SEMINAR

ON

PRIMARY HEALTH CARE

Desh Bhagat University

M.SC (N) 1ST YEAR

Learning objectives

At the end of presentation students will able to:-

• Define primary health care.

• Describe the elements of PHC.

• Explain the principles of PHC.

• Explain the strategies of PHC.

• Explain the basic requirements for sound PHC

• Explain the responsibility of nurses in primary health

care

Introduction

Definition

• PHC is essential health care based on practical,

scientifically sound and socially acceptable methods

and technology made universally accessible to

individuals and families in the community through

their full participation and at a cost that community

and the country can afford.

(Alma-Ata, 1978)

Contd..

PHC is essential health care that is a socially

appropriate, universally accessible, scientifically

sound first level care provided by a suitably trained

workforce supported by integrated referral systems

and in a way that gives priority to those most in need,

maximises community and individual self-reliance

and participation and involves collaboration with

other sectors. It includes the following:-

• Health promotion

• Illness prevention

• Care of the sick

Elements of primary health care

Elements

Education

Water and sanitation

Nutrition

Maternal and child health

Immunization

Prevention of endemic disease

Treatment

Drug availability

Principles of primary health care

• Equitable distribution

• Community participation

• Appropriate technology

• Focus on prevention

• Multisectorial coordination

Equitable distribution

• Notwithstanding the color, caste, sex, area, religion

and money etc. The health services and resources

should be equally distributed.

• The principle states that primary health care should

available to all individuals, family and community

without any discrimination. Thus primary health care

is based on the concept of social justice; availability

of health care system to poor.

• People living in rural areas are the main target of

primary health care

Contd..

Essential health care facilities must be:-

• Available for all

• Accessible to all

• Acceptable by all

• Affordable by all

Community participation

• This includes meaningful involvement of the

community in planning, implementing and

maintaining their health services. Through the

involvement of the community, maximum utilisation

of local resources, such as manpower, money and

materials, can be utilised to fulfil the goals of PHC.

Contd..

• Close contact between health services and the

community is essential and should be a two way

process. Primary health care by the people and for the

people, therefore active participation of individual,

family and community is necessary

Appropriate technology

• Internationally conference on PHC(1978) has defined

technology as an association of methods, techniques

and equipment, which together with people using

them, can contribute significantly to solving a health

problem.

Contd..

Appropriate means that the technology is

• Scientifically sound

• Acceptable to those who apply it and to those for

whom it is used

• Compatible with local culture

Contd..

• Understandable by PHC workers and in some

instances even by individuals family/community

• Cost effective

• In primary health care only those techniques should be

used which are suitable to local requirements, socially

acceptable, with in financial limits and scientifically

recognized.

Focus on prevention

• Main focus of primary health is not the treatment but

prevention of disease and it is a part of all the

constitutes of health services. Health education and

specific protection is also stressed by the primary

health care.

Multisectorial approach

• Only medical field cannot replace all the constituents

of primary health care. Therefore proper coordination

should be planned among medical field, agriculture,

housing, nutrition, communication and education etc.

• All the developmental sectors have their influences on

health and impact on the health status of the

community.

Strategies of PHC

• Reducing excess mortality of poor marginalized

populations.

• Reducing the leading risk factors to human health.

• Developing Sustainable Health Systems.

• Developing an enabling policy and institutional

environment

Reducing excess mortality of poor

marginalized populations

• PHC must ensure access to health services for the

most disadvantaged populations, and focus on

interventions which will directly impact on the major

causes of mortality, morbidity and disability for those

populations.

Reducing the leading risk factors to

human health

• PHC, through its preventative and health promotion

roles, must address those known risk factors, which

are the major determinants of health outcomes for

local populations

Developing Sustainable Health

Systems

• PHC as a component of health systems must

develop in ways, which are financially

sustainable, supported by political leaders, and

supported by the populations served

Developing an enabling policy and

institutional environment

• PHC policy must be integrated with other policy

domains, and play its part in the pursuit of wider

social, economic, environmental and development

policy.

The Basic Requirements for Sound

PHC (the 8 A’s and the 3 C’s)

• Appropriateness

• Adequacy

• Accessibility

• Acceptability

• Availability

Contd..

• Affordability

• Assessability

• Accountability

• Completeness

• Comprehensiveness

• Continuity

Responsibility of nurses in primary

health care

Summarization

• Definition of primary health care.

• Elements of PHC.

• Principles of PHC.

• Strategies of PHC.

• Basic requirements for sound PHC

• Responsibility of nurses in primary health care