Objectives • At the end of the session you should be able to: 1. Explain what PHC is. 2. List and explain the 8 elements of PHC. 3. List and explain 6 principles of PHC. What is PHC? • PHC is a whole-of-society approach to health that aims to bring essential health services, health promotion, disease prevention and health-supporting actions as close as possible to where people live, work, learn and worship. Has 3 components 1. Integrated health services with an emphasis on primary care and public health functions: promotive, protective, preventive, curative, rehabilitative and palliative care throughout the life course 2. Multisectoral policy and action: systematically addressing the broader determinants of health (including social, economic and environmental factors, as well as individual characteristics and behaviour) through evidence-informed policies and actions across all sectors; 3. Empowered people and communities: empowering individuals, families and communities to optimize their health, as advocates of policies that promote and protect health and well-being, as co developers of health and social services, and as self-carers and caregivers Eight (8) elements of PHC 1. E-Education concerning prevailing health problems and the methods of identifying, preventing, and controlling them. 2. L– Locally endemic disease prevention and control. 3. E–An expanded program of immunization against major infectious diseases. 4. M–Maternal and child health care including family planning. 5. E– Essential drugs arrangement. 6. N–Nutritional food supplement, an adequate supply of safe and basic nutrition. 7. T– Treatment of communicable and non-communicable diseases and the promotion of mental health. 8. S– Safe water and sanitation. Extended Elements in the 21st Century: 1. Expended options of immunizations. 2. Reproductive health needs. 3. Provision of essential technologies for health. 4. Health promotion. 5. Prevention and control of non-communicable diseases. 6. Food safety and the provision of selected food supplements. Six Principles of Primary Health Care (PHC): 1. Universal access to health care services for all people, regardless of income or social status; 2. Equitable distribution of health resources and services, so that everyone has an equal chance to enjoy good health; 3. A focus on preventive measures to keep people healthy, rather than simply treating them when they fall ill; Six Principles of Primary Health Care (PHC) continued 4. A community-based approach to health care, with an emphasis on local solutions to local problems; 5. A recognition that good health is a fundamental human right, not a privilege reserved for the wealthy 6. The involvement of people in their own health care, including decisions about treatment and service delivery

Objectives • At the end of the session you should be able to: 1. Explain what PHC is. 2. List and explain the 8 elements of PHC. 3. List and explain 6 principles of PHC. What is PHC? • PHC is a whole-of-society approach to health that aims to bring essential health services, health promotion, disease prevention and health-supporting actions as close as possible to where people live, work, learn and worship. Has 3 components 1. Integrated health services with an emphasis on primary care and public health functions: promotive, protective, preventive, curative, rehabilitative and palliative care throughout the life course 2. Multisectoral policy and action: systematically addressing the broader determinants of health (including social, economic and environmental factors, as well as individual characteristics and behaviour) through evidence-informed policies and actions across all sectors; 3. Empowered people and communities: empowering individuals, families and communities to optimize their health, as advocates of policies that promote and protect health and well-being, as co developers of health and social services, and as self-carers and caregivers Eight (8) elements of PHC 1. E-Education concerning prevailing health problems and the methods of identifying, preventing, and controlling them. 2. L– Locally endemic disease prevention and control. 3. E–An expanded program of immunization against major infectious diseases. 4. M–Maternal and child health care including family planning. 5. E– Essential drugs arrangement. 6. N–Nutritional food supplement, an adequate supply of safe and basic nutrition. 7. T– Treatment of communicable and non-communicable diseases and the promotion of mental health. 8. S– Safe water and sanitation. Extended Elements in the 21st Century: 1. Expended options of immunizations. 2. Reproductive health needs. 3. Provision of essential technologies for health. 4. Health promotion. 5. Prevention and control of non-communicable diseases. 6. Food safety and the provision of selected food supplements. Six Principles of Primary Health Care (PHC): 1. Universal access to health care services for all people, regardless of income or social status; 2. Equitable distribution of health resources and services, so that everyone has an equal chance to enjoy good health; 3. A focus on preventive measures to keep people healthy, rather than simply treating them when they fall ill; Six Principles of Primary Health Care (PHC) continued 4. A community-based approach to health care, with an emphasis on local solutions to local problems; 5. A recognition that good health is a fundamental human right, not a privilege reserved for the wealthy 6. The involvement of people in their own health care, including decisions about treatment and service delivery

The Role of Public Health in Primary Health Care From population health intelligence to prevention, protection, promotion and community action Solomon Islands focus Applying public health functions to communities, provinces and the national health system. Core message PHC connects primary care with essential public health functions, multisectoral action and empowered communities. Presented by Mr. Rudgard Palapu School of Public Health Faculty of Nursing, Medicine & Health Sciences Role of Public Health in Primary Health Care | 1 Learning outcomes At the end of the session the students should be able to: 1. 2. 3. 4. 5. Define Primary Health Care (PHC) and distinguish it from primary care. Explain why public health is a core component of PHC. Describe major public health functions that support PHC. Apply public health roles to Solomon Islands community and provincial settings. Identify how public health contributes to equity, prevention and Universal Health Coverage (UHC). Role of Public Health in Primary Health Care | 2 What is Primary Health Care? WHO definition in practice PHC is a whole-of-society approach that brings health and wellbeing closer to people's everyday environments. Three inter-related components 1) Integrated primary care + essential public health functions 2) Multisectoral policies and action 3) Empowered people and communities • PHC covers health promotion, disease prevention, treatment, rehabilitation and palliative care. • PHC addresses wider determinants such as water, sanitation, food, housing, education and environment. • PHC aims for equity: people should receive services according to need, not simply geography or ability to pay. Source: WHO, Primary health care (2025). Role of Public Health in Primary Health Care | 3 Primary Care vs Primary Health Care PRIMARY CARE First-contact, continuous, comprehensive and coordinated care for individuals and families. Where public health fits communities, promote wellbeing and reduce inequities. PRIMARY HEALTH CARE A broader whole-of-society approach combining primary care, essential public health functions, multisectoral action and community empowerment. Public health provides the population-level intelligence and action that helps PHC prevent illness, protect Source: WHO, Primary health care; Primary care (2025). Role of Public Health in Primary Health Care | 4 Why is Public Health important to PHC? • PHC is not only about treating people after they become sick. • Public health shifts attention upstream—to risks, causes, environments, populations and prevention. • Public health identifies community health needs and priorities using data and epidemiological evidence. • It helps primary care services respond to population needs rather than operating in isolation. • Strong public health capacity improves preparedness, health security, equity and resilience. Key idea Primary care focuses strongly on people who seek care; public health also asks: Who is getting sick, why, who is being missed, and what can we change at population level? Source: WHO, Essential public health functions (2025). Role of Public Health in Primary Health Care | 5 Major public health roles within PHC 1. Health surveillance Monitor diseases, risk factors, deaths, outbreaks and service use. 3. Health promotion Build health literacy, healthy behaviours and supportive environments. 