Primary Health Care and Global Health, Exams of Nursing

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HCA 502 Final Exam

What is Primary Health Care? ch 5 - Answer -Essential healthcare made universally accessible to all people in the community by means acceptable to them, through their full participation and at a cost that the community/country can afford What are the Primary Health Care Core Components? (5 components) ch 5 - Answer -1. Promotion of adequate food supply and proper nutrition

2. Adequate supply for safe water and basic sanitation
3. Maternal and child health care including family planning
4. Immunizations against vaccine-preventable diseases such as measles, diphtheria, tetanus, pertussis, and polio
5. The prevention and control of locally endemic diseases by means of timely diagnosis, treatment, and vector control What are the societal concerns of primary health care? (3 concerns) ch 5 - Answer -1. Proper professional training
6. Monitored governmental expenditures and debt
7. The issue of rural vs urban communities What are the three benefits of primary health care? ch 5 - Answer -1. Offers more cost-effective health care than hospital care
8. Reduces human suffering
9. Is more accessible

What are the four problems with primary health care? ch 5 - Answer -1. How to evaluate PHC

2. How to pay the cost of PHC
3. How community utilizes PHC programs
4. The sociopolitical roles of PHC workers What are the objectives of Alma-Ata? (4 objectives) ch 5 - Answer -1. Promote PHC
5. Exchange experiences and info on the development of PHC
6. Evaluate the present health and health care
7. Define the principles and operational means of PHC What are the socio-economic issues relating to maternal health? (4 issues) ch 6 - Answer -1. Female genital mutilation (FGM)
8. Unsafe abortions
9. Nutritional deficiencies
10. Barrier to health care services Define mortality ch 6 - Answer -Death. The state of being subjected to death Define morbidity ch 6 - Answer -A diseases state or symptom. The incidence of disease Define maternal death - Answer -The disease of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental causes What are the two types of maternal death? ch 6 - Answer -Direct: obstetric death resulting from complications, interventions, omissions, incorrect treatment such as hemorrhage, infection, eclampsia, and obstructed labor Indirect: obstetric death resulting from a previous existing disease such as diabetes What is infant mortality rate? (IMR) ch 6 - Answer -A key indicator measuring socioeconomic development, hygienic conditions, and overall health of a population.

What are the three types of IMR? ch 6 - Answer -Neonatal (within the first 28 days of life) - First day death (within 7 days of age) Late neonatal death (between 7 and 28 days) Post-neonatal (between 28 days and 1 year) Perinatal deaths (between gestational age and first 7 days of age) How many abortions are done each year and what percent of them are unsafe? ch 6 - Answer - Million, 90% are unsafe Before 1989..... (Romania Case Study) ch 6 - Answer -Abortion, contraceptive, and sex education were outlawed What are the impacts of the political ideology on health care? (2 impacts) ch 7 - Answer -1. Social democracies lead to universal health coverage

2. Individual responsibility ethos lead to private for-profit systems Healthcare services are organized to promote what four things? ch 7 - Answer -1. Reduce health care inequalities
3. Increase efficiency
4. Protect individuals, families, and communities from financial loss
5. Enhance fairness in financing and delivering health services What does a crisis in health care mean in USA? ch 7 - Answer -Ever-spiraling costs What does a crisis in health care mean in Russia? ch 7 - Answer -Organizational disarray and lack of essential services What does a crisis in health care mean in Ghana? ch 7 - Answer -Systematic collapse of medical services

Who has the highest average life expectancy? ch 7 - Answer -Switzerland 83 years What is the total health care expenditure and average life expectancy in China? ch 7 - Answer -5.2 and 75 years What is the total health care expenditure and average life expectancy in Japan? ch 7 - Answer -9.3 and 85 years What are two health indices for comparisons among nations? ch 7 - Answer -1. Infant mortality rate

