WEEK 8 - PRIMARY HEALTH CARE
What is Primary Health Care (PHC)? ➔ It addresses the broader determinants of health
➔ Primary health care (PHC) is essential health and focuses on the comprehensive and
care made universally accessible to individuals interrelated aspects of physical, mental and
and acceptable to them, through full participation social health and wellbeing.
and at a cost the community and country can ➔ It provides whole-person care for health needs
afford. It is an approach to health beyond the throughout the lifespan, not just for a set of
traditional health care system that focuses on specific diseases.
health equity-producing social policy. Primary ➔ Primary health care ensures people receive
health-care (PHC) has basic essential elements comprehensive care - ranging from promotion
and objectives that help to attain better health and prevention to treatment, rehabilitation and
services for all. palliative care - as close as feasible to people’s
everyday environment.
➢ Primary Health Care (PHC) is the health care ➔ WHO has developed a cohesive definition based
that is available to all the people at the first level on three components:
of health care. 1. meeting people’s health needs through
➢ According to World Health Organization (WHO), comprehensive promotive, protective,
‘Primary Health Care is a basic health care and preventive, curative, rehabilitative, and
is a whole of society approach to healthy palliative care throughout the life course,
well-being, focused on needs and priorities of strategically prioritizing key health care
individuals, families and communities.’ services aimed at individuals and families
➢ Primary Health Care (PHC) is a new approach to through primary care and the population
health care which integrates at the community through public health functions as the
level all the factors required for improving the central elements of integrated health
health status of the population. services;
➢ Primary health care is both a philosophy of 2. systematically addressing the broader
health care and an approach to providing health determinants of health (including social,
services. economic, environmental, as well as
➢ It addresses the expansive determining factor of people’s characteristics and behaviours)
health and ensures whole person care for health through evidence-informed public
demands during the course of the natural life. policies and actions across all sectors;
➢ It is developed with the concept that the and
people of the country receive at least the 3. empowering individuals, families, and
basic minimum health services that are communities to optimize their health, as
essential for their good health and care. advocates for policies that promote and
protect health and well-being, as
➔ Primary health care is rooted in a commitment to co-developers of health and social
social justice and equity and in the recognition of services, and as self-carers and
the fundamental right to the highest attainable care-givers to others.
standard of health, as echoed in Article 25 of the
Universal Declaration on Human Rights: History of Primary Health Care:
“Everyone has the right to a standard of living ➢ Before 1978, globally, existing health services
adequate for the health and wellbeing of himself were failing to provide quality health care to the
and of his family, including food, clothing, people.
housing and medical care and necessary social ➢ Different alternatives and ideas failed to
services […]”. establish a well-functioning health care system.
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WEEK 8 - PRIMARY HEALTH CARE
➢ Considering these issues, a joint WHO-UNICEF 5 Principles of Primary Health Care (PHC):
international conference was held in 1978 in 1. Social equity
Alma Ata (USSR), commonly known as 2. Nation-wide coverage/wider coverage
Alma-Ata conference. 3. Self- reliance
➢ The conference included participation from 4. Intersectoral coordination
government from 134 countries and other 5. People’s involvement (in planning and
different agencies. implementation of programs)
➢ The conference jointly called for a revolutionary
approach to the health care. Principles of Primary Health Care (PHC):
➢ The conference declared ‘The existing gross ➔ Equitable distribution of health care – according
inequality in the health status of people to this principle, primary care and other services
particularly between developed and developing to meet the main health problems in a
countries as well as within countries is politically, community must be provided equally to all
socially and economically unacceptable’. individuals irrespective of their gender, age, and
➢ Thus, the Alma-Ata conference called for caste, urban/rural, and social class.
acceptance of WHO goal of ‘Health for All’ by ➔ Community participation - comprehensive
2000 AD. healthcare relies on adequate numbers and
➢ Furthermore, it proclaimed Primary Health Care distribution of trained physicians, nurses, allied
(PHC) as a way to achieve ‘Health for All’. health professions, community health workers,
➢ In this way, the concept of Primary Health and others working as a health team and
Care (PHC) came into existence globally in supported at the local and referral levels.
