Introduction
Primary health care entails the provision of crucial health care services through scientifically and socially accepted technologies and skills. It involves full participation of the entire community. In most cases, these services are affordable by the community since the country can maintain and sustain the service at all levels of development. According to Milo (2010), “…the technologies used in primary health care are universally accessible to individuals and families in the community through their full participation” (p. 211). This equates all the people in the community through the provision of affordable health care to all regardless of economic status, tribe, culture or race. This therefore encourages full participation of all individuals in the society. Primary health care advocates for self-determination and participatory spirit by all in the community through accessibility of and affordability of health care services by all. The major achievement in which primary health care focuses on is the provision of good health to all (Judge, & Welton 2010, p. 92). For instance, nineteen (19) years ago before the realization of vision 2030, childhood obesity in Saudi Arabia persisted as a national health problem, affecting girls more than the boys. In pursuit of solving this problem, different approaches came into play to realize the present status- a Saudi Arabia without childhood obesity. Realization of this goal entailed Provision of health education to schools (Teachers, parents and children), Provision of sporting activities in girl schools and inclusion of food and health topics in schools. Reduction in social disparities in health sector, conducting health services to those who need them in time, integrating health education and practices into all sectors and increasing health stakeholders for better provision of the health services have led to reduction of obesity in Saudi Arabia (Winslow 2005, p.23). Through a comprehensive primary health care plan, the realization of the 2030 vision came to a reality.
Although primary health care continues to propagate the provision of better health for all, health inequity continues to be an area of concern for many countries where disparities exist in accessibility and quality of health care provided. These differences cut across many populations, races, and socioeconomic groups. Some populations are at risk of developing certain diseases than others, and therefore differences in disease occurrence across the populations. For instance, obesity in Saudi Arabia occurs more to girls as compared to boys. Several factors determine this disparity including empowerment of boy child through sporting activities in school while girls do not have the sporting activities in their schools. Populations prone to certain diseases like girls in Saudi Arabia, experience higher mortality rates and chronic disease outbreaks. On the other hand, socioeconomic classes of people also determine the disparities observed in disease distribution among populations in that, those at higher socio economic status are more likely to suffer from obesity, simply because they can afford the luxuries, which cause obesity. For instance, rich families can afford to take their children to restaurants for fast foods. Primary health care has helped to reduce the prevalence of obesity in girls in Saudi Arabia through government provision of sporting activities, inclusion of education on food and health in the school curriculum. These factors have led to the realization of the present status of few cases of childhood obesity in Saudi Arabia.
Vision 2030 on the health sector
In the last nineteen years, the health sector adhered to comprehensive primary health care plan, which emphasized on the mitigation of health inequity based on socioeconomic status. According to Leeder (2007), “Although gender and race are significant factors in explaining health inequity, socioeconomic factor is the greatest determining factor in an individual’s level to access health care” (p. 501). For instance, rich families in Saudi Arabia could afford health consultation professionals on obesity to their children while the poor families could not. For the case of Saudi Arabian childhood obesity, socioeconomic factors contribute significantly to the accessibility of quality health care for all children in the community. Poor or low socioeconomic status meant low education, poor employment or outright lack of employment leading to low or no income to the parents. Thus, children suffering from obesity from such families had little access to health care. On the other hand, good or high socioeconomic status means the individuals have access to good education, well-developed careers hence good jobs and high income impregnated with health benefits such as health insurance covers and medical attention allowances. Thus, children suffering from obesity from such families can access quality health care services. With reference to Saudi Arabia, every family could afford a car and television before 2030 and therefore, many girls waste many hours doing stationary activities like watching the television other than playing and doing physical exercise. On the other hand, boys tend to play more than watch the television that led to development of obesity more in girls than in boys. With the efforts of realising the vision 2030, this problem in disparity of obesity between girls and boys remains under control. Introduction of sporting and dieting programs in schools helped to check the disease. Dauble (2008) observes that, “lack of medical insurance cover will lead to many patients more likely to postpone their medical care, more likely to go without medical care and more likely to go without prescription medicine” (p. 56). High cost of medical or health services results into many of the Saudi Arabian parents postponing medical attention of their children suffering from obesity. This resulted into increment of health risks in the community. To prevent this in the present 2030, primary health care approach applies its principles of prevention and curative to ensure health of the children especially the girls and prevent obesity.
