Activity 1
To what extent have you noticed the principles and conditions of PHC demonstrated in your workplace or broader community?
Primary health care or PHC is defined as the essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self determination ( 1978). Primary health care is an approach for building interventions that can lead to improved health outcomes for an entire population ( 1997). Primary health care incorporates five principles: (a) Equitable distribution, (b) Appropriate technology, (c) A focus on health promotion and disease prevention, (d) Community participation and (e) A multi-sectoral approach ( 2004).
Deep concern about health care for the majority of the world’s population, specifically low life expectancies and high mortality rates among children led to the global health strategy of primary health care. The WHO declaration emphasized health or well-being as a fundamental right and a worldwide social goal. It attempted to address inequality in health status of persons in all countries and to target government responsibility for policies that would promote economic, social, and health development. Both economic and social developments are considered basic to the achievement of health for all.
Hong Kong is composed of a very diverse population. Aside from a very diverse population, the health problems that affect the population are also as diverse. Although no one is exempted from illness and disease, the health problems presents a pattern that shows health problems are more commonly directed at those at a disadvantaged level, for example those that commonly affect members of a lower socioeconomic level and can often be traced to poor community services with regards to water treatment, waste disposal, air quality, and transportation services.
However, this is easily solved in this Chinese territory. In Hong Kong, consumers, governments, and public health departments such as public health departments and city councils are involved in the planning and delivery of health care, which is a characteristic of primary health care. The health care system in Hong Kong (a) provides easy access by residents to the system, (b) is flexible in responding to the health care needs that individuals and families identify, (c) promotes care between and among health care agencies through improved communication mechanisms, (d) provides appropriate support for family caregivers, and (e) is affordable.
The Hong Kong health care system is also a dual system, meaning that the private and public sectors are working side by side, each complementing the other and providing patients with much needed choices (2006). Patients are also taking an active role in the planning and implementation of their own health care interventions. All these are characteristics of the Hong Kong health care system which shows that the principles and conditions of primary health care are demonstrated in Hong Kong communities.
This is further supported by the (1999). According to the report, Hong Kong’s health care system is characterized as equitable, improved quality and efficiency, and cost-effective. On the other hand, although these characteristics would mirror a demonstration of primary health care principles, the report details that the quality of health care in Hong Kong is highly variable and that public funds are also not well targeted.
This would mean that on the larger picture, the Hong Kong health care system follows the principles and conditions of primary health care. However, this demonstration is not complete and may be manifested by the lack of support from some areas of the Hong Kong health care organization.
When it comes to the workplace, it is first important to discuss the role of health care professionals in the provision of primary health care in order to understand how it is applied to a specific workplace where individuals work. The health care process is a systematic, scientific, dynamic, on-going interpersonal process in which the health care professionals and the patients are viewed as a system with each affecting the other and both being affected by factors within the behavior. From this, one could surmise that not only the health care professionals are essential for the provision of effective health care but it also needs the cooperation of the patients.
In the hospital, which is the health care setting providing the most commonly used health care services, the principles and conditions of primary health care are also demonstrated. In this current work environment, the health care professionals work closely with all the other members of the health care team to plan, coordinate, and deliver care for patients. In this work environment, primary health care looks beyond primary care with essential elements that include health education, proper nutrition, maternal/child health care, family planning, immunizations, and control of locally endemic diseases. This model being followed by the hospital is consistent with primary health care principles and conditions.
A closer look at the sectors that make up Hong Kong will also reveal that they are all linked and that events within each sector have an impact, either positive or negative, on each other and on the outcome of the population’s health. This is consistent with the fact that a primary health care approach requires a multi-sectoral and multi-disciplinary approach by addressing many of the determinants of health. It can be summarized that the principles and conditions of primary health care are clearly demonstrated in the workplace and broader community in Hong Kong.
However, the health care system of Hong Kong is not perfect and even if they have a clear demonstration of primary health care principles and conditions, there is still room for improvement in the area. Further recommendations for the current situation in Hong Kong, according to the Harvard report, include strengthening primary care, facilitating dental care, and promoting Chinese medicine in order to provide cheap and effective medicine to the less privileged group.
Activity 2
What groups in your community are marginalized by the health system? What justifications are given for the maintenance of this marginalization?
