Component Of Primary Health Care Research Articles

How Under-Nutrition (Karshya) is Responded to Ayurvedic Treatment: A Case Study

Despite numerous global sensible corrective attempts to provide nutrition, undernutrition (Kaarshya) remains one of the most pressing issues. The bulk of the population in underdeveloped nations is undernourished. It is one of the main causes of death and morbidity in both children and adults. One of the eight components of primary health care in the worldwide campaign for health for all is the promotion of appropriate diet. A person who is malnourished is prone to a slew of problems. It is a condition in which the body's fat and muscles are depleted. This is why it is critical to treat it to restore the body's normalcy. With its unique approach to lifestyle management and medication therapy, Ayurveda, with its holistic perspective, can aid with this disease. Swasthavritta (Community Medicine) has a part in Kaarshya management. Ashwagandhadi avaleha acts as an excellent nutritional treatment to alleviate the symptoms of Kaarshya in youngsters. As a result, Ayurvedic therapy for Kaarshya was arranged. After one month of treatment, the patient gained 1.5 kg of weight, and the next month, i.e., the follow-up period, the patient exhibited substantial improvement in weight growth. Other anthropometric measures improved as a result of the therapy. The assessment was carried out over two months.
 Aim: To study the effect of Ashwagandhadi avaleha on BMI and weight in karshya.
 Materials and Methods: This is a single case study on underweight female. Ashwagandhadi avaleha was given for two months. Anthropometric parameters such as weight, body mass index (BMI), hip circumference (HC) and mid-arm circumference (MAC) and subjective parameters were assessed before and after 2 months.
 Result: Significantly increased in weight i.e. 2Kg was observed after two months.
 Conclusion: Regular intake of Ashwagandhadi avaleha significantly increases weight and body mass index in Karshya.

Proceedings From the California Dental Association Symposium on Geriatrics and Oral Health

he California Dental Association and the University of the Pacific, Arthur A. Dugoni School of Dentistry convened a gathering of experts and stakeholders to conduct a strengths, weaknesses, opportunities and threats (SWOT) analysis with regard to oral health needs, dental education and workforce, financial and reimbursement structures and legislative opportunities as they relate to improving oral health for older Californians. The consensus was that change must begin in dental education, with relevant and innovative clinical experiences in geriatric care, including interprofessional education (IPE) and interprofessional practice (IPP) with appropriately trained faculty. Incentives for faculty and professional development are needed to develop role models who can appropriately manage the diverse and unique oral health care needs of older adults as part of an interprofessional team. Value-based care and novel dental benefit and reimbursement mechanisms are needed to support many older Californians who are lacking financial resources for care. Innovation in care delivery models to meet the needs of those who are most vulnerable and removed from opportunities for care are also needed to improve access to care and health outcomes across California. The entire health care team must be engaged. Oral health care must be perceived and practiced as an integral component of primary health care to achieve optimal health outcomes.

Essential Medicines Research in India: Situation Analysis

<p style="text-align: justify;">World Health Organization established the concept of essential medicines with the main aim to improve the availability of most necessary drugs to fulfil basic health care needs of population. Access to essential medicines is one of the crucial components of primary health care. Access to medicines is included in millennium development goals as well as universal health coverage policy. In 2000, India made a policy &ldquo;Health for All&rdquo; and one of the main objective of this policy is to ensure availability of quality medicines at reasonable cost to the society. The overall budget on medicines differs widely in different states of India and as a result their access is also highly variable. This review will emphasis on essential medicine concept and report of various research surveys conducted to evaluate availability of essential medicines in different parts of India. An exhaustive literature search was planned to study the availability of essential medicines in India. The search engines used were PubMed and Google Scholar. Relevant keywords were used to make the searches such as essential medicines concept, essential medicines report, essential medicine research in India, availability of essential medicines in India. The articles published in English language between the years 2003 and 2017 were extracted and included. The findings of these studies were summarized into a narrative review. <p style="text-align: justify;"><strong> Key words:</strong> Essential medicines, Public health, Government sector, Private sector, Health for All, National policy, Universal health coverage.

