Family planning services are defined as "educational, comprehensive medical or social activities which enable individuals, including minors, to determine the number and spacing of their children and to select the means by which this may be achieved". Family planning may involve consideration of the number of children a woman wishes to have, including the choice to have no children, as well as the age at which she wishes to have them; these matters are influenced by external factors such as marital situation, career considerations, financial position, any disabilities that may affect their ability to have children and raise them, besides many other considerations. If sexually active, family planning may involve the use of contraception and other techniques to control the timing of reproduction. Other techniques used include sexuality education and management of sexually transmitted infections, pre-conception counseling and management, infertility management. Family planning as defined by the United Nations and the World Health Organization encompasses services leading up to conception and does not promote abortion as a family planning method, although levels of contraceptive use reduces the need for abortion.
Family planning is sometimes used as a synonym or euphemism for access to and the use of contraception. However, it involves methods and practices in addition to contraception. Additionally, there are many who might wish to use contraception but are not planning a family. Contemporary notions of family planning, tend to place a woman and her childbearing decisions at the center of the discussion, as notions of women's empowerment and reproductive autonomy have gained traction in many parts of the world, it is most applied to a female-male couple who wish to limit the number of children they have and/or to control the timing of pregnancy. In 2006, the US Centers for Disease Control issued a recommendation, encouraging men and women to formulate a reproductive life plan, to help them in avoiding unintended pregnancies and to improve the health of women and reduce adverse pregnancy outcomes. Raising a child requires significant amounts of resources: time, social and environmental. Planning can help assure.
The purpose of family planning is to make sure that any couple, man, or woman who has a child has the resources that are needed in order to complete this goal. With these resources a couple, man or woman can explore the options of natural birth, artificial insemination, or adoption. In the other case, if the person does not wish to have a child at the specific time, they can investigate the resources that are needed to prevent pregnancy, such as birth control, contraceptives, or physical protection and prevention. There is no clear social impact case against conceiving a child. Individually, for most people, bearing a child or not has no measurable impact on person well-being. A review of the economic literature on life satisfaction shows that certain groups of people are much happier without children: Single parents Fathers who both work and raise the children equally. Singles The divorced The poor Those whose children are older than 3 Those whose children are sickHowever, both adoptees and the adopters report that they are happier after adoption.
Adoption may insure against costs of prenatal or childhood disability which can be anticipated with prenatal screening or with reference to parental risk factors. For instance, older fathers and/or Advanced maternal age increase the risk of numerous health issues in their offspring, including autism and schizophrenia. Template:Sanchez, 2018 When women can pursue additional education and paid employment, families can invest more in each child. Children with fewer siblings tend to stay in school longer than those with many siblings. Leaving school in order to have children has long-term implications for the future of these girls, as well as the human capital of their families and communities. Family planning slows unsustainable population growth which drains resources from the environment, national and regional development efforts; the WHO states about maternal health that: "Maternal health refers to the health of women during pregnancy and the postpartum period. While motherhood is a positive and fulfilling experience, for too many women it is associated with suffering, ill-health and death."About 99% of maternal deaths occur in less developed countries.
Both early and late motherhood have increased risks. Young teenagers face a higher risk of complications and death as a result of pregnancy. Waiting until the mother is at least 18 years old before trying to have children improves maternal and child health. If additional children are desired after a child is born, it is healthier for the mother and the child to wait at least 2 years after the previous birth before attempting to conceive. After a miscarriage or abortion, it is healthier to wait at least 6 months. Joselyne When planning a family, women should be aware that reproductive risks increase with the age of the woman. Like older men, older women have a higher chance of having a child with autism or Down syndrome, the chances of having multiple births increases, which cause further late-pregnancy risks, they have an increased chance of developing gestational diabetes, the need for a Caesarian section is greater, older women's bodies are not as well-suited for delivering a baby; the risk of
American Academy of Family Physicians
The American Academy of Family Physicians was founded in 1947 to promote the science and art of family medicine. It is one of the largest medical organizations in the United States, with over 131,400 members; the AAFP was instrumental in establishing family medicine as a recognized medical specialty. The AAFP is headquartered in Kansas; the mission of the AAFP is to improve the health of patients and communities by serving the needs of members with professionalism and creativity. To fulfill its mission, the AAFP has four objectives: advocacy, practice enhancement and health of the public. In its advocacy efforts, the AAFP shapes health care policy through interactions with government, the public and the health care industry. Areas of advocacy include advancing health care for all, promoting the Patient-Centered Medical home model of care, increasing the family physician workforce; the AAFP helps its members fulfill their practice and career goals by assisting their practices in becoming designated Patient-Centered Medical Homes, promoting practice transformation through education and communication, assisting members in achieving financial success through optimal practice management.