Social factors and lifestyles also play a major role in the determination of health of an individual. These factors may include the lifestyle of the person dictated greatly by the economic status of that person as well. Social behaviours and lifestyles such as consumption of fast foods from a restaurant increased the risk of obesity development in many children in Saudi Arabia and within the last 19 years, counter measures have changed the situation. Families of high economic class are more likely to suffer from obesity and related diseases. Such people overeat and take little or no physical exercise. On the other hand, the low economic class people are less likely to suffer such illnesses for the simple reason that they cannot afford high luxury lifestyles such as dining in restaurants. Saudi Arabian culture advocates for the disbandment of social activities such as sporting activities in girl’s schools, thereby increasing the prevalence of obesity among girls than in boys. This scenario created health equity between obesity in girls and boys and vision 2030 sort to address this disparity. Presently the case rests settled as the government enforces sporting activities in girl’s schools.
On its framework, the world health organization emphasizes on providing affordable health services to all citizens and works out means of reducing the disparity between the high and the low social classes, which eventually helps to reduce the prevalence of social related disease to a certain social, gender or age group. In the quest for the full realization of the vision 2030, the primary health care approach brought into play its principles of accessibility, public participation, health promotion, application of technology and inter-sector cooperation (Baum 2008, p. 24). In Saudi Arabia, these factors play an important role in maintaining a nation free of childhood obesity.
Comprehensive primary health care
The realization of the vision 2030 on the health sector depended largely on the performance of the comprehensive primary health care as it focused on individuals and community. It emphasized on prevention, cure and promotion of health education to all. Furthermore, primary health care allowed individual participation in decision making concerning their health especially in Saudi Arabia during the pursuit of decreasing the disparity in childhood obesity between girls and boys. In 2011, before realization of the current state, only those families who could afford quality health for obesity had the privilege to access the health facilities. In 2030, the access to both health care professionals and facilities has however become easier. Provision of health professionals and care services to the rural, remote and neglected areas is crucial and ensures patients receive appropriate health care from appropriate health professionals within appropriate period as it presently (Keleher, & MacDougal 2009, p.247). Within the last 19 years, the government approved policies to provide health incentives to the less fortunate in the society in order to access basic health care. This helps to reduce cases of childhood obesity in Saudi Arabia.
In addition, comprehensive primary health care provides for public participation, whereby all the individuals take part in decision making on their health matters. For instance, Saudi Arabia culture did not allow for sporting activities among girls and women. Sporting provides physical exercise, which increase blood circulation in turn helping to control obesity development. In this case, the Saudi Arabian citizens especially the girls in girl’s school had to decide to take sports to control obesity development. An institution such as school decides on nutritional programs to alleviate disease occurrence among the learners and this encourages teachers and parent’s decision on dietary measures to their children. In Saudi Arabia, through CPHC nutritional education programs are in place to equip teachers and parents with important information concerning nutrition and help to control the disparity in obesity prevalence between girls and boys in the present 2030. In addition, CPHC encourages the identification of a health need affecting the community and determination of alternative measures to mitigate complications accruing from the problem (Smedley, & Stith 2002, p. 24). Through CPHC, Saudi Arabians identified girls suffered from obesity more than boys and took precautions to mitigate the problem. The government introduced sporting activities in girl’s schools contrary to the norms of the cultures to offer physical body exercises required to check obeseness, included food and health topics in school syllabus and increased health education to the parents through print media and televisions. These led to the present reduction in the number of obesity cases and the maintenance of the present health equity in 2030. Dissemination of information to the public in the present health state reduces the chances of unhealthy living involving unhealthy dieting and lifestyles, which could lead to health problems. Furthermore, health promotion helps in educating people on health issues and entails dissemination of information concerning nutrition, sanitation, maternal health care, child health care, immunization, prevention and control of endemic diseases (Fryer, & Dovey 2000, p. 477). For instance, health education to both parents and teachers in Saudi Arabian schools has reduced the cases of obesity among schoolchildren, particularly in girls. Strict adherence to the stipulated measures of health