PHC

1. By
Dr. Fatma khalil Abd Elhameed
Associated professor of Community Health
Nursing

2.  This topic is intended to provide a
comprehensive understanding of the primary
health care system and highlighting this system
in Egypt

3.  Enumerate Goals of primary health care system
 Define primary health care system
 Memories influences on the primary health
care systems

4.  Classify organization of the primary health
care systemh
 Describe characteristics of the ideal primary
health care system
 Recognize role of the community nurse in the
primary health care system
 Discuss out comes of the primary health care
system

5.  Appreciate the importance of primary health
care system for community and world health
 To help any work to succeed and achieve its
planned objectives provide it through system
to regulate it.
 The primary health care as to must have
systems to regulate and give this care
effectively. We are still facing a global health
crisis with in and between countries because of
failure of the primary health care system.

6.  Health is not only absence of
disease, it includes several
dimensions like physical, social and
psychological well being of the
individual.
 Health is a dynamic state of
complete physical, mental and
social wellbeing and not merely the
absence of diseases and infirmity.

7.  In 1978, an international
Conference on PHC, held at
Alma-Ata , It was the first
international declaration
underlining the importance of
PHC. which mobilized a
"Primary Health Care
movement".

8.  The ultimate goal of primary healthcare
is the attainment of better health services
for all. Health is a fundamental human
right and that the attainment of the
highest possible level of health is a most
important worldwide social goal.
 The existing gross inequality in the
health status of the people particularly
between developed and developing
countries is politically, socially and
economically unacceptable.

9.  The call of health for all by the year 2000
through PHC has provided a
motivational and unifying concept in
international health development
 Astana 2018
It declares that ‘strengthening primary
health care is the most inclusive,
effective and efficient approach to
enhance people’s physical and mental
health, as well as social well-being, and
is a cornerstone of a sustainable health
system’

10.  It 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 by means of
acceptable to them, Services are
provided at a cost that the community
and the country can afford at every
stage of their development .

11. After the introduction of the primary health
care concept, a variety of vertical
programs were launched e.g.:
 Extended Program of Immunization
(1977).
 Selective Primary Health Care (1979).
 Child Survival and Development
Revolution (1982).
 Safe Motherhood Initiative (1986).
 Better Health through Family Planning
(1987).

12.  Providing a wider coverage of health care.
 Preventing social disparities in health care.
 Organizing health services to meet health
needs.
 Helping to make health and health care a part
of public policy in every sphere.
 Helping to train leaders in effective health care.

13.  ● Health Visitors (for children & the elderly)
 ● Community nurses.
 ● Community physician.
 ● Physiotherapists .
 ● Midwives.

14. Levels of care:
Primary health care.
Secondary health care.
Tertiary health care and
Quaternary Care.

15.  The “first” level of contact between the
individual and the health system.
 Essential health care (PHC) is provided.
 A majority of prevailing health problems can
be satisfactorily managed.
 The closest to the people.
 Provided by the primary health centers.
 The first contact when a person have any
emergency.

16. More complex problems are dealt with .
 Comprises curative services
 Provided by the district hospitals ( that is why
they called it hospital care).
 The 1st referral level (this care is also found in
emergency departments).
 Provide training programs.

17. Tertiary care refers to highly specialized
treatment Offers super-specialist care
 Provided by regional/central level institution.
 Provide training programs.
 Examples: plastic surgery, treatment for burns
and any other complex medical and surgical
intervention. such as neurosurgery, transplants
and secure forensic mental health services

18.  Is considered an extension of tertiary care.
However, it is even more specialized and
highly unusual.
 Because it is so specific, not every hospital or
medical center offers quaternary care. Some
may only provide quaternary care for
particular medical conditions or systems of the
body.

19. E – Education for Health.
L – Locally endemic disease control
E – Expanded program for immunization
M – Maternal and Child Health including
responsible parenthood.
E – Essential drugs.
N – Nutrition.
T – Treatment of communicable and non-
communicable diseases.
S – Safe water and sanitation.