The AAFP offers its physician and student members Continuing Medical Education on topics related to family medicine. The AAFP promotes increased funding for undergraduate and continuing medical education, strives to develop mechanisms that will increase the Part II maintenance of certification passing rate of family medicine residency graduates. To better the health of the public, the AAFP aims to take a leadership role in health promotion, disease prevention and chronic disease management; the AAFP works to involve family physicians in public health activities such as tobacco cessation, obesity prevention, encouraging exercise and immunizations. The AAFP provides patients with free educational resources on its consumer health site. In 1992, the AAFP began offering membership to osteopathic physicians who completed residencies approved by the American Osteopathic Association; the AAFP is governed by a Congress of Delegates composed of two delegates from each of its 55 constituent chapters, as well as from resident and student groups, new physicians, the special constituencies.
The Congress meets annually prior to the Academy's Family Medicine Experience event and has sole power to establish policies and define principles. These policies are carried out between annual meetings by the Board of Directors and a number of standing and special commissions and committees. Delegates to the Congress of Delegates elect the Board, which in turn appoints commission and committee members. Constituent chapters are organized similarly. AAFP News Now - the official news publication of the American Academy of Family Physicians American Family Physician - a clinical medical journal Family Practice Management - a peer-reviewed journal dedicated to making primary care practice better Annals of Family Medicine - a collaborative effort with six family medicine organizations Advanced Life Support in Obstetrics American Board of Family Medicine American Osteopathic Board of Family Physicians American College of Osteopathic Family Physicians World Organization of Family Doctors Official website American Family Physician - a journal by the AAFP Family Practice Management - a journal by the AAFP Annals of Family Medicine - a collaborative journal of the six family medicine organizations familydoctor.org, - The AAFP's patient education site.
Includes handouts, brochures and other resources for patients
Vaccination is the administration of a vaccine to help the immune system develop protection from a disease. Vaccines contain a microorganism in a weakened or killed state, or proteins or toxins from the organism. In stimulating the body's adaptive immunity, they help prevent sickness from an infectious disease; when a sufficiently large percentage of a population has been vaccinated, herd immunity results. The effectiveness of vaccination has been studied and verified. Vaccination is the most effective method of preventing infectious diseases. Smallpox was most the first disease people tried to prevent by inoculation and was the first disease for which a vaccine was produced; the smallpox vaccine was invented in 1796 by English physician Edward Jenner and, although at least six people had used the same principles years earlier, he was the first to publish evidence that it was effective and to provide advice on its production. Louis Pasteur furthered the concept through his work in microbiology.
The immunization was called vaccination. Smallpox was a contagious and deadly disease, causing the deaths of 20–60% of infected adults and over 80% of infected children; when smallpox was eradicated in 1979, it had killed an estimated 300–500 million people in the 20th century. Vaccination and immunization have a similar meaning in everyday language; this is distinct from inoculation. Vaccination efforts have been met with some controversy on scientific, political, medical safety, religious grounds. In the United States, people may receive compensation for those injuries under the National Vaccine Injury Compensation Program. Early success brought widespread acceptance, mass vaccination campaigns have reduced the incidence of many diseases in numerous geographic regions. Vaccines are a way of artificially activating the immune system to protect against infectious disease; the activation occurs through priming the immune system with an immunogen. Stimulating immune responses with an infectious agent is known as immunization.
Vaccination includes various ways of administering immunogens. Most vaccines are administered before a patient has contracted a disease to help increase future protection. However, some vaccines are administered after the patient has contracted a disease. Vaccines given after exposure to smallpox are reported to offer some protection from disease or may reduce the severity of disease; the first rabies immunization was given by Louis Pasteur to a child after he was bitten by a rabid dog. Since its discovery, the rabies vaccine have been proven effective in preventing rabies in humans when administered several times over 14 days along with rabies immune globulin and wound care. Other examples include cancer and Alzheimer's disease vaccines; such immunizations aim to trigger an immune response more and with less harm than natural infection. Most vaccines are given by injection. Live attenuated polio, some typhoid, some cholera vaccines are given orally to produce immunity in the bowel. While vaccination provides a lasting effect, it takes several weeks to develop.
