PRIMARY HEALTH CARE

HEALTH CARE :- It is defined as multiple services rendered to individuals, families or communities

by the agents of health services or professionals for the purpose of promoting, maintaining,
monitoring or restoring health.

LEVELS OF HEALTH CARE

1) Primary level health care

2) Secondary level health care
3) Tertiary level health care

PRIMARY HEALTH CARE:-

 This is the first level of contact between the recipient of care and the health care delivery
system. Majority of the problems at this level are solved by the people with some assistance
and guidance of health workers.
 In rural area these services are given by the means of sub centres, PHC and CHC.
 In urban areas these services are given by maternal child health and family welfare centres
and dispensaries.

SECONDARY LEVEL HEALTH CARE:-

 At this level more complex problems are taken care mostly which require secondary level of
preventive services and curative services.
 These services are provided at district health centres/ hospitals.
 Those cases which cannot be handled at PHC or CHC are referred to district health centres.

TERTIARY LEVEL HEALTH CARE:-

 This level of health care is provided at the state/regional/central level institutions.

 These institutions serve as referral units for primary and secondary levels.
 They also serve as a teaching institution for education and training of various categories of
health care professionals.

PRIMARY HEALTH CARE:-Primary health care is essential health care and technology based on
practical scientifically sound and social acceptable methods and technology made universally
accessible to individuals and families in the community by means acceptable to them, through their
full participation and at the cost that the community and country can afford.

CONCEPT:-The concept of primary health care was introduced at international level jointly by
WHO and UNICEF at the Alma Atta conference in 1978 to achieve the goal of HFA(Health for all)
by the year 2000A.D

PRINCIPLES:-

1) EQUITABLE DISTRIBUTION Healthcare services must be equally shared by all the

people of the community irrespective of their race, creed or economic status. This concept
 helps to shift the centre of gravity of healthcare from the cities to the rural areas where the
most needy and vulnerable groups of the population live.
2) COMMUNITY PARTICIPATION In order to make the fullest use of local, national and
other available resources Community participation was considered sustainable due to its grass
roots nature and emphasis on self-sufficiency.
3) INTERSECTORAL COORDINATION
 Agriculture
 Education
 Communication
 Housing
 Public works
 Industry
 Community organizations.

4 ) APROPRIATE TECHNOLOGY

 Scientifically sound
 Effective
 Acceptable
 In keeping with local culture
 Capable of further development
 Simple to design, use and understand

5) FOCUS ON PREVENTION

 Promote health and healthy lifestyles with emphasis on prevention.

 Presently there are 23,109 PHCs in India.
 1156 of them are in Madhya Pradesh
 Out of which 10 comes under Bhopal district.

ELEMENTS OF PRIMARY HEALTH CARE:-

 Education to the people concerning prevailing health problems and methods of preventing
and controlling them.
 Promotion of food supply and proper nutrition
 Adequate supply of safe water and basic sanitation
 Maternal and child health care and family planning
 Immunization against the major infectious diseases
 Prevention and control of locally endemic disease
 Appropriate treatment of common diseases and injury
 Provision of essential drugs
 Principles of CHN:-
1) Recognized needs and functioning within the total health programme.
2) Clearly defined objectives and purposes of services
3) An active organized citizens group of the community group is an integral part of the
community health programme.
4) Community health nursing services are available to the entire community
5) Community health nursing recognized the family and community as units of service.
6) Health education and counselling for the individual, family and community are the integral
part of community health nursing.
7) Participation in planning relating to goals for the attainment of health.
8) The community health nurse should qualify as full-fledged nurse.
9) Based on the needs of the patient and there should be proper continuity of services to patients
10) Periodic and continuous appraisal and evaluation of health situation
11) The community health nurse should function/serve as an important member of the health
team.
12) There should be provision for qualified nurse to make supervision for community health
services.
13) The community health nurse directs the patient to appropriate community resources for
necessary financial and social assistance.
14) Should not accept gifts or bribes from the patients.
15) The community health nurse should not belong to one particular section or political group.
16) Community health agency should provide a continuing education programme for nurse
17) The nurses assume responsibilities of their own continuing professional development through
acquiring higher and higher education and forming and strengthening the professional
associations
18) The community health nursing services should develop proper guidelines, in maintaining
records and reports.
19) There should be proper facilities and job conditions.
20) The community health nurse should maintain professional relationship with all leaders in the
community and maintain ethics at all times.

SCOPE OF COMMUNITY HEALTH NURSING

1. HOME CARE
2. NURSING CARE
3. MCH & FAMILY PLANNING
4. SCHOOL HEALTH NURSING
5. COMMUNITY HEALTH NURSING
6. INDUSTRIAL HEALTH NURSING
7. DOMICILIARY NURSING SERVICES
8. MENTAL HEALTH NURSING
9. REHABILITATION SERVICES
10. GEDIATRIC HEALTH NURSING
1) We are providing nursing care to the actual situation of home .history taking, physical
examination, assess the characteristics of illness, provide nursing care & treatment,
providing health education to the family
2) Nursing home provides health care mainly medical & nursing care to the individual &
family .they provides the facilities more than other hospitals & charges less fees
3) Periodic care is provided to the mother & child during antenatal, perinatal & postnatal
period
4) School health nurse provides care to the school going children. she provides following
care immunization,first aid,detection of diseases, sanitation health records
5) She provides care to the whole community through phc & clinics.
6) First aid care during emergency care,periodic health check up,care during sicknes period
etc
7) She provides care to the mother & child during the home delivery
8) She provides care to the mentaly ill persons mainly in psychiatric hospitals
9) Community health nuirse works in rehabilitation centre & rehabilitate the patient who are
physically & mentally ill
10) She provides care to the old people mainly in medical & nursing care