5. Community engagement Mobilise communities and strengthen participation in health decisions. 2. Disease prevention Vaccination, screening, early detection and prevention programmes. 4. Health protection Food safety, water safety, environmental and occupational health. 6. Emergency preparedness Detect threats, prepare response systems and maintain essential services. Source: WHO, Essential public health functions (2025). Role of Public Health in Primary Health Care | 6 1. Population health assessment & surveillance • Collect, analyse and interpret information about the health of populations. • Identify priority diseases, risk factors, vulnerable groups and geographical inequities. • Detect outbreaks and unusual health events early. • Use routine health information, community reports, surveys and research to guide decisions. • Feed findings back to health facilities, provincial teams, communities and policymakers. Solomon Islands example A provincial public health team can use surveillance data to identify malaria hotspots, low immunisation coverage or increasing NCD risk and then target outreach and prevention activities. Role of Public Health in Primary Health Care | 7 2. Disease prevention & health promotion Disease prevention Prevent disease before it occurs; detect it early; reduce complications and transmission. Health promotion Enable people and communities to increase control over the factors that influence health. • Immunisation and communicable disease prevention • Maternal, newborn and child health promotion • NCD risk reduction: tobacco, unhealthy diet, physical inactivity and harmful alcohol use • Nutrition education and food security initiatives • School, workplace, church and community health promotion • Screening and early detection where appropriate Role of Public Health in Primary Health Care | 8 3. Health protection & environmental health • Protect communities from environmental, food, water, occupational and other health hazards. • Support safe water, sanitation and hygiene (WASH). • Promote food safety and investigate foodborne disease events. • Support vector control and communicable disease control. • Assess health risks associated with disasters, climate change and environmental change. • Work with other sectors because many health risks cannot be controlled by the health sector alone. PHC principle Healthy communities require healthy environments—not only clinical services. Role of Public Health in Primary Health Care | 9 4. Community participation and empowerment • Engage communities in identifying health problems and setting priorities. • Use local knowledge, culture and community structures when designing interventions. • Support self-care, health literacy and community capacity. • Work with churches, schools, women's groups, youth groups, chiefs, NGOs and other local organisations. • Use participatory approaches rather than designing programmes entirely from the top down. Solomon Islands application Community-based approaches are particularly important where communities are geographically dispersed and access to facilities is difficult. Role of Public Health in Primary Health Care | 10 5. Multisectoral action: public health cannot work alone Health Services, surveillance, prevention Education Health literacy, schools, adolescent health Agriculture Food systems, nutrition, food security Water & sanitation Safe water, sanitation, hygiene Environment Climate, waste, vectors, hazards Public Health role Local government & communities Planning, participation, local action Coordinate evidence, advocate for healthy policies, assess health impacts and keep equity at the centre of decision-making. Role of Public Health in Primary Health Care | 11 6. Equity and Universal Health Coverage • Identify groups that experience barriers to health services. • Map service coverage and unmet health needs. • Advocate for resources to underserved communities and provinces. • Promote culturally appropriate and accessible services. • Monitor whether health programmes are reaching those who need them most. • Use evidence to reduce avoidable differences in health outcomes. Solomon Islands policy connection The National Health Strategic Plan 2022–2031 aims for equitable access to quality preventive, curative, rehabilitative and promotional health services irrespective of where people live. Source: Solomon Islands NHSP 2022–2031; WHO CPCD. Role of Public Health in Primary Health Care | 12 7. Public health preparedness and emergency response • Maintain disease surveillance and early warning systems. • Prepare communities and health workers for outbreaks, disasters and other emergencies. • Develop response plans, communication systems and referral pathways. • Support risk communication and community engagement during emergencies. • Protect essential health services and vulnerable populations during crises. • Learn from incidents through debriefing, evaluation and improvement. Solomon Islands relevance Island geography, extreme weather, outbreaks and transport challenges make preparedness, surveillance and continuity of primary health services especially important. Role of Public Health in Primary Health Care | 13 Public Health and PHC: a practical community cycle 1. Assess Collect data and listen to the community 2. Prioritise Identify the most important problems and inequities 3. Plan Select evidence based and culturally appropriate actions 4. Act Implement prevention, promotion, protection and services 5. Monitor Track coverage, quality and outcomes Outcome 6. Improve Use findings to adapt and strengthen PHC Better population health + stronger communities + more equitable access + a more resilient health system Role of Public Health in Primary Health Care | 14 Solomon Islands application: example Problem A rural community has increasing hypertension and diabetes, low physical activity and limited access to screening. Public health assessment Review available data, identify risk factors, map underserved groups and consult community leaders. Multisectoral action Health + agriculture + education + churches + local leaders + community groups work together. PHC response Community screening + health education + healthy food initiatives + physical activity groups + referral and follow-up. Evaluation Measure screening coverage, referral completion, BP/glucose control, behaviour change and community participation. Role of Public Health in Primary Health Care | 15 Key messages for Public Health students • Public health is a core component of a strong PHC-oriented health system. • The public health lens is population-based: it asks who is affected, why, where and what can be done upstream. • Surveillance, prevention, health promotion, health protection and emergency preparedness strengthen PHC. • Community participation and multisectoral collaboration are essential. • Equity should guide planning, resource allocation, service delivery and evaluation. • In Solomon Islands, public health must respond to geography, culture, climate, communicable diseases, NCDs and social determinants of health.

