2. 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
4. 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)
5. 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
6. Elements of primary health care
Elements
Education
Water and
sanitation
Nutrition
Maternal and
child healthImmunizatio
n
Prevention of
endemic
disease
Treatment
Drug
availability
7. Principles of primary health care
• Equitable distribution
• Community participation
• Appropriate technology
• Focus on prevention
• Multisectorial coordination
8. 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
9. Contd..
Essential health care facilities must be:-
• Available for all
• Accessible to all
• Acceptable by all
• Affordable by all
10. 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.
11. 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
12. 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.
13. 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
14. 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.
15. 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.
16. 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.
17. 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
18. 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.
19. 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
20. 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
21. 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.
22. The Basic Requirements for Sound
PHC (the 8 A’s and the 3 C’s)
• Appropriateness
• Adequacy
• Accessibility
• Acceptability
• Availability
25. 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