This differs from passive immunity has immediate effect. A vaccine failure is. Primary vaccine failure occurs when an organism's immune system does not produce antibodies when first vaccinated. Vaccines can fail to produce an immune response; the term "vaccine failure" does not imply that the vaccine is defective. Most vaccine failures are from individual variations in immune response; the term inoculation is used interchangeably with vaccination. However, some argue. Dr Byron Plant explains: "Vaccination is the more used term, which consists of a'safe' injection of a sample taken from a cow suffering from cowpox... Inoculation, a practice as old as the disease itself, is the injection of the variola virus taken from a pustule or scab of a smallpox sufferer into the superficial layers of the skin on the upper arm of the subject. Inoculation was done'arm to arm' or less effectively'scab to arm'..." Inoculation oftentimes caused the patient to become infected with smallpox, in some cases the infection turned into a severe case.
Vaccinations began in the 18th century with the work of the smallpox vaccine. Just like any medication or procedure, no vaccine can be 100% safe or effective for everyone because each person's body can react differently. While minor side effects, such as soreness or low grade fever, are common, serious side effects are rare and occur in about 1 out of every 100,000 vaccinations and involve allergic reactions that can cause hives or difficulty breathing. However, vaccines are the safest they have been in history and each vaccine undergoes rigorous clinical trials to ensure their safety and efficacy before FDA approval. Prior to human testing, vaccines are run through computer algorithms to model how they will interact with the immune system and are tested on cells in a culture. During the next round of testing, researchers study vaccines in animal, including mice, guinea pigs, monkeys. Vaccines that pass each of these stages of testing are approved by the FDA to start a three-phase series of hu
A health system sometimes referred to as health care system or as healthcare system, is the organization of people and resources that deliver health care services to meet the health needs of target populations. There is a wide variety of health systems around the world, with as many histories and organizational structures as there are nations. Implicitly, nations must design and develop health systems in accordance with their needs and resources, although common elements in all health systems are primary healthcare and public health measures. In some countries, health system planning is distributed among market participants. In others, there is a concerted effort among governments, trade unions, religious organizations, or other co-ordinated bodies to deliver planned health care services targeted to the populations they serve. However, health care planning has been described as evolutionary rather than revolutionary; the World Health Organization, the directing and coordinating authority for health within the United Nations system, is promoting a goal of universal health care: to ensure that all people obtain the health services they need without suffering financial hardship when paying for them.
According to WHO, healthcare systems' goals are good health for the citizens, responsiveness to the expectations of the population, fair means of funding operations. Progress towards them depends on how systems carry out four vital functions: provision of health care services, resource generation and stewardship. Other dimensions for the evaluation of health systems include quality, efficiency and equity, they have been described in the United States as "the five C's": Cost, Consistency and Chronic Illness. Continuity of health care is a major goal. Health system has been defined with a reductionist perspective, for example reducing it to healthcare system. In many publications, for example, both expressions are used interchangeably; some authors have developed arguments to expand the concept of health systems, indicating additional dimensions that should be considered: Health systems should not be expressed in terms of their components only, but of their interrelationships. The World Health Organization defines health systems as follows: A health system consists of all organizations and actions whose primary intent is to promote, restore or maintain health.
This includes efforts to influence determinants of health as well as more direct health-improving activities. A health system is therefore more than the pyramid of publicly owned facilities that deliver personal health services, it includes, for example, a mother caring for a sick child at home. It includes inter-sectoral action by health staff, for example, encouraging the ministry of education to promote female education, a well known determinant of better health. Healthcare providers are individuals providing healthcare services. Individuals including health professionals and allied health professions can be self-employed or working as an employee in a hospital, clinic, or other health care institution, whether government operated, private for-profit, or private not-for-profit, they may work outside of direct patient care such as in a government health department or other agency, medical laboratory, or health training institution. Examples of health workers are doctors, midwives, paramedics, medical laboratory technologists, psychologists, chiropractors, community health workers, traditional medicine practitioners, others.
There are five primary methods of funding health systems: general taxation to the state, county or municipality national health insurance voluntary or private health insurance out-of-pocket payments donations to charitiesMost countries' systems feature a mix of all five models. One study based on data from the OECD concluded that all types of health care finance "are compatible with" an efficient health system; the study found no relationship between financing and cost control. The term health insurance is used to describe a form of insurance that pays for medical expenses, it is sometimes used more broadly to include insurance covering disability or long-term nursing or custodial care needs. It may be provided from private insurance companies, it may be purchased by individual consumers. In each case premiums or taxes protect the insured from unexpected health care expenses. By estimating the overall cost of health care expenses, a routine finance structure can be developed, ensuring that money is available to pay for the health care benefits specified in the insurance agreement.
