Course Number: CHS243
Course Title: Primary Clinical Care III

STUDENT LEARNING OUTCOMES

General

Students will demonstrate basic knowledge and skills of primary health care organization. Students will learn how to examine a health care program and how to plan and implement changes and maintain a dispensary to better serve the community.

Specific

Students will be able to:

- Know the 10 principles for health workers in the Code of Conduct of the International Red Cross
  (see Community Health. Wood, CH. AMREF, 2nd ed. Nairobi Kenya, 1997.)
- Discuss the concepts, elements and activities of Primary Health Care (PHC) and its role in the reorganization of health services.
- Define, discuss, and illustrate the concept of decentralization with reference to health care service and cite the advantages and
  disadvantages of decentralization.
- Describe FSM national health status according to the 2005 FSM Health Sector Strategic Development Plan indicators or most current
  indicators.
- Describe FSM national and state health curative and public health programs.
- Define management.
- Recognize how a satisfactory dispensary outcome is dependent upon the management of the dispensary.
- Recognize poor management of health care systems and understand the principles of change in health care service management.
- Name 3 broad functions of management and show how they relate to one another.
- Explain the reasons health organizations are particularly resistant to change.
- Define community participation and identify steps to bring about increased community involvement.
- Identify the cultural and educational obstacles to community participation and identify various modes of community participation.
- Decide which management styles are appropriate to a variety of situations.
- Define "health team".
- Create a work team, using principles of interpersonal relations.
- Know how to assure that dispensary/health center objectives are agreed upon by as many of the people concerned as possible.
- Understand and apply factors that motivate people to work.
- Decide when, how and to whom to delegate authority and responsibility.
- Choose a style of supervision that suits the health team and  the circumstances in which it works.
- Know how to coordinate the activities of a health team.
- Know techniques for communicating effectively with the team and community.
- Describe how to prepare for and conduct successful meetings.
- Know how to help resolve disputes among team members.
- Identify common causes of work deficiencies.
- Complete a performance assessment of another team member.
- Complete a self assessment of job performance.
- Explain the difference between expendable and non-expendable equipment.
- Name the four main procedures in the management of equipment.
- Explain how to care for a solar charged battery to make it last a long time.
- Explain how to obtain water suitable for use in a battery when no distilled water is available.
- Demonstrate how to clean and maintain the following: solar panels and batteries, microscope, hemoglobin meter, blood glucose
  meter, SSB radio, dispensary latrine, dispensary building. 
- Take an inventory of medicines, supplies and equipment in a dispensary.
- Create an equipment inspection and maintenance checklist and schedule for the dispensary that the student is assigned to.
- Explain the value and uses of accurate equipment records.
- Describe techniques for preventing wastage of drugs.
- Estimate the quantities of drugs needed based on current drug use.
- Order and stock drugs correctly, using the "split shelf" system.
- Discover and investigate discrepancies in drug usage.
- Perform an assessment of student's own and team members' time.
- Plan the use of time according to the work to be carried out (i.e. arrange time tables and schedules, arrange duty rosters, arrange
   long-term programs, make notes on a yearly calendar).
- Rearrange a dispensary so that work flows smoothly and for the convenience of the patients who use it.
- Make a sketch map of the catchment area of a dispensary.
- Describe the target population of a dispensary including:
          number in total population,
          preschool age population,
          population of reproductive age women,
          number residing in each village,
          major causes of death and major preventable illnesses.
- Construct case registers for the following target sub-populations for a dispensary:     
          children 1-5 years old for fluoride varnish application,
          patients with diabetes, hypertension or heart disease,
          children with special health care needs,
          patients with TB or Hansen's Disease.
- Explain the reasons for a good filing system and confidentiality of patient records.
- Write a SOAP note for a patient encounter.
- Establish a patient chart filing system at a dispensary. Demonstrate proper use of this filing system.
- Describe and demonstrate the procedure for referring a patient to the central hospital and ensuring continuity of care when he or
  she returns.
- Send and receive E-Mail (using Wavemail system in outer islands) to the State hospital, to the field supervisor, and to another outer
   island dispensary.
- Send a mental health assessment of a chronically mentally ill patient to the state Substance Abuse and Mental Health program
   manager using Wavemail E-Mail.
- Send all of the information needed for a birth certificate and a death certificate to the state vital statistics technician using Wavemail E-Mail.
- Define performance indicators and use raw data to calculate common indicators for a dispensary including:
          % complete immunization coverage of 2 year olds in a dispensary's target population,
          % 6-12 year olds in dispensary's target population with dental sealants,
          % of essential medicines in stock,
          % of stock medicines within expiration date,
          # of patient encounters per provider per week,
          average # prescriptions written per encounter.
- Describe sources and types of information that can be gathered from the community for a health assessment.
- Describe the uses of a community health assessment for primary care programs.
- Describe how to select important problems from a list of community problems according to criteria.
- Set objectives for an important community health problem that are relevant, feasible, measurable and observable.
- Specify measurable targets.
- Recognize obstacles to the achievement of targets.
- Analyze ways of overcoming obstacles.
- Recognize limitations that cannot be removed.
- Select a strategy based on obstacles and resources.
- Describe how to mobilize community resources.
- Write a simple plan for a health intervention.
- List the functions of management dealing with the coordination of activities, and the use of direction and supervision.
- Name specific aspects of implementation that call for organization, direction and supervision.
- Describe the importance of conducting an evaluation of a planned community health intervention.
- Describe ways to evaluate the progress of a health team's work.
- Complete an employee performance assessment.
- Perform a management assessment of a dispensary.
- Assist community members in performing a dispensary satisfaction assessment.