1978 from the Alma-Ata Conference. ➔ Multi-sectional approach - recognition that health
cannot be improved by intervention within just
Objectives of Primary Health Care(PHC): the formal health sector; other sectors are
➢ To increase the programs and services that equally important in promoting the health and
affect the healthy growth and development of self-reliance of communities.
children and youth. ➔ Use of appropriate technology - medical
➢ To boost participation of the community with technology should be provided that accessible,
government and community sectors to improve affordable, feasible, and culturally acceptable to
the health of their community. the community.
➢ To develop community satisfaction with the
primary health care system. Behind these elements lies a series of basic objectives
➢ To support and advocate for healthy public policy that should be formulated in national policies to launch
within all sectors and levels of government. and sustain primary healthcare (PHC) as part of a
➢ To support and encourage the implementation of comprehensive health system and coordination with
provincial public health policies and direction. other sectors.
➢ To provide reasonable and timely access to
primary health care services. ● Improvement in the level of health care of the
➢ To apply the standards of accountability in community.
professional practice. ● Favorable population growth structure.
➢ To establish, within available resources, primary ● Reduction in the prevalence of preventable,
health care teams and networks. communicable, and other diseases.
➢ To support the provision of comprehensive, ● Reduction in morbidity and mortality rates
integrated, and evidence-based primary health especially among infants and children.
care services.
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WEEK 8 - PRIMARY HEALTH CARE
● Extension of essential health services with ● It also ensures effective and strategic planning
priority given to the underserved sectors. and evaluation of health care services.
● Improvement in basic sanitation. ● In lack of community participation, the health
● Development of the capability of the community programs cannot run smoothly and universal
aimed at self-reliance. achievement by primary health care cannot be
● Maximizing the contribution of the other sectors achieved.
for the social and economic development of the 2. INTER-SECTORAL COORDINATION
community. ● Inter-sectoral coordination plays a vital role in
performing different functions in attaining health
What are the Pillars of Primary Health Care (PHC)? services.
Primary health care consists of an integrative group of ● The involvement of specialized agency, private
health care professionals coordinating to provide basic sectors, and public sectors is important to
health care services to a particular group of people or achieve improved health facilities.
population. These pillars are reinforcement for the ● Intersectoral coordination will ensure different
delivery of safe health care. sectors to collaborate and function
interdependently to meet the health care needs
of the people.
● It also refers to delivering health care services in
an integrated way.
● Therefore, the departments like agriculture,
animal husbandry, food, industry, education,
housing, public works, communication, and other
sectors need to be involved in achieving health
for all.
3. APPROPRIATE TECHNOLOGY
● Appropriate healthcare technologies are an
important strategy for improving the availability
and accessibility of healthcare services.
● It has been defined as ‘’technology that is
scientifically sound, adaptable to local needs
and acceptable to those who apply it and to
whom it is applied and that can be maintained by
people themselves in keeping with the principle
1. COMMUNITY PARTICIPATION of self-reliance with the resources the
● Community participation is a process in which community and country can afford.’’
community people are engaged and participated ● Appropriate technology refers to using cheaper,
in making decisions about their own health. scientifically valid and acceptable equipment and
● It is a social approach to point out the health techniques.
care needs of the community people. ● It is also necessary to ensure that the
● Community participation involves participation of technology is:
the community people from identifying the health ○ Scientifically reliable and valid
needs of the community, planning, organizing, ○ Adapted to local needs
decision making and implementation of health ○ Acceptable to the community people
programs. ○ Accessible and affordable by the local
resources
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WEEK 8 - PRIMARY HEALTH CARE
4. SUPPORT MECHANISM MADE AVAILABLE T– Treatment of communicable and non-communicable
● Support Mechanism is vital to health and quality diseases and the promotion of mental health.
of life. Support mechanism in primary health S– Safe water and sanitation.
care is a well-known process focused to develop
the quality of life.