Modified scoping review of the enablers and barriers to implementing primary health care in the COVID-19 context.

Since the Alma Ata Declaration of 1978, countries have varied in their progress towards establishing and sustaining comprehensive primary health care (PHC) and realizing its associated vision of ‘Health for All’. International health emergencies such as the coronavirus-19 (COVID-19) pandemic underscore the importance of PHC in underpinning health equity, including via access to routine essential services and emergency responsiveness. This review synthesizes the current state of knowledge about PHC impacts, implementation enablers and barriers, and knowledge gaps across the three main PHC components as conceptualized in the 2018 Astana Framework. A scoping review design was adopted to summarize evidence from a diverse body of literature with a modification to accommodate four discrete phases of searching, screening and eligibility assessment: a database search in PubMed for PHC-related literature reviews and multi-country analyses (Phase 1); a website search for key global PHC synthesis reports (Phase 2); targeted searches for peer-reviewed literature relating to specific components of PHC (Phase 3) and searches for emerging insights relating to PHC in the COVID-19 context (Phase 4). Evidence from 96 included papers were analysed across deductive themes corresponding to the three main components of PHC. Findings affirm that investments in PHC improve equity and access, healthcare performance, accountability of health systems and health outcomes. Key enablers of PHC implementation include equity-informed financing models, health system and governance frameworks that differentiate multi-sectoral PHC from more discrete service-focussed primary care, and governance mechanisms that strengthen linkages between policymakers, civil society, non-governmental organizations, community-based organizations and private sector entities. Although knowledge about, and experience in, PHC implementation continues to grow, critical knowledge gaps are evident, particularly relating to country-level, context-specific governance, financing, workforce, accountability and service coordination mechanisms. An agenda to guide future country-specific PHC research is outlined.

Adolescent sexual behaviour in a refugee setting in Uganda

BackgroundChildren under 18 years old constituted more than half (52%) of the refugee population in 2017. Adolescent Sexual and reproductive health is an essential component of primary health care. Yet, not every refugee adolescent is able to access sexual and reproductive health services.MethodsUsing quantitative data from 356 refugee adolescents and qualitative data (17 in-depth interviews and nine key informant interviews), we examine refugee adolescent sexual behaviour in Bidibidi settlement—the largest refugee settlement in Uganda using a binary logistic regression model.ResultsThe results show that 25% of refugee adolescents in Bidibidi refugee settlement had ever had sex. After controlling for all factors, results show that refugee adolescents aged 16–18 years (OR = 3.47; 95% CI = 1.09–10.94), males (OR = 17.59; 95% CI = 4.48–69.07), not in school (OR = 14.57; 95% CI = 2.20–96.35) were more likely to engage in sexual behaviour than their counterparts. Refugee adolescents who do not agree that a girl cannot get pregnant if she has sex while standing up (knowledge about getting pregnant) were significantly less associated with sexual behaviour (OR = 0.30; 95% CI = 0.10–0.85).ConclusionsResults from this study show that keeping refugee adolescents in school and providing sexual and reproductive health information are likely to delay refugee adolescents’ engagement in sexual behaviour. Therefore, there is need to promote keeping refugee adolescents in school in order to improve sexual and reproductive health of adolescent refugees living in low-income countries such as Uganda.

Global community perception of \u2018surgical care\u2019 as a public health issue: a cross sectional survey

