwives:Care for pregnancy, birth, and women's health" by Susan Klein, Suellen Miller, and Fiona Thomson

blue-bullet There are a number of informative pages on www.engenderhealth.org, including contraceptive methods and an online/downloadable course on Sexuality.

blue-bullet Resources available from the UNHCR library include "Reproductive Health in Refugee Situations: an Inter Agency Field Manual"(143 page PDF).

blue-bullet The Population Council's mission is to improve the well-being and reproductive health of current and future generations. Read more at www.popcouncil.org

blue-bullet If you want to know more about female genital circumcision go to the WHO home page and type FGM or female genital mutilation into the search slot.

blue-bullet A paper on prevention of obstetric fistula in South Asia especially Pakistan - an overview of possible measures and prevention: click here

blue-bullet www.healthlink.org.uk has a number of newsletters that you might want including "Child Health dialogue". Go to the site and type "newsletters" into the Search slot.

blue-bullet Do you want to know more about your body, the facts of life and sexual health? A good short book is the BBC’s Sexwise — 22 pages, available in 22 languages. However it does not discuss homosexuality much and it does not have illustrations…

blue-bullet So the next stop could be Chapter 4 of “Where Women Have No Doctor” (PDF) – it covers the reproductive system of both men and women, with pictures both of the insides and outsides of our bodies.

blue-bullet A Zimbabwean website with an 'Agony Aunt': www.tarsc.org/auntstella

blue-bullet At www.fhi.org there is downloadable stuff on RH and young adults. Go to the site and type "RH adolescents" into the search slot— look for "Key Issues in Adolescent Health"

blue-bullet There is an excellent manual at at www.path.org. called "Reaching the Hardly reached". It has articles looking at needs and approaches with homosexuals, trafficked women, female genital mutilation etc.

blue-bullet Ipas have developed a gender and reproductive health resource pack for training adolescents and professionals who serve youth, which you can download as a pdf (now available directly from our own server).

blue-bullet Other sites that cover aspects of Reproductive Health: www.rho.org, www.cedpa.org and www.ippf.org

Expanded Programme of Immunisation (EPI)

blue-bullet For an outline of activities, download "Principles & Practice of PHC" from this site and look at section 2.1.

blue-bullet About increasing coverage: www.who.int/...

Nutrition

blue-bullet Download "Principles & Practice of PHC" from this site and look at Part Two, Section 3: "Interventions to Improve Nutritional Status - 3.1. Protein-Calorie malnutrition and 3.2. Micro-Nutrients". The text refers to the relative failure of PHC to deal effectively with malnutrition in children under five.

blue-bullet There are papers on community nutrition initiatives including the 3-page PDF, "The essential nutrition actions" at www.basics.org

Malaria

blue-bullet For activities at the different levels of care, download "Principles & Practice in PHC" from this site and look at Part Two, Section 5.1.

blue-bullet You can keep your knowledge up-to-date at WHO's malaria section

blue-bullet The Royal Perth Hospital, Australia offers information on Malaria in English, French and Spanish: diagnosis, prophylaxis and treatment as well as "an innovative interactive Test & Teach self assessment module" in English, French and Spanish. CD-Roms with the same content as the website can also be ordered, free of charge.

HIV/AIDS

blue-bullet Read "An Overview of the HIV/AIDS Epidemic & Responses to it" in this section of the site.

blue-bullet To consider activities at different levels of care, download "Principles and Practice of PHC" from this site; look at Part Two 5.2.

Important websites on HIV/AIDS are at:

blue-bullet who.int/hiv

blue-bullet aidsalliance.org

blue-bullet unaids.org

blue-bullet unfpa.org, whopublishes country statistics and programmes.

Methods of transmission – High risk groups:

blue-bullet avert.org Go to the site and then click on your topic from the list on the left side of the screen

Preventing transmission:

blue-bullet At individual level: avert.org

blue-bullet The Drum Beat; get on the mailing list for its electronic newsletter

blue-bullet The AIDS Alliance (HIV/AIDS and communities) now has a newsletter. For copies, email This email address is being protected from spambots. You need JavaScript enabled to view it.

blue-bullet Building emotional strength – for carers,etc: Interviewing & Counselling at the Grass Roots

blue-bullet Peer Education (PDF)

Treatment:

blue-bullet Treating HIV & AIDS: A Training Toolkit at the NAM/AIDSmap website offers basic training on HIV treatment and care for health care workers in resource-limited settings, to support the safe and effective introduction of antiretroviral therapy.

blue-bullet NAM/Aidsmap have simple information booklets for the general public on HIV/AIDS.

