Pharmaceutical Sciences Notes

NTA Level 6 • Semester 1 • PST06104 Introduction to the Health System in Tanzania Health and Medicine Policy • Source Session/Topic 1 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 1: Introduction to Health System in Tanzania 1 Learning Tasks By the end of this session students are expected to be able to: Define terms related to health system State the vision and mission of the MoHCDGEC List levels of health care in Tanzania List roles of the MoHCDGEC (Ministry of Health, Community Development, Gender, Elderly and Children) in Health care System in Tanzania 2 Definition of Terms Related to Health System Health is a state of complete physical, mental, and social well being, and not merely the absence of disease or infirmity. (WHO) Policy is a law, regulation, procedure or administrative action created by government or non-government institution Health policy is a visionary program of action adopted by the government to have a healthy society, with improved social wellbeing that will contribute effectively to personal and national development. 3 Definitions Cont… Medicines Policy is a written document specifying the medium – to long – term goals set by the government for the pharmaceutical sector, their relative importance, and their main strategies for attaining them. It is a political commitment to a goal and a guide for action. It provides a framework for coordinating activities for pharmaceutical sector. 4 Vision and Mission of Ministry of Health in Health and Medicine system Vision To improve health and wellbeing of all Tanzanian, with a focus on those most at risk, and to encourage the health system to be more responsive to the needs of the people 5 Cont… Mission To facilitate the provision of basic health services that are good, quality, equitable, accessible, affordable, sustainable and gender sensitive 6 Levels of Health Care in Tanzania Community health services Dispensaries: village/ street level Health centres: ward level District hospitals: district level Regional/referral hospitals: regional level (are consultant hospitals) National, Consultant and specialized hospitals: national level 7 Community Health Services It is the responsibility of each individual and/or household to take care of its own health Village Government should recognize and enhance the essential role of communities in directing local health services. The community will have the mandate to choose their own community health worker who will be the main linkage between the community and the nearest health facility. 8 Dispensary Services This is the first formal health unit of level one health services. It is a primary health facility which offers outpatient services including reproductive and child health services, and diagnostic services. A dispensary caters for 5,000 people and oversees all the village health services. Dispensaries shall provide primary health care services to the community. Refer the references to identify the primary health services to be provided at dispensary level 9 Health Center Services This is the second formal health unit of level one-health services. It is a primary health facility, which offers Outpatient and In-patient services, maternity care, laboratory, dispensing and mortuary services. A Health Centre shall cater for 50,000 people and supervise all the dispensaries in the Division. 10 District Hospital Services It is also a level one health services and plays the following roles: Out-patient and In-patient care Act as the second referral level f or the primary health care facilities in the district or catchment’s area Perform general surgical and obstetric operations Conduct teaching, training and research programs in the district concerning community health Give supportive supervision and inspection and provide technical skills to lower health facilities in the district and refers patients to the regional hospital. 11 Regional Hospital Services This is a hospital establishment providing level two (Secondary) referral services from level one hospital This level have the following functions: To provide all services offered at district level but at a higher level of expertise Conduct health research programs in the Region Provide technical skills to lower health facilities in the Region and offer specialized treatment in Medicine, Surgery, Obstetrics and Gynaecology and Paediatric, and shall include Eye, Dental, Mental illnesses, Orthopaedics and Trauma 12 National, Consultant and Specialized Hospital Services This is level three and the highest level of hospital services in the country It acts as referral centre for level two hospitals. 13 National Hospital Muhimbili is the currently national hospital It also acts as Eastern zonal referral hospital 14 Zonal Consultant Hospitals At present there are four zonal referral or consultant hospitals. Muhimbili National Hospital Two voluntary agency hospitals: Bugando Medical Centre and Kilimanjaro Christian Medical Center (KCMC) Mbeya Referal Hospital (owned by the government) 15 Specialized Hospitals There are two specialized hospitals Mirembe Hospital (Dodoma) and Kibongoto ( Moshi ) They provide services to the mentally sick and TB patients respectively 16 Roles of the MoH in Health and Medicine Policy Policy formulation, health legislation, regulation and control Resource mobilization and allocation Management support of level three hospitals including National, Consaltant and Special Hospitals Supervision and Monitoring of special and Consultant Hospitals owned by NGOs Monitoring and evaluation of health services countrywide Activity: Use the given references for extra roles of MoH 17 Key Points Health Policy is important in a country like ours where resources and technology are more limited than in other countries. Medicines Policy is a written document specifying the medium – to long – term goals set by the government for the pharmaceutical sector, their relative importance, and their main strategies for attaining them. MoHCDGEC mission is to facilitate the provision of basic health services that are good, quality, equitable, accessible, affordable, sustainable and gender sensitive 18 Review Questions What is the vision and mission of the MoH of health care in Tanzania? What are the levels of health care in Tanzania. 19 References URT (2007): The National Health Policy , Dar es Salaam, Tanzania. Government Printer URT (2016): Task sharing policy guidelines for health sector services

