Primary Health Care Initiative Research Paper

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Health Care -- PHI

A Primary Health Care Initiative (PHI) is a fundamental, affordable health care mode clearly illustrated the Declaration of Alma-Ata. Michelle Obama's "Let's Move!" adheres to the PHI format and uses the Health Belief Model as its guide. Unfortunately, several problems with both the Model and the initiative hamper its success. Several measures can be taken to significantly enhance the initiative's impact.

Identify PHI (20%)

A PHI is a fundamental and affordable mode of health care that is grounded in realistic, well-established and culturally agreeable science and practices, and is made accessible to all members of a community (WHO, 1978, pp. 2-3). It relies on continuous financial and ideological support from the immediate and larger communities, as well as the wholehearted participation of community members, who are deemed partners in their own health care (WHO, 1978, pp. 2-3). Though the initiative works with individuals in their local communities, the initiative is part of a far larger, ongoing health care system and springs "organically" from those communities through their expressed health needs and as a result of social and medical education and experience (WHO, 1978, pp. 2-3). In addition, the initiative is pointedly devoted to the prevention and cure of one or more major community health problems. Furthermore, the initiative is multi-faceted in that it includes at least: basic necessities for healthy living; basic medical care; and education about the health problem and its prevention/cure (WHO, 1978, pp. 2-3). Focused on the community members' partnership in their well-being, the initiative seeks and enhances the involvement of all disciplines devoted to the betterment of communities, including but not limited to: agriculture, nutrition and housing. Working harmoniously, these multiple systems focus on individuals and communities who most need the initiative, while continuously improving the harmony between local and larger communities (WHO, 1978, pp. 2-3). Due to the multi-disciplinary nature of the initiative, the "team" facilitating the initiative typically includes traditional health care providers, as well as individuals from other disciplines devoted to individual, community and national well-being. In order to engender and enhance the partnership of individuals and communities in the initiative, it uses and promotes their resources "from the ground up" through their participation in all stages of the initiative, including the initiative's planning and operation (WHO, 1978, pp. 2-3).

Let's Move is a clear example of the PHI. Launched by First Lady Michelle Obama in 2009 (Keating Simons, 2010), this initiative is dedicated to the eradication of childhood obesity in the United States within a single generation (White House, 2013). Aided by a Taskforce on Childhood Obesity, the initiative is based on five pillars: "creating a health start for children"; "empowering parents and caregivers"; "providing healthy food in schools"; "improving access to healthy, affordable foods"; and "increasing physical activity" (White House, 2013). Let's Move follows the basic tenets of a PHI by: addressing the alarming incidence of childhood obesity in the United States, which is a local and national health issue; addressing the basic health facet of nutrition without expenditure of large additional sums for its facilitation; being based in realistic and well-established scientific knowledge about the negative impacts of obesity on individual, community and national health; using culturally agreeable practices for better nutrition and exercise (White House, 2013); focusing on children with the wider goal of better nutrition and fitness for all; requiring continuous support from all members of the local and national community; being multi-faceted and using a multi-disciplinary team of health care providers, school officials and nutritionists, among others.

Part B -- Discussion pertaining to the Declaration of Alma-Ata (25%)

Alma-Ata, USSR was the site of the International Conference on Primary Health Care, September 6 -- 12, 1978, which declared that: "health" consists of physical, mental and social well-being, is a basic human right and worthwhile goal requiring the cooperation of multi-disciplinary sectors; there is "gross inequality in health status" within communities and among countries, which is unacceptable and is a concern shared by all countries; the "New International Economic Order" requires the best health for all so they can economically and socially develop; people have the right and duty to be partners in the planning and implementation of health care; governments are responsible for providing adequate health and social measures for the health of their people, ideally attained by the year 2000, so they can enjoy productive lives, both socially and economically (WHO, 1978, p. 1); primary health care is based on every element that was set forth in Part A of this assignment; every government should fully participate in their members' health by policies, strategies and plans of action using internal and external resources; worldwide health is the ideal and should be sought through international cooperation with the assistance of WHO/UNICEF; all governments should pursue "genuine policy of independence, peace, detente and disarmament" freeing resources for health (WHO, 1978, pp. 2-3).

