Strategies of Primary Health Care

Levels of Care
Primary health care Secondary health care Tertiary health care

Primary health care The first level of contact between the individual and the health system. Essential health care (PHC is !rovided. " ma#ority of !revailing health !roblems can be satisfactorily managed. The closest to the !eo!le. Provided by the !rimary health centers.

Secondary health care

$ore com!le% !roblems are dealt with. Com!rises curative services Provided by the district hos!itals The &st referral level

Tertiary health care

'ffers su!er(s!ecialist care Provided by regional)central level institution. Provide training !rograms

What is Primary Health Care?

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 inte rated referral systems and in a way that ives priority to those most in need, ma!imises community and individual self"reliance and participation and involves collaboration with other sectors# $t includes the followin %
health promotion illness prevention care of the sick advocacy community development

Primary Health Care (PHC)

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, !"#$

Principles for PHC

PHC based on the followin principles %
Social e&uity 'ation"wide covera e Self"reliance $nter"sectoral coordination People(s involvement in the plannin and implementation of health pro rams

Principles of PHC
The )*+, -eclaration of .lma".ta proposed a set of P/$'C$PL0S for primary health care# PHC should%
)# 1/eflect and evolve from the economic conditions and socio" cultural and political characteristics of the country and its communities, and be based on the application of the relevant results of social, biomedical and health services research and public health e!perience2 3# 1.ddress the main health problems in the community, providin promotive, preventive, curative and rehabilitative services accordin ly2

4# 1$nvolve, in addition to the health sector, all related sectors and aspects of national and community development, in particular a riculture, animal husbandry, food, industry, education, housin , public works,

5# 1Promote ma!imum community and individual

self"reliance and participation in the plannin , or ani6ation, operation and control of primary health care, makin fullest use of local, national and other available resources7 and to this end develop throu h appropriate education the ability of communities to participate2

8# 19e sustained by inte rated, functional and mutually"supportive referral systems, leadin to the pro ressive improvement of comprehensive health care for all, and ivin priority to those most in need2 :# 1/ely, at local and referral levels, on health workers, includin physicians, nurses, midwives, au!iliaries and community workers as applicable, as well as traditional practitioners as needed, suitably trained socially and technically to work as a health team and to respond to the e!pressed health needs of the community#2

Core .ctivities for PHC

There is a set of C;/0 .CT$<$T$0S, which were normally defined nationally or locally# .ccordin to the )*+, -eclaration of .lma".ta proposed that these activities should include%

)# 0ducation concernin prevailin health problems and the methods of preventin and controllin them

3# Promotion of food supply and proper nutrition

4# .n ade&uate supply of safe water and basic sanitation

5# =aternal and child health care, includin family plannin

8# $mmuni6ation a ainst the ma>or infectious diseases

:# Prevention and control of locally endemic diseases

+# .ppropriate treatment of common diseases and in>uries

,# 9asic laboratory services and provision of essential dru s#

*# Trainin of health uides, health workers and health assistants#

)?# /eferral services

 =ental health Physical handicaps Health and social care of the elderly

WH; Strate ies of PHC

)#

/educin e!cess mortality of poor mar inali6ed populations% PHC must ensure access to health services for the most disadvanta ed populations, and focus on interventions which will directly impact on the ma>or causes of mortality, morbidity and disability for those populations# 3# /educin the leadin risk factors to human health% PHC, throu h its preventative and health promotion roles, must address those known risk factors, which are the ma>or determinants of health outcomes for local populations#

4# -evelopin 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# 5, -evelopin an enablin policy and institutional environment% PHC policy must be inte rated with other policy domains, and play its part in the pursuit of wider social, economic, environmental and development policy#

The 9asic /e&uirements for Sound PHC @the , .(s and the 4 C(sA
.ppropriateness .vailability .de&uacy .ccessibility .cceptability .ffordability

.ssessability .ccountability Completeness Comprehensiveness Continuity

.ppropriateness
*hether the service is needed at all in relation to essential human needs+ !riorities and !olicies. The service has to be !ro!erly selected and carried out by trained !ersonnel in the !ro!er way.

.de&uacy

The service !ro!ortionate to re,uirement. Sufficient volume of care to meet the need and demand of a community

.ffordability
The cost should be within the means and resources of the individual and the country.

.ccessibility

-eachable+ convenient services .eogra!hic+ economic+ cultural accessibility

.cceptability

.cceptability of care depends on a variety of factors, includin satisfactory communication between health care providers and the patients, whether the patients trust this care, and whether the patients believe in the confidentiality and privacy of information shared with the providers#

.vailability

.vailability of medical care means that care can be obtained whenever people need it#

.ssessability

.ssessebility means that medical care can be readily evaluated#

.ccountability

.ccountability implies the feasibility of re ular review of financial records by certified public accountants#

Completeness

Completeness of care re&uires ade&uate attention to all aspects of a medical problem, includin prevention, early detection, dia nosis, treatment, follow up measures, and rehabilitation#

Comprehensiveness

Comprehensiveness of care means that care is provided for all types of health problems#

Continuity

Continuity of care re&uires that the mana ement of a patient(s care over time be coordinated amon providers#

To Summari6e
Primary health care is an approach that% Bocuses on the person not the disease, considers all determinants of health $nte rates care when there is more than one problem Cses resources to narrow differences

 Borms the basis for other levels of health systems .ddresses most important problems in the community by providin preventive, curative, and rehabilitative services ;r ani6es deployment of resources aimin at promotin and maintainin health#

TH"/0 1'2