21. Principles
of Primary
Health
Care
Equitable
distribution
Appropriate
technology
Inter-sectoral
coordination
Community
participation
(Man power,
Money and
Material).

22. Organization
of the Primary
Health Care
System
Who gives care
(primary care
physicians, specialist
nurses, or
practitioners)
who pays for medical
services (self-pay,
private insurance or
Medicare)
The delivery of care: -
(how and where
medical services are
provided)

23.  Appropriateness Availability
 Adequacy Accessibility
 Acceptability Affordability
 Assess ability Accountability
 Completeness Comprehensiveness
Continuity

24.  Proportion of the population covered by insurance.
 Kinds of benefits available to the insured.
 Ease of accessing the insurance coverage and
benefits.
 Organizational features of the health care delivery
system in terms
 Effectiveness, efficiency, and products delivered.
 Level and kinds of technology applied in the
course of delivering
 Preventive or health care services are accessible.

25.  1- The Egyptian Ministry of Health has
adopted initiatives aimed at supporting
citizens' health, such as:
 100 million health to eliminate the virus C.
 Women's Health Initiative to eliminate
malignant diseases and early detection and
treatment.
 The initiative to eliminate chronic diseases such
as obesity, hypertension and diabetes.
 Covid 19 vaccinations.

26.  Population, Reproductive Health, and Family
Planning Program :
 Control of Diarrheal Diseases and Acute
Respiratory Infections Programs
 Expanded Program on Immunization
 Maternal and child Health programs.

27.  Expanding the social health insurance coverage
 Reorganizing services so that they are provided
through a holistic family health approach.
 Strengthening management systems and
developing a regulatory framework and
institutional relationships to ensure quality of care
and to support the reform of the health sector.
 Developing the domestic pharmaceutical industry
and reducing government involvement in the
production of pharmaceuticals while
strengthening its role as a financier.

28.  There are four broad classes of HIO
beneficiaries:
 a) all employees working in the government
sector
 b) some public and private sector employees.
 c) pensioners ( ‫)المتقاعديين‬.
 d) widows .

29.  CCOs operate 11 hospitals In general, the 11
hospitals are high-quality “middle- and top of-
the-market” institutions, providing a full range
of quality curative care services and programs

30.  Private pharmacies, private doctors, and
private hospitals of all sizes.
 Private Practices: Physicians represent the
most powerful professional group in the health
sector. Doctors are permitted to work
simultaneously for the government and in the
private sector.
 Private Facilities: Hospitals that are large,
modern, and sophisticated to smaller hospitals,
day care centers, and polyclinics.

31.  Private Voluntary Organizations: Private
voluntary organizations (PVOs) providing
care through polyclinics and small hospitals
that are usually affiliated with charitable or
religious organizations.
 Nongovernmental Organizations : (NGOs)
provide many developmental, social, and
health care services, including reproductive
health and family planning service delivery.

32.  Work with Local Communities and Enrolled
Populations
 Identify and Remove Health Inequalities.
 Offer Access to Comprehensive Services to
Improve, Maintain and Restore People’s
Health.
 Co-ordinate Care Across Service Areas.
 Develop the Primary Health Care Workforce.
 Continuously Improve Quality Using Good
Information.

33.  Health promotion Illness prevention
 Research Education
 Quality control Advocacy Community
development
 Coordinators of care.
 Midwifery, antenatal and postnatal care
 Treatment and care of sick people, usually in
interdisciplinary teams
 Rehabilitation and palliation
 Population health and public health

34.  Chronic illness management
 Organising clinical work environments, including
infection control and risk management
 Providing education and support to other
providers such as doctors and administration staff
 Problem solving in clinical or organizational
contexts
 Being an agent of connectivity between different
health disciplines and between patients and health
services