2. Life expectancy What are the 5 types of health care coverage? ch 7 - Answer -1. Beveridge Model
3. Bismarck Model
4. Douglas Model
5. Out-of-Pocket Model
6. American Model What are the 4 characteristics of the Beveridge Model? ch 7 - Answer -1. Health care is provided and financed by the government through tax payments
7. Not all hospitals and clinics are owned by the government
8. Patients do not get a doctor bill
9. Government as a sole payer controls the charges What are the 4 characteristics of the Bismarck Model? ch 7 - Answer -1. Similar to the US system using insurance systems called sickness funds through payroll deductions
10. Unlike the US insurance industry, it covers everyone, and makes no profits
11. Hospitals and physicians are private
12. Government tight regulations control the cost of healthcare

What are the 3 characteristics of the Douglas Model? ch 7 - Answer -1. It is a mixture of the Beveridge and Bismarck Models

2. Providers are private, but payment comes from the government-run insurance program
3. It is a single-payer system that has power to control costs through: No financial motive to make a profit, power to negotiate for lower prices, and ability to limit medical services What are the 3 characteristics of the Out-of-Pocket Model? ch 7 - Answer -1. Basic rule is no money, no service (the rich get medical care, the poor stay sick or die)
4. Patients can sometimes scratch together enough money to pay a doctor bill or pay in potatoes or chickens
5. If they have nothing, they go without medical care What are the 5 characteristics of the American Model? ch 7 - Answer -1. A mixture of the Beveridge, Bismarck, the National Health Insurance and out-of-pocket Models
6. Veterans belong to the Beveridge Model
7. People over 65 years old belong to the Douglas Model
8. Working people belong to the Bismarck Model
9. People without health insurance belong to the out-of-pocket model What is epidemiology? ch 8 - Answer -The study of disease/injury patterns in human populations to enable preventing them How does epidemiology characterize the distribution of health? (3 ways) ch 8 - Answer -1. Person (acquired: marital status, hereditary: age, gender, ethnicity)
10. Place (geography, climate, population densities)
11. Time What are the three frequency rates? ch 8 - Answer -1. Prevalence = (existing cases / pop at risk) x 1,
12. Incidence rate = (new cases / pop at risk ) x 1,
13. Cumulative incident rate = (# new cases during specified time / pop at risk) x 1,

What are specialized epidemiological measures? (2 measures) ch 8 - Answer -1. Years of potential life lost (YPLL)

2. Dependency ratio (DR) What are the 4 infectious disease concepts? ch 8 - Answer -1. Endemic
3. Epidemic
4. Pandemic
5. Sporadic Define endemic ch 8 - Answer -The typical or normal level of disease occurrence in a population Define epidemic ch 8 - Answer -A major increase and spread of the disease throughout a population Define pandemic ch 8 - Answer -The spread of the disease beyond its normal population of occurrence sometimes approaching a worldwide distribution Define sporadic ch 8 - Answer -The disease occurs episodically What are the 4 properties of infectious agents? ch 8 - Answer -1. Pathogenicity
6. Toxigenicity
7. Infectivity
8. Virulence Define pathogenicity ch 8 - Answer -The ability of the agent to cause disease once it gains access to the host Define toxigenicity ch 8 - Answer -The ability of the agent to produce toxins that cause the host to be sick

Define infectivity ch 8 - Answer -The ability of the agent to enter and multiply in the host Define virulence ch 8 - Answer -The ability of the agent to do harm to the host What is Germ Theory? ch 8 - Answer -Each disease has one and only one specific etiological agent What is life-style disease? ch 8 - Answer -A whole panoply of interrelated factors that both predispose to and cause the disease What is Web of Causation? ch 8 - Answer -Provides a basis for developing disease control and prevention measures for groups at risk What are three types of communicable diseases? ch 9 - Answer -1. STDs

