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The impact of community-oriented primary care in Trongsa Dzongkhag, Kingdom of Bhutan
Research questions: Community-oriented Primary Care (COPC) approaches the community as the "patient" and treats it via a combination of acute curative and public health interventions. We evaluated the applicability of this approach in Bhutan.
Hypothesis: COCP interventions produce measurable changes in community health.
Design: The population was defined, healthcare team assembled, and epidemiological data collected. Based upon the results of this "community diagnosis", the most prevalent conditions were targeted for intervention. The interventions were evaluated and adapted.
Setting: A rural district in central Bhutan, a nation which only recently introduced modern health services.
Participants: The district population of approximately 11 000.
Interventions: Improvements in sanitation and safe water supply, education addressing tobacco, smokeless kitchens, safe childbirth, and immunizations.
Statistical analysis: This report is primarily descriptive in nature. No statistical calculations were employed.
Results: Improved community health was demonstrated. diarrhoea and dysentery decreased from the leading cause of morbidity to third in rank. A decrease in acute respiratory infections was not noted. Immunization coverage is high; perinatal morbidity is decreasing.
Conclusion: Complementing similar findings in quite dissimilar geographic settings and cultures reported in the literature, the success illustrated in this account strongly supports the broader application of COPC.