GROUP ONE

COURSE: HEALTH CARE SYSTEM

PRESENTATION ON PRIMARY HEALTH CARE
PRIMARY HEALTH CARE

Primary Health Care is essential health care which is

made universally accessible to individuals and families
in the community by means acceptable to them
through their full participation, and at a cost that the
community and country can afford. It
forms the nucleus (central part) of the country’s
health system.
CONT.
 
This ideal model of health care was adopted in the
declaration of the International Conference on Primary
Health Care held in Alma Ata, Kazakhstan in 1978 (known
as the "Alma Ata Declaration"), and became a core concept
of the World Health Organization's goal of Health for all.[6]
 The Alma-Ata Conference mobilized a "Primary Health
Care movement" of professionals and institutions,
governments and civil society organizations, researchers
and grassroots organizations that undertook to tackle the
"politically, socially and economically unacceptable" 
health inequalities in all countries.
  DEFINITION BY WORLD HEALTH ORGANISATION
[WHO], 2003

It is the socially appropriate, universally accessible,

scientifically sound first level care provided by a
suitable trained workforce supported by integrated
referral system and in a way that gives priority to
those most need, maximises community and
individual self – reliance and participation and
involves collaboration with other sectors.
CONT.
The ultimate goal of primary health care is better health for
all. WHO has identified five key elements to achieving that
goal:
reducing exclusion and social disparities in health
(universal coverage reforms);
organizing health services around people's needs and
expectations (service delivery reforms);
integrating health into all sectors (public policy reforms);
pursuing collaborative models of policy dialogue (leadership
reforms); and
increasing stakeholder participation.
 
Essential Terms in the Definition of Primary Health
Care

Essential: Health service is important or peculiar to meet the health

needs of the people
Accessible: Bringing the health service very near or at easy reach to
the people in the community
Universal: Health service is provided to everyone, that is, to all
nations, races, ages and sexes.
Acceptable: The service provided should be acceptable and used by the
people. The health worker should be sensitive to the reaction of the
people in order to assess the acceptability of the services.
Available: The service must be easy to get or available for every
individual to assess.
Affordable: The nation, community, family and the individual should
be able to afford the health service provided.
 
Reasons for Primary Health Care in Ghana

Emphasis was placed on construction of health facilities

rather than provision of health service and therefore failed to
control common endemic diseases effectively.
There was the training of sophisticated health personnel,
such as doctors, nurses, pharmacists, technologists, and so
on, most of which were designed to work in the hospitals in
the urban areas at the disadvantage of the rural areas who
form a greater proportion of the population, and who
contribute greatly to the nation’s development.
Inadequate and inequitable distribution of the health staff
and equipment in the health institutions across the country.
CONT:
Health services were more curative than preventive and
had failed to decrease the unnecessary deaths of children
under one year, and also failed to control endemic diseases.
There was a top - down health care delivery. This means the
hospitals catered for only 30% of the total population in the
cities and towns, and the rural people which form 70% were
deprived of basic health care.
There was lack of community involvement and
participation in the own health care
Lack of collaboration with the other sectors e.g. health
related agencies and other government ministries.
Main Objectives of Primary Health Care
By the year 2000, the following main objectives were
to be achieved:
To prevent or treat conditions which cause
unnecessary ill health, disabilities and death in the
community
To increase community participation as much as
possible in the health care delivery
Components of primary health care
Health Education on Prevailing Problems and Prevention of diseases
 
 Promotion of Food Supply and Proper Nutrition
 
 Promotion of Environmental Hygiene
 
 Maternal and Child Health, and Family Planning
 
 Prevention and Control of Local Endemic Disease.
 
 Immunization against Communicable Diseases
 
Provision of Essential Drugs
 
 Appropriate Treatment of Common Diseases
 
 Basic Health Education

Rehabilitation and Prevention of Accidents:

 Mental Health
Levels of Primary Health Care

LEVEL A- COMMUNITY LEVEL

Staff of Level A
Traditional Birth Attendant (TBA)
Community Clinic Attendant (CCA) or Village Health
Workers (VHW)
Community Based Distributors
Level B- Health Centre

STAFF OF LEVEL B
Medical assistant is the leader
The community health nurse - midwife
Enrolled nurse - midwife
Disease control assistant
Nutrition assistant
Supporting staff
FUNCTIONS OF LEVEL B

Training and technical supervision of level A

 Diagnoses and treatment of diseases and injuries
 Immunization of children and pregnant women
Supervision of pregnant and delivery, identification of
high risks and refer
Collection of data from both levels B and A, and
collating to level C
CONT:
Control of communicable and common diseases
Ensuring food, water and environmental protection
Acting as liaison between level C and A
Level B serves as a point of contact with MOH
It serve as first referral point for level A
 
LEVEL C OR THE DISTRICT LEVEL

Staff of Level C
District Director of the Health Services
The District Public Health Nurse
The District Disease Control Officer
The District Nutrition Officer
Other members
FUNCTIONS OF LEVEL C

Most of their activities are supervisory and include:

Planning budgeting and general management of the
district health service
Supervision of level B staff
Provision of technical expertise
Taking care of the referrals from level B.
 
 
PRINCIPLES OF PRIMARY HEALTH CARE
Equitable Distribution of Health Services
Community Participation
Appropriate Technology
Multi-sectorial Approach
Focus on Prevention
 
THE PROBLEMS OF PRIMARY HEALTH CARE

The problems associated with the practicality of the

Primary Health Care should not be overlooked. These
can be categorized into:
CONT.
Peculiar problems of staff at level A
 Inadequate staff recruitment
 Lack of commitment which can be at the individual or
government level
 Shortage of appropriate staff (favoritisms)
 Lack of manpower training and development
2. INFRASTRUCTURE PROBLEMS

 Poverty in the aspect of the community

 Poor road network
SOCIO-ECONOMIC PROBLEMS
 Lack of incentives
 Shortage of funds
 Lack of materials and equipment
 Inadequate inter-sectoral collaboration