1. PRIMARY HEALTH
CARE
LECTURE 1
AYO NELSON
CLINICAL INSTRUCTOR
LIRA INSTTITUTE OF HEALTH AND MANAGEMENT SCIENCES
EMAIL: ayonelson617@gmailo.com
2. COURSE DESCRIPTION
• This course equip trainee with general public health knowledge so as
to be resourceful to different health care needs in the community.
3. COURSE OBJECTIVES
By the end of the course, the trainee should be able to
• Describe the concept of primary health care
• Explain the pillars of primary health care
• Describe the role of the different players( government, public, private
sector) in primary health care
• Explain approach in health promotion
• Describe the level of health care delivery in the country
• Ability to carryout health promotion activities eg(community
sensitization, mobilization and participation)
4. INTRODUCTION
• Many disparities in Basic Health Services (BHS) necessitated a different
approach to provision of health care. These disparities were revealed by
studies carried out by many organisations, e.g.
• In 1975, a joint WHO-UNICEF study estimated that only 20% of the rural
population in developing countries received any basic health care on regular
basis.
• In 1976, an ILO study estimated that about 67% of the population of
developing countries lived in serious poverty
5. INTRODUCTION
• Declaration of Alma-Ata, USSR on 6-12 September 1978:
• The International Conference on Primary Health Care,
expressed the need for urgent action by all governments, all
health and development workers, and the world community to
protect and promote the health of all the people of the world.
• WHO defines Primary health care as, 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 the community and country can
afford and maintain at every stage of their development in the
spirit of self-reliance and self-determination.
6. MEANING OF THE WORDS IN PHC
• The word Primary in PHC means the first, or basic, or essential, or most
important, or most urgent need(s).
• The word Health: is defined by WHO as state of complete physical, mental
and social wellbeing and not merely the absence of disease or infirmity
(disability)”. This definition was made 60 year ago and there are many
problems associated with it. The definition assumes a human body as a
machine, and well-being is not easy to measure. This is why health indicators
are usually used, as proxies, to measure health.
7. MEANING OF THE WORDS……..
• The word Care: care means looking after, or protection of, or giving attention to,
or maintaining sometime. This care includes the following services:
- prevention
- promotion
- curative
- rehabilitative
• Primary care: means those activities undertaken before a person develops a
disease.
• Secondary care: means services rendered when a disease has occurred, but it is
silent; and even a person might not know that he/she has the disease. The main
activity in secondary care is screening to detect the disease early for early
treatment
• Tertiary care: is provided when a person shows signs and symptoms of disease to
prevent disability and death.
8. Concept of primary health care
• HC is for all especially the needy, regardless of social and
economic status every individual must access health
• community and there must be The services should be acceptable
by the active involvement of the community
• The services should form an integral parts of country’s health
system.
• The program must be efficient, multisectoral because health does
not exist in isolation
9. LEVEL OF HEALTH CARE
• Primary care level
The first level of contact of individual and community and is the most
effective. This include; VHTs etc.
• Secondary care level
High level of care at which complex problems are dealt with. This include;
health centers and hospital
• This is where specialization health care are provided and include; teaching
hospitals, regional referral hospital, care hospitals and specialized hospital.
• Tertiary care: is provided when a person shows signs and symptoms of
disease to prevent disability and death.
10. PRINCIPLES OF PHC
The are 4 core principles of PHC
• Equity
• Community participating
• Intersectoral coordination
• Appropriate technology
11. Principles cont……..
• Equity/equitable distribution.
The first key principle of PHC strategy is equitable distribution of health
services. Health services should be shared equally irrespective of poor,
rich or disable
Currently health services are mainly in town and there are inability of
majority of people in developing countries to obtain good health.
• Community participation
Overall its responsibility of the state, but involvement of families,
communities in promotion of their own health care is important. PHC
achieve by their involvement.
12. Principle cont.
• Intersectoral coordination
In addition to health sector, all related sectors and aspects of
development should be embraced to ensure PHC. In particularly,
education,agriculture,animal husbandry,food,industry and housing.
• Appropriate technology
Technology that are scientifically sound, adaptable to local needs and
acceptable to those that apply it.
13. Essential component/elements of PHC
1. Education concerning prevailing health problems and methods of
identifying, preventing and controlling them
2. Promoting of food supply and proper nutrition and adequate supply
of safe water and basic sanitation
3. Maternal and child care including family planning
4. Immunization against major infectious diseases
5. Preventing and controlling locally endemic diseases
6. Treatment of common diseases and injuries
7. Promotion of mental health
8. Provision of essential drug
14. Cont….
However currently, the extended elements include;
• Expanded option on immunization
• Reproductive health needs
• Provision and essential technologies to health
• Health promotion
• Prevention and control of non communicable diseases
• Food safety and provision of selected food supplements
15. Reference text books
• WHO&UNICEF; ALMA-ATA 1978 primary health care
• Primary health care concept and challenges in changing world, E. Tarimo,E.G
Webster, WHO/ARA/97.1
• Infection control, policies and procedures department of quality assurance
ministry of health Uganda, Kampala
• Community health,3rd edition by Chris wood, AMREEF(2008) Nairobi keneya
16. Assignment
1. Describe the role of a pharmacy personnel in PHC?
2. What should be done to make quality PHC accessible and affordable
for every one and every where?