promotion reduces the cost of health maintenance and therefore lifts the heavy financial burden of health provision to the low socioeconomic group. Disparities created due to differences in socioeconomic status in matters of provision of health care services reduce with the intensive health educational campaigns. In fact, the number of people falling sick reduces proportionally with the adherence to the set health values. For instance, educational health campaigns targeting nutrition and obesity in Saudi Arabia helps to reduce consumption of fatty foods thus reducing the prevalence of obesity in girls. Socioeconomic differences among individuals in a community bring about the differences in the value of life the children from these backgrounds get. High economic status group have their children privileged to enjoy child health care and nutrition guidance as compared to those from low economic class and therefore before the attainment of the vision 2030, the child health care for the low economic class was poor and this propagated subsequent health problems in late life such as development of obesity. This problem now with the attainment of the vision 2030, gets its solution in that, CPHC ultimately aims at providing health services including guidance to all mothers on appropriate diets to their children at affordable cost (Fiscella, & Fanks 2000, p. 2007). Child mortality has continued to reduce drastically following the continued adherence to stipulated conditions of child health. The vision 2030 strategies emphasize on provision of these health services even free to the less fortunate in the society. Hurst (2007) notes, “The goal of health promotion is to reduce the demands for curative and rehabilitative care and through health promotion individuals and families find understanding of determinants of health” (p. 39). The understanding of health determinants helps in the subsequent health maintenance and includes among others social factors, behaviours and lifestyles. Social health factors include the physical exercises through regular sports to prevent occurrence of diseases such as obesity and thus reduce the need by many to look for obesity medication. In this sense, individuals develop skills on how to improve their health, live a healthy life, and even protect themselves from diseases such as obesity (Hurst 2007, p. 40). Knowledge propagates healthy living and streamlines personal behaviours to fit a definite lifestyle. Health education integration in school curriculum helps disseminate health information to the most vulnerable, especially on diseases such as obesity prevalence to girls than boys in Saudi Arabian schools and universities. This reduces by about half the reported cases of health complications from the school attending age. In addition, good health currently experienced by the young children helps to develop and build self-esteem and confidence as compared to ill health. In ill health, both young and adult lose self-esteem, happiness and joy of life. The situation becomes even worse, when the financial status does not allow for proper or descent health care. This can cause stress to the family providers, which can lead to development of stress related illness and depression; this was the case before 2030. However, CPHC currently provides health information to all, which has greatly improved the health standards of all the people. Moreover, the adaptation of the primary health care leads to the application of new technology in health, which facilitates quick delivery of health services. According to Goldberg and Hayes (2004), “…adoption of appropriate technology means that modes of health care are accepted in the community and signify improvement of knowledge and capacity building in delivery of health services to the target group” (p. 36). By providing actual diagnosis through use of technology, the community was able to combat complicated illness such as obesity. In fact, these technologies have led to prevention of conditions, which were once unpreventable during and before 2011. The result has therefore been reduction in death cases from such conditions. Primary health care provides these advanced technologies to all the people at affordable cost simply because it bears a definite goal of providing better health to all, regardless of their financial and economic status. Before the development of the primary health care programs and its subsequent implementation, appropriate technology was too expensive to access and therefore it remained a facility for the few (Smith 2006, p. 241). Only those whose economic status would allow had the privilege to access the technology. The implication here is that, those from poor backgrounds and unable to meet the high costs of the appropriate health technology would helplessly die out of such complications. In the pursuit of the vision 2030, application of appropriate health technology at affordable cost would help many to get appropriate treatment and doses, which otherwise would not be possible. Decentralization of the new health technologies to the rural and remote areas significantly reduces overcrowding of patients in the national health facilities. Furthermore, it reduces the chances of patient to die since the patient can access the appropriate technology at the local health facility (Pencheon 2001, p. 250). Provision of these technologies by the concerted efforts of the world health organization and the government through the primary health care program helps to propel the sustenance of the current health status of the vision 2030.