The benefit is administered by a government agency, a non-profit health fund or a
Classification of Pharmaco-Therapeutic Referrals
The Classification of Pharmaco-Therapeutic Referrals is a taxonomy focused on defining and grouping together situations requiring a referral from pharmacists to physicians regarding the pharmacotherapy used by the patients. It has been published in 2008, it is bilingual: English/Spanish. It is a simple and efficient classification of pharmaco-therapeutic referrals between physicians and pharmacists permitting a common inter-professional language, it is adapted to any type of referrals among health professionals, to increase its specificity it can be combined with ATC codes, ICD-10, ICPC-2 PLUS. It is a part of the MEDAFAR Project, whose objective is to improve, through different scientific activities, the coordination processes between physicians and pharmacists working in primary health care. Pharmaceutical Care Foundation of Spain Spanish Society of Primary Care Doctors Raimundo Pastor Sánchez Carmen Alberola Gómez-Escolar Flor Álvarez de Toledo Saavedra Nuria Fernández de Cano Martín Nancy Solá Uthurry It is structured in 4 chapters and 38 rubrics.
The terminology used follows the rules of ICPC-2. Each rubric consists in an alphanumeric code and each title of the rubric is expressed and explained by: – A series of terms related with the title of the rubric. – A definition expressing the meaning of the rubric – A list of inclusion criteria and another list with exclusion criteria to select and qualify the contents corresponding to a rubric. – Some example to illustrate every term. It includes a glossary of 51 terms defined by consensus, an alphabetical index with 350 words used in the rubrics. E 0. Effectiveness / Efficiency, unspecified E 1. Indication E 2. Prescription and dispensing conditions E 3. Active substance / excipient E 4. Pharmaceutical form / how supplied E 5. Dosage E 6. Quality E 7. Storage E 8. Consumption E 9. Outcome. I 0. Information / Health education, unspecified I 1. Situation / reason for encounter I 2. Health problem I 3. Complementary examination I 4. Risk I 5. Pharmacological treatment I 6. No pharmacological treatment I 7. Treatment goal I 8.
Socio-healthcare system. N 0. Need, unspecified N 1. Treatment based on symptoms and/or signs N 2. Treatment based on socio–economic-work issues N 3. Treatment based on public health issues N 4. Prevention N 5. Healthcare provision N 6. Complementary test for treatment control N 7. Administrative activity N 8. On patient request. S 0. Safety, unspecified S 1. Toxicity S 2. Interaction S 3. Allergy S 4. Addiction S 5. Other side effects S 6. Contraindication S 7. Medicalisation S 8. Non-regulate substance S 9. Data / confidentiality. Pharmaceutical care Referral Pastor Sánchez R, Alberola Gómez-Escolar C, Álvarez de Toledo Saavedra F, Fernández de Cano Martín N, Solá Uthurry N. Clasificación de Derivaciones Fármaco-terapéuticas. MEDAFAR. Madrid: IMC. ISBN 978-84-691-8426-4 Álvarez de Toledo Saavedra F, Fernández de Cano Martín N, coordinadores. MEDAFAR Asma. Madrid: IMC. Álvarez de Toledo Saavedra F, Fernández de Cano Martín N, coordinadores. MEDAFAR Hipertensión. Madrid: IMC. Aranaz JM, Aibar C, Vitaller J, Mira JJ, Orozco D, Terol E, Agra Y.
Estudio sobre la seguridad de los pacientes en atención primaria de salud. Madrid: Ministerio de Sanidad y Consumo. Aranaz JM, Aibar C, Vitaller J, Ruiz P. Estudio Nacional sobre los Efectos Adversos ligados a la Hospitalización. ENEAS 2005. Madrid: Ministerio de Sanidad y Consumo. Criterios de derivación del farmacéutico al médico general/familia, ante mediciones esporádicas de presión arterial. Consenso entre la Sociedad Valenciana de Hipertensión y Riesgo Vascular y la Sociedad de Farmacia Comunitaria de la Comunidad Valenciana. 2007. Fleming DM; the European study of referrals from primary to secondary care. Exeter: Royal College of General Practitioners. Foro de Atención Farmacéutica. Documento de consenso 2008. Madrid: MSC, RANF, CGCOF, SEFAP, SEFAC, SEFH, FPCE, GIAFUG. 2008. García Olmos L. Análisis de la demanda derivada en las consultas de medicina general en España. Tesis doctoral. Madrid: Universidad Autónoma de Madrid. Garjón Parra J, Gorricho Mendívil J. Seguridad del paciente: cuidado con los errores de medicación.
