PHC fundamentals
Which declaration of 1978 introduced the slogan “Health for All,” and which 2018 declaration renewed its commitment?
The Alma-Ata Declaration (1978) introduced it, and the Astana Declaration (2018) renewed it and linked PHC to Universal Health Coverage.
Who forms the basic PHC team in Uzbekistan?
A family doctor and a family nurse, responsible for a defined catchment population.
Give one example each of primary, secondary and tertiary prevention in a PHC setting.
Primary: measles vaccination. Secondary: cervical (Pap) screening or blood pressure checks. Tertiary: rehabilitation after a stroke.
What are the five classic signs of inflammation?
Redness (rubor), swelling (tumor), heat (calor), pain (dolor) and loss of function (functio laesa).
What is the difference between primary care and primary health care (PHC)?
Primary care is the service-delivery level, such as the family doctor’s work. PHC is the wider approach that also covers prevention, health promotion and intersectoral action.
What is a QVP and whom does it serve?
The rural physician point (Qishloq vrachlik punkti) is the nearest PHC unit for the rural population. It came out of the rural health reform of the late 1990s
Why should a screening test have high sensitivity?
High sensitivity means few false negatives, so few people with the disease are missed.
Which two simple blood tests commonly rise in systemic inflammation and are often used in primary care?
C reactive protein (CRP) and erythrocyte sedimentation rate (ESR).
Name the four core features of good primary care (Starfield).
First contact, continuity, comprehensiveness and coordination.
What is dispanserizatsiya, and which groups does it cover?
It is systematic, active follow-up of defined groups: chronic patients, pregnant women, children and high-risk persons.
A polyclinic has 200 children in the target group and 180 are fully vaccinated. What is the coverage?
180 ÷ 200 × 100 = 90%.
A boy has progressive muscle weakness and difficulty climbing stairs, and his maternal uncle had the same problem. Which condition is likely, and what is its inheritance pattern?
Duchenne muscular dystrophy, X-linked recessive. The family doctor’s role is early recognition, referral and genetic counseling for the family.
Name four principles of PHC.
Any four of: accessibility, equity, community participation, intersectoral cooperation, emphasis on prevention and promotion, appropriate technology.
What is patronaj and why is it important?
It is home visiting by the nurse or doctor, especially for newborns and mothers after discharge. It allows early detection of problems such as infections, poor feeding and jaundice.
If R₀ of a disease is 4, what is the herd immunity threshold?
1 − 1/R₀ = 1 − 0.25 = 75%.
During routine growth monitoring, a 2-year-old’s weight is far below the expected range for age. What tool is used, and what is the concern?
WHO growth charts (z-scores). The concern is malnutrition (a nutritional dystrophy, such as hypotrophy), which needs a cause search, feeding counseling and follow-up.
Why is the family doctor called a “gatekeeper”?
The family doctor is the first contact and decides whether the patient can be managed at the primary level or needs referral to secondary or tertiary care. After specialist care, the patient returns to the family doctor for follow-up.
Which reform, piloted from 2021, aims to link health financing to results in Uzbekistan?
State (mandatory) health insurance.
Name the four shared behavioral risk factors of the major noncommunicable diseases.
Tobacco use, harmful alcohol use, unhealthy diet and physical inactivity.
A patient suddenly develops facial droop and weakness of the right arm. Which side of the brain is likely affected, and why?
The left hemisphere. The corticospinal tract crosses (decussates) at the medulla, so each hemisphere controls the opposite side of the body. This is a stroke emergency, so call emergency care immediately.