GOLLIS UNIVERSITY

(Berbera Campus)
CHAPTER FOUR

PRIMARY HEALTH CARE

Introduction:

Primary health Care is essential health care that is a socially appropriate,

universally accessible, scientifically sound first level care provided by a suitably
trained workforce supported by integrated referral systems and in a way that
gives priority to those most in need, maximizes community and individual self-
reliance and participation and involves collaboration with other sectors.

LEVELS OF HEALTH CARE

1) Primary Health care

2) Secondary Health care
3) Tertiary Health care

PRIMARY HEALTH CARE

In primary Health care the “first” level of contact between the individual
and the health system.
Essential health care (PHC) is provided.
A majority of prevailing health problems can be satisfactorily managed.
Provided by the primary health centers.

Secondary health care

More complex problems are dealt with.

Comprises curative services
Provided by the district hospitals

Lecturer: Mohamed Mohamoud Duale (Akram) 1

Course: Community Health Development
 The 1st referral level

Tertiary health care

Offers super-specialist care

Provided by regional/central level institution.
Provide training programs (rehabs and re- arrangements)

COMPENANTS OF PRIMARY HEALTH CARE

Essential health care consisting of