Primary Health Care
Mamata Sharma , PUSHS

Primary Health Care

Health Care
• Health is fundamental human right.
• It is the responsibility of the government.
• Current criticism – predominantly urban oriented
- mostly curative
- accessible mainly to small part
of the population

Levels of Health Care
primary
Secondary
Tertiary

District hospital
Primary health centre
Health Post
Sub Health Post

Primary Health Care
• Primary – first level of contact….essential health care
PHC, HP
• Secondary – complex problems are dealt…
district hospitals, Zonal Hospital
• Tertiary – specialized level ….medical colleges,
specialized hospitals

Primary Health Care (PHC)/concept
• In the year 1946 Sir Joseph
Bhore recommended in
his report
• A PHC for every 30,000 pop in Terai
& 20,000 pop in hilly areas

What is Primary Health Care (PHC)
• Primary Health Care (PHC) is the health care that is available to all the
people at the first level of health care.
• According to World Health Organization (WHO), ‘Primary Health Care is
a basic health care and is a whole of society approach to healthy well-
being, focused on needs and priorities of individuals, families and
communities.’
• Primary Health Care (PHC) is a new approach to health care
which integrates at the community level all the factors required for
improving the health status of the population.
• Primary health care is both a philosophy of health care and an approach
to providing health services.
• It is developed with the concept that the people of the country receive at
least the basic minimum health services that are essential for their good
health and care.

Concept of PHC
• Before 1978, globally, existing health services were failing to provide quality health care to the people.
• Different alternatives and ideas failed to establish a well-functioning health care system.
• Considering these issues, a joint WHO-UNICEF international conference was held in 1978 in Alma Ata
(USSR), commonly known as Alma-Ata conference.
• The conference included participation from government from 134 countries and other different agencies.
• The conference jointly called for a revolutionary approach to the health care.
• The conference declared ‘The existing gross inequality in the health status of people particularly
between developed and developing countries as well as within countries is politically, socially and
economically unacceptable’.
• Thus, the Alma-Ata conference called for acceptance of WHO goal of ‘Health for All’ by 2000 AD.
• Furthermore, it proclaimed Primary Health Care (PHC) as a way to achieve ‘Health for All’.
• In this way, the concept of Primary Health Care (PHC) came into existence globally in 1978 from the
Alma-Ata Conference.

Definition of PHC
• Definition:
• In 1978 the alma-Ata conference( USSR)
“Is the essential health care made universally accessible
to individuals and acceptable to them , through their full
participation and at a cost the community and country
can afford.

Elements of PHC
There are eight (8) elements of Primary Health Care.
These 8 elements are also known as ‘essential health care’. They are:
1. Education concerning prevailing health problem & the methods of
preventing & controlling them.
2. Promotion of food supply and proper nutrition.
3. An adequate supply of safe water & basic sanitation.
4. Maternal & child health care, including family planning.
5. Immunization against major infectious diseases.
6. Prevention & control of locally endemic diseases.
7. Appropriate treatment of common diseases & injuries.
8. Provision of essential drugs.

Principle of PHC
1. Equitable distribution of health services.
2. Community participation
3. Multisectorial approach
4. Appropriate technology should be used

• Equitable distribution of health services.
This means that health services must be shared by all people irrespective
of their ability to pay, and all (rich or poor, urban or rural) must have
access to health.
• Community Participation: active involvement of individuals, families, and
communities in promotion of their own health.
• Multisectorial approach : Coordinated action between health sector and
other related sectors. An important element of multispectral approach is
planning with other sectors to avoid unnecessary duplication of activities.
• Appropriate technology : appropriate technology is the technology that is
scientifically sound, adaptable to local needs, and acceptable to those
who apply it and for whom it is used, and that can be maintained by the
people themselves in keeping with the principle of self reliance with the
resources the community and counter can afford.

Challenges for Implementation of PHC
• Poor staffing and shortage of health personnel
• Inadequate technology and equipment
• Poor condition of infrastructure/infrastructure gap, especially in the rural areas
• Concentrated focus on curative health services rather than preventive and
promotive health care services.
• Challenging geographic distribution
• Poor quality of health care services
• Lack of financial support in health care programs
• Lack of community participation
• Poor distribution of health workers/health workers concentrated on the urban
areas.
• Lack of interpectoral collaboration

Role of Public Health Nurse in PHC
• Assessing the health status of individuals and
communities.
• Health Education
• Food Supply And Proper Nutrition
• Water supply and basic sanitation.
• Maternal and Child Health Care including Family Planning.

cont,…
• Immunization
• Treatments of Minor ailments.
• Mobilizing community involvement.
• Providing integrated health care
including the treatment of emergencies
and making referrals.

Basic Health Needs
• Basic needs refer to those things that are necessary
to sustain life.
• It is the minimum requirements of a community for
a decent standard of life.
• Basic needs consists of adequate food, shelter, and
clothing plus some household equipment and
furniture.
• Food, water and environment are personal and
immediate matters.
Nutritious food maintains health, promotes growth
in children, and prevents blindness. Safe
drinking water nurtures and restores; unsafe water,
even when it looks clean, is harmful.

Food, Air ,Water
• Like light, air (oxygen in particular) can be good and bad for you.
Oxygen is essential for life. Without oxygen we would only survive
for a few minutes at the most.
• Oxygen is our most important nutrient. It is fundamental to all
animal and plant life. Oxygen is needed constantly by every cell
because it releases the energy in food that the cells need to
function.
• Physical and mental well-being starts with access to fresh air and
water, nutritious food, and the security of a stable home. People
also need healthy relationships—with freedom to express gender
and sexuality—and a life free from violence, injury, and toxic stress.

• Water is the stuff of life. We cannot survive for long without it.
• Water comprises about 60 percent of solid tissue by weight in the human
body. Besides oxygen, it is the most important nutrient in the body,
functioning as a physiological “jack of all trades.”
• Water has an important role in nearly every major function in the body,
regulating body temperature, carrying nutrients and oxygen to cells, removing
waste, cushioning joints and protecting organs and tissues.
• The rest of our body is made from the nutrients we get from food that are
reliant on water for their existence.
• Many things are soluble in water so it makes it an ideal medium
• It is liquid at temperatures organisms survive in
• It has a neutral ph
• Make sure you drink plenty of water. At least 3 liters a day.

Clothing
• Wearing clothes satisfy three basic human needs; physical,
psychological, social.
• These needs are satisfied through protection, adornment,
identification, modesty, and status.
• A traditional list of immediate "basic needs"
is food (including water), shelter and clothing

Shelter/Housing
• Adequate housing is universally viewed as one of the
most basic human needs.
• The United Nations identifies adequate housing as a fundamental
human right, defining it as “the right to live somewhere in security,
peace and dignity.
• For many low-income families a house is more than just a shelter.
Their home has turned into a valuable asset. It has given them the
opportunity to work out of the comfort of their space and change
their lives for the better.

Education
• Education is a basic human right and is necessary for sustainable
social and economic development. The education of girls is one of
the most important determinants of development.
• Education is crucial for poverty reduction, because it is an
empowering tool that cannot be restricted to the power-holding
classes.

Health Security
• According to the World Health Organization (WHO), health
security encompasses the “activities required to minimize the danger and
impact of acute public health events that endanger the
collective health of populations living across geographical regions and
international boundaries”.
• Health security is essential to achieving human security.
• Health security focuses on pandemics, epidemics, and the spread of
infectious disease. Infectious diseases are the most significant threat to
public health.