"Let's Move's" coincides with the Declaration because it: uses a multi-disciplinary approach aimed at eliminating childhood obesity within a generation, focusing on physical, mental and social well-being through proper diet and exercise; is dedicated to achieving nutritional and fitness equality in all sectors of America; operates on the principle that good nutrition and fitness are essential to economic and social development; enlists the partnership of children in planning and implementing their own good nutrition and physical fitness; operates on the theory that the government is responsible for at least assisting and sometimes providing adequate nutrition and physical fitness measures; as set forth in Part A of this assignment, Let's Move mirrors all the key attributes of a PHI; involves the full participation of government resources; is a policy, strategy and plan initiated by the government examining and using all available resources; dedicates considerable resources to implementation and achieving its goals.

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Part C -- Theory (25%)

One theory applicable to Let's Move is the "Health Belief Model." Developed by the U.S. Health Service in the 1950's the Health Belief Model was developed to understand, predict and alter health-related behaviors based on beliefs about a recommended behavior and the health problem(s) that the recommended behavior is supposed to prevent or treat. Applied to "Let's Move!," the program attempts to understand, predict and eliminate poor nutrition and lack of exercise based on the beliefs that good nutrition and physical fitness can prevent and/or remedy childhood obesity within a generation by employing the "five pillars" discussed in Part A.

Let's Move's reliance on the "Health Belief Model" is problematic in several aspects. First, it does not account for the "unrealistic optimism" that undermines an individual's participation in the program. Studies show that individuals tend to be unrealistically optimistic about the severity of a problem, their own susceptibility to the problem, the perceived benefits of altering their behavior and the perceived barriers to altering their behavior (Clarke, Lovegrove, Williams, & Machperson, 2000, pp. 368-9). Applying those concepts to "Let's Move!," the program is hampered by individuals' beliefs: that the childhood obesity problem in the United States is not as severe as it actually is; that they/their children are not obese and/or will not suffer the serious health consequences of being obese; that the measures for better nutrition and exercise will not prevent or effectively counteract obesity; and that the measures for better nutrition and exercise are too unpleasant to adopt. Secondly, the "Health Belief Model," and Let's Move in reliance on that model, operate on the assumption that people make rational decisions and consistently adhere to them (Keating Simons, 2010). In fact, the alarming incidence and persistence of childhood obesity show that neither children nor their parents think rationally about the consequences of poor diet and lack of exercise. Third, Let's Move is trying to sell good health as its product, which is an ineffective marketing method (Keating Simons, 2010). Successful advertising is based on: a large promise; supporting core values such as youth, freedom or sex; feelings (Keating Simons, 2010); however, the Health Belief Model and Let's Move use none of those successful methods and instead focus on an intellectual approach to simply attaining good health, which is does not tend to attract and inspire participants (Keating Simons, 2010). Fourth, the Health Belief Model, and Let's Move in reliance on that model, operate on the assumptions that people want to change their behavior and will adhere to those changes (Keating Simons, 2010). In reality, the Task Force on Childhood Obesity surveyed a very small, enthusiastic group about preventing/treating childhood obesity but did not ask the American public if "they felt they were able to, or intended to, buy healthier food or to become more physically active" (Keating Simons, 2010). As a result of these four flaws, some experts strongly believe that Let's Move is doomed to failure.

Part D- Initiative / Reflection (20%)

While Let's Move is not necessarily doomed, there are definite measures that can be taken to significantly increase its effectiveness. First, the initiative would benefit from the "Diffusion of Innovation Model," in which numerous social networking avenues are used by numerous innovators with….....

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