The Role of Public Health in Primary Health Care From population health intelligence to prevention, protection, promotion and community action Solomon Islands focus Applying public health functions to communities, provinces and the national health system. Core message PHC connects primary care with essential public health functions, multisectoral action and empowered communities. Presented by Mr. Rudgard Palapu School of Public Health Faculty of Nursing, Medicine & Health Sciences Role of Public Health in Primary Health Care | 1 Learning outcomes At the end of the session the students should be able to: 1. 2. 3. 4. 5. Define Primary Health Care (PHC) and distinguish it from primary care. Explain why public health is a core component of PHC. Describe major public health functions that support PHC. Apply public health roles to Solomon Islands community and provincial settings. Identify how public health contributes to equity, prevention and Universal Health Coverage (UHC). Role of Public Health in Primary Health Care | 2 What is Primary Health Care? WHO definition in practice PHC is a whole-of-society approach that brings health and wellbeing closer to people's everyday environments. Three inter-related components 1) Integrated primary care + essential public health functions 2) Multisectoral policies and action 3) Empowered people and communities • PHC covers health promotion, disease prevention, treatment, rehabilitation and palliative care. • PHC addresses wider determinants such as water, sanitation, food, housing, education and environment. • PHC aims for equity: people should receive services according to need, not simply geography or ability to pay. Source: WHO, Primary health care (2025). Role of Public Health in Primary Health Care | 3 Primary Care vs Primary Health Care PRIMARY CARE First-contact, continuous, comprehensive and coordinated care for individuals and families. Where public health fits communities, promote wellbeing and reduce inequities. PRIMARY HEALTH CARE A broader whole-of-society approach combining primary care, essential public health functions, multisectoral action and community empowerment. Public health provides the population-level intelligence and action that helps PHC prevent illness, protect Source: WHO, Primary health care; Primary care (2025). Role of Public Health in Primary Health Care | 4 Why is Public Health important to PHC? • PHC is not only about treating people after they become sick. • Public health shifts attention upstream—to risks, causes, environments, populations and prevention. • Public health identifies community health needs and priorities using data and epidemiological evidence. • It helps primary care services respond to population needs rather than operating in isolation. • Strong public health capacity improves preparedness, health security, equity and resilience. Key idea Primary care focuses strongly on people who seek care; public health also asks: Who is getting sick, why, who is being missed, and what can we change at population level? Source: WHO, Essential public health functions (2025). Role of Public Health in Primary Health Care | 5 Major public health roles within PHC 1. Health surveillance Monitor diseases, risk factors, deaths, outbreaks and service use. 3. Health promotion Build health literacy, healthy behaviours and supportive environments. 5. Community engagement Mobilise communities and strengthen participation in health decisions. 2. Disease prevention Vaccination, screening, early detection and prevention programmes. 4. Health protection Food safety, water safety, environmental and occupational health. 6. Emergency preparedness Detect threats, prepare response systems and maintain essential services. Source: WHO, Essential public health functions (2025). Role of Public Health in Primary Health Care | 6 1. Population health assessment & surveillance • Collect, analyse and interpret information about the health of populations. • Identify priority diseases, risk factors, vulnerable groups and geographical inequities. • Detect outbreaks and unusual health events early. • Use routine health information, community reports, surveys and research to guide decisions. • Feed findings back to health facilities, provincial teams, communities and policymakers. Solomon Islands example A provincial public health team can use surveillance data to identify malaria hotspots, low immunisation coverage or increasing NCD risk and then target outreach and prevention activities. Role of Public Health in Primary Health Care | 7 2. Disease prevention & health promotion Disease prevention Prevent disease before it occurs; detect it early; reduce complications and transmission. Health promotion Enable people and communities to increase control over the factors that influence health. • Immunisation and communicable disease prevention • Maternal, newborn and child health promotion • NCD risk reduction: tobacco, unhealthy diet, physical inactivity and harmful alcohol use • Nutrition education and food security initiatives • School, workplace, church and community health promotion • Screening and early detection where appropriate Role of Public Health in Primary Health Care | 8 3. Health protection & environmental health • Protect communities from environmental, food, water, occupational and other health hazards. • Support safe water, sanitation and hygiene (WASH). • Promote food safety and investigate foodborne disease events. • Support vector control and communicable disease control. • Assess health risks associated with disasters, climate change and environmental change. • Work with other sectors because many health risks cannot be controlled by the health sector alone. PHC principle Healthy communities require healthy environments—not only clinical services. Role of Public Health in Primary Health Care | 9 4. Community participation and empowerment • Engage communities in identifying health problems and setting priorities. • Use local knowledge, culture and community structures when designing interventions. • Support self-care, health literacy and community capacity. • Work with churches, schools, women's groups, youth groups, chiefs, NGOs and other local organisations. • Use participatory approaches rather than designing programmes entirely from the top down. Solomon Islands application Community-based approaches are particularly important where communities are geographically dispersed and access to facilities is difficult. Role of Public Health in Primary Health Care | 10 5. Multisectoral action: public health cannot work alone Health Services, surveillance, prevention Education Health literacy, schools, adolescent health Agriculture Food systems, nutrition, food security Water & sanitation Safe water, sanitation, hygiene Environment Climate, waste, vectors, hazards Public Health role Local government & communities Planning, participation, local action Coordinate evidence, advocate for healthy policies, assess