● Support mechanism includes that the people are Extended Elements in the 21st Century:
getting personal, physical, mental, spiritual and
instrumental support to meet goals of primary ➔ Expanded options of immunizations.
health care. ➔ Reproductive health needs.
● Primary health care depends on adequate ➔ Provision of essential technologies for health.
number and distribution of trained physicians, ➔ Health promotion.
nurses, community health workers, allied health ➔ Prevention and control of non-communicable
professions and others working as a health team diseases.
and supported at the local and referral levels. ➔ Food safety and the provision of selected food
supplements.
Why is Primary Health Care (PHC) Important?
ESSENTIAL ELEMENTS OF PRIMARY HEALTH
CARE (PHC):
There are 8 elements of primary health care (PHC).
E - Education concerning prevailing health problems
and the methods of identifying, preventing, and
controlling them. ➔ Stronger primary health care is essential to
L – Locally endemic disease prevention and control. achieving the health-related Sustainable
E – An expanded program of immunization against Development Goals (SDGs) and universal health
major infectious diseases. coverage. It will contribute to the attainment of
M – Maternal and child health care including family other goals beyond the health goal, including
planning. those on poverty, hunger, education, gender
E– Essential drugs arrangement. equality, clean water and sanitation, work and
N– Nutritional food supplement, an adequate supply of
safe and basic nutrition.
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WEEK 8 - PRIMARY HEALTH CARE
economic growth, reducing inequality and What are the Challenges for Implementation of
climate action. PHC?
➔ Primary health care is well-positioned to respond
to rapid economic, technological, and ● Poor staffing and shortage of health personnel
demographic changes, all of which impact health ● Inadequate technology and equipment
and well-being. A recent analysis found that ● Poor condition of infrastructure/infrastructure
approximately half of the gains in reducing child gap, especially in the rural areas
mortality from 1990 to 2010 were due to factors ● Concentrated focus on curative health services
outside the health sector (such as, water and rather than preventive and promotive health care
sanitation, education, economic growth). A services.
primary health care approach draws in a wide ● Challenging geographic distribution
range of stakeholders to examine and change ● Poor quality of health care services
policies to address the social, economic, ● Lack of financial support in health care programs
environmental and commercial determinants of ● Lack of community participation
health and well-being. Treating people and ● Poor distribution of health workers/health
communities as key actors in the production of workers concentrated on the urban areas.
their own health and well-being is critical for ● Lack of intersectoral collaboration
understanding and responding to the
complexities of our changing world. What are the mitigating measures for Ensuring
Effective PHC?
➢ Primary Health Care focuses more on quality ● Encouraging community participation through
health service and cost-effectiveness. rapport building, effective communication and
➢ Primary Health Care focuses on “Health for all” sharing objectives and benefits of PHC.
➢ Primary Health Care integrates preventive, ● Developing quality assurance mechanisms
promotive, curative, rehabilitative and through the development of various indicators
palliative health care services. and standards.
➢ Primary Health Care encourages new ● Development of clinical guidelines including the
connection and community participation. implementation of Essential drugs list
➢ It includes services that are readily accessible ● Allocating resources as per the need of the
and available to the community. central, provincial/state and local level.
➢ Primary Health Care can be easily accessible by ● Develop a planning process to define objectives
all as it includes services that are simple and and set targets by giving priority on those
efficient with respect to cost, techniques and families and communities most at risk.
organization. ● Promoting problem-orientated research in health
➢ Primary Health Care promotes equity and management system.
equality. ● Creating pathways to give health higher priority
➢ Primary Health Care improves safety, on the agenda of district development and
performance, and accountability. collaboration of health departments to perform
➢ Primary Health Care advocates on health its role in health activities.
promotion and focuses on prevention, screening ● Develop guidelines and framework that specify
and early intervention of health disparities. the roles and responsibilities of the provincial
➢ Primary Health Care is also perceived as an states.
integral part of country’s socio-economic
development.