NTA Level 6 • Semester 1 • PST06104 Introduction to Primary Health Care Health and Medicine Policy • Source Session/Topic 2 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 2: Introduction of Primary Health Care (PHC) 1 Learning Tasks By the end of this session students are expected to be able to: Define primary health care List principles of primary health care Mention components of primary health care Explain WHO strategies of primary health care Explain the basic requirements for sound primary health care List rights and responsibilities of all participants in PHC 2 Introduction Primary Health Care (PHC) is 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 It is the first level of contact of individuals, the family, and the community with the national health system 3 Determinants of Health Internal Biological and cognitive Genetics, race, sex and age (diabetes, breast cancer are genetic in nature; diarrheal more common in children) Psychological and spiritual Life stress causes mental disorders, hypertension, heart attack, diabetes, gastric ulcer 4 Cont… External Environmental Socio-economic conditions Welfare services Food and nutrition Education Occupation Culture 5 Activity What are the emphasizes of government on primary health care? Brainstorming : What could be the principals of primary health care? 6 Principles of Primary Health Care Equity Accessible Acceptable Affordable Appropriate Technology Community Participation Intersectoral Coordination Decentralization Health Prevention and Promotion 7 Components of Primary Health Care Health education Food supply and nutrition Safe drinking water and sanitation Maternal and child health, family planning Expanded programme in Immunization (EPI) Prevention and control of endemic diseases Appropriate treatment and prevention of common diseases, injuries and accidents Provision of essential drugs 8 Global Targets on Primary Health Care All people globally will have ready access at least to essential health care and to first-level referral facilities All people will be actively involved in caring for themselves and their families in community action for health Communities throughout the world will share government’s responsibility for the health care of their members All governments will assume the overall responsibility for the health of their people Safe drinking water and sanitation will be available to all people 9 Cont… All people will be adequately nourished/fed All children will be immunizes against the major diseases of childhood Communicable diseases in the developing countries will be of no greater public health significance Essential drugs will be available to all 10 WHO Strategies of Primary Health Care Reducing excess mortality of poor marginalized populations Reducing the leading risk factors to human health Developing Sustainable Health Systems Developing an enabling policy and institutional environment: Primary Health Care policy must be integrated with other policy domains 11 Basic Requirements for Sound Primary Health Care Appropriateness Availability Adequacy Accessibility Acceptability Affordability Assessability Accountability Completeness Comprehensiveness Continuity Review clarification of each requirement 12 Rights and Responsibility of all participants in PHC Individual Responsibility Personal hygiene Healthy lifestyles Healthy environment Sanitation Family planning and population management Rights Vaccination and preventing diseases Medical examination/ treatment Safe water 13 Cont… Community Responsibility Utilizing health facilities Supporting and strengthening health centres Activist for health promotion and protection Improving sanitation and environment Rights Community health workers training Promoting family planning, breastfeeding, healthy lifestyles Restricting causative factors of ill health like poverty Food safety, adequate water 14 Cont… Government Policies and plans Resources Accessibility Awareness – building Human resources development Monitoring/ support Outbreak control Exchanging of experiences 15 Cont… International Human resources development Capacity building Technical corporation among developing countries Information sharing Technical support Building partnerships Financial support 16 Activity Refer Handout 1: Essential Health Care Package to understand more about primary health care 17 Key Points The principles of primary health care are: equity, accessible, acceptable, affordable, appropriate technology, community participation, intersectoral coordination, decentralization, health prevention and promotion The following are components of primary health care; health education, food supply and nutrition, safe drinking water and sanitation, maternal and child health, family planning, expanded programme in Immunization (EPI), prevention and control of endemic diseases, appropriate treatment and prevention of common diseases, injuries and accidents, provision of essential drugs 18 Review Questions What are the WHO strategies of primary health care? What are the basic requirements for the sound primary health care? 19 References Declaration of Alma-Ata International Conference on Primary Health Care, Alma-Ata, USSR, 6–12 September 1978. (2004). Development, 47 (2), 159-161. doi:10.1057/palgrave.development.1100047 Alma Ata Conference 1978 Report. ( n.d .). Retrieved from https://www.scribd.com/document/158435776/Alma-Ata-Conference-1978-Report WHO (2012). Who Expert Committee on Specifications for Pharmaceutical Preparations: Geneva, Switzerland: Forty-sixth report . 20 ← Previous TopicNext Topic →View all Health and Medicine Policy topicsOpen Complete Full Notes PDF / OFFLINE NOTES Unataka kutumiwa notes hizi kupitia WhatsApp?Kwa notes zilizopangiliwa vizuri kwa kusoma offline au PDF, bonyeza kitufe hapa chini. Ujumbe wenye Level, Semester, Module na Topic utaandaliwa moja kwa moja.TUMIWA NOTES WHATSAPP WhatsApp: 255620339260

