Israel journal of medical sciences
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The need for alternative strategies in providing personal health services in the community is discussed in relation to Israel, which has a widespread network of community-based curative clinics and preventive family health centers. Community-oriented primary health care (C-OPHC) is the major alternative strategy, which has been developed and evaluated by the Hadassah Teaching and Research Health Center in Kiryat Hayovel, a neighborhood of Jerusalem. The case for adapting this C-OPHC approach throughout the country is presented in a review of existing primary health care services.
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Prevention is a key element of primary health care, as defined by the Alma-Ata Conference and promoted by the World Health Organization. Developed as well as developing countries are giving renewed emphasis to prevention in the planning of health care. Israel has much to gain by placing high priority on prevention in its health policy.
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A community program for the control of cardiovascular risk factors, the CHAD program, was integrated into the primary care system of a family practice in Jerusalem. The steps used in introducing a community orientation in primary health care are used as a basis for description of the program. In the preliminary steps cardiovascular diseases and their risk factors were defined as the priority for the adult population of the community. ⋯ Planning for intervention included setting up objectives and planning strategies using standardized guidelines, and preparation of the staff and the community. Methods of implementation and surveillance are described. Two examples of evaluation of the program are cited.
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Since primary health care (PHC) is central to good doctoring and pervades all levels of medical services, a suitable system for teaching it must be developed. Whereas the traditional approach in teaching has been toward a set objective, PHC requires an approach that aims to meet urgent and changing needs. ⋯ Other teaching implications are those of organization and team training and continuing medical education. The conflict between different approaches is considered in an attempt to resolve the problem of who teaches what, when.