BackgroundIn the last decade surgical care has been propelled into the public health domain with the establishment of a World Health Organisation (WHO) designated programme and key publications. The passing of the historic World Health Assembly Resolution (WHA) acknowledged surgical care as a vital component towards achieving Universal Health Coverage (UHC). We conducted the first worldwide survey to explore the perception of surgical care as a public health issue.MethodThe anonymous, cross sectional survey targeted worldwide participants across a range of professional backgrounds, including non-medical using virtual snowball sampling method (in English) using Google Forms (Google Inc., Mountain View, CA, USA) from 20th February 2019 to 25th June 2019. The survey questions were designed to gauge awareness on Sustainable Development Goals (SDGs), UHC, WHO programmes and key publications on surgical care as well as perception of surgical care as a priority topic in public health.ResultsThe survey was completed by 1954 respondents from 118 countries. Respondents were least aware of surgical care as a teaching topic in public health courses (27%; n = 526) and as a WHO programme (20%; n = 384). 82% of respondents were aware of UHC (n = 1599) and of this 72% (n = 1152) agreed that surgical care fits within UHC. While 77% (n = 1495) of respondents were aware of SDGs, only 19% (n = 370) agreed that surgery was a priority to meet SDGs. 48% (n = 941) rated surgical care as a cost-effective component of Primary Health Care. 88% (n = 1712) respondents had not read the WHA Resolution on ‘Strengthening emergency and essential surgical care and anaesthesia as a component of UHC’.ConclusionThere is still a widespread gap in awareness on the importance of surgical care as a public health issue amongst our respondents. Surgical care was not seen as a priority to reach the SDGs, less visible as a WHO programme and not perceived as an important topic for public health courses.

Village Health Volunteers: Facing up to the Covid-19 Challenge

Village Health Volunteers (VHVs) are a crucial component of primary health care in Thailand. They have applied their role in collaboration with the nation’s public health officials at primary and community hospitals since 1978. The outbreak of the 2019 Coronavirus disease (COVID-19), first recorded in Wuhan, China at the end of 2019, has infected millions of people in almost every country in the world, leading to illness, hospitalization and, in many cases, untimely death. During this time global healthcare systems have been under enormous strain to contain the virus outbreak and treat sick people. COVID-19 first came to the attention of Thailand as a highly infectious disease on 26 February 2020, but the nation has successfully responded to the pandemic by focusing effort and resources on primary healthcare. VHVs have contributed significantly in their central role in preventing and controlling the virus in communities around the country.

The Two Great Healing Traditions: Issues, Opportunities, and Recommendations for an Integrated First Nations Healthcare System in Canada

ABSTRACT The First Nations in Manitoba, Canada, are calling for active recognition and incorporation of holistic traditional healing and medicine ways and approaches by the mainstream healthcare system that has hitherto tended to ignore all but biomedical approaches. This request for recognition requires elaboration on areas of opportunity for collaboration that could positively influence both Indigenous and allopathic medicine. We discuss pathways to an integrated healthcare system as community-based primary healthcare transformation. A community-based participatory research approach was used to engage eight Manitoba First Nations communities. One hundred and eighty-three (183) in-depth, semi-structured key informant interviews were completed in all communities. Grounded theory guided data analysis using NVivo 10 software. We learned that increased recognition and incorporation of traditional healing and medical methods would enhance a newly envisioned funded health system. Elders and healers will be meaningfully involved in the delivery of community-based primary health care. Funding for traditional healing and medicines are necessary components of primary health care. An overall respect for Indigenous health knowledge would aid transformation in community-based primary health care. Recognition of and respect for traditional healing, healers, medicines, therapies, and approaches is also recommended as part of addressing the legacy and intergenerational impact of assimilative policies including Indian residential schools as the Truth and Reconciliation Commission of Canada has stated in its Calls to Action.

SUBSTANTIATION OF COMPONENTS OF AVAILABILITY AND INTEGRATION OF PRIMARY HEALTH CARE ASSOCIATED WITH AMBULATORY CARE SENSITIVE CONDITIONS IN UKRAINE