health impacts and keep equity at the centre of decision-making. Role of Public Health in Primary Health Care | 11 6. Equity and Universal Health Coverage • Identify groups that experience barriers to health services. • Map service coverage and unmet health needs. • Advocate for resources to underserved communities and provinces. • Promote culturally appropriate and accessible services. • Monitor whether health programmes are reaching those who need them most. • Use evidence to reduce avoidable differences in health outcomes. Solomon Islands policy connection The National Health Strategic Plan 2022–2031 aims for equitable access to quality preventive, curative, rehabilitative and promotional health services irrespective of where people live. Source: Solomon Islands NHSP 2022–2031; WHO CPCD. Role of Public Health in Primary Health Care | 12 7. Public health preparedness and emergency response • Maintain disease surveillance and early warning systems. • Prepare communities and health workers for outbreaks, disasters and other emergencies. • Develop response plans, communication systems and referral pathways. • Support risk communication and community engagement during emergencies. • Protect essential health services and vulnerable populations during crises. • Learn from incidents through debriefing, evaluation and improvement. Solomon Islands relevance Island geography, extreme weather, outbreaks and transport challenges make preparedness, surveillance and continuity of primary health services especially important. Role of Public Health in Primary Health Care | 13 Public Health and PHC: a practical community cycle 1. Assess Collect data and listen to the community 2. Prioritise Identify the most important problems and inequities 3. Plan Select evidence based and culturally appropriate actions 4. Act Implement prevention, promotion, protection and services 5. Monitor Track coverage, quality and outcomes Outcome 6. Improve Use findings to adapt and strengthen PHC Better population health + stronger communities + more equitable access + a more resilient health system Role of Public Health in Primary Health Care | 14 Solomon Islands application: example Problem A rural community has increasing hypertension and diabetes, low physical activity and limited access to screening. Public health assessment Review available data, identify risk factors, map underserved groups and consult community leaders. Multisectoral action Health + agriculture + education + churches + local leaders + community groups work together. PHC response Community screening + health education + healthy food initiatives + physical activity groups + referral and follow-up. Evaluation Measure screening coverage, referral completion, BP/glucose control, behaviour change and community participation. Role of Public Health in Primary Health Care | 15 Key messages for Public Health students • Public health is a core component of a strong PHC-oriented health system. • The public health lens is population-based: it asks who is affected, why, where and what can be done upstream. • Surveillance, prevention, health promotion, health protection and emergency preparedness strengthen PHC. • Community participation and multisectoral collaboration are essential. • Equity should guide planning, resource allocation, service delivery and evaluation. • In Solomon Islands, public health must respond to geography, culture, climate, communicable diseases, NCDs and social determinants of health.

The Role of Public Health in Primary Health Care From population health intelligence to prevention, protection, promotion and community action Solomon Islands focus Applying public health functions to communities, provinces and the national health system. Core message PHC connects primary care with essential public health functions, multisectoral action and empowered communities. Presented by Mr. Rudgard Palapu School of Public Health Faculty of Nursing, Medicine & Health Sciences Role of Public Health in Primary Health Care | 1 Learning outcomes At the end of the session the students should be able to: 1. 2. 3. 4. 5. Define Primary Health Care (PHC) and distinguish it from primary care. Explain why public health is a core component of PHC. Describe major public health functions that support PHC. Apply public health roles to Solomon Islands community and provincial settings. Identify how public health contributes to equity, prevention and Universal Health Coverage (UHC). Role of Public Health in Primary Health Care | 2 What is Primary Health Care? WHO definition in practice PHC is a whole-of-society approach that brings health and wellbeing closer to people's everyday environments. Three inter-related components 1) Integrated primary care + essential public health functions 2) Multisectoral policies and action 3) Empowered people and communities • PHC covers health promotion, disease prevention, treatment, rehabilitation and palliative care. • PHC addresses wider determinants such as water, sanitation, food, housing, education and environment. • PHC aims for equity: people should receive services according to need, not simply geography or ability to pay. Source: WHO, Primary health care (2025). Role of Public Health in Primary Health Care | 3 Primary Care vs Primary Health Care PRIMARY CARE First-contact, continuous, comprehensive and coordinated care for individuals and families. Where public health fits communities, promote wellbeing and reduce inequities. PRIMARY HEALTH CARE A broader whole-of-society approach combining primary care, essential public health functions, multisectoral action and community empowerment. Public health provides the population-level intelligence and action that helps PHC prevent illness, protect Source: WHO, Primary health care; Primary care (2025). Role of Public Health in Primary Health Care | 4 Why is Public Health important to PHC? • PHC is not only about treating people after they become sick. • Public health shifts attention upstream—to risks, causes, environments, populations and prevention. • Public health identifies community health needs and priorities using data and epidemiological evidence. • It helps primary care services respond to population needs rather than operating in isolation. • Strong public health capacity improves preparedness, health security, equity and resilience. Key idea Primary care focuses strongly on people who seek care; public health also asks: Who is getting sick, why, who is being missed, and what can we change at population level? Source: WHO, Essential public health functions (2025). Role of Public Health in Primary Health Care | 5 Major public health roles within PHC 1. Health surveillance Monitor diseases, risk factors, deaths, outbreaks and service use. 3. Health promotion Build health literacy, healthy behaviours and supportive environments. 5. Community engagement Mobilise communities and strengthen participation in health decisions. 