This course explores why primary health care is central for achieving Health for All. It provides examples of how primary health care has been instrumental in approaching this goal in selected populations and how the principles of primary health care can guide future policies and actions. Two of the most inspiring, least understood, and most often derided terms in global health discourse are “Health for All” and “Primary Health Care.” In this course, we will explore these terms in the context of global health, their origins and meanings, the principles upon which they rest, and examples of how these principles have been implemented at both small and large scale. We will also explore some ultra-low-cost approaches to Health for All through primary health care, and the promise that primary health care holds for eventually achieving Health for All. Each module of this course consists of approximately one hour or lecture, approximately one hour of additional readings or video presentations, and two additional hours devoted to studying for each of the quizzes, writing and evaluating two short peer-review assignments, and participating in the discussion forums. Developed in collaboration with Johns Hopkins Open Education Lab.
Course Wrap-Up
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Из курса от партнера Johns Hopkins University
Health for All Through Primary Health Care
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Wrapping Up
In this module, we'll summarize what we covered in the preceding modules. Then, you'll have an opportunity to describe your own plan for implementing primary health care in our final peer review assignment.
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Dr. Henry Perry, MD, PhD, MPHSenior Scientist, International Health
Bloomberg School of Public Health
Well, here we are. We're at the end of our journey.
We've been on this bus ride on Coursera Express.
We've been traveling around the world. We went back in time.
And we've been looking forward about what things might be able to be achievable
through the application of these principles of primary health care.
We've talked about the origins of primary health care and the development f these
principles down to the present. We've talked about some of the challenges
that have been encountered in the process and disappointments, of course along the
way. This has not been an easy process.
It will not be an easy process in the future, but I think represents an
important way forward that we can make steady progress and that we can engage
communities in helping them improve their health.
I hope that you've gotten a sense of some of the excitement and enthusiasm that
surrounding, particularly the community-based approach to primary health
care. Working with people in communities, with
community health workers, applying proven strategies and interventions that we know
work that save the lives of children, of mothers, and can help to control disease,
and reduce that burden. Through these partnerships, that otherwise
would not be possible, because the number of trained professionals, the number of
facilities, is just not adequate to reach the, the great need that's out there.
And we cannot do this without community partnerships.
So, I hope that idea has gotten through to you and you've begun to think about how,
perhaps you, yourself, can engage communities, work with communities, to
help them improve their health. It's one of the great frontiers and
challenges of global, global health. I'm absolutely convinced.
We have spent so much time and money and resources in top-down approaches, which
are important, but we've missed the boat in really engaging people and helping them
understand what they can do to improve their health.
And that's one of the main themes of this course.
As we think about what health for all really means, we need to think about how
we will know that we've achieved it. It's one of those great ideas that we can
all get behind. It sounds great.
It is great. We know it's great, but how are we going
to know that we achieved it? And of course, there'll always be disease
and some degree of premature death. And death is unavoidable, we know that.
But what we want to be focused on is eliminating readily preventable or
treatable death. We want to prevent readily or preventable
conditions that lead to death, that lead to serious illness, that lead to serious
disability. That's what achieving health for all
really means for me. And so, one of the ideas that I really
like about measuring this has come forth with the notion of ending preventable
child deaths by the year 2035. You've been exposed to this a little bit
through your video in which you heard Hilary Clinton speak about this idea, but
I want to just mention it briefly in terms of the measurement of it.
Preventable child death means in the minds of the people who established this dream
of ending preventable death by the year 2035.
It means achieving an under five mortality rate of 20 or less in every country of the
world and in every subpopulation within that country, the poorest segments, the
most isolated areas. So we will know that we have achieved the
elimination of preventable death according to their criteria, when we have an under
five mortality rate that is at that level. This is a great challenge.
Some people say it can't be done, but I'm absolutely convinced that it can be done
if we apply our know-how. Use our available resources and bring
professional leadership, and political leadership to this process.
And so, ending preventable child death is one very important, but not the only
aspect of achieving health's role. We can think of it in other discrete
measurable kinds of ways as well. We're now beginning to think about ending
AIDS in a generation. What an exciting idea.
We know that the elimination of the transmission of maternal to child HIV
infection has been achieved in the developed world and is not far from being
achieved in the developing world. What a exciting idea that is.
Maybe some time in the not-too-distant future, blindness will be eliminated in
our world. These are but a few of the kinds of
illnesses and conditions that we need to be thinking about in, in order to achieve
health for all. But let's think about some of the other
elements that I think are critical for achieving health for all.
One is universal access to basic health care services, whether it's prenatal care,
delivery care treatment of childhood illness, access to family planning.
All of these are fundamental elements of primary health care that are essential and
most of these can be provided in the community by community level workers.
And so, we don't need to have to wait until we can build facilities and have
higher level staff out in isolated areas. We can do this now in the near future and
we can achieve universal coverage. My colleagues and I have recently carried
out computation in which we have been able to estimate that if very basic, simple
interventions were able to be implemented to everybody in developing countries with
high mortality of children. We could save the lives of four million
children every year. So this is one small example of the power
of primary health care that excites me and I hope excites you as well.
As we think about the idea of health for all being achieved, perhaps, within our
lifetime, but if not in our lifetime, certainly within the 21st Century.
And I hope sooner rather than later, I think about this quotation that the great
English Historian Albert Toynbee wrote some years ago.
And let me read it, because it is relevant for our final closing thoughts here.
The 20th Century will be chiefly remembered in future centuries, not as an
age of political conflicts or technical inventions, but as an age in which human
society dared to think of the welfare of the whole human race as a practical
objective. Increasingly, we're thinking like that and
we're going to achieve it. And it's my great belief that by building
all these principals of primary health care, we will be able to achieve health
for all sooner rather than later. And I look forward to your contributions
to this great effort. And I will hope that your participation in
this course has made it possible for you to achieve even more than you might have
without taking it. So onward and upward and all the best to
you as you apply these principles. Thank you.
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