The subjects include: • Adherence (sticking to the treatment); • Anti-HIV Drugs; • Clinical Trials; • HIV and Children; • HIV and Hepatitis; • HIV and Women; • HIV & Sex; • HIV and TB; • HIV Therapy; • Lipodystrophy (Changes in your fat & metabolism); •Nutrition; • Resistance; • Viral Load & CD4 Count.

blue-bullet NAM/Aidsmap also offers an online newsletter on developments in treatmentfor doctors, nurses, managers etc. IF YOU WORK IN THIS FIELD IT WOULD BE SAD IF YOU WERE NOT BEING UPDATED THROUGH THE RIGHT NEWSLETTER - ESSENTIAL READING.

blue-bullet NAM/AIDSmap newsletters Updates on trials and treatments

blue-bullet engenderhealth.org offers an online course to bring you up-to-date on HIV/AIDS

HIV/AIDS & Gender:

blue-bullet eldis.org had a lot on gender and HIV/AIDS with links to hundreds of documents and organisations on the web. Go to the site and put the words "Women & AIDS" into the Search slot.

blue-bullet At www.healthlink.org.uk click the following words into the search slot:"HIV & Safe Motherhood". They have free Manuals, CD-ROMs etc; They also have downloadable Newsletters.

Home Care/Palliative care:

blue-bullet The World Association for Palliative Care (thewpca.org) make their resources available in various languages. Of special interest:

  1. Palliative Care Toolkit - Improving care from the roots up in resource limited settings. This was written to empower health workers in resource-poor settings to integrate palliative care into the work they are doing. (In Spanish, Portuguese, Mandarin,  Russian  Swahili , French , Bengali)
  2. Training Manual for the Palliative Care Toolkit. This Training Manual was produced to accompany the Toolkit. It contains structures teaching modules and resources which can help others use the Toolkit. (In Spanish  Portuguese , Mandarin, Bengali)
  3. Advocacy Toolkit.This Toolkit highlights the key advocacy tools that are specifically of relevance to hospice and palliative care organisations who wish to develop their advocacy work. It also provides examples of how these tools have been used and have worked in practice. (Currently English Only)
  4. An introduction to resource mobilisation. This document provides information about effective fundraising. (Currently English only)

blue-bullet See section 7 of our publication Principles & Practice of PHC, on Palliative Care;

blue-bullet Worldwide Hospice and Palliative Care Online offer newsletters and factsheets.

blue-bullet "Palliative care: Issues and Challenges" (3 pp. PDF)

blue-bullet UNAids.org offer a technical update on palliative care (16pp PDF)

blue-bullet CDC offer global and regional guides to AIDS and palliative Care

blue-bullet For carers, see our publication Interviewing and Counselling at the Grassroots

Care of AIDS Orphans:

blue-bullet Avert.org has information on approaches to helping AIDS Orphans for people working with vulnerable children such as AIDS orphans. See also othe other resources for children

STDs other than HIV/AIDS

In some circumstances the importance of HIV/AIDS means that other STDs are forgotten or neglected. Gonorrhoea, syphilis and chlamydia are bacterial infections and can be treated with antibiotics if the strain has not developed a resistance; herpes and HIV are viruses and cannot.

All these diseases are more common in poor countries where access to treatment is difficult; they are also more common where people have many sexual partners.