2. Emerging diseases (new diseases such as ebola)
3. Reemerging diseases (resistance to antimicrobials such as malaria) What are examples of non-communicable diseases and where are they more common? ch 9 - Answer - More common in developed and developing nations. Examples include: Cardiovascular disease What do refugees and displaced persons suffer from? (2 things) ch 9 - Answer -1. Poor sanitation
4. Lack of clean food and water Who has the title of Minister of Health? ch cuba - Answer -Fidel Castro What is the average life expectancy in Cuba? ch cuba - Answer -78 years What is the GDP in Cuba? ch cuba - Answer -128.5 billion When was Cuba's first reform, and why did they have it? ch cuba - Answer -1960s. To remedy the uneven distribution of healthcare that prevailed in pre-revolutionary Cuba

When was Cuba's second reform, and why did they have it? ch cuba - Answer -1990s. In response to the economic crisis caused by the collapse of the Soviet Union and the tightening of the U.S. embargo What kind of care does Cuba focus on? ch cuba - Answer -Primary Care What is the infant mortality rate in Cuba? ch cuba - Answer -4.5 per 1,000 deaths How many doctors are there in Cuba? ch cuba - Answer -1 for every 175 people What two things does Cuba lack and why? ch cuba - Answer -Drugs and Equipment. Due to embargo and insufficient foreign currency What three problems will Cuba face in the future? ch cuba - Answer -1. Poverty

2. Growth of elderly population
3. High rates of smoking What is the average life expectancy in France? - Answer -82 years What is the Yin Yang principle? ch 1 - Answer -The idea of a body as a microcosmic universe. Used to describe balance in our lives. Yin is the female energy and the yang is the male energy. The opposing energies balance the body and other things in life. What is the definition of health according to WHO? ch 1 - Answer -A state of complete physical, mental, and social well-being. Not just the absence of disease Who wrote the textbook of medicine? ch 1 - Answer -Galen What were the causes and consequences of the Black Death? ch 1 - Answer -Causes: disease was transmitted to humans by rodents via fleas Consequences: population growth halted and actually reversed

What were the concerns of the first civilization? (3 concerns) ch 1 - Answer -1. Sanitary concerns

2. Clean water supplies
3. Spread of infectious diseases as travel between communities increases What influence do dominant cultures have? ch 2 - Answer -They kill off smaller languages. 10,000 - 15,000 languages existed in prehistoric times. Now it is reduced to 6,000 in the year 2000 What effects does globalization have? ch 2 - Answer -1. Economic development: raising global standards of living, combating hunger
4. Human well-being: empowering women, promoting literacy, and extending life
5. Environment: causing more pollution
6. Culture: changing local cultures
7. Political: turning to populism What is the Malthus theory? ch 3 - Answer -Increases in agricultural production grow arithmetically, while human populations grow geometrically. "Carrying capacity" is known as the maximum population that a particular environmental/geographical area can maintain What are the strategies to slow down population growth? (4 strategies) ch 3 - Answer -1. Promote late marriage
8. Advocate one couple one child
9. Promote proper spacing (the time between children is adequate)
10. Encourage family planning What are the four types of diseases involved in non-potable water? ch 3 - Answer -1. Waterborne diseases: feces/urine contamination
11. Water-washed diseases: inadequate washing
12. Water-based diseases: parasites
13. Water-related diseases: vectors using water for reproductive cycle

What is malnutrition? ch 4 - Answer -Not simply the lack of nutritious food. It is the lack of essential vitamins and minerals which lead to problems associated with various deficiencies What is over-nutrition? ch 4 - Answer -An excess of energy or nutrients. A condition that generally leads to diseases such as obesity, diabetes, heart disease, hypertension, and cancer What is protein-energy malnutrition? (2 kinds) ch 4 - Answer -1. Marasmus - a physical process of starvation. Common in children who's mothers have recently has another child and have weaned the first child

2. Kwashiorkor - the body begins to metabolize its own protein sources. This is accelerated by inadequate intake of zinc, iodine, and vitamin A