16.1 Introduction to Community-orientated primary care (COPC)

Question 1

Define and explain COPC.

Answer 1

COPC is primary care where professionals from different disciplines and approaches work together with organizations and people in defined communities to identify and respond systematically to health and health-related needs to improve health.

Question 2

List the important concepts.

Answer 2

Primary care
work together-team approach.
defined communities
systematically

Question 3

Explain the important concepts.

Answer 3

-Primary care:
Based on principles of primary health care, epidemiology, public health and quality
improvement (Distributed apprenticeship)

-work together
team approach: To do big, meaningful things you often need a village.

-defined communities:
In COPC the healthcare worker looks beyond the individual patient and assumes responsibility
for the health of a specific community

NB that the community should be a partner in every step of the COPC process.

-systematically:
COPC implementation requires that you follow certain steps in the process to address and
improve health concerns within the community.

Question 4

Guiding principles

Answer 4

1. Local health and institutional analysis
2. Comprehensive care
3. Equity
4. Practice with science
5. Service integration around users

Question 5

local health and institutional analysis

Answer 5

Know the community

Question 6

Comprehensive care

Answer 6

Health-disease continuum

Question 7

Equity

Answer 7

Accessible, affordable, appropriate and relevant care

Question 8

Practice with science

Answer 8

Evidence-based and interdisciplinary care

Question 9

Service integration around users

Answer 9

Person-centered, continuity of care and partnership with community.

Question 10

What are community-related factors that lead to dysfunction and disease?

Answer 10

-Stigma:lack of education
-socio-economic issues: crime and violence,poverty, proper housing and sanitation(sewage pipes leading to cholera,lack of water leading to waterborne diseases) pollution (air and water,etc)
-Accessibility to healthcare
- Poor hygiene
- - Loadshedding
- - Substance usage: alcohol and smoking
- - Food insecurity

Question 11

Discuss the history of COPC

Answer 11

Dr Sidney and Emily Kark (1940): Pholela KZN
-Trained Health Assistants
-Visited families in their homes every 4 – 6 weeks:
Built relationships.
Collected information on births, deaths, nutrition status, illness, employment, sanitation, water, food, work, education, etc
- Able to make a socio-medical diagnosis

Question 12

Discuss the rationale for using the COPC approach.

Answer 12

-COPC can help you learn more about and reach those who are not attending health services.
- Many factors that cause health
problems can only be addressed on a community level.
- COPC helps you to get to the
root causes of illness.

Question 13

What are the steps involved in COPC.

Answer 13

1. Define and characterize the community.
2. Identify the community’s health problems.
3. Develop and implement intervention
4. Monitor the impact of the intervention.
   In all the steps include the community

Question 14

Define and characterize the community.

Answer 14

Community definition:
-Group of people living in the same place or having a particular characteristic in common.
* Geographic community
* Health care coverage
* Users of a defined service
* Special population

Question 15

Identify community’s health problems.

Answer 15

Community diagnosis: SOAP approach
S-Subjective information
O-Objective information
A- Analyse information
P- Problem prioritisation

Question 16

Develop and implement intervention

Answer 16

Things to consider when developing and implementing interventions:
* Time
* Resources
* Community assets
* Personnel – partners
* Tracking
* Impact
* Ethics
* Sustainability

Question 17

Monitor impact of intervention

Answer 17

Two important questions to ask:
* Was the intervention effective?
* What was the impact of the intervention?

Question 18

Discuss the role of the team.