2. Disease prevention Vaccination, screening, early detection and prevention programmes. 4. Health protection Food safety, water safety, environmental and occupational health. 6. Emergency preparedness Detect threats, prepare response systems and maintain essential services. Source: WHO, Essential public health functions (2025). Role of Public Health in Primary Health Care | 6 1. Population health assessment & surveillance • Collect, analyse and interpret information about the health of populations. • Identify priority diseases, risk factors, vulnerable groups and geographical inequities. • Detect outbreaks and unusual health events early. • Use routine health information, community reports, surveys and research to guide decisions. • Feed findings back to health facilities, provincial teams, communities and policymakers. Solomon Islands example A provincial public health team can use surveillance data to identify malaria hotspots, low immunisation coverage or increasing NCD risk and then target outreach and prevention activities. Role of Public Health in Primary Health Care | 7 2. Disease prevention & health promotion Disease prevention Prevent disease before it occurs; detect it early; reduce complications and transmission. Health promotion Enable people and communities to increase control over the factors that influence health. • Immunisation and communicable disease prevention • Maternal, newborn and child health promotion • NCD risk reduction: tobacco, unhealthy diet, physical inactivity and harmful alcohol use • Nutrition education and food security initiatives • School, workplace, church and community health promotion • Screening and early detection where appropriate Role of Public Health in Primary Health Care | 8 3. Health protection & environmental health • Protect communities from environmental, food, water, occupational and other health hazards. • Support safe water, sanitation and hygiene (WASH). • Promote food safety and investigate foodborne disease events. • Support vector control and communicable disease control. • Assess health risks associated with disasters, climate change and environmental change. • Work with other sectors because many health risks cannot be controlled by the health sector alone. PHC principle Healthy communities require healthy environments—not only clinical services. Role of Public Health in Primary Health Care | 9 4. Community participation and empowerment • Engage communities in identifying health problems and setting priorities. • Use local knowledge, culture and community structures when designing interventions. • Support self-care, health literacy and community capacity. • Work with churches, schools, women's groups, youth groups, chiefs, NGOs and other local organisations. • Use participatory approaches rather than designing programmes entirely from the top down. Solomon Islands application Community-based approaches are particularly important where communities are geographically dispersed and access to facilities is difficult. Role of Public Health in Primary Health Care | 10 5. Multisectoral action: public health cannot work alone Health Services, surveillance, prevention Education Health literacy, schools, adolescent health Agriculture Food systems, nutrition, food security Water & sanitation Safe water, sanitation, hygiene Environment Climate, waste, vectors, hazards Public Health role Local government & communities Planning, participation, local action Coordinate evidence, advocate for healthy policies, assess health impacts and keep equity at the centre of decision-making. Role of Public Health in Primary Health Care | 11 6. Equity and Universal Health Coverage • Identify groups that experience barriers to health services. • Map service coverage and unmet health needs. • Advocate for resources to underserved communities and provinces. • Promote culturally appropriate and accessible services. • Monitor whether health programmes are reaching those who need them most. • Use evidence to reduce avoidable differences in health outcomes. Solomon Islands policy connection The National Health Strategic Plan 2022–2031 aims for equitable access to quality preventive, curative, rehabilitative and promotional health services irrespective of where people live. Source: Solomon Islands NHSP 2022–2031; WHO CPCD. Role of Public Health in Primary Health Care | 12 7. Public health preparedness and emergency response • Maintain disease surveillance and early warning systems. • Prepare communities and health workers for outbreaks, disasters and other emergencies. • Develop response plans, communication systems and referral pathways. • Support risk communication and community engagement during emergencies. • Protect essential health services and vulnerable populations during crises. • Learn from incidents through debriefing, evaluation and improvement. Solomon Islands relevance Island geography, extreme weather, outbreaks and transport challenges make preparedness, surveillance and continuity of primary health services especially important. Role of Public Health in Primary Health Care | 13 Public Health and PHC: a practical community cycle 1. Assess Collect data and listen to the community 2. Prioritise Identify the most important problems and inequities 3. Plan Select evidence based and culturally appropriate actions 4. Act Implement prevention, promotion, protection and services 5. Monitor Track coverage, quality and outcomes Outcome 6. Improve Use findings to adapt and strengthen PHC Better population health + stronger communities + more equitable access + a more resilient health system Role of Public Health in Primary Health Care | 14 Solomon Islands application: example Problem A rural community has increasing hypertension and diabetes, low physical activity and limited access to screening. Public health assessment Review available data, identify risk factors, map underserved groups and consult community leaders. Multisectoral action Health + agriculture + education + churches + local leaders + community groups work together. PHC response Community screening + health education + healthy food initiatives + physical activity groups + referral and follow-up. Evaluation Measure screening coverage, referral completion, BP/glucose control, behaviour change and community participation. Role of Public Health in Primary Health Care | 15 Key messages for Public Health students • Public health is a core component of a strong PHC-oriented health system. • The public health lens is population-based: it asks who is affected, why, where and what can be done upstream. • Surveillance, prevention, health promotion, health protection and emergency preparedness strengthen PHC. • Community participation and multisectoral collaboration are essential. • Equity should guide planning, resource allocation, service delivery and evaluation. • In Solomon Islands, public health must respond to geography, culture, climate, communicable diseases, NCDs and social determinants of health.

