Primary health care

1. PRESENTED BY,
MR. KAILASH NAGAR
ASSIST. PROF.
DEPT. OF COMMUNITY HEALTH NSG.
DINSHA PATEL COLLEGE OF NURSING, NADIAD

3. HEALTH PROMOTION
INTRODUCTION:
 A t the beginning of the 20th century,
a new concept, the concept of health
promotion began to take shape. It was
realized that public health had
neglected the citizen as an individual
and that state had a direct
responsibility for the health of the
individual.

4. INTRODUCTION
CONTT
……
Consequently in addition to disease
control activities, one more goal was
added to public health. I.e. health
promotion of the individual.

5. DEFINITION:
Health promotion is the process
of enabling people to increase
control over and to improve
health.” It is not directed against
any particular disease, but is
intended to strengthen the host
through a variety of approaches
(interventions).

6. GOALS OF HEALTH PROMOTION
 To create environments that
allow all the ability to access all
needed services.
 To equip with the skills to
determine their own health needs.

7. STRATEGIES OF HEALTH
PROMOTION
1.Building healthy public policy
 Development of smoke free spaces
2.Creating supportive environment
3.Strengthening community Action
 Encouragement to initiate community
groups

8. STRATEGIES OF HEALTH PROMOTION
CONTT……
4. Developing personal skills
 HIV/AIDS, Malaria, TB, MCH
5. Reorienting health services
Reforming of the health sector to
incorporate adepartment focusing on
adolescent health

9. HEALTHINTERVENTIONS
AREA IN
PROMOTION:
 1 . Health education
 2 . Environmental
modifications
 3 . Nutritional interventions
 4 . Lifestyle and behavioral
changes

10. HEALTH EDUCATION
 This is one of the most cost-
effective interventions. A large
number of diseases could be
prevented with little or no medical
intervention if people were
adequately informed about them
and if they were encouraged to
take necessary precautions in time.

11. HEALTH EDUCATION
CONTT……
 The targets of educational efforts
mayinclude the general public,
patients, priority groups, health
providers, community leaders and
decision-makers.

12. ENVIRONMENTAL
MODIFICATI
ON
A comprehensive
approach to health
promotion requires
environmental
modifications, such as
provision of safe water;
installation of sanitary

13. ENVIRONMENTAL MODIFICATION
 The history of medicine has shown
that
man
y infectious diseases have been
successfully controlled in many
countries through environmental
modifications.

14. NUTRITIONAL INTERVENTIONS
 These comprise food
distribution and nutritional
improvement of vulnerable
groups: child feeding
programmes,food fortification;
nutritional education,etc.

15. LIFESTYLE AND
BEHAVIOURAL
CHANGES
 The conventional public health
measures or interventions have
not been successful in making in
roads into lifestyle reforms. The
action of prevention in this case, is
one of individual and community
responsibility for health.

16. LIFESTYLE AND
BEHAVIOURAL
CHANGES
Health education is a basic element
of all health activity. It is of paramount
importance in changing the views,
behavior and habits of people.

17. PRIMARY HEALTH
CARE

18. INTRODUCTION:
With increasing recognition of the
failure of existing health services to
provide health care, alternative ideas
and methods to provide health care
have been considered and tried. The
concept of primary health care came
into limelight in 1978 following an
international conference in Alma-Ata,
USSR

19. DEFINITION:
Primary health care 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 the country can
afford.

20. PURPOSES
Increase in life expectation.
Improvement in nutritional
status.
Provision of basic sanitation.
Development of manpower
and other resources.

21. CARE:
 The Alma-Ata conference outlined 8
essential components of primary
health care.
Education concerning prevailing health
problems andthe methods of preventing
and controlling them.
Promotion of food supply and proper
nutrition
 A n adequate supply of safe water and
basic sanitation.

22. Maternal and child health care,
including family planning.
Immunization against major infectious
diseases.
Prevention and control of locally
endemic diseases.
Appropriate treatment of common
diseases andinjuries.
Provision of essential drugs.

23. CARE:
EQUITABLE DISTRIBUTION:
 The first key principle in the primary
health care strategy is equity or
equitable distribution of health
services.

24. EQUITABLE DISTRIBUTION
CONTT……
Health services must be shared
equally by all people irrespective of
their ability to pay, and all must have
access to health services.
 A t present health services are mainly
concentrated in the major towns and cities
resulting in inequality of care to the
people in rural areas.

