definition of the basic term

PRIMARY HEALTH CARE

AND

HEALTH CARE ADMINISTRATION

DEFINITION OF BASIC TERMS

Health: For most people, health means simply the absence of disease- and all or non-phenomenon, but this is not true in real life.

Early in the 1950s, The World Health Organization (WHO) defined health as a state of complete physical, mental and social well being and not merely the absence of disease or infirmity.

The problem in this definition is related to the meaning of the word “complete” and who decides this completeness.

Although the WHO definition of health is “theoretical”, it implies a positive valuation of health and encourages almost all world nations to work for the improvement of their people health.

Another definition of health is that “ health is a successful adaptation of the human body to stresses and stimuli (in the environment) to which it is exposed, such that it expresses adequate functioning under given genetic and environmental conditions.

Thus, health may be seen as extending over a spectrum. At one end of the spectrum is the optimal health and at the other end is the end of any health or death.


Optimal health -----------------------Death

2. Disease (Dis-ease): Failure of the adaptive mechanism of an organism to counteract the stimuli and stresses to which it is exposed, resulting in abnormal structure and function of one or more parts of the body.

3. Need: Need can be defined as the gap between optimal health (successful adaptation to environment) and ill-health (failure of such adaptation) or equivalently, need can be taken to mean the required measures and services to bridge or at least to narrow that gap.


4. Demand: The desire and actual effort involved in attempting to bridge the gap between optimal health and ill health (to meet health needs) through the utilization of health care services.

In general, demand reflects

* Population health needs,

* Their ability to pay for service utilization

* Availability of services to be used.

5. Utilization: It expresses what people actually “consume” of the health care services. Coverage rates or utilization rates are used to express utilization of a given item of services in quantitative terms. For example, the coverage rate (utilization rate) of BCG immunization for a given population at a given time is calculated as according to the following formula:

Number of babies immunizes

Coverage rate = -------------------------------------------------- x 1000

Total number of live births

Some times, we use the number of events of utilization (e.g., number of visits to outpatient clinics, number of admissions to a hospital) instead of the number of service users (persons who use outpatient care or persons admitted to a hospital) in the numerator of utilization rates.

The level of utilization of health care services is variable and is determined by

(Determinants of services utilization):

* Extent of illness

* Awareness, perception and expectation

*Distance

* Income

* socio demographic

* Sociocultural and


* Organizational factors

Utilization is very useful indicator of interaction between services and population that assists health policy makers to rectify and improve services availability and delivery.

A high utilization rate suggests a high level of morbidity and/ or a good accessibility to available health care services. A low utilization rate may suggest a relatively high standard of population health, inaccessible health care services (due to high cost, complicated administrative rules) or very low level of service supply.

6. Goal: A general term, signifying a desired end, which may be the change required on a given state, condition or situation or maintenance of that state, condition or situation.

7. Priority: A ranking of problems, needs or solutions in order of preference based on views derived from data and intelligent judgment. Factors that are taken into consideration when ranking problems, needs or solutions are:

a. Prevalence of the problem.

b. Seriousness of the problem.

c. Availability of effective measures to solve the problem.

d. Community concern.

Prioritization is resorted to when resources are not adequate (as the situation is in almost all countries) to deal simultaneously with problems, needs or solutions in a given community.

8.Norm – Standard: A desired state, acceptable level of health or qualification. Who decides such norm?


9.Resources: Trained personnel, facilities, supplies, equipment …etc that can be used in attaining goals or objectives.

10.Health care services: All services (personal or public) performed by individuals or institutions for the purpose of promoting, maintaining or restoring health.

11. Health care: the product of health care services delivered through personal and public health services. It implies a comprehensive care (promotive, protective, curative and rehabilitative).

12. Medical care: A term used to emphasize the organization and delivery of curative care. It is a subset of health care.