Activity 1: 1. Define primary health care: 2. List the 8 elements of PHC: 3. State the 3 components of PHC: 4. Integrated health services with emphases on PHC and public health function in component one. State the six functions: 5. List the six principles of PHC. 6. Define health promotion: 7. In your own words list and explain the three strategies for health promotion 8. In your own words, list and explain the five action areas for health promotion. 9. List the social determinants of health. 10. Define what PHC policies are, using the note given. 11. List and describe the four types of health policies. 12. Identify the factors that influencing the development of policies that affect the health of the population using the notes given. 13. Define PHC and distinguish it from primary care: 14. In own words describe major public health functions that support PHC: 15. In own words explain the roles and responsibilities of health workers at community and primary care level: use your notes. 16. In your own words describe teamwork, referral, community participation and health promotion in PHC:

Theory of Community Health Water Supply · Sanitation · Waste Management Prepared for Diploma in Nursing — Community Health Nursing Module Water Supply Sanitation Waste Mgmt. INTRODUCTION Environment Is the Foundation of Community Health Community health nursing theory holds that the health of a population depends as much on its physical environment as on individual behaviour or medical care. Access to safe water, sound sanitation, and proper waste disposal interrupt the chain of transmission of many communicable diseases before illness ever begins —making them core, preventable responsibilities of the community health nurse. 1.4M deaths preventable each year with safe water, sanitation & hygiene 74M healthy life-years (DALYs) that could be saved annually 69% of diarrhoeal deaths worldwide are linked to unsafe WASH Source: WHO Global Health Observatory —Burden of Disease Attributable to Unsafe WASH, 2023 update (2019 data) Theory of Community Health 2 OVERVIEW Three Pillars of Environmental Sanitation Water Supply Ensuring water that is adequate in quantity, safe in quality, and physically accessible to every household. Sanitation & Hygiene Safe disposal of human excreta and consistent hygienic practices at home, school and in health facilities. Waste Management Proper collection, treatment and disposal of sewage and solid rubbish generated by the community. Together, these three pillars break the environmental chain of disease transmission within a community. Theory of Community Health 3 01 Water Supply WATER SUPPLY Why Safe Water Matters Importance of Safe Water • Sustains life, food preparation and personal hygiene • Prevents waterborne diseases: cholera, typhoid, dysentery, hepatitis A • Supports maternal health and healthy child growth • Enables environmental cleanliness in homes and health facilities Sources of Water Supply Surface sources Rivers, lakes, ponds, reservoirs Ground sources Wells, boreholes, protected springs Rainwater harvesting Roof catchment & storage tanks Piped municipal supply Treated, distributed water systems Theory of Community Health – Water Supply 5 WATER SUPPLY Making Water Safe to Drink Characteristics of Safe Water • Free from disease-causing pathogens • Clear, colourless and free of odour • Free from excess chemicals, minerals & toxins • Palatable and aesthetically acceptable • Adequate in quantity for daily household needs Purification Methods Boiling Kills pathogens; simplest household method Chlorination Disinfects large or piped water supplies Filtration Sand or ceramic filters remove particles & microbes Sedimentation & coagulation Settles suspended solids before further treatment 6 Theory of Community Health – Water Supply WATER SUPPLY The Nurse's Role in Safe Water Provision Health Education Teach families household water treatment, safe storage and handling Sanitary Surveys Inspect and assess water sources for contamination risk Outbreak Surveillance Monitor, detect and report waterborne disease outbreaks early Advocacy & Liaison Work with local authorities to extend safe water access to underserved areas Theory of Community Health –Water Supply 7 02 Sanitation SANITATION Sanitation & Personal Hygiene Sanitation is the practice of maintaining clean environmental and personal conditions —through hygienic measures —that break the pathways by which disease-causing organisms spread within a community. Handwashing with Soap At critical times: before eating, after using the toilet, after handling waste Personal Cleanliness Regular bathing, oral care, nail and clothing hygiene Safe Food Handling Washing produce, safe storage, protecting food from contamination Environmental Cleanliness Clean living spaces, safe water storage, controlled vectors (flies, rodents) Theory of Community Health –Sanitation 9 SANITATION Safe Excreta Disposal & the Nurse's Role Methods of Excreta Disposal Pit latrine Simple, low-cost option for rural households Pour-flush latrine Water seal reduces odour and flies Septic tank system On-site treatment for individual homes Sewered (flush) toilet Piped to a central sewerage system Theory of Community Health – Sanitation Nurse's Role in Sanitation • Teach correct latrine use, cleaning and maintenance • Promote community-led total sanitation initiatives • Supervise sanitation standards in schools & health facilities • Run health education campaigns against open defecation 10 03 Waste Management WASTE MANAGEMENT Sewage Disposal Systems Sewage is the liquid waste from households, institutions and industry —containing human excreta, wastewater and other refuse —that must be safely collected, treated and discharged. Common Disposal Methods • Sewerage (sewer) systems carrying waste to treatment plants • Septic tank & soakage pit for individual homes • Waste stabilization ponds for low-cost biological treatment • Effluent treatment before discharge into water bodies Hazards of Poor Sewage Disposal • Contamination of drinking-water sources • Breeding ground for flies, mosquitoes & rodents • Spread of enteric diseases (typhoid, cholera, dysentery) • Foul odour and degraded living environment Theory of Community Health –Waste Management 12 WASTE MANAGEMENT Solid Waste (Rubbish) Disposal Segregation Separate organic, inorganic & hazardous waste at source Sanitary Landfill Controlled burial that limits contamination & odour Composting Converts organic waste into useful soil manure Incineration High-temperature burning for infectious/hazardous waste Recycling Recovers materials such as plastic, paper, metal & glass Theory of Community Health –Waste Management 13 WASTE MANAGEMENT The Nurse's Role & Key Takeaways Nurse's Role in Waste Management Teach households waste segregation and the 3Rs (reduce, reuse, recycle) Supervise sanitary waste disposal within health facilities Collaborate with municipal & environmental health teams M onitor vector-borne disease trends linked to poor waste disposal Key Takeaways • Water, sanitation & waste management form the environmental core of community health theory • Each pillar breaks a distinct link in the chain of disease transmission • The community health nurse acts as educator, supervisor, and advocate across all three • Prevention at the environmental level protects the whole community, not just the individual Theory of Community Health – Waste Management 14 Thank You Questions & Discussion — Community Health Nursin

