Health is more than the absence of disease. It is at the heart of human wellbeing. For this reason, the aim of all care is “to protect health when it exists and to restore it when it is absent” (Ibn Sina “The Canon of Medicine” c1012). This ancient ideal of medicine is embodied into what we now call community oriented primary care (COPC). COPC is a cooperative approach to quality cost effective health care. It is a way of doing health that extends between people – as individuals, patients, families, health and care professionals, workers, educators – and systems and services in defined geographical spaces. It is a way of doing health that empowers, builds and enriches everyone. “COPC – A Practical Guide” is a revised and substantially expanded version of “A Practical Guide to Doing Community Oriented Primary Care”. It is a learning aide to support ways of thinking about and doing COPC. It is there to support everyone engaged in health and care.
Section 1 covers the approaches to health care and learning used to deliver COPC. The first chapter “the health care challenge’, explains the burden of disease and the problem of the health care system as the driver of primary care reengineering and the NHI. It then describes the principles of COPC as a practical approach to the reform and sets out four interrelated issues that need to be addressed to ensure success. Chapter 2, “Learning for Effect”, explains the capability approach to learning as a lifelong way to continuously learn and help others learn. It describes work-i-learn, which is formal, intentional learning in the work place that uses the best available methods. And it explains the methods and techniques of facilitation to support work-i-learn.
Section 2 covers the most common health conditions. Chapter 3 focuses on communicable diseases, particularly, HIV/AIDS and TB. Chapter 4 focuses on non-communicable diseases, specifically lifestyle risks, diabetes, heart disease, cancer, mental health, psychological wellbeing and mental illness as well as substance use harm reduction. The focus of chapter 5 is on maternal and child health. It covers maternal and child mortality, pregnancy and the journey into life, pregnancy choices, and pregnancy risks and responses. It also explains newborn and infant feeding. Chapter 6 covers violence and injury, with sections focusing on violence and intentional injury, domestic violence and road traffic accidents and unintentional injury.
Section 3 explains the practice of COPC. It is designed to enable health care teams to do COPC in an effective and consequential way. Chapter 7, “the team and the community”, focuses on identifying the place of practice, the health care team, and available resources. It also covers building partnerships and responding to resource gaps. Chapter 8 is about the assessment of community health. It explains information and research ethics and confidentiality. It also covers how to assess and describe health and wellbeing. Chapter 9 focuses on delivering health care.
In it, planning, implementation and monitoring, and evaluation are explained. The authors of health are ordinary women, men and children and the teams of professional and health care workers, learners, educators and managers who support and practically make health a daily reality. The best I can hope is that this guide will be of use to them.