Screening in Primary Health Care

CALL  NUM:362.177 BRA

Physical Description:viii, 196 pages : illustrations ; 24 cm

Establishes a framework and a method for assessing the place of screening programmes in primary health care and determining which programmes will be most likely to benefit patients and health services alike. Though the principles described can be used in any country, particular attention is given to the setting of priorities in situations where resources are extremely limited and choices must be carefully made. Some 97 different health problems and risk factors which might form the focus of screening programmes are critically assessed. The book has eight chapters. The first three examine a number of policies, principles, and widely held assumptions that arise when decisions are made about the value of screening programmes. Chapter one discusses the aims, requirements, and potential benefits of preventive screening within the context of primary health care. In chapter two, the authors establish seven criteria that can help planners and programme administrators decide whether screening will contribute to the aims of primary health care in a particular situation. Chapter three on the planning and implementation of services alerts readers to several important issues that frequently arise at the local level when screening services are implemented. Various proposals for mandatory HIV screening are used to illustrate legal and ethical issues. In a key achievement, chapter four sets out a method for the systematic assessment of screening programmes and the setting of priorities. Focused on the questions of why, who, how, and when, the method is intended to help decision-makers assess local conditions, think through resource needs for diagnosis and intervention as well as screening anticipate problems, and then select the most appropriate preventive option. Having established a framework for setting priorities, the remaining chapters issue recommendations for a large number of screening options of potential value in primary health care programmes. Separate chapters cover screening in maternal, reproductive and newborn health care, child health care, care to prevent communicable disease, and the health care of adults. Readers are also alerted to situations where screening constitutes a waste of resources where patients may be harmed, and where other preventive options should have first call on resources. The book concludes with a 25-page tabular summary of all screening options considered; the level of resources required for screening, diagnosis, and intervention; and the recommendations made.