Objectives At the end of the session the students should able to: 1. Define health; 2. Define health promotion; 3. Define primary health care; 4. List the social determinants of health 5. List and explain the three (3) strategies for health promotion 6. List and explain the five(5) action areas for health promotion This Photo by Unknown Author is licensed under CC BY What is health? • “…a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities. Therefore, health promotion is not just the responsibility of the health sector, but goes beyond healthy lifestyles to wellbeing.” • Defined as: A state o complete physical, mental and social well-being and not merely the absence o disease or infirmity. (WHO, 1998). Health Promotion • “…the process of enabling people to increase control over, and to improve, their health. To reach a state of complete physical mental and social wellbeing, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment…” (WHO, 1986). “Primary health care is essential health care PHC Defined based on practical, scientifically sound and socially acceptable methods and techniques 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 in the spirit of self reliance and determination” (WHO, 1978). • PHC encompasses a broad spectrum o activities to encourage health and wellbeing. These can include: PHC Defined cont…. oPrimary (initial) care oFollow-up activities for promoting health of the community oProtecting community members rom harm, and/ or oPreventing illness or injury (McMurray & Clendon, 2010) Goal of PHC • Build community capacity to enable sustainable health and wellbeing. oBased on the fundamental vales o equity, community participation and sel determination. Prerequisites for health “The fundamental conditions and resources for health are peace, shelter, education, food, income, a stable ecosystem, sustainable resources, social justice and equity. Improvement in health requires a secure foundation in these basic prerequisites.” (WHO, 1986) Major principles HP: 1. Participation 2. Intersectoral collaboration (Holistic view of Health) 3. Equity 4. Social justice 5. Empowerment This Photo by Unknown Author is licensed under CC BY This Photo by Unknown Author is licensed under CC BY-SA-NC (WHO, 1986) Neighbourhood and Built Environment Economic Stability SDOH Education Health and Health Care Social and Community Context Key areas • Each of the five determinant areas reflects a number of key issues that make up the underlying factors in the arena of SDOH. Crime and Violence Access to Food that Support Healthy Eating Patterns Environmental Conditions Neighbourhood and Built Environment Quality of Housing Access to Primary Care Access to Health Care Health and Health Care Health Literacy Discrimination Civic Participation Incarceration Social and Community Context Social Cohesion Enrolment in Higher Education Early Childhood Education and Development High School Graduation Education Language and Literacy Food Security Employment Housing Instability Economic Stability Poverty 3 Key Strategies Three HP strategies 1. Enable 2. Mediate 3. Advocate These strategies are applied to all five action areas of HP as per the emblem. (WHO,1986) 1. Enable • HP actions aims at reducing differences in current health status and ensuring equal opportunities and resources to enable all people to achieve their fullest health potential. • Include: oSupportive environment oAccess to information oLife skills and oOpportunities for making healthy choices • People cannot achieve their fullest health potential unless they are able to take control of those things which determine their health. 2. Mediate • Professional and social groups and health personnel have a major responsibility to mediate between differing interests in society; for the pursuit of health having in mind that the prerequisite of health cannot be ensured by the health sector alone, but requires a multisectoral approach. 3. Advocate (public support for an idea) • Advocate for political, economic, social and cultural, environmental, behavioural and biological factors to favour health, knowing that health is a major resource for social, economic and personal development and an important dimension of quality of life. Five action areas for health 1. Building healthy public policy; 2. Creating supportive environments; 3. Strengthening community action; 4. Developing personal skills; and 5. Reorienting health services. (WHO,1986) 1. Building healthy public policy • Putting health on the agenda of all policy makers • May include legislation, fiscal measures, taxation and organisation change for example: • Higher taxes on cigarettes and alcohol • Compulsory wearing of seat belts • Smoking bans in public places 2. Creating supportive environments • Living and working conditions that are safe, stimulating, satisfying and enjoyable • May include policy or environmental changes that make it easier to make healthy choices for example: • Well-lit walking and cycling paths • Healthy food in school canteens • Backyard gardening • Accessibility to sports field and parks This Photo by Unknown Author is licensed under CC BY-SA 3. Strengthening community action • Empowerment of communities to take control of endeavours and destinies •May include measures to enhance self help and social support or systems to increase public participation and direction of health matters, for example: • Local Drug Action Groups • Neighbourhood Watch Program (community policing) This Photo by Unknown Author is licensed under CC BY-SA-NC 4. Developing personal skills • Personal and social development • Includes providing information and education for health and life skills for example: • Supermarket tours looking at food labels • Information on immunisation • Safe sex education at schools • How to grow your own food (backyard gardening) workshops 5. Reorienting health services •Developing a health care system that contributes to the prevention of illness and injury and promotes health • May include professional education and training and redirecting resources into prevention, for example: • School teacher conducting healthy eating education. • A company Occupational Health and Safety (OHS) personnel conducting a blood pressure and weight and height check. • Student nurses conducting health screenings. Emerging Strategy • Health in all policy (HiAP) “HiAP is an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies, and avoids harmful health impacts in order to improve population health and health equity. As a concept, it reflects the principles of: legitimacy, accountability, transparency and access to information, participation, sustainability, and collaboration across sectors and levels of government…It includes an emphasis on the consequences of public policies on health systems, determinants of health and well-being.” (WHO, 2014) References • Talbot, L & Verrinder, G. (2010). Promoting Health: A Primary Health Care Approach. USA: Elsevier. • WHO. (2014) Health in all policies: Helsinki statement. Framework for country action. Finland; Ministry of Social Affairs and Health. • WHO. (1978) The Declaration of Alma-Ata • WHO. (1986) Ottawa Charter for Health Promotion. Canada • McMurray, A., Clendon, J. (2010). Community Health and Wellness: Primary Health Care in Practice (4th Edn.). USA: Elsevier

Objectives At the end of the session the students should able to: 1. Define what PHC policies are using the notes. 2. List and describe the four (4) types of health policies. 3. Identify the factors influencing the development of policies that affect the health of the population by reading the notes. 4. Explain the global issues that have an impact on national and regional policy development. 5. Discuss the issues that must be considered in planning health services to be responsive to the needs of different population groups 6. Discuss the role of nurses and midwives in policy planning and implementation This Photo by Unknown Author is licensed under CC BY What are Primary Health Care policies? •Primary Health Care policies are policies that guide governments and health organisations in providing essential, equitable and community-based health services, with an emphasis on health promotion, disease prevention, early intervention and community participation. PHCPI The requirements •The policies must be fair: that means advocating for those most in need while ensuring the need of those born to privilege are also not overlooked. – inclusive. •Must be made in a bi-directional manner: to ensure that consumer group input at the local level is heard at the national level, and that their input is accommodated in policy, and then fed back to the local level. TYPES OF HEALTH POLICIES 1. Distributive policies (Who gets the benefits)?: ensures that services or benefits are provided to a particular segment of the population; for example, family allowances or baby bonuses provided by the governments. 