80893584-Concept-of-Phc by Dr.RaafatAL-Awadhi.ppt

Nursing College

2. CONCEPT OF PRIMARY HEALTH
CARE
Introduction
The concept of Primary health care
is based on practical, scientifically sound
and socially acceptable methods and
technology. Such care is delivered in
multiple settings, such as community
nursing centers, health maintenance
organizations, and community based
clinics.

3. Primary health care
Primary health care is the
strategy evolved to achieve Health for All
by 2000 AD by the International
Conference on primary health care.

4. Definition
The concept of primary health care
came into lime-light in 1978 following an
international conference in Alma-Ata,
 It has been defined 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 the country can afford
to maintain at every stage of their development in
the spirit of self-determination."

5. Definition
Primary health care is 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.

6. GENESIS OF PRIMARY HEALTH CARE:
The Bhore Committee
(1946) recommended that an
integrated health service
comprising primary health care,
and other levels of care should
be established for rural
community.

7. The Alma-Ata Declaration:
The Alma-Ata conference which in 1978
formally launched primary health care as
the main thrust and focus for the
promotion of world health. The
declaration was formally adopted by
representatives of 134 governments thus
committing them to the development of
primary health care.

8. The declaration of Alma Ata stated that
primary health care includes at least:
education about prevailing health problems
and methods of preventing controlling them;
promotion of food supply and proper nutrition;
an adequate supply of safe water and basic
sanitation;
maternal and child health care, including family
planning;
immunization against infectious diseases;
prevention and control of endemic diseases;
appropriate treatment of common diseases and
injuries; and
Provision of essential drugs.

9. The concept of primary health
care involves
Concerted effort to provide the rural population of
developing countries with at least the bare minimum of
health services.
The list can be modified to fit local circumstances. For
example, some countries have specifically included
mental health, physical handicaps, and the health and
social care of the elderly
The primary health care approach integrates at the
community level all the factors required for improving
the health status of the population
As a signatory to the Alma Ata Declaration, the
Government of India has pledged itself to provide
primary health care

10. Obstacles
 To the implementation of primary
health care in India include shortage
of health manpower, entrenchment
of a curative culture within the
existing health system, and a high
concentration of health services and
health personnel in urban areas.

11. CIRCLE OF PRIMARY HEALTH CARE:

12. THE PRIMARY HEALTH CARE
PHILOSOPHY:
1.Health is fundamentally related to availability
and distribution of resources not just health
resources such as doctors, nurses, clinics,
medicines, but also other socio-economic
resources such as education, water supply
and food supply.
2. Health is an integral part of overall
development. Thus factors, which influence
health are social, cultural and economic as
well as biological and environmental.

13. 3. Achievement of better health requires
much more involvement of people
themselves as individuals, families and
communities, in taking action on their own
behalf by adopting healthy behavior and
ensuring a healthy environment. Self-
reliance, separate from and additional to
the contributions of conventional health
services is required.

14. PRIMARY HEALTH CARE STRATEGY:
The PHC strategy incorporates the values
expressed in the PHC philosophy as follows:
a)The need for change in the Health care
system
b)Intersectoral Action for Health
c)Individual and collective responsibility for
health
d)PHC as a level of Health care

15. Elements of primary health care
E -Ensure safe water supply
L -Locally endemic diseases control
E -Education/Expanded programme of
immunization or Universal immunization
programme (UIP).
M -Maternal and child health.
E -Environment sanitation
N -Nutritional services (nutrition and food supply)
T -Treatment of minor ailments/common diseases
S -School health services.

16. FUNCTIONS OF PRIMARY HEALTH
CENTRE:
Medical care
Maternal child health
Control of communicable disease
Collection and reporting of vital statistics
Immunization services
Improvement in environment sanitation.
School health services.
Referral services
National health programmes
Prevention of food adulteration practices.
Nutritional services.
Training Programmes.
 

17. Principles of primary health care
Equitable distribution
Community participation
Focus on prevention
Inter sectoral co-ordination
Appropriate technology

18. Equitable distribution:
Goal of HA/2000 was a vision founded
on social equity.
Essential health care facilities/services
must be,
Available for all
Accessible to all
Acceptable by all
Affordable by all

19. No uncovered/neglected pockets exist in
the rural/tribal/peri-urban areas.
Urban areas due to political and socio
economic forces enjoy the advantage of
concentration of health care resources for
many years
Social equity calls for
redistribution/preferential allocation of
resources to underserved areas.

20. Community involvement
(Participation):
Community participation means involvement
of the people in the development process
voluntarily and willingly.
Close contact between health services and
the community is essential and should be a
two-way process.
Health workers and the services must remain
responsive to the perceived and real health
needs of the people.

21. Similarly, the community must understand the
objectives and constraints of the health system
Community leaders can be particularly valuable
in mobilizing resources and assisting health
workers for effective delivery of health care.
Various community organizations and social
networks such as village development
committees, youth associations, religious
organizations etc. can serve as the mechanism
for participation.

