Primary Health Care

Dr Aboelez Hassan
Ibrahem
Community medicine
department
‫جنيف‬
 KAZAKHSTAN \ ALMA ATA

 aAA
 DEFINITION OF HEALTH

 Health is state of complete ,physical, mental

and social wellbeing and not merely an
absence of disease or infirmity.

WHO 1948
CONCEPTS OF HEALTH CARE
 Provision of services by health personnel It
includes:
 Promotion

Prevention

 Diagnosis
Treatment

 Rehabilitation
 LEVEL OF SERVICES
 At community level ;
➢ Mid wives

➢ Community health workers

 At health facilities;
➢ Medical assistance

➢ Doctors
PHC HISTORY

 WHO’s Constitution 1946

 Health for All by the year 2000 (Assembly) 1977

 International Conference on Primary 1978

Health Care (Alma – Ata)
MILE STONES:
WHA 1977
 The 30th World Health Assembly Comes with new
philosophies:
• Social justice and equity are essential for health
• Recognition of the role of community
participation
• The importance of the political will
• The relation between health and development
(health is essential for development and
development is essential for health)
HFA

 The ideas concluded in the international

objective of Health for All

 Definition of HFA: Attainment by all peoples of

the highest level of health that permit them to
lead socially and economically productive life
FUNDAMENTAL PRINCIPLES FOR HEALTH FOR
ALL

1. Health is fundamental human right and a worldwide social goal

2. Health is an integral part of development

3. The existing gross inequality in the health status of people is of

common concern to all countries and must be drastically reduced.
4. People have the right and the duty to participate individually and
collectively in the planning and implementation of their health care

5. Governments have a responsibility for the health of their people

6. Countries must become self-reliant in health matters.

7. Fuller and better use must be made of the world’s resources to

promote health and development.
ALMA-ATA CONFERENCE (1978)

 proclaimed PHC
as way to
achieving HFA
PRIMARY HEALTH CARE
 It is the first level of
contact of individuals,
the family and the
community with the
national health
system, bringing
health care as close
as possible to where
people live and work
PRIMARY HEALTH CARE (PHC)

• PHC
is essential health care based on practical,
scientifically sound and socially acceptable
methods and technology made universally
accessible to individuals and families in the
community through their full participation
and at a cost that community and the
country can afford … (Alma-Ata, 1978)
PHC

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.

Social Environments Employment /

Income & Social Status
Working Conditions

Culture Physical Factors Social Support Networks

Prenatal / Early Childhood

Level of Education
Experiences
 PHC
It 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
 PRIMARY HEALTH CARE
 Services are generally provided in the community
 Some services are also provided in hospitals
 PHC
 Primary health care is an
approach that more broadly
addresses illness prevention
and health promotion.

 It encompasses determinants
of health, such as the
influence of culture, education
and income on health and well-
being.
 PRIMARY HEALTH CARE
 Varies 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.
COST
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 stable economy
 PRINCIPLES OF PRIMARY HEALTH CARE
Principled health care improvements required
based on Declaration of Alma Ata: 1978

 Universal access
 Health equity
 Community
participation
 Inter-sectoral actions

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PRIMARY HEALTH CARE REFORM

Medical model Primary Health Care

 Treatment  Health promotion

 Illness  Health

 Cure  Prevention, promotion, cure

 Episodic care  Continuous care

 Specific problems  Comprehensive care

 Individual practitioners  Teams of practitioners

 Health sector alone  Intersectoral collaboration

 Professional dominance  Community participation

 Passive reception  Joint responsibility

 E L E M E N T S OF PHC

 E – Education
 L – Local and endemic diseases prevention

 E – Expand Program of Immunization ( EPI)

 M– Maternal and child health including ( FP)

 E - Essential drugs

 N – Nutrition

 T – Treatment of common diseases and injury

 S - water and Sanitation

(SECONDARY) ELEMENTS OF PHC
• Mental Health
• Care of elderly
• Occupational Health
• School Health
• Reproductive Health
• Adolescent Health
 Challenges of PHC
Lack of community participation
Lack of inter-sectoral collaboration
Lack of inter-country collaboration
Lack or misuse of human and material resources
Lack or Mismanagement
Lack of operational researches
PRIMARY HEALTH CARE

Working
together for
better health
THANK YOU