The aim: Identifying the components of availability of Primary Health Care (PHC) and integration between PHC and secondary Health care (SHC) which need strengthening to reduce the rate of Ambulatory Care Sensitive Hospitalizations (ACSH) in Ukraine. Materials and methods: The study was conducted in two stages: the focus of interviewing experts on the list of components of the availability of PHC and its integration with SHC; survey of our questionnaire is based on the results of the first stage of the study. The responses of 93 respondents - 20 experts and 73 general practitioners/family doctors - were analyzed using descriptive and analytical statistics. Results: There were identified 14 components of PHC availability and 8 integration components of PHC with SHC, their quantitative value (in points) of impact on ACSH. The informativeness of components is confirmed by the agreement of opinions of experts on their list (concordance coefficient W = 0.75 -0.87; p <0.01) and the reliable correlations of scores of impact assessments of the identified components with overall values of the impact availability PHC and the integration between PHC and SHC on the ACSH. Conclusions: The results of the study can be used to develop an action plan for reform of PHC, the implementation of which will reduce rates hospitalizations of Ambulatory care sensitive conditions and increase the efficiency use of limited resources of health care system of Ukraine.

Influence Factors Utilization of Family Planning Services among Reproductive Age Women’s in Primary Health Care

Background: Family planning services as an essential component of primary health care and reproductive health, contributes to reducing maternal and newborn mortality and morbidity and transmission of HIV. Attitudes and knowledge towards family planning services are role play and consider influence factors on family planning services, assess to the means of fertility regulation and communication between husband and wife about desired family size and timing of pregnancy are essential for family planning. Objective: To determine the influence factors on family planning services of women in reproductive age. Also to determine the association between influence factors of family planning of women in reproductive age and their demographic characteristic. Materials of the Study: The study design a quantitative research by descriptive study, the sampling it is non-Probability “purposive” sample was a conducted on 150 females which attended with requirement health care services attained in primary health care centers at AL-Najaf city for period from September 7, 2018 to February 16, 2018 November. A questionnaire it has used as a tool of data collection to fulfill the study. A descriptive and inferential statistics was used to analyze the data. Results: The study results indicate that the majority of study responses are age (30_37)years with 42.0%, duration marriage the most study sample (6_11)years with 44.0%. Related to number of children more half study sample (3_5) with 49.3%, Level of education most are higher secondary school with 28.0%,Occupation the majority study sample homemaker with 70.7% and live in urban. The study sample utilization of met family planning was oral contraceptive pills with 34.7%.In addition, the study sample are more than half their knowledge are poor and attitude negative about family planning. Conclusion: The majority of the sample study used contraceptive pills and IUD due easy and do not need to procedures and knowledge. There is a significant relationship between knowledge, attitude and items of family planning. Some of demographic data effect upon knowledge and attitude because different in level of education and residence.

Health & Wellness Centers to Strengthen Primary Health Care in India: Concept, Progress and Ways Forward.

In February 2018, the Indian Government announced Ayushman Bharat Program (ABP) with two components of (a) Health and Wellness Centres (HWCs), to deliver comprehensive primary health care (PHC) services to the entire population and (b) Pradhan Mantri Jan Arogya Yojana (PMJAY) for improving access to hospitalization services at secondary and tertiary level health facilities for bottom 40% of total population. The HWC component of ABP aims to upgrade and make 150,000 existing Government Primary health care facilities functional by December 2022. The first HWC was launched on 14 April 2018 and by 31 March 2020, a total 38,595 AB-HWCs were operational across India. This article documents and analyses the key design aspects of HWCs, against core components of PHC & the health system functions. The article reviews the progress and analyses the potential of HWCs to strengthen PHC services and therefore, advance Universal Health Coverage in India. Challenges emerged from COVID-19 pandemic & learnings thus far has also been analyzed to guide the scale up of HWCs in India. It has been argued that effectiveness and success of HWCs will be dependent upon a rapid transition from policy to accelerated implementation stage; focus on both supply and demand side interventions, dedicated and increased funding by both union and state governments; appropriate use of information and communication technology; engagement of community and civil society and other stakeholders, focus on effective and functional referral linkages; attention on public health services & population health interventions; sustained political will & monitoring and evaluation for the mid-term corrections, amongst other. Experience from India may have lessons and learnings for other low and middle-income countries to strengthen primary healthcare in journey towards universal health coverage.

