Primary Health Care

Ms. Alina Hameed

Lecturer
Lahore School of Nursing
The University of Lahore

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Learning Objectives
By the end of this session the learners will
be able to :
1. Define Primary care and PHC?

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 Primary Health Care – Definition
Primary Health Care is the first level of
contact with the health system to promote
health, prevent illness, care for common
illnesses, and manage ongoing health
problems.

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Primary Health Care- Definition
Primary Health Care extends beyond the
traditional health sector and includes all
human services which play a part in
addressing the inter-related determinants of
health.

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Primary Health Care- Definition
Primary Health Care includes:
Primary Care (physicians, midwives & nurses)
Health promotion, illness prevention;
Health maintenance & home support;
Community rehabilitation;
Pre-hospital emergency medical services; &
Coordination and referral to other areas of
health care.
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Primary Health Care – Definition
Primary Health Care is different in each
community depending upon:
Needs of the residents;
Availability of health care providers;
The communities geographic location; &
Proximity to other health care services in the
area.

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Primary Health Care - Benefits
PHC focuses on keeping people healthy &
addressing illness early so as to increase
probability of cure.
PHC is client focused.
Individuals have access to appropriate care.
Services are matched to community needs.
Targeted services will have a positive impact
on the utilization of health and social services.
Healthy communities with healthy people
contribute to a vibrant & stable economy.
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COMPREHENSIVE PRIMARY HEALTH
CARE
Complete physical, mental and social
wellbeing
Addresses issues of equity and social justice
Considers the impact of education, housing,
food and income
Acknowledges the value of community
development
Recognises the expertise of individuals over
their own health 8
COMPREHENSIVE PRIMARY HEALTH
CARE
Acknowledges other factors that contribute to
poor health including:
Social influences which look at the
Impacts of the key determinants of health
which leads to the social determinants of
health

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 Models of primary health care
Comprehensive Selective Medical model
View of health Positive wellbeing Absence of disease Absence of Disease
Locus of control over Communities and Health professionals Medical practitioners
health individuals
Major focus Health through equity Health through Disease eradication
and community medical interventions through medical
development interventions
Health care providers Multidisciplinary Doctors plus other Doctors
teams health professionals
Strategies for health Multi-sectoral Medical interventions Medical interventions
collaboration
Elements of PHC
1. Promotion of food supply, water supply and
sanitation.
2. Education about prevailing health problems
and methods of preventing and controlling
them.
3. Promotion of mental health
4. Immunization
5. Maternal and child health programs, including
family planning.
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Elements of PHC
6.Control of locally endemic diseases
7. Appropriate treatment of common
diseases and injuries
8. Provision of essential drugs

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Application of PHC in Pakistan
SELECTIVE PRIMARY HEALTH CARE
PHC implies that if one cannot afford to
offer universal coverage for even the most
basic of health care, one could offer
treatment & preventive strategies for the few
diseases identified as having the greatest
threat to mortality, & which are amenable to
prevention / cure at low cost.

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UNICEF proposed a selective approach
with emphasis on mother and child health
according to GOBI-FF which indicates:
o G: Growth monitoring
o O: ORS
o B: Breast feeding
o I: Immunization
o F: Family Planning
o F: Female Education

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SELECTIVE PRIMARY
HEALTH CARE
ADVANTAGES
o Donor friendly
o Elimination of selected disease
o Easy to plan & implement
o Is focused & have more impact
o Easy to manage & measure output
o Require limited resources
o Improve quality of services

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DISADVANTAGES
o Disease rather than health oriented
o Doesn’t ensure equity
o Top down decision making
o Neglect other problems
o Leads to outbreak
o Resources (tight) might not be available for
urgent needs (emergencies)
o Less community involvement– donor priority

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 References:
 Allender, J. A., &Spradley, B. W. (2010). Community Health Nursing:
Promoting and Protecting the Public's Health (7th ed.). Philadelphia:
Lippincott Williams &Wilkins.
 Anderson, E. T., & McFarlane, J. M.(2008). Community as partner: Theory
and practice in Nursing (5th ed.). Philadelphia: Lippincott Williams
&Wilkins.
 Basavanthappa, B. T. (2008). Essentials of Community Health Nursing
(2nd ed.). India: Jaypee.
 Clark, M. J. D. (1999). Community Health Nursing Handbook Value Pack.
Stamford: Prentice Hall.
 Hitchcock, J. E., Schubert, P. E., & Thomas, S. A. (2003). Community
Health Nursing: Caring In Action (2nd ed.). Clifton Park, NY:
Thomson/Delmar Learning.
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Hunt, R. (2001). Introduction to Community-Based
Nursing(2nd ed.). Philadelphia: Lippincott Williams &
Wilkins.
Naidu, K. M. (2010). Community Health Nursing. India:
Gyan Publishing House.
Park, J. E. (1989). Text book preventive and social
medicine (22nded.). India: Jabalpur.
Patney, S. (2008). Text Book of Community Health
Nursing. New Delhi: CBS.
Thornbory, G. (2009). Public Health Nursing: A Textbook
for Health Visitors, School Nurses and Occupational
Health Nurses. Chichester: Wiley-Blackwell.

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