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At Which Level is iHTP Used?
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From the administrative and clinical point of view, there are several levels of
healthcare delivery: a national or tertiary level, a provincial level, a district
level and finally, a primary care level. The various levels have different functions
within a country’s healthcare system.
Primary care is seen as an "integral, permanent,
and pervasive part of the formal health care system in all countries" or as the
"means by which the two goals of health services system - optimization of health
and equity in distributing resources - are balanced" (Basch P. Textbook of international
health. New York, Oxford University Press, 1990). It addresses the most common problems
in the community by providing preventive, curative, and rehabilitative services
to maximize health and well-being. (Health Evidence Network, WHO Regional Office
for Europe,
www.euro.who.int/HEN/Syntheses/primaryvsspecialist). Tertiary care refers
to highly specialized care given to patients who are in danger of disability or
death often requiring sophisticated technologies (e.g., neurosurgeons or intensive
care units). The intermediary levels such as provincial or district usually are
within the sphere of influence of the local government. They provide healthcare
which links local priorities with national health policies.
IHTP is developed for
all different levels of healthcare. It ensures that the scope and complexity of
healthcare technologies is realistic for any given level of healthcare delivery.
The IHTP consists of
a comprehensive map of all healthcare technology needs
per intervention per healthcare level (Heimann, P., Kader, H. IHTP: Brief Technical
Discussion, WHO, 2002). IHTP contributes to a clearer understanding of why the resources
are needed at each level of healthcare delivery, in what quantities the resources
are needed and how they fit together into an integrated healthcare system.
IHTP
inherently bridges the gap between the planners at the strategic levels (national
or regional), who may not have full knowledge of field realities, and practitioners
at the operational level, who may be too immersed in their day-to-day clinical activities
to be aware of the big picture. IHTP allows technology needs appropriate for each
level of healthcare to be identified (Heimann, P. Planning Technologies for the
Making Pregnancy Safer Initiative, WHO internal presentation, 2001); it thus facilitates
the upward flow of information to be amassed into national requirements.
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