Community participation in prevention and control of infectious diseases

Historically, the health status of the people of Bangladesh has been greatly influenced by communicable diseases. Infant mortality, maternal mortality, life expectancy and many other health indicators are determined by diseases like cholera, malaria, kala-azar, tetanus and diphtheria. Contamination of water, prevalence of vectors, poor nutritional status and poor hygienic behaviour increase people’s vulnerability to sickness and death when exposed to various communicable diseases. In recent years, however, measures including provision of safe water, better nutritional interventions, vector management, and strengthened immunization efforts brought improvement in health scenario of the country. Health service is a basic requirement for every human being and it is liability of government to ensure adequate medical facilities to the people. People involvement is central to all aspects of human development of which health is one. During the last two decades it becomes obvious that people’s participation is not only beneficial but essential in the pursuit of better health objectives. According to the Alma-Ata conference in 1978, community participation was described as an essential component of primary health care.

Mammography adherence among medically underserved women undergoing cancer genetic risk assessment.

1554 Background: Medically underserved women bear a disproportionate burden of breast cancer (BC) mortality. Early detection is vital for reducing BC deaths. Cancer genetic risk assessment (CGRA) provides an opportunity to identify women at highest risk so that risk-adapted screening can be implemented. The effect of CGRA on mammography adherence among underserved women is unknown. Methods: We conducted a study to test the feasibility of performing cancer genetic risk assessment (CGRA) as part of standard primary healthcare at two Federally Qualified Health Centers in Chicago, IL. Racial/ethnically diverse women age 25-69 without a personal history of BC underwent CGRA at the time of an annual well-visit and received the result from their PCP. Medical record review provided data on mammography adherence. Demographic data and measures of perceived BC risk, BC cultural beliefs, fatalism, and BC worry were collected with an enrollment survey. McNemar’s test compared the rate of adherence to screening mammography before and after implementation of CGRA, defined as completing a screening mammogram within 18 months prior to or following CGRA, resp., among women eligible for screening (age &gt; 40 at study enrollment). Logistic regression models tested for associations between mammography adherence and demographic characteristics/health beliefs. Results: Data was available for 90 participants with increased BC risk (IR) who were eligible for screening and 98 eligible, average risk (AR) participants (in total, 61% black and 37% Latina). Overall, adherence improved from 38% at baseline to 49% following CGRA (p = 0.03). Adherence increased from 35% to 51% among IR participants (p = 0.04), and from 40% to 47% among AR participants (p = 0.39). Data on predictors of adherence will be presented. Conclusions: Implementing CGRA as a standard component of primary healthcare improved adherence to screening mammography among racial/ethnically diverse underserved women. The effect was seen primarily in those with increased risk. This intervention could be used to improve uptake of mammography in the subgroup of underserved women who benefit the most from screening.

Recommendations to Improve Antenatal Care Uptake through Community Participation and Local Accountability

Antenatal care, an integral component of primary health care, is offered as a free health service for pregnant women at public health facilities. However, the death of women during pregnancy, during childbirth, or after delivery continues to be a major challenge in health care systems due to poor antenatal care uptake. The main aim of this study was to explore and describe recommendations from local stakeholders and health governance structures to promote the uptake of Basic Antenatal Care (BANC) services in the areas surrounding local clinics. The study used a qualitative, descriptive design, with purposively selected participants sharing detailed information in their own words on the subject. Twenty individual in-depth interviews were conducted at three selected community health centres (CHCs) in the Bushbuckridge sub-district, Mpumalanga province. The results revealed the following needs: clinic committees must participate in promoting BANC awareness through health education, use of existing community-based structures must be strengthened, men’s support for their pregnant partners must be harnessed, and the roles and responsibilities of clinic committees must be amplified. The study showed that community leaders and clinic committees are willing to work in collaboration with health care providers in promoting antenatal care uptake in the community by expanding BANC awareness. Clinic committees’ previous involvement in health awareness campaigns is a strength that could contribute to making antenatal care awareness programmes successful. Vital recommendations include formalising reporting mechanisms for clinic committees so that they can be accountable to the community in promoting BANC services, strengthening stakeholder collaboration, and resourcing.