25. EQUITABLE
DISTRIBUTIO
N: CONTT……
 The worst hit are the poor and the
needyand vulnerable groups of the
population in rural areas and urban
slums. This has been termed as
social injustice.
 The failure to reach the majority of
thepeople is due to inaccessibility.

26. EQUITABLE
DISTRIBUTIO
N: CONTT……
Primary health care aims to redress
this imbalance by shifting the centre of
gravity of the health care system from
cities to the rural areas and bring
these services as near people’s homes
as possible.

27. COMMUNITY
PARTICIPATIO
N:
•  The overall responsibility of the central and
state governments, the involvement of
individuals, families, and communities in
promotion of their own health and welfare, is an
essential ingredient of primary health care..

28. PARTICIPATI
ON
CONTT……
Countries are now conscious of the fact
that the universal coverage by primary
health care cannot be achieved without
the involvement of the local community

29. COMMUNITY PARTICIPATION
CONTT……
There must be a continuous effort to
secure meaningful involvement of the
community in the planning, implementation
and maintenance of health services,
besides maximum reliance on local
resources such as manpower, money and
materials .In short, primary health care
must be built on the principle of community
participation (or involvement).

30. COMMUNITY PARTICIPATION
CONTT……
 One approach that has been tried
successfully inIndia is the use of village
health guides and trained dais.
They are selected by the local community
and trained locally in the delivery of
primary health care to the community they
belong, free of charge .By overcoming
cultural and communication barriers, they
provide primary health care in ways that are
acceptable to the community.

31. INTERSECTORAL
COORDINATION:
There is an increasing realization of the
fact that thecomponents of primary health
care cannot be provided by the health
sector alone.

32. INTER SECTORAL COORDINATION
CONT…
The declaration of Alma-Ata states, primary
health care involves in addition to the
health sector, all related sectors and
aspects of national and community
development,in particular agriculture,
animal husbandry, food,
industry, education,
housing, public works,
communication and
other sectors”

33. INTER SECTORAL
COORDINATI
ON CONTT……
This requires strong political will to
translate values into action, an
important element in intersectoral
approach is planning –planning with
other sectors to avoid unnecessary
duplication of activities.

34. APPROPRIATE TECHNOLOGY:
Appropriate technology has been
defined as “technology that is
scientifically sound, adaptable to
local needs, and acceptable to those
who apply it and for those 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 the

35. APPROPRIATE
TECHNOLO
GY CONTT……
 The term appropriate is emphasized
because insome countries, large
luxurious hospitals that are totally in
appropriate to the local needs are
built, which absorb a major part of the
national health budget, effectively
blocking any improvement in general
health services.

36. APPROPRIATE
TECHNOLO
GY CONTT……
This also applies to use of costly
equipment, procedures and
techniques when cheaper,
scientifically valid and acceptable
ones are available, viz, oral
rehydration fluid.

37. ROLE OF NURSES IN PRIMARY
HEALTH CARE
Assessing the health status of
individuals andcommunities.
Health Education
Food Supply And ProperNutrition
Water supply and basic sanitation.
Maternal and Child Health Care
including Family Planning.

38. ROLE OF NURSES IN PRIMARY
HEALTH CARE CONTT……
 Immunization
 Treatments of
Minorailments.
Mobilizing
community
involvement.
Providing integrated
health care including the
treatment of
emergencies and making
referrals.

39. RESEARCH STUDY
Nurse delivered lifestyle interventions in primary
health care to treat chronic disease risk factors
associated with obesity: a systematic review.
Sargent GM, Forrest LE, Parker RM.
Abstract
Nurses in primary health care (PHC) provide an
increasing proportion of chronic disease management and
preventive lifestyle advice. The databases MEDLINE,
CINAHL, EMBASE and PsychINFO were searched and
the articles were systematically reviewed for articles
describing controlled adult lifestyle intervention studies
delivered by a PHC nurse, in a PHC setting. (i) no
difference of effect when the same intervention was
delivered by a PHC nurse compared to other health
professionals in PHC

40. RESEARCH STUDY
(ii)the provision of counselling delivered by a PHC
nurse was more effective than health screening
(iii)counselling based on behaviour change theory
was more effective than the same dose of non-
behavioural counselling when at least three
counselling sessions were delivered The
evidence supports the effectiveness of lifestyle
interventions delivered by nurses in PHC to affect
positive changes on outcomes associated with
the prevention of chronic disease including:
weight, blood pressure, cholesterol, dietary and
physical activity behaviours, patient satisfaction,
readiness for change and quality of life.