To provide quality care, health care professionals must become informed about and sensitive to the culturally diverse subjective meanings of health, illness, caring, and healing practices. Culture can be defined as the nonphysical traits, such as values, beliefs, attitudes, and customs, that are shared by a group of people and passed from one generation to another (2000). Culture also defines how health is perceived; how health care information is received; how rights and protections are exercised; what is considered to be a health problem, and how symptoms and concerns about the health problem are expresses; who should provide treatment and how; and what kind of treatment should be given (2004).
From this definition, one could conclude that patterns of health care interventions and delivery vary from one individual to another given the nature of differences that exist within cultures and individuals. Therefore, health care professionals must be aware that, although people from a given group share certain beliefs, values, and experiences, often there is also widespread intra-group diversity. Major differences within groups may be due to several factors which influence the patient’s beliefs, practices, and expectations of health care.
For these reasons, effort must be made and care taken to avoid the discrimination, stereotyping or marginalization of people from a specific group. However, anywhere you look around the world, even in the most industrialized nations, there is still some degree of discrimination and marginalization within the health care system. And it is sad to say that Hong Kong is not an exemption. This only goes to show that no health care system is perfect. No matter how hard health care systems strive to be the best, there are often loopholes that have been overlooked either intentionally or unintentionally.
It cannot be denied that the composition of people in Hong Kong has changed during the past years. Given this change in population, one can surmise that demographics, culture and language do have a considerable impact on how clients access and respond to health care services. All groups of people face issues in adapting to their environment: providing nutrition and shelter, caring for and educating children, dividing labor, developing social organization, controlling disease, and maintaining health. Humans adapt to varying environments by developing cultural solutions to meet these needs (2004).
Hong Kong is often viewed as a society of Chinese immigrants. Since the British handover to China, a new group of immigrants from mainland China have increased the ethnic diversity of the Chinese population. According to Kim-Ming (2006), recent Chinese immigrants are socially excluded in Hong Kong. It has been argued that the mechanisms of social exclusion are the result of the interplay of several factors: immigration policies, the stage of the economic development, state-building and local identity formation. From a historical perspective, it is shown that Hong Kong's immigration policy regime corresponds with the developmental stage of the economy. when we speak of social exclusion, this includes exclusion also in the health care aspects. Chinese immigrants in Hong Kong are included in those who are considered marginalized in the health care system of Hong Kong.
When it comes to pregnant women, the position and status of women in Hong Kong had been constantly improving. In the area of health, the government offers a comprehensive range of preventive, curative and rehabilitative health care services for women of all ages. Presently there are three Women Health Centres which provided services for women in the region of Hong Kong, Kowloon and the New Territories. The claims of marginalization of some pregnant women could possibly be a combination of other factors present in the woman herself, such as her ethnic background and belonging to a lower socioeconomic level and cannot afford the health care costs.
The act of marginalization or discrimination is the differential treatment of individuals or groups based on categories such as race, ethnicity, gender, social class, or exceptionality. This occurs when a person acts on prejudice and denies another person one or more of the fundamental rights. The act of marginalization cannot be justified in terms of racial differences or condition. Every person regardless of gender, socioeconomic status, nationality, age, or any other factor, has the fundamental right to health and the services provided. When one is in a certain area or locale, the individual could avail primary health care provided when the need arises.
Perhaps the marginalization of some occupants of Hong Kong is attributed to factors that are not in any way related to being an immigrant, being pregnant, or being of another nationality. The only possible accepted justifications could be that marginalization occurs because of (a) lack of access to quality care due to financial constraints or difficulty in language, (b) differences in the patient’s health care perceptions to that of the Hong Kong health care system, and (c) the lack of the proper and needed documents such as in the case of other foreign nationals residing in Hong Kong. These are just some of the possible reasons why some occupants in Hong Kong feel marginalized. However, a number of other reasons are possible. These reasons are diverse and complex and the only thing sure is that it is not fair to point the blame for the marginalization of health care to the Hong Kong government. The Hong Kong health care system is doing its best to be able to provide equal and quality care access to everyone.
In fact, the Hong Kong government has policies that promote the provision of services consistent with primary health care conditions and principles. Furthermore, the Hong Kong government encourages that to ensure equal access to quality health care by diverse populations, health care organizations and health care professionals should promote and support the attitudes, behaviors, knowledge, and skills necessary for staff to work respectfully and effectively with patients and each other in a diverse work environment. In fact, as the population in Hong Kong becomes more diverse in many ways possible, health care professionals are caring for an increasing number of patients from many different cultural and linguistic backgrounds. And they have been able to care for them well.
0 comments:
Post a Comment