Primary health care also involves the integration of different health care providers and stakeholders and coordination of all inter-sector bodies with an ultimate goal of providing good health to all. Economic, social and political sectors consolidate efforts through the primary health care program to ensure basic medical attention to all (Gillam 2007, p. 112). Different professionals and service providers collaborate and function independently to provide better health services.
Power and empowerment
Power entails the possession of ability or authority to acquire services while empowerment is the act of increasing the economic, social or political strength of a person (or a group of people) with an intention of developing his/her confidence for self-sustenance (Laverack 2009, p.27). Socioeconomic empowerment has increased the economic status of all members in the community than it was in 2011, thereby increasing society’s ability to access basic health care services. This means that through economic empowerment the minorities and marginalized communities have the capacity to access health care services. Health empowerment can also imply the physical increase in body strength to fight infection enhanced by physical exercise, good dieting, hygienic living and general sanitation around living environments (White 1991, p. 621). For instance, exclusion of sports in school curriculum of many Saudi Arabian girls’ schools and universities encourage development of obesity in many girls as their bodies lack physical empowerment while the boys’ schools have sporting programs; consequently they are at lesser risk of developing obesity. Physical fitness of children helps them to fight a number of diseases. Consumption of fatty foods, as many Saudi Arabian children prefer, sets a risk of obesity especially to those who do little or no physical exercises. The government’s initiative of providing sporting programs in girls’ schools and inclusion of female teachers in sports helps to check the prevalence of obesity in girls and reduce the disparity of obesity prevalence between girls and boys in Saudi Arabia.
Economic empowerment of many families ensures accessibility of good health education by many parents. This ensures that they provide good health living to their children. In Poor families, parents have low education due to lack of fess and therefore they have little health education. As a result, these parents lack empowerment (Fee 1991, p. 443). Disparity between the low and high economic class has therefore reduced in 2030. In addition, the economic empowerment targets the less fortunate in the society and aims at assisting the marginalised to create their own non-profit organization, which facilitate structural changes reducing the need for dependence experienced 19 years ago (Marmot 2003, p. 146). In Saudi Arabia, community educational centres provide health education to the less fortunate in the society and therefore empowering them. For example, these local organizations demonstrate healthy cooking and provide healthy foodstuffs to the needy in the community.. Empowering the parents economically and educationally provided a strong foundation for the sustenance of the current good health to both the girls and boys in Saudi Arabian schools and universities.
Conclusion
Through the implementation of the primary health care program, the World Health organization aims at providing healthcare to all the people regardless of their economic, political or social status. It achieves so by reducing the gap between people and accessibility to primary health care. The comprehensive primary health care addresses adequately the inequity between the high socioeconomic and low socioeconomic classes. The primary health care seeks to provide better health to all the people at affordable cost. Economic empowerment on the other hand, facilitated the attainment and sustenance of the current health status in 2030 by increasing the economic background of all people in the community. The example of obesity in Saudi Arabia, exemplifies the importance of empowerment through the inclusion of sporting activities, provision of health education and foodstuffs to the needy in the community. The focus on the millennium development goals has lead to great improvement in the provision of health care services and more so the adoption of new technology has led to combating of disease such as obesity. The health sector therefore continues to achieve its goals.
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