1. HEALTH FOR ALL BY YEAR 2000 AD (HFA) 1977 – WORD HEALHT ASSEMBLY - Attainment by all the people of the world by the year 2000 AD of a level of health that will permit them to lead a socially and economically productive life. 1978 – International Conference – PHC.

2. Health for all by the year 2000 Attainment of a level of Health - Providing PHC to underserved rural and poor urban. - Accessible to all individuals & fenilis - Acceptable - Affordable - Full participation of Community

3. Indicators Assess the progress for HFA - Reduction of IMR to 60 - Expectation of life to 64 - Reduce CDR 9 - Reduce CBR 21 - Achieve NRR one - Pottable water supply to entire population.

4. MILLENNIUM DEVELOPMENT GOALS (MDGs) INDICATORS Eradicate extreme poverty and hunger Improve Maternal Health & reduce child Mortality Combat HIV/AIDS, malaria and other diseases Achieve Universal Primary Education Ensure environmental sustainability Develop a global partnership for development

5. District Health System A well functioning health district is one that contributes to sustained health status improvement through the provision of equitable, efficient, technically good quality, acceptably appropriate and affordable health care.

6. Strengthening Health Care System Strengthening Distt. health system Strengthening existing health facilities Rationalizing human resources Greater responsibility of private sector Empowering community to take role in health system Decentralization of health system

7. Sustainable health system Making quality care Preventing & controlling disease & protecting health Promoting legislation & regulation in support of health system Developing health information system & ensuring active surveillance Fostering the use and innovation in health – related science & technology Building & maintaining human resources for health Securing adequate & sustainable financing

12. Comparison of Kerala and all-India Health Statistics KeralaAll-India Death rate/1000(2002) 6.48.1 Rural birth rate(2002) 16.825.0 Infant mortality rate (2002) 1064 Annual growth rate, per cent (2001) 0.91.93 Life expectancy at birth 2001-06 (Projection) Male Female 66.5 71.7 75 61.5 64.1 65.4 Literacy rate, percent(2001) 90.9265.38 Female literacy rate (2001) 87.8654.16 Mean age at marriage females (1999) 22.119.5 Per capita income (2000-1) Rs. 21046Rs. 16707 Doctor-population ratio (1991) 1: 72131:2148

13. DISEASE Dis-ease – Uneasiness, wrong with body functions. A condition in which body health is impaired. A departure from a state of Health An alteration of the human body interrupting the performance of vital functions A condition of the body or some organ in which its functions are disrupted or deranged. A maladjustment of human organism to the environment. Any deviation from the normal functioning or state of complete physical, mental well being.

14. Illness It refers not only the presence of disease but individual perceptions and behavior in response to disease. It is the subjective state of person who feels aware of not being well

15. Sickness It is a state of social dysfunction. The individual is unable to perform his role that the individual assumes in life.

16. Disease Causation Super natural theory of disease Miasmatic theory of disease/evils Theory of humours. Theory of spontaneous generation. Concept of contagion Germ theory of disease causation Epidemiological Triad Multifactorial Causation Web of Causation