Primary Health Care Rukhsana.M.Haroon (PHC) : 22 September 2019

PRIMARY HEALTH CARE
Rukhsana.M.Haroon
(PHC)
22 September 2019
Contents
• At the completion of this unit, students will be able to:
• 1Explain Alma Atta Deceleration “Health for All by the

Year 2000”and beyond.
• 2. Define Primary care and PHC
• 3. Describe the five basic principle of PHC
• 4. Explain the elements of PHC in relation to health
• 5. Discuss application of PHC in Pakistan
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Emergence of PHC
• 28th World Health Assembly 1975 in Geneva the
global situation of the world’s health was judged to
be unhealthy and unjust.
• 30th World Health Assembly 1977 officially

movement begin.
• 12th September 1978 delegates from 134 nation

including Pakistan met in Alma At USSR Union of
Soviet Socialist Republics (they committed
themselves and heir resources to the
achievement of HEALTH FOR ALL By year 2000
through PHC (HFA/2000)
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Health For All (HFA)
DEFINITION
‘’ The attainment of a level of health that

will enable every individual to lead a
socially and economically productive life,,
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Strategy
• The basis of HFA strategy is PHC.
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Principles(HFA)
1. Strong political will.
2. Right and duty of the people to
participate in development of health.
3. Duty of health professionals to provide
relevant information to the public.
4. Self- determined with community.
5. Equitable distribution of health resources.
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6. Preventive and promotive measures with
well integrated with curative and rehabilitative
care.
7. Health services research and speedy

application of finding of research.
8.Social orientation of health workers to

community people
9.Appropriate technology.
10.Coordinatrd efforts of health sector and

other socio economic sectors.
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PHC
• “Primary health care is essential health car
e based on practical, scientifically sound a
nd socially acceptable method and technol
ogy made universally accessible to individ
ual and families in the community through
their full participation and at a cost which
the community and country can afford to
maintain at every stage of development in
the sprit of self reliance and self determina
tion”
22 September 2019
Alma ata Declaration
An international conference on Primary health
Care was held in Alma-Ata
Capital of Kazakh Soviat socialist Republic
from September 6-12 1978. It was attended
by delegates from 134 nations including
Pakistan They committed themselves and
their resources to the achievement of
HEALTH FOR ALL
By year 2000 through PHC (Roy 1988).
22 September 2019 9
In accordance with the decision of the
WHO assembly and the Executive
Board of the UNICEF declaration stated
that Primary Health Care includes at
least:
1. Education about prevailing problems
and methods of preventing & controlling
them.
2. Promotion of food supply and proper
nutrition.
3. An adequate supply of safe water and
basic sanitation.
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4. Maternal and child health care
including family planning services.
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.
Alma Ata Declaration 1978
1 Health is a fundamental human right and
that the attainment of highest possible
level of health is a most important world
wide Goal.
2 The inequity in the health status of people
is politically, economically and socially
unacceptable and therefore of common
concern for all.
3 Health is directly proportional to economic
and social development.
.
4 The people have the right and duty to

participate in the planning and
implementation of their health care.
5 GOVT has a responsibility for the health of

their people, which can be fulfilled by the
provision of adequate health and social
measures.
6 PHC is essential health care based on
practical, scientifically sound and socially
acceptable methods and technology.
.
8 All GOVT should formulate national policies,

strategies and plans for implementing PHC.
9 All countries should help each other for
promoting PHC
10 An acceptable level ”HFA” of the world by
the year 2000 could be attained through a
fuller and better use of world's resources.
(but it wasn’t)
11 Revised HFA policy on HFA in 21st century.
Definition of PHC
“PHC is essential health care based on
practical scientifically sound and acceptable
methods and technology made universally
accessible to individual and families in the
community through their full participation and
at a cost which the country and community
can afford to maintain at every stage of their
development in the spirit of self-reliance and
self-determination”
Types of PHC
• Selective PHC:-
This approach to PHC is best
represented by well
known UNICEF components of GOBI
(Growth monitoring, ORS, Breast
feeding and Immunization)
• Comprehensive PHC:-
When along with GOBI other services
are also provided like Antenatal,
Family planning, Treatment of Disease
e.g. T.B. etc.The PHC program is said
to be comprehensive.
• Integrated PHC:-
.
When a health program along the essential

components GOBI) and services like:
Maternal care etc are involved.

and when it also include services from other
sectors like:
water, sanitation, female literacy etc,then it
is called as integrated PHC Program.
Characteristic of primary
health care
• The main characteristics of primary health

care have been identified as;
• ACCESSIBILTY:It service not withstanding
social, cultural or geographic barriers. Primary
health care infusers uniformity to reach
equitably to all segments of papulation.
• ACCEPTABILITY; Is measure of community
approval
• ADAPTABILTY; is a measure of flexibility,
denoting the ability of a system to permit
alteration and modification.
• AFFORDABILITY; Signifies the financial and
economic dimension of health care system.
• AVAILABILITY; Is a time function, demanding
round-the-clock presence of a services.
• APPROPRIATENESS; Is a measure of
relevance in terms need and demands of their
consumers.
• CLOSENESS; Is a measure proximity between
the providers and consumers of services.
• CONTINUITY; Services is a measure of its
length of association.
• COMPREHENSSIVENESS; It is a
measure of its ability to meet the total
needs of a community.
• COORDINATIVENESS; It is a measure of
participation, cooperation and involvement’
ELEMENTS OF PRIMARY
HEALTH CARE
• As per Alma Ata declaration primary
health includes at least;
• (a) Education concerning prevailing
health problem and controlling them.
• (b) Promotion of food supply and
proper nutrition.
• (c) An adequate supply of safe water
and basic sanitation.
• (d) Maternal and child health
care including family planning.
• (e) Immunization against the
major infection diseases.
• (f) Prevention and control of
local endemic diseases.
• (g) Appropriate treatment of
common diseases and
injuries.
Principles of primary health care
• Equitable Distribution
• Manpower development
• Community participation
• Appropriate technology
• Multisectoral approach
22 September 2019
Equitable Distribution
• Health services must be shared equally by
all people irrespective of their ability to pay
, and all the people rich or poor ,rural or ur
ban must have access to health services
22 September 2019
Manpower development
• Primary health care aims at mobilizing the
human potential of the entire community b
y making use of available resources .
• Vigorous action to be taken to ensure avail
ability of adequate number of approprate h
ealth personnel required to devise and imp
lement plan of action
22 September 2019
Conti….
• this would require reorientation of existing
health workers ,development of new categ
ories of workers in health and related sect
ors and motivation and training of all manp
ower to serve the community .
22 September 2019
Community participation
• Community involvement is concerned with
the level of community resident participatio
n in health decision making . To promote t
he development of the community and the
community’s self reliance , residents them
selves need to participate in decisions abo
ut the health of the community .
• Residents and health providers need to work together in
partnership to seek solutions to the complex problems fa
cing communities today
22 September 2019
Appropriate technology
• Health care that is relevant to people’s hea
lth needs and concerns , as well as being
acceptable to them . It includes issues of c
osts and affordability of services within the
context of existing resources as the numb
er and type of the health professionals and
other workers, equipment , and their patter
n of distribution throughout the community
.
22 September 2019
Conti…
• Appropriate technology means those whic
h are decentralized, require low capital inv
estment, conserve natural resources, are
managed by their users
22 September 2019
Multisectoral approach
• Health and family welfare programs canno
t stand on its own in an isolated manner. It
is recognized that the health of the commu
nity cannot be improved by intervention wit
hin just the health sector , other sectors ar
e equally important in promoting the comm
unity's health and self reliance .
22 September 2019
Role of Nurses in Primary
Health care
• health promotion
• illness prevention
• midwifery, antenatal and postnatal care
• treatment and care of sick people
• rehabilitation and palliation
• community development
• population and public health
• education and research
•22 September
policy 2019development and advocacy.
FUNCTION OF PRIMARY HEALTH
CARE
 Health education
 Nutrition
 Personal hygiene
 Sanitation and water
 Spiritual value
 Treatment
 Promotion of mental health.
 Provision of essential drugs.
PROBLEM OF PRIMARY
HEALTH CARE
• Lack of control communicable diseases
• Lack of proper environment for recording
• Controlling and complaining of vital data.
• Lack of adequate maternal health care and
child welfare services.
• Lack of adequate finance and administration
machinery.
References
• www.who.int/publications/almaata_declaration
_en.pdf
• www.who.int/social_determinants/tools/multi
media/alma_ata/en
• www.who.int/topics/primary_health_care/en
• Ansari.I.M.,(2003) community medicine an
d public health.(6th ed).
22 September 2019
Thank you
22 September 2019

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PRIMARY HEALTH CARE

• 1Explain Alma Atta Deceleration “Health for All by the

• 30th World Health Assembly 1977 officially

• 12th September 1978 delegates from 134 nation

‘’ The attainment of a level of health that

7. Health services research and speedy

8.Social orientation of health workers to

10.Coordinatrd efforts of health sector and

4 The people have the right and duty to

5 GOVT has a responsibility for the health of

8 All GOVT should formulate national policies,

When a health program along the essential

Maternal care etc are involved.

• The main characteristics of primary health

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