Boletín de Información Farmacoterapéutica de Navarra. 2010. Pharm Care Esp. 2003. Hospital Ramón y Cajal, Área 4 Atención Primaria de Madrid. Guía Farmacoterapéutica. Madrid. CD-ROM. Ley 29/2006, de 26 de julio, de garantías. BOE. 2006 julio 27. Ley 41/2002, de 14 de noviembre, básica reguladora de la autonomía del paciente y de derechos y obligaciones en materia de información y documentación clínica. BOE. 2002 noviembre 15. Ley Orgánica 15/1999, de 13 de diciembre, de Protección de Datos de Carácter Personal. BOE. 1999 diciembre 14. Organización Médica Colegial. Código
Maternal health is the health of women during pregnancy and the postpartum period. It encompasses the health care dimensions of family planning, preconception and postnatal care in order to ensure a positive and fulfilling experience in most cases and reduce maternal morbidity and mortality in other cases; the United Nations Population Fund estimated that 289,000 women died of pregnancy or childbirth related causes in 2013. These causes range from severe bleeding to obstructed labour, all of which have effective interventions; as women have gained access to family planning and skilled birth attendance with backup emergency obstetric care, the global maternal mortality ratio has fallen from 380 maternal deaths per 100,000 live births in 1990 to 210 deals per 100,000 live births in 2013. This has resulted in many countries halving their maternal death rates. While there has been a decline in worldwide mortality rates much more has to be done. High rates still exist in impoverished communities with over 85% living in Africa and Southern Asia.
The effect of a mother's death results in vulnerable families, their infants, if they survive childbirth, are more to die before reaching their second birthday. Both maternal mortality and severe maternal morbidity are "associated with a high rate of preventability."In 2010 the U. S. Joint Commission on Accreditation of Healthcare Organizations described maternal mortality as a "sentinel event", uses it to assess the quality of a health care system. Four elements are essential to maternal death prevention. First, prenatal care, it is recommended that expectant mothers receive at least four antenatal visits to check and monitor the health of mother and foetus. Second, skilled birth attendance with emergency backup such as doctors and midwives who have the skills to manage normal deliveries and recognize the onset of complications. Third, emergency obstetric care to address the major causes of maternal death which are haemorrhage, unsafe abortion, hypertensive disorders and obstructed labour. Lastly, postnatal care, the six weeks following delivery.
During this time bleeding and hypertensive disorders can occur and newborns are vulnerable in the immediate aftermath of birth. Therefore, follow-up visits by a health worker is assess the health of both mother and child in the postnatal period is recommended. According to a UNFPA report and economic status, culture norms and values, geographic remoteness all increase a maternal mortality, the risk for maternal death in sub-Saharan Africa is 175 times higher than in developed countries, risk for pregnancy-related illnesses and negative consequences after birth is higher. In developed countries, Black women have higher maternal mortality rates than White women. According to the New York City Department of Health and Mental Hygiene - Bureau of Maternal and Reproductive Health, it was found that from 2008 to 2012, Black women have a pregnancy-related mortality rate twelve times higher than White women. Poverty, maternal health, outcomes for the child are all interconnected. Women living in poverty-stricken areas are more to be obese and engage in unhealthy behaviors such as cigarette smoking and drug use, are less to engage in or have access to legitimate prenatal care, are at a higher risk for adverse outcomes for both the mother and child.
A study conducted in Kenya observed that common maternal health problems in poverty-stricken areas include hemorrhaging, hypertension, placenta retention, premature labor, prolonged/complicated labor, pre-eclampsia. Adequate prenatal care encompasses medical care and educational and nutritional services during pregnancy. Although there are a variety of reasons women choose not to engage in proper prenatal care, 71% of low-income women in a US national study had difficulties getting access to prenatal care when they sought it out. Additionally and Hispanic women are at higher risk than white or black women for receiving little to no prenatal care, where level of education is an indicator. Adolescents are least to receive any prenatal care at all. Throughout several studies and adolescents ranked inadequate finances and lack of transportation as the most common barriers to receiving proper prenatal care. Income is correlated with quality of prenatal care. Sometimes, proximity to healthcare facilities and access to transportation have significant effects on whether or not women have access to prenatal care.
An analysis conducted on maternal healthcare services in Mali found that women who lived in rural areas, far away from healthcare facilities were less to receive prenatal care than those who lived in urban areas. Furthermore, researchers found an stronger relationship between lack of transportation and prenatal and delivery care. In addition to proximity being a predictor of prenatal care access and colleagues found similar results for proximity and antenatal care in rural Ethiopia. Maternal HIV rates vary around the world, ranging from 1% to 40%, with African and Asian countries having the highest rates. Whilst maternal HIV infection has health implications for the child in countries where poverty is high and education levels are low, having HIV/AIDS while pregnant can cause heightened health risks for the mother. A large concern for HIV-positive pregnant women is the risk of contracting tuberculosis and/or malaria, in developing countries. During pregnancy, women of an average pre-pregnancy weight