PRIMARY HEALTH CARE

Overview
 Introduction

 Definition of primary health care

 Principles of primary health care

 Elements of primary health care

 Levels of health care

 Functions of primary health care

 IPHS standards of PHC

 Summary
PRIMARY HEALTH CARE
Introduction
 Health – basic human right

 Health is defined as “a state of complete physical,

mental and social well-being and not merely the
absence of disease or infirmity.”

- Constitution of W.H.O, 1948

- If this health has been universal..????

Health situation during the early 20th
century..!!!
Disparities in health service provision- inter/intra
country; urban oriented
Hospital based health care system

FAILURE OF HEALTH
Expensive, complex, available only for privileged
Advanced science and technology could not bring
SYSTEM
the best advantage to all people
Lack of emphasis on prevention; curative

Poverty, Malnutrition and disease- vicious cycle

Lack of peripheral health workers

Birth of Primary Health Care
Comprehensive Health care - Bhore Committee, 1946
Provision of integrated preventive, curative, promotional health services from
womb to tomb to every individual residing in a defined geographic area
First committee to emphasize the need for Primary health centre in India

Basic Health services, 1965

Network of co-ordinated, peripheral & intermediate health units capable
of performing effectively a selected
group of functions essential to the health of an area

Primary Health Care, 1978

Health for All by 2000 AD
 Definition of Primary Health Care
“ Primary health care is essential health care made
universally accessible to individuals and acceptable to
them, through their full participation and at a cost
community and country can afford ”.
-Alma-Ata international conference, 1978.
Equitable distribution
Community Participation
Community Participation
Intersectoral co-ordination
Agricult
ure
Voluntar Animal
y health husband
Agencies ry
To achieve such cooperation, countries may have to
review their administrative system, reallocate their
resources
Transporand introduce suitable legislation to ensure
Food
t
that coordination can take place. This requires strong
political will to translate values into action. An
important element of intersectoral approach is
Health
planning
Municip
- planning with other sectors to avoid
Fisheries
unnecessary
ality duplication of activities.

Informat
Public ion &
works broadcas
ting

Commun Educatio
ication n
Appropriate technology
 Appropriate technology has been defined as "technology that is
scientifically sound, adaptable to local needs, and acceptable to
those who apply it and those for whom it is used, and 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“
 Soft- change in behaviour through advocacy and social
participation
 Hard- engineering designs, manufacturing materials &
equipments; affordable and locally available
 Egs: ORS, Growth chart, Shakir’s tape, IFA, DDK
Appropriate technology
Elements of Primary Health Care
Treatment of
the prevailing
diseases
Essential Water and
Medicines Sanitation

Promotion of
Education Elements Nutrition and
food supply

Prevention of Maternal and

locally endemic
child health
disease

Immunisation
 Levels of Health care
 Primary care level
Village level, sub centre, PHC

 Secondary care level

CHC, DH

 Tertiary care level

Medical colleges, regional level, all India institutes.
 Primary health care in India
 Village level.

 Sub-centre level.

 Primary health centre.

 Functions of Primary Health Care
 Medical care
 MCH care including family planning
 National health programmes
 Prevention and control of endemic diseases
 Laboratory services
 Safe water supply and basic sanitation
 Collection and reporting of vital statistics
 Health education
 Training –HW / ASHA etc
 Referral services
Indian public health standards for
Primary health centre
Indian public health standards for
PHCs
 20,000-30,000 population, with 6 beds.

 Medical care

 MCH care

 Family planning services

 MTP services

 Nutrition services

 Health education
Indian public health standards for
PHCs
 National health programmes
 School health services
 Adolescent health services
 Prevention and control of endemic diseases
 Reporting of vital events
 Promotion of sanitation
 Testing water quality
 Training
Indian public health standards for
PHCs
 Basic laboratory services

 Monitoring and supervision

 Selected surgical procedures

 Maternal death review

Conclusion
 PHC not a complete success

 But still, made an advent to reduce the inequalities in

health system

 Primary Health centres were strengthened.

 It generated a mass movement for managing the health of

the community and a basis for holistic community health
development, which is still relevant.
Summary
REFERENCES
 Park K. health care of the community. Preventive and
social medicine.25th edn. Jabalpur: Bhanot
Publishers.2019.950-55.

 AM Kadri, Ankit Sheth, Anupam Banerjee. Managing

Community Health. IAPSM book of Community Medicine.
1st edn. New Delhi: Jaypee Brothers Medical Publishers.
2019. 928-33
THANK YOU 