PRIMARY HEALTH CARE

Summary on History, Definition and Principles of Primary Health Care.

1. CONTENTS Introduction Evolution Definition of primary health care Characteristics of Primary health care Essential elements Principles

2. HISTORY The concept of 'Primary Health Care' came into existence, following a Joint WHO - UNICEF International Conference at Alma Ata , USSR (present day Kazakhstan), on 12th September 1978 .

3. Delegates to the conference expressed "the need for urgent action by all governments, all health and development workers, and the world community to protect and promote the health of all the people of the world ….“ Alma-Ata put HEALTH EQUITY on the international political agenda for the first time . And a way of approaching this equity was through Primary Health Care.

4. The PHC concept paper was prepared under the guidance of Kenneth Newell, Director of WHO’s Strengthening of Health Services Division. 

5. Primary health care is an approach to health care , which integrates at the community level all the factors required for improving the health status of the population . The services provided are, - Simple and efficient with regard to cost, techniques , and organization, - Readily accessible to those concerned and contributes to improving the living conditions of individuals, families and the community as a whole.

6. WHO, in the year 1977 launched its HEALTH FOR ALL, BY THE YEAR 2000 strategy. And on 12th September 1978, the Alma -Ata conference called for acceptance of the WHO goal of Health for All by 2000 and proclaimed primary health care as a way to achieving Health for All.

7. Primary health care is the first level of contact of individuals, the family and the community with the national health system, where essential health care is provided.

8. CONCEPT Primary health care is essential health care based on p ractical scientifically sound socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost , the community and country can afford to maintain at every stage of its development in a spirit of self-reliance and self determination

9. Thus, it is based on social equity, nation-wide coverage , self-reliance, inter sectoral coordination , a nd people's involvement in the planning and implementation of health programs in pursuit of common health goals. This approach has been described as " health by the people" and "placing people's health i n people's hands".

10. Basically, t he concept involves a concentrated effort to provide the rural population of developing countries with at least the bare minimum of health services.

11. CHARACTERI STICS It is essential health care, which is based on practical, scientifically sound and socially acceptable methods and technology. It should be rendered universally acceptable to individuals and the families. Its availability should be at a cost, which the community and country can afford to maintain at every stage of their development in a spirit of self-reliance and self-development.

12. 4. It requires joint efforts of the health sector and other health related sectors like, education , food and agriculture, social welfare , animal husbandry, housing, etc . 5. Reflects and evolves from the economic conditions and socio-cultural and political characteristics of the country. 6. Based on the application of the relevant results of social, biomedical and health services research and public health experience

13. 7. Addresses the main health problems in the community , providing promotive, preventive , curative and rehabilitative services. 8. Relies on health workers, including physicians, nurses , midwives, auxiliaries, community workers , as well as traditional practitioners , suitably trained socially and technically to work as a health team.

14. ELEMENTS / COMPONENTS

15. 1. Education about prevailing health problems and methods of preventing and controlling them. 2. Promotion of food supply and proper nutrition . 3. An adequate supply of safe water and basic sanitation. 4 . Maternal and child health care, including family planning. 5 . Immunization against infectious diseases. 6 . Prevention and control of endemic diseases. 7. Appropriate treatment of common diseases and injuries. 8 . Provision of essential drugs .

16. PRINCIPLES

17. 1. Equitable Distribution First key principle Health services must be shared equally by all people irrespective of their ability to pay, and all (rich or poor, rural or urban) must have assess to the health services.

18. At present, health services are mainly concentrated in major towns and cities, and the worst hit are the needy and vulnerable groups of population in rural areas and urban slums and this is termed as 'social injustice '. Primary health care aims to shift the centre of gravity of health care system from cities to rural areas and bring these services to as near the people's homes as possible.

19. 2. Community participation: The involvement of individuals, families, and communities in promotion of their own health and welfare.

20. That is, the community must involve in the planning, implementation and maintenance of health services, besides maximum reliance on local resources such as manpower , money and materials.

21. In India we have village health guides and trained dais (mid-wives). They provide primary health care b overcoming cultural and communicatio barriers , in ways that are acceptable to th community .

22. In China, 'community participation is in the form of bare-foot doctors '.

23. 3. Intersectorial coordination ( Multisectoral approach): This is basically, planning with the other sectors to avoid unnecessary duplication of activities .

24. “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".

25. The major reason for lack of success of many oral health programs is the fact that they operate in isolation, separate from general health care structure. Oral health could better be integrated into general health programs by tackling common causes , by including oral health in general health education.

26. 4. Appropriate technology: Appropriate technology has been defined: " technology that is scientifically sound, adaptable to local needs , acceptable to those who apply it and those for whom it is used, that can be maintained by the people themselves in keeping with the principle of self reliance with the resources the community and country can afford".

27. This applies to using costly equipments, procedures and techniques when cheaper , scientifically valid and acceptable ones are available .

28. The technology should also be: # Effective # Acceptable to those who apply it # Acceptable to those who use it # In keeping with local culture # Capable of further development # Simple to design and use # Easily understood by people # Easily understood by health volunteers

29. 5. Focus on prevention: This means that the health services should however not only be curative but should also promote health and healthy lifestyles with emphasis on prevention . Eg : immunization

30. In Summary We have seen, the origins of PHC definition Characteristics Elements And functions of PHC in any country.