2. 3. 4. Regulatory policies (What behaviour is controlled?): they guide or control action. Usually take the form of legislation, such as the Acts concerned with food and water quality standards, and smoking. Self-regulatory policies (How does a profession control its own members?): maintain or control actions of groups or organisations. Example, nursing code of practice. Redistributive policies (How are resources shifted to improve equity?): Government resources are collected and allocated in a way that improves access for disadvantaged or underserved populations. Examples of Health Policies in the Solomon Islands Policy type Solomon Islands example Why it fits 1. Distributive policies National Health Strategic Plan 2022–2031 – equitable health service delivery Directs health resources and services toward populations and locations that need them, including rural and provincial communities. The plan explicitly aims for equitable access to quality health services regardless of where people live. (SIBCONLINE) Maternal, newborn and child health services Government and partners provide specific services and programmes to pregnant women, mothers and children—for example antenatal care, immunisation and child health services. These benefits are directed toward particular population groups. Provincial/rural health service programmes Resources, health facilities, medicines and health workers are directed to rural and provincial populations that may otherwise have limited access. The NHSP includes investment in rural health clinics and provincial services. (Solomon Islands Government) Policy type Solomon Islands example Why it fits 2. Regulatory policies Tobacco Control Act 2010 Controls tobacco sale, advertising, promotion, packaging, smoking in public places and exposure to second-hand smoke. It is a clear example of government using legislation to regulate behaviour. (PacLII) Pure Food Act 1996 Provides a legal framework for regulating food safety and protecting the public from unsafe or contaminated food. The Act is listed by the Solomon Islands Attorney General's Chambers as legislation currently in force. (Attorney General's Office) Pharmacy and Poisons Act Regulates the manufacture, sale and supply of medicines and poisons, including restrictions on the sale or supply of certain poisons without appropriate authorization or prescription. (Attorney General's Office) Health Services Act Provides the legal framework for public hospitals and health services, including management of hospitals, patient services, staff responsibilities and charges for certain services. (Attorney General's Office) Policy type Solomon Islands exampleWhy it fits 3. Self-regulatory policies Nursing professional standards and ethical requirements Nursing is a good example because the profession has professional standards that guide nurses' behaviour, responsibilities, accountability and ethical practice. Solomon Islands has a Nursing Council Act 1987 and its 1997 amendment, which provides the regulatory framework for the profession. (UNGM) Professional standards for doctors and other health professionals Professional bodies and regulatory arrangements establish standards concerning competence, professional conduct, ethics and accountability. These influence how members of a profession practise. Code of Ethics/Professional Conduct for health professionals Codes establish expected professional behaviour—for example confidentiality, respect for patients, competence, professional integrity and appropriate relationships with patients and colleagues. The ICN Code of Ethics provides a useful international framework for understanding this type of professional self-regulation. (ICN - International Council of Nurses) Policy type Solomon Islands exampleWhy it fits 4. Redistributive policies National Health Strategic Plan 2022–2031 – equitable access/UHC This is the strongest Solomon Islands example. The plan seeks to redistribute health resources toward achieving equitable access to health services, rather than allowing access to depend solely on geography or ability to pay. (SIBCONLINE) Public-sector health services through MHMS Government financing of public hospitals, clinics, health workers, medicines and preventive programmes pools public resources so that health services can be provided to the wider population. Provincial health grants and support for essential services Government and development-partner financing directed to provincial health services can help shift resources toward populations with greater geographical and service access disadvantages. For example, the current Solomon Islands–Australia Health Partnership supports provincial grants for essential health-service delivery and equitable access. (DFAT) Goal for Primary Health Policies • Ensure that essential health services are accessible, affordable, acceptable, equitable and appropriate for all people, particularly those living in vulnerable, rural and underserved communities. Aspects commonly addressed by PHC Policies • Health promotion and disease prevention – e.g., immunisation, nutrition, physical activity, tobacco control and health education. • Essential health services – ensuring people can access services such as maternal and child health, treatment of common illnesses and NCD screening. • Equity and access – reducing differences in access to health care between urban and rural populations. • Community participation – involving communities in identifying health problems, planning interventions and making decisions about their health. • Multisectoral collaboration – recognising that health is influenced by sectors such as education, agriculture, water and sanitation, housing and environment. • Health workforce and resources – guiding the deployment, training and management of health workers and allocation of medicines, equipment and funding. • Quality and safety of care – establishing standards and guidelines for the delivery of primary health services. Factors influencing policy development in health •Political will • Leadership •Health care orientation (who to provide health care) ▪Health in all policy •Competing interests e.g. SODH – multiple interests •Vested interests: hidden agenda • Shifting of responsibility especially to a less resourced government agencies •Spatially diverse conditions •Diversity of tastes, preferences, and business interests Global Issues Impacting National and Regional Policy Developments •Global economic and social crises (poverty, education or lack of it) •War •Geopolitical alliances: e.g. Taiwan/China shift •Conflicting interests on biophysical environment issues such as climate change •Use of unreliable tools to measure indicators that inform policy development processes •Dynamic regional conditions •Migration

Activity 1: 1. Define primary health care: 2. List the 8 elements of PHC: 3. State the 3 components of PHC: 4. Integrated health services with emphases on PHC and public health function in component one. State the six functions: 5. List the six principles of PHC. 6. Define health promotion: 7. In your own words list and explain the three strategies for health promotion 8. In your own words, list and explain the five action areas for health promotion. 9. List the social determinants of health. 10. Define what PHC policies are, using the note given. 11. List and describe the four types of health policies. 12. Identify the factors that influencing the development of policies that affect the health of the population using the notes given. 13. Define PHC and distinguish it from primary care: 14. In own words describe major public health functions that support PHC: 15. In own words explain the roles and responsibilities of health workers at community and primary care level: use your notes. 16. In your own words describe teamwork, referral, community participation and health promotion in PHC: