Concept of primary health care

community health nursing II, unit iv, concept of primary health care

1. CONCEPT OF PRIMARY HEALTH CARE Prepared By Krupa Mathew. M, Assistant Professor

2. OBJECTIVES The student will be able to, define primary health care list out the elements of primary health care explain the principles of primary health care detail the roles and responsibility of community health nurse in primary health care

3. INTRODUCTION Primary health care approach had its inception in the year 1978 following an international conference at Alma –ATA in USSR. Primary health care is equally applicable for all the countries from most to the least developed countries have accepted primary health care as the vital part of the health system. 3

4. DEFINITION “Primary Health Care is essential health care made universally accessible to individuals & acceptable to them, through their full participation & at a cost the community & country can afford ”. 4

5. ELEMENTS OF PRIMARY HEALTH CARE The Alma-Ata conference outlined 8 essential components of primary health care. Education concerning prevailing health problems and the methods of preventing and controlling them. Education and information concerning prevailing health problems and methods of preventing and 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 major infectious diseases. Prevention and control of locally endemic diseases. Appropriate treatment of common diseases and injuries.  Provision of essential drugs.   5

6. PRINCIPLES OF PRIMARY HEALTH CARE Equitable distribution. Community participation. Inter sectoral coordination. Appropriate technology . Focus on Prevention 6

7. EQUITABLE DISTRIBUTION The first key principle in the primary health care strategy is equity or equitable distribution of health services. Health services must be shared equally by all people irrespective of their ability to pay, and all must have access to health services.  At present health services are mainly concentrated in the major towns and cities resulting in inequality of care to the people in rural areas. The worst hit are the poor and the needy and vulnerable groups of the population in rural areas and urban slums. This has been termed as social injustice. 

8. The failure to reach the majority of the people is due to inaccessibility. 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.

9. Community participation Health of the people is not just the responsibility of central and state government alone. Involvement of people in the development process voluntarily and willingly is vital component of primary health care. 9

10. There must be a continuing effort to secure meaningful involvement of the community in planning, implementing & maintenance of health services, besides maximum reliance on local resources such as manpower, money & materials. 10

11. Best example for community participation is introduction of village Health Guides” & “Trained Dais” using people from local community. It is an essential feature of primary health care in India. China had set his fore front strategy by introducing community participation in the from of “bare foot doctors” . 11

12. INTERSECTORAL COORDINATION There is an increasing realization of the fact that the components of primary health care cannot be provided by the health sector alone. 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”. 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.

13. Appropriate technology Appropriate technology has been defined as “technology that is scientifically sound, adaptable to local needs, & acceptable to those who apply it & for those whom it is used & that can be maintained by the people themselves in keeping with the principles of self reliance with the resources the community & country can afford 13

14. Cont.. The term appropriate is emphasized because in some countries luxurious hospitals that are totally inappropriate to the local needs, are built, which absorb a major part of the national health budget, effectively blocking many improvement in general health services. 14

15. Focus on Prevention Prevention is the core strategy of primary health care. Community health nurses focus on health promotion and health maintenance activities for which they engage in primary ,secondary and tertiary level of preventive care activities. 15

16. ROLE OF NURSE IN PRIMARY HEALTH CARE WHO study group in 1985 highlighted the following roles and functions of nurses in primary health care. 1. Direct care provider The nurse provide direct care to individual, families and community with reference to 8 elements of primary health care Ex:MCH Care 16

17. Health educator & teacher In order to promote health, prevent disease, regain and maintain health, the nurse educates individuals, families and community at large about healthful behavior, sanitary environment, prevention of diseases etc., she educates family members to take c are of the sick in her absence and also other preventive measures. As a teacher, she trains other health workers such as ANMs, health Guides, Village Dais 17

18. Good planner & care manager The nurse working for primary health care makes assessment of health needs, health problems of individuals, families and community. The nurses involves individuals, families and community in planning and implementing of the care. She makes referrals when required. She maintains the record of care given and evaluates the effectiveness of the same. 18

19. Guide & supervisor As a nurse engaged in providing primary health care, she is expected to supervise, guide and help other personnel in providing care, planning health services for families and for the community. 19

20. Specific functions-PHC Assessment of health needs and health problems of individuals and community. Provide integrated comprehensive primary health care service related to 8 essential elements. Mobilize involvement of individuals, families and community in providing primary health care. 20

21. Surveillance of locally endemic diseases. Monitoring and analysis of health condition to determine the progress in primary health care. Training and supervision of health workers. Working in collaboration with other socioeconomic sectors. Maintenance of accurate, complete and up-to-date records of health care services rendered 21

22. REFERENCES 1. Shyamala , D. ( 2018). Text book of community health nursing –II , 1 st edition, CBS Publishers 2. Neelam Kumari,(2011) A textbook of community health nursing –II First Edition, S vikas & Company Medical publisher . 3. K.PARK, (2019).Textbook of Preventive and Social Medicine, 25 rd edition , Banarsidas Bhanot Publishers. 22

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