3. What are the challenges hindering globalization of PHC for all
4. Why is PHC important for every country?
5. List and explain the Alma-Ata declaration on primary health 1978.
18. ROLES OF PHARMACY TECHNICIAN
• Managing of patients
• Recommend appropriate sources of support for patients experiencing
Common health problems.
• Advice patients on current health promotion compaign
• Refer patients for the management of medication therapy needs that
fall beyond their individual scope of practice.
19. Roles of community Health workers in
Health (CHW)
• Creating connection between vulnerable population and health care system
• Facilitating health care and social services system navigation
• Managing care and care transition for vulnerable population
• Reducing social isolation among patients population
• Determining eligible and enrolling individual in health insurance plan
• Ensuring cultural competence among health care professional services
vulnerable population.
20. Roles of community Health workers in
Health…….
• Educating health system providers and stake holders about community
health needs
• Providing cultural appropriate health education on topic related to
chronic disease prevention, physical activities and nutrition.
• Advocating for underserved individual to receive appropriate services
• Collecting data and relaying information to policy makers to inform
policy change and development
• Providing informal counselling,health screening and referral
• Building capacity to address health issues.
21. ADVANTAGES OF CHEWs
• Develop trusting one on one relationship with patient
• Act as liaison between providers, patients and families
• Gain support from other organization serving communities
• Strengthen care coordination by connecting patients with available
health care and social support services
• Extent the reach of health care providers and services
• Deliver services that are appropriate based on patients language and
culture
22. ROLES OF GOVERNMENT/LOCAL
LEADERS IN HEALTH
Potential public health action of responsive government classified in to
the following
Promoting free and open health information
• Regulating advertisement law
• Nutritional facts channel
• Public reporting of health care providers performance
• Sex education for teens, antitobacco advertisement
• Promoting pharmaceutical package inserts/information leaflets
23. ROLES OF GOVERNMENT/LOCAL
LEADERS IN HEALTH…….
Protecting individual form harms caused by others
• Non adulteration of food and protecting against counterfeit drugs
• Law against alcohol impaired driving
• Infectious disease reporting
• Laws requiring smoke free places
• Protecting against natural occurring health hazards
• Elimination of artificial trans fat
• Restricting sales and marketing of alcohol to children
24. ROLES OF GOVERNMENT/LOCAL…
Taking societal actions to promote and protect health
• Vaccination mandate
• Water treatment
• Micronutrient fortification of manufactured food eg.iodized salt
25. ROLES OF HEALTH PRACTITIONERS
• Health education
• Early diagnosis and treatment of disease
• Counselling for behavioral change
• Immunization and chemoprophylaxis
26. Assignment 2
• Describe the role of the following in health promotion in relation to
cholera outbreak in the society
1. Community
2. Media
3. Village health
4. Local leaders
27. Answer to assignment 1
• Question 1, refer to lecture 2
• Question 2, promotion of access and affordability to health
Improving means of transport
Health workers arranging appropriate opening hours
Having welcoming attitude by health workers/service providers
Locating health facilities near where people live
Cost of training, treatment must be with resource that people can
afford
Careful selection and promoting of essential medicine list
28. Cont…
• Question 3, challenges to global health for all
Weak health system
Rising inequalities
Aging population
Toll of non communicable disease
Pressure from urbanization
29. Cont….
• Question 4, importance of PHC
Address vast majority health needs
Improve quality of services while reducing inequalities in health along
the life course
Empower individual and communities
Responds to day-to-day needs and foster trust in health workers
It boost resilience and enables a faster more effective response
Build foundation for effective, efficient and equitable health system
Accelerate progress towards universal health coverage.
30. Cont….
• Question 5 Alma-Ata recommend/declarations
It recommended the government diagnosing the community in accessing to incorporate
strengthen the primary health care with other sectors
The health services should be comprehensive which includes preventive,
promotive,culative and inhabilitative
PHC should aim at the health problems and appropriate actions for promote of health
PHC should encourage community’s participation and appropriate technologies
The health system should be organized in such a way to strengthen and support PHC
through various sector
The conference identified the needs to train health personnel at all levels for better
implementation of health services
The conference recommends provision of maximum care to special risk group
It recognized that PHC requires continuous supply of drugs and proper managerial
process including planning, organizing, monitoring and evaluation of health services.