Disaster management in rural and remote primary healthcare settings: a scoping review protocol.

This scoping review aims to systematically identify and map the roles of primary healthcare professionals in rural and remote areas during natural, man-made and pandemic disasters. Disasters can be caused by natural events, man-made incidents or infective agents resulting in a pandemic. Healthcare practitioners working in primary care settings have important roles during disaster prevention, preparedness, response and recovery. When rural and remote settings are affected by disasters, there are unique challenges for healthcare professionals. This review will aim to contribute to disaster management knowledge within rural and remote primary health care, and assist in the development of practice-based disaster preparedness and future policy discussion. This review will consider studies that include primary healthcare professionals, defined as having first-level contact with patients in the community, in rural or remote areas only. The role of the healthcare professional will also be discussed within the paper. Research from Australia, Canada, the USA, New Zealand and the UK will be included. Databases to be searched include CINAHL (EBSCOhost), PubMed, Scopus and Embase (Elsevier), as well as gray literature within Trove, MedNar and OpenGrey. The search will be limited to articles written in English and published from 1978 to the present. Titles and abstracts will be screened by two independent reviewers, and full-text studies will be retrieved and assessed against the inclusion criteria. Results will be recorded in a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagram. Data will be extracted and presented as a tabular summary with supporting narratives and figures.

Stigma and discrimination related to mental health and substance use issues in primary health care in Toronto, Canada: a qualitative study

ABSTRACT Purpose: Community Health Centres (CHCs) are an essential component of primary health care (PHC) in Canada. This article examines health providers’ understandings and experiences regarding stigma towards mental health and substance use (MHSU) issues, as well as their ideas for an effective intervention to address stigma and discrimination, in three CHCs in Toronto, Ontario. Methods: Using a phenomenological approach, we conducted twenty-three interviews with senior staff members and peer workers, and three focus groups with front-line health providers. Ahybrid approach to thematic analysis was employed, entailing a combination of emergent and a priori coding. Results: The findings indicate that PHC settings are sites where multiple forms of stigma create health service barriers. Stigma and discrimination associated with MHSU also cohere around intersecting experiences of gender, race, class, age and other issues including the degree and visibility of distress. Clients may find social norms to be alienating, including behavioural expectations in Canadian PHC settings. Conclusions: Given the turmoil in clients’ lives, systematic efforts to mitigate stigma were inhibited by myriad proximate factors that demanded urgent response. Health providers were enthusiastic about implementing anti-stigma/recovery-based approaches that could be integrated into current CHC services. Their recommendations for interventions centred around communication and education, such as training, CHC-wide meetings, and anti-stigma campaigns in surrounding communities.

Effect of Instructional Program on Knowledge Regarding Vulvovaginal Candidiasis Among Female University Students

Adolescents learn about Vulvo vaginal candidiasis (VVC) because its common clinical problem in female during this age throughout the world particularly in hot, subtropical climates. Annually in the United States there are approximately 13 million cases of vulvo vaginal candidiasis (VVC), resulting in 10 million gynecologic office visits per year. It is estimated that 75% of women will experience at least one episode in their lifetime, with a projected 50% of all female experiencing multiple episodes (Kamath, etal , 2014). Education in health is one of the key components of primary health care and one of the most vital health care requirements for female that must be considered much more in the primary health care system, particularly maternal and child health. Moreover Knowledge of how to prevent vaginal Candidiasis could save many female from frequent office visit, uncomfortable vaginal infections and prevent complications of it (Gilson, 2012). To assess the knowledge of female university students about (VVC) and examine the effect of instructional program on their knowledge regarding Vulvovaginal Candidiasis among female university students. A quasi-experimental design "time-series" will be utilized to achieve the aim of current study. The current study was conducted at Cairo University hostel were the female students were residing and selected from non medical faculties. A simple random sample of 100 female university students was recruited for this study. Two tools were used to collect the study data; structured interview tool, and "VVC" structured knowledge assessment interviewing tool. The current study findings revealed that, mean age of the participents was 20.18± 1.19 years. More than two thirds of them fell in the age range 20-24 years. Regarding menstrual characteristics among the participants, age range at menarche was 11-14 years with a mean of ± SD was (12.30±1.88) years, duration of menstruation ranged between 2-6 days with a mean of (4.23±1.25). The total mean knowledge score of (VVC) was 18.87 ± 7.83 out of /85 in the pretest; which indicated poor knowledge level and 81.20 ± 5.01 in posttest after two weeks from instruction program; which indicated good knowledge level that remain good knowledge in the post test ( 2) with a mean of 74.35± 6.68 after eight weeks from instruction program, and 62.85 ± 6.89 in the post test (3) after 12 weeks from weeks from instruction program; which indicated satisfactory knowledge level with high statistical significant differences (P = 0.001). The instructional program had positive effect on knowledge and awareness regarding (VVC) among female university students and this results hence the research hypotheses .&#x0D; Keywords- instructional program, vulvovaginal candidiasis, female university students&#x0D;