These other STDs are important because

  • they make HIV infection easier. This is because they can cause small sores on the genitals through which the HIV virus can pass.
  • they are very common. In parts of the USA and in Africa, over 30% of groups of women or girls may have chlamydia. Both chlamydia and gonorrhoea may be present in women with no symptoms showing.
  • they cause serious problems. Both chlamydia and gonorrhoea can  leave girls and women unable to have children. Chlamydia is also a common cause of trachoma and blindness. Syphilis can be passed by mothers to their babies (congenital syphilis). Many of the babies will die in their first year; others will have serious mental and physical consequences

A priority in developing countries is to screen pregnant women, to prevent the passing on of syphilis to the babies. Women in primary health centres should be tested and treated at the same clinic visit. The introduction of decentralised testing in Haiti reduced the cases of congenital syphilis by 75% in 2 years. Many developing countries are now scaling up programmes for the prevention of mother-to-child transmission of HIV. This offers an opportunity to screen for syphilis as well.

Sources:

blue-bullet WHO over syphilis

blue-bullet WHO over vaccine research (PDF. English is written for graduates)

Further reading:

blue-bullet http://www.cdc.gov/std This site offers picture cards - illustrations of the disease in people. If you are teaching they could be very useful.

Diarrhoea

blue-bullet For an overview of activities at different levels of care, download "Principles & Practice in PHC" from this website; look at Part Two, 5.3. The problem of diarrhoea is closely linked to the provision of Water & Sanitation or lack of it - so look also at Part Two, 6.

blue-bullet From UNICEF: "Guidelines for the Treatment of Diarrhoea in Children" (54pp PDF)

blue-bullet UNIVEF and WHO published: Diarrhoea: Why Children are Still Dying and What Can be Done

blue-bullet Solar Water Disinfection is a simple way of purifying small amounts of dirty water to make it suitable for drinking and rehydrating children with diarrhoea.

Tuberculosis

blue-bullet For an overview of services at different levels of care, download "Principles & Practice of PHC" from this site. Look at Part Two, 5.4. Tuberculosis interacts with HIV/AIDS. It is a desease that for a time seemed to be declining but it is now a very serious problem and is increasingly becoming resistent to common drugs

blue-bullet Keep up to date with WHO

blue-bullet Subscribe to the AIDSMAP newsletter that will keep you up to date with TB in HIV/AIDS patients.

blue-bullet WHO explains The 5 elements of DOTS (Directly Observed Treatment)

Leprosy

blue-bullet For an overview of services at different levels of care, download "Principles & Practice of PHC"Look at Part Two 5.5.

blue-bullet Keep up to date with WHO: www.who.int/lep

Water, Sanitation & Waste disposal

blue-bullet For an overview of activities at different levels of care download "Principles & Practice of PHC", Part Two Section 6. Look also at 5.3, Diarrhoea; 5.6, Common Local Diseases related to water; 5.8. Infections prevented by better water & sanitation. This is a big subject that requires a lot of exploration.

blue-bullet Try WHO's publications on water, sanitation and health

blue-bullet WHO offer a safe health-care waste management policy paper (pdf)

blue-bullet Also, Management of solid health-care waste at primary health-care centres

blue-bullet Another good website is www.irc.nl, the site of the International Water and Sanitation Centre. Use the search slot to find what you need. For example they have a fact-sheet on on-site sanitation, and a monitoring tool for school latrines, and  good articles on Community Management.

Health Education

blue-bullet For an introduction to the discipline and an overview of activities at different levels of care, download "Principles & Practice of PHC" on this site and go to Part Two, Section 4. Then look at the webpage "Behaviour Change" on this site, where you will find our resources on this topic including the manual "Health Education for Behaviour change".

Alternative approaches to health

blue-bullet Operation Upgrade have a manual linking literacy and health, "Good Health Begins at home; A guide for literacy tutors" (36 pp in Zulu and English).

blue-bullet Interest in Traditional Medicines seems to come and go. Valid sites on the Web dissapear. The lunatic claims for traditional remedies curing HIV/AIDS have done harm.

blue-bullet The World Bank website has a section on indigenous knowledge and practices known as IK. This is a field that may become more important in the future.

NGO FIELDS

Help us to develop this field!

—Do you have a good link or resource you can recommend?

—Are you making a difference locally that could inspire others elsewhere?

All feedback is welcome!
» This email address is being protected from spambots. You need JavaScript enabled to view it.

maeve
Maeve Moynihan
Health & PHC Editor

Can't find what you want? Enter a keyword for your topic and click 'FIND'