NTA Level 6 • Semester 1 • PST06104 Alma-Ata Declaration Health and Medicine Policy • Source Session/Topic 3 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 3: Alma-Ata Declaration 1 Learning Tasks By the end of this session students are expected to be able to: Define Alma-Ata declaration Mention themes leading to Alma Ata List objectives of Alma Ata declaration Explain components of Alma Ata declaration 2 Activity: Brainstorming What could you explain about alma- ata declaration? 3 Definition Alma Ata declaration is the International Declaration on Primary Health Care expressing the need for urgent action by all governments, all health and development workers, and the world community to protect and promote the health of all the people of the world It identified primary health care as the key to the attainment of the goal of health for all 4 Themes of Alma-Ata Declaration Changing theories of health and development Concerns about poverty and population control Increasing reliance upon alternative approaches to medical care model Success of community health workers and associated emphasis on community participation Revival of interest in public health: tackling causes of ill health rather than symptoms 5 Objectives of Alma-Ata Declaration To promote the concept of primary health care in all countries To exchange experience and information on the development of primary health care within the national health systems and services To evaluate the present health and health care situation throughout the world as it relates to primary health care To define the principles of primary health care as well as the operational means of overcoming practical problems in the development of primary health care 6 Cont… To define the role of governments, national, and international organizations in technical cooperation and support for the development of primary health care To formulate recommendations for the development of primary health care. 7 Components of Alma-Ata Declaration Current world health situation Primary health care approach Primary health care and development Technical and operational aspects National strategies and international support 8 Current world health situation The conference declared that the health status of hundreds of people in the world today is unacceptable, particularly in developing countries. More than half the population of the world does not have the benefit of proper health care. The conference analyzed the magnitude of health problems and the inadequate and inequitable distribution of health resources between and within countries The Conference called for a new approach to health and health care to achieve more equitable distribution of health resources. 9 Primary health care approach The Conference considered primary health care to be essential It is the first level of contact of individuals, the family, and the community with the national health system The Conference reaffirmed that governments have a responsibility for the health of their peoples Each country must interpret and adapt particular, detailed aspects of primary health care within the country’s own social, political, and developmental context All persons have the right and duty to participate individually and collectively in the planning and implementation of their health care The Conference affirmed that the primary health care approach (health for all) would be attained by the year 2000 10 Primary health care and development The Conference considered the close interrelationship and interdependence of health, social and economic development Health activities should be undertaken concurrently with measures such as those for the improvement of nutrition, increase in production and employment and protection and improvement of the environment The Conference Emphasized the importance of full and organized community participation in the recognition and solution of their health problems Self-reliance. Affirmed the need for a balanced distribution of all available resources. 11 Technical and Operational Aspects in Primary Health Care The varied experience of countries dealing with diverse health problems in rural and urban areas was discussed. Thus the national health system have to support primary health care through appropriate training, super-vision, referral, and logistic support. The government should ensure the main health problems in the community are identified and taken to action with special attention to vulnerable groups The agreed translation of the principles of primary health care into action would require the priority allocation of budgetary resources to primary health care, better distribution and use of existing resources Also research with full involvement of populations especially in health services should be carried out 12 National strategies and international support Each nation should now make a strong and continuing commitment to primary health care at all levels of government and society. National strategies are required to: Translate policies