Empanelment: A foundational component of primary health care.

Empanelment is a foundational strategy for building or improving primary health care systems and a critical pathway for achieving effective universal health coverage. However, there is little international guidance for defining empanelment or understanding how to implement empanelment systems in low- and middle-income countries. To fill this gap, a multi-country collaborative within the Joint Learning Network for Universal Health Coverage developed this empanelment overview, proposing a people-centered definition of empanelment that reflects the responsibility to proactively deliver primary care services to all individuals in a target population. This document, building on existing literature on empanelment and representing input from 10 countries, establishes standard concepts of empanelment and describes why and how empanelment is used. Finally, it identifies key domains that may influence effective empanelment and that must be considered in deciding how empanelment can be implemented. This document is designed to be a useful resource for health policymakers, planners and decision-makers in ministries of health, as well as front line providers of primary care service delivery who are working to ensure quality people-centered primary care to everyone everywhere.

Psychosocial care and healthcare for the homeless population: an integrative review

The homeless population has physical and mental health issues and is exposed to conditions that lead to vulnerabilities, premature mortality, difficulty of access to basic services, all of which demands intersectoral actions. Outreach homeless clinics are components of Primary Health Care of the psychosocial health services network and play an important role in healthcare for this group. The goals of this integrative review are to assess health actions directed to this population, identify if actions result from dialogue between health service providers and the population attended and if such actions are sufficient to cater to their needs. Initially, 264 related papers were located, 27 of which were pre-selected and a further 11 were selected using pre-defined criteria. The findings were divided into 3 categories: 1) Characteristics of health actions seeking to cater to the needs of the homeless population; 2) Factors limiting health actions that restrict the care to the needs of this population; 3) Participation of the homeless population in the planning and execution of actions provided by the health services. The studies show advances in access to basic rights and provide input that support initiatives to enhance and strengthen the provision of intersectoral care to this population.

Role of Pharmacology in self medication practices among undergraduate medical students in a medical college and hospital in North India

Background: Self medication is an important component of primary health care. It involves treatment of common ailments on ones own initiative or on the advice of a pharmacist. With the easy accessibility to information regarding use of drugs, there is an alarming increase in the self medication practices. Medical students, during their course of study gain considerable knowledge of drugs and it may have an influence on their self medication practices. The present study was designed to gather the knowledge, attitude and behavior of medical students towards self medication and whether an increased knowledge of drugs further promoted self medication.Methods: A questionnaire based study was carried out on students of 2nd semester students relating to their knowledge, attitude and practice of self medication.Results: Though the knowledge regarding drugs is quite comparable in both the first and third year medical students, 39% students in group A took the medicine without doctors’ advice in the last month whereas 58% 5th semester students in group B did the same.Conclusions: The frequency of self medication is higher among third year students as they believe that the medical training makes them capable enough to self medicate easily without any harm. Hence, there is need to promote rational self medication practice to bring awareness about irresponsible self medication.