22. Focus on prevention:
Three levels of prevention/intervention in health care
Primary:
Health promotion
Specific protection
Secondary:
Early detection/diagnosis
Treatment
Tertiary:
Disability limitation
Rehabilitation

23. Intersectoral co - operation:

24. Appropriate Technology:
Internationally conference on PHC
(1978) has defined technology as an
association of methods, techniques and
equipments, which, together with the
people using them, can contribute
significantly to solving a health problem.

25. Appropriate means that the technology is
scientifically sound
acceptable to those who apply it and to those for
whom it is used
compatible with local culture
capable of using adapted and further developed if
necessary
understandable by the PHC workers and in some
instances even by individuals, family, community
cost-effective

26. CHARACTERISTICS OF PRIMARY
HEALTH CARE:
Primary health care is essential health care
made universally accessible to individuals,
families in the community.
It is socially acceptable to all implies that
care has to be appropriate
Affordable primary health care implies that
whatever the methods of payment used
It is made available to them through their
full participation.

27. In primary health care we use appropriate
technology, which means using
appropriate methods and techniques and
with locally available supplies and
equipment
It is based on socially accepted methods
which the country can afford. Thus, self-
reliance and self determination are
emphasized

28. SEVEN SUPPORTING ACTIVITIES
FOR PRIMARY HEALTH CARE:

29. PRIMARY HEALTH CARE IN INDIA :
In 1977, the Government of India
launched a rural health scheme,
based on the principle of “placing
people’s health in people’s hands”.
It is the three tier system of health
care delivery in rural areas based on
the recommendation of the
Shrivastav committee in 1975.

30. The National Health policy
(2002) includes all that is wanted
from a progressive document
and protect and provide primary
health care to all.

31. a) Village level:
One of the basic tenets of primary health
care is universal coverage and equitable
distribution of health resources. To
implement this policy at the village level,
the following schemes are in operation:
(i)Village health Guides
(ii)Local Dais
(iii)Anganwadi worker

32. (b) Sub-centre level:
The sub-centre is the peripheral out post of the
existing health delivery system in rural areas.
Each sub-centre is manned by one male and
one female multipurpose health worker. The
functions of sub-centre is, mother and child
health care, family planning, immunization, IUD
insertion and simple laboratory investigations
like routine examination of urine for albumin
and sugar.

33. (c) Primary health centre level:
The Bhore committee in 1946 gave the
concept of a primary health centre as a
basic health unit, to provide, as close to
the people as possible, an integrated
curative and preventive health care to
the rural population, preventive and
promotive aspects of health care.

34. Functions of Primary health
centres:
Medical care
Maternal child health including family planning
Safe water supply and basic sanitation
Prevention and control of locally endemic diseases
Collection and reporting of vital statistics.
Education about health
National health programmes – as relevant
Training of health guides, health workers, local dais and
health assistants.
Referral services.
Basic laboratory services.

35. Staffing pattern of primary
health centre:
Medical office:1
Pharmacist :1
Nurse mid-wife:1
Health worker (female)/ANM:1
Block extension educator:1
Health assistant (male) :1
Health assistant (female)/LHV:1
U.D.C :1
L.D.C:1
Lab technician:1
Driver (subject to availability to vehicle):1
Class IV: 4
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36. (d) Community Health centre:
 In each community health
centre covering a population of 80,000 to
1.20 lakhs with 30 beds and specialists
in surgery, medicine, obstetrics and
gynaecology and pediatrics with X-ray
and laboratory facilities.

37. Staff for community health
centre:
Medical officer -4
Nurse-midwives- 7
Dresser -1
Pharmacist/Compounder - 1
Lab technician- 1
Radiographer- 1
Ward boys - 2
Dhobi -1
Sweepers - 3
Mali- 1
Choukidar - 1
Aya - 1
Poen- 1
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38. (e) Role of nurse in primary
health care:
Collaborator
Adviser
Consultant
Advocate
Prevent or of illness
Promoter of health
Care provider
Team leader
Observer
Potentiator
Manager
Participant
Practitioner

39. Nurses role in the delivery of Primary
health care
Primary care environment
Society
Primary care delivery system
Primary health care providers
Professional competence
Interpersonal competence
Intraprofessional and
Interprofessional competence

40. contd
Multicultural competence
Client and family
Health promotion
Disease prevention
Health protection
Technological resources
Community based practice

41. contd
Community -oriented primary care
The community as a partner in
primary care
The nursing process and the delivery
of primary care services

42. CONCLUSION:
 Health promotion strategies are not
limited to a specific health problem, not
at a specific set of behaviors. The
primary health care should be
community based with the involvement
of community. It aims to provide a total
package of health and developmental
activities in a community/nation.