into action Make health care available, equitably to the entire population. Take into account socioeconomic factors and policies, available resources and the particular health problems and needs of the population The Conference emphasized that the strategies should be formulated and applied with fullest participation of communities and sectors of the government. Countries can learn and benefit from each other’s experience 13 Cont… International organizations, multilateral and bilateral agencies, nongovernmental organizations, and other partners should actively promote the national development of primary health care and give technical and financial support with full respect for the principles of national self-reliance and self determination and maximum utilization of locally available resources. Any progress towards universal peace would release resources that could be used to accelerate socioeconomic development including primary health care and also benefit populations . 14 Key Points Alma Ata Declaration is the International Declaration on Primary Health Care, expressing the need for urgent action by all governments, all health and development workers, and the world community to protect and promote the health of all the people of the world The components of the Alma Ata declaration are Current World Health Situation, Primary Health Care Approach, Primary Health Care and Development, Technical and Operational Aspects, National Strategies and International Support 15 Review Questions What are the objectives of Alma Ata declaration? What was the world situation before declaration? List themes

NTA Level 6 • Semester 1 • PST06104 National Health Policy Health and Medicine Policy • Source Session/Topic 4 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 4: National Health Policy 1 Learning Tasks By the end of this session students are expected to be able to: Define policy State the vision and mission of the national health policy List objectives of national health policy 2 Activity: Brainstorming What is policy? 3 Introduction Policy directs how the government has to achieve its goals and objectives with regard to a specific area such as health, education, agriculture. It can be described as a deliberate plan of action to guide decisions and achieve rational outcome 4 Vision and Mission of National Health Policy Vision To have a healthy community that contributes effectively to individual and nation’s development To improve the health and well being of all Tanzanians with a focus on those most at risk, and to encourage the health system to be more responsive to the needs of the people. 5 Cont… Mission The mission is to facilitate the provision of basic health services that are of good quality, equitable, accessible, affordable, and sustainable and gender sensitive This will help to reduce disability, morbidity and mortality, improving nutritional status and raising life expectancy. The policy recognizes that, good health is a major resource essential for poverty eradication and economic development. 6 Objectives of National Health Policy Effective health promotion services Reduced malnutrition in the country Comprehensive and sustainable immunization services Improved reproductive, maternal, newborn, child and adolescent health services. Reduced prevalence of communicable diseases Efficient prevention and management of Neglected Tropical Disease (NTD) Reduced morbidity, disability and mortality due to non-communicable diseases. 7 Refer handout 2: National Health Policy Statements for further reading 8 Key Points Policy is a statement on how the government is to achieve its goals and objectives with regard to a specific area such as health, education, agriculture. It can be described as a deliberate plan of action to guide decisions and achieve rational outcome(s). Health policy is a visionary program of action adopted by the government to have a healthy society, with improved social wellbeing that will contribute effectively to personal and national development. The vision of the government is to have a healthy community that contributes effectively to individual as well as to the nation’s development towards becoming a middle income country. 9 Review Question What are the objectives of National Health Policy ? 10 References URT(2007). The National Health Policy , Dar es salaam, Tanzania: Government Printer URT(1991). The National Drugs Policy , Dar es salaam, Tanzania: Government Printer WHO (2012). Who Expert Committee on Specifications for Pharmaceutical Preparations: Geneva, Switzerland: Forty-sixth report . URT. (Draft – 2017). National Health Policy . Dar es Salaam, Tanzania 11 ← Previous TopicNext Topic →View all Health and Medicine Policy topicsOpen Complete Full Notes PDF / OFFLINE NOTES Unataka kutumiwa notes hizi kupitia WhatsApp?Kwa notes zilizopangiliwa vizuri kwa kusoma offline au PDF, bonyeza kitufe hapa chini. Ujumbe wenye Level, Semester, Module na Topic utaandaliwa moja kwa moja.TUMIWA NOTES WHATSAPP WhatsApp: 255620339260

NTA Level 6 • Semester 1 • PST06104 National and International Health Initiatives Health and Medicine Policy • Source Session/Topic 5 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 5: National and International Health Initiatives 1 Learning Tasks By the end of this session students are expected to be able to: Define medicine policy Explain links between National Health Policy with National and International Initiatives Explain factors which influences implementation of National Health and Medicines Policy 2 Definition National Medicines Policy (NMP) is a political commitment guide for action that shows how the government will ensure that efficacious and safe medicines of good quality are affordable, accessible, and rationally used It provides a frame work for coordinating the activities of all the parties involved, such as public and private sectors, nongovernmental organizations (NGO’s), donors and other interested stakeholders. 3 Links Between National Health Policy with National and International Initiatives Refer handout 3: National Health Policy and National and International Initiatives 4 Factors which Hinder Implementation of National Health Policy Weak implementation structure for quality improvement approach Attitude change problem among health workers Shortage of human resources Unreliable resource supplies and allocation Poor implementation of several approaches to health sector 5 Factors that Influence Decision Making Past experiences A variety of cognitive biases An escalation of commitment and sunk outcomes Individual differences i.e. age and socioeconomic status A belief in personal relevance Policies and beliefs of a nation 6 Factors that affect community health. Housing Financial security Community safety Employment Education Environment Risk behaviours of a population Health status Others??? 7 Key points Tanzania’s One Health Strategic Plan focuses on five thematic areas in consonance with its objectives The Task Sharing Policy Guidelines constitutes an important guiding document regarding the expansion of a task sharing approach as one method of strengthening and expanding the health workforce rapidly to a health services 8 Review Questions Which factors hinder implementation of quality improvement approach? What are factors which influence implementation of National Health Policy? 9 References URT (2015): National One Health Strategic Plan 2015 – 2025 , Dar es Salaam, Tanzania: Government Printer URT (2016): Task Sharing Policy Guidelines for Health Sector Services in Tanzania , Dar es Salaam, Tanzania: Government Printer WHO (2012). Who Expert Committee on Specifications for Pharmaceutical Preparations: Geneva, Switzerland: Forty-sixth report . URT. (Draft – 2017). National Health Policy . Dar es Salaam, Tanzania 10 ← Previous TopicNext Topic →View all Health and Medicine Policy topicsOpen Complete Full Notes PDF / OFFLINE NOTES Unataka kutumiwa notes hizi kupitia WhatsApp?Kwa notes zilizopangiliwa vizuri kwa kusoma offline au PDF, bonyeza kitufe hapa chini. Ujumbe wenye Level, Semester, Module na Topic utaandaliwa moja kwa moja.TUMIWA NOTES WHATSAPP WhatsApp: 255620339260

NTA Level 6 • Semester 1 • PST06104 Millennium Development Goals Health and Medicine Policy • Source Session/Topic 6 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 6: Millennium Development Goals 1 Learning Tasks By the end of this session students are expected to be able to: Define millennium development goals Explain objectives of millennium development goals Explain the achieved millennium development goals List factors hindering implementation of millennium development goals 2 Definition The Millennium Development Goals (MDGs) were the eight international development goals for the year 2015 that had been established following the Millennium Summit of the United Nations in 2000, following the adoption of the United Nations Millennium Declaration About 191 United Nations member states and 22 international organizations participated 3 Objectives of Millennium Development Goals To eradicate extreme poverty and hunger To achieve universal primary education To promote gender equality and empower women To reduce child mortality To improve maternal health To combat HIV/AIDS, malaria, and other diseases To ensure environment sustainability To develop a global partnership for development 4 Achieved Millennium Development Goals Eradication of extreme poverty and hunger Achievement on universal primary education Promotion of gender equality and empower women 5 Activity: Brainstorming What are the hindering factors for achievement of other development goals? 6 Factors Hindering Achievement of Millennium Development Poor enlightenment and public mobilization Poor support of Millennium Development Goals Cultural differences and problems Economic problems Political instability Poor leadership and administrative bottleneck 7 Cont… Sub-Saharan Africa has had the best record of improvement in primary education of any region since the MDGs were established Many more girls are now in school compared to 15 years ago. The developing regions as a whole have achieved the target to eliminate gender disparity in primary, secondary and tertiary education. 8 Key Points The Millennium Development Goals (MDGs) were the eight international development goals for the year 2015 that had been established following the Millennium Summit of the United Nations in 2000, following the adoption of the United Nations Millennium Declaration Extreme poverty has declined significantly over the last two decades. 9 Review Questions What are millennium development goals? The Concept of Millenium Development Goals was based on what aspects? Which factors hinders implementation of millennium development goals? 10 References The Millennium Development Goals Report 2013. (2013). Millennium Development Goals Report . doi:10.18356/2e9902b5-en, Publisher : UN Department of Economic and Social Affairs WHO (2012). Who Expert Committee on Specifications for Pharmaceutical Preparations: Geneva, Switzerland: Forty-sixth report . URT(2003). The National Health Policy , Dar es salaam, Tanzania: Government Printer URT(1991). The National Drugs Policy , Dar es salaam, Tanzania: Government Printer 11 ← Previous TopicNext Topic →View all Health and Medicine Policy topicsOpen Complete Full Notes PDF / OFFLINE NOTES Unataka kutumiwa notes hizi kupitia WhatsApp?Kwa notes zilizopangiliwa vizuri kwa kusoma offline au PDF, bonyeza kitufe hapa chini. Ujumbe wenye Level, Semester, Module na Topic utaandaliwa moja kwa moja.TUMIWA NOTES WHATSAPP WhatsApp: 255620339260