PRIMARY HEALTH CARE

OCTOBER 22, 2020.

Dr Asad

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After attending this
lecture you will be able
to:

Define Primary Health Care

Differentiate the levels of
health care
Describe the healthcare
referral system
Explain the elements of PHC
Describe the principles of
PHC
Evaluate the Primary Health
Care system in Pakistan

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 PRIMARY HEALTH CARE
The 1st level of contact of
individual, the family and
community with the national
health system, where primary
or essential health care is
provided. Its close to the
people, where most of their
health problems are dealt with
& resolved, area’s needs &
limitations are taken into
account – BHU, RHCs.

 SECONDARY HEALTH CARE

The next higher level, where
more complex problems are
dealt with – DHQ Hospitals.

 TERTIARY LEVEL
More specialized, requires
specific facilities & attention of
highly specialized health
workers. Provided by the
regional or central level
institution - medical college
hospitals, specialized hospitals,
other apex institutions.
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 REFRRAL SYSTEM
A fundamental & necessary function of
health care system is to provide a SOUND
REF SYSTEM
It must be a 2-way exchange of
information & returning patients to those
who ref them for follow up care.
IT ENSURES CONTINUITY OF CARE &
INSPIRE CONFIDENCE OF THE PATIENTS IN
THE SYSTEM
But this system is still VERY WEAK IN
PAKISTAN

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 Came into existence
in 1978 following an
international
conference at
ALMATY
 Previously known as PHC
BASIC HEALTH
SERVICES
 A RELATIVELY NEW
APPROACH

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 PHC
“ PHC is essential health care
made universally accessible
to individuals and acceptable
to them, through their full
participation and at a cost
the community and country
can afford “

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 PHC is equally valid for all
countries from the most
to the least developed
although it takes various
forms in each of them
 The concept has been
accepted by all countries
PHC
 Health for all by year
2000 was the motto
 Afsoooooooos [not
accomplished]

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 Education concerning
preventing health problems
& the methods of
preventing & controlling
them
 Promotion of food supply &
proper nutrition
 An adequate supply of safe
water & basic sanitation
PHC – 8
 Maternal & child health
care, including family ESSENTIAL
planning
 Immunization against major ELEMENTS
infectious diseases
 Prevention & control of
locally endemic diseases
 Appropriate treatment of
common diseases & injuries
 Provision of essential drugs
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1. EQUITABLE DISTRIBUTION

The first key principle of health

care strategy is EQUITY OR
EQUITABLE DISTRIBUTION of
health services - health services
should be shared equally by all
people irrespective of their
ability to pay, and all [rich or
poor, rural or urban] must have
access to health
PHC –
Social injustice due to the
concentration of health svs in
4 PRINCIPLES
major towns, presently be
rectified
PHC aims to redress this
imbalance from cities [where ¾
of health budget is spent] to the
rural areas [where ¾ of the
population lives] near to their
homes
Inverse Care Law

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2. COMMUNITY
PARTICIPATION, AN
ESSENTIAL INGREDIENT OF
PHC
Involvement of individuals,
families, & communities in
promotion of their own
health & welfare
There must be a meaningful
& continuous involvement of PHS -
the community in the
planning, implementation &
maintenance of health
PRINCIPLES
services
Maximum reliance on local
resources ; manpower,
money, & material
PHC should be built on the
principle of community
participation or involvement

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3.INTERSECTORIAL
COORDINATION
The ALMA ATA declaration
states that PHC involves in
addition to the health sector,
all related sectors & aspects
of national & community
development, in particular
agriculture, animal
husbandry, food, industry,
education, housing, public
works, communication and PHC -
other sectors
To achieve this, review in
administrative structure &
PRINCIPLES
reallocation of resources is
required
Appropriate legislation, to
ensure coordination
Coordinated inter sectoral
planning to avoid
unnecessary duplication of
activities

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4. APPROPRIATE
TECHNOLOGY
Is defined as “ technology that
is scientifically sound, adaptable
to local needs, & acceptable to
those who apply it & for whom PHC -
it is used & that can be
maintained by the people PRINCIPLES
themselves in keeping with the
principle of self reliance with
the resources the community &
the country can afford

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Discussion/ Arguments by class

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 PHC – status in Pakistan
Discussion by class ;
Is it
satisfactory ?? What
improvements are
needed. Can the goal
be achieved in another
10 yrs?

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Always be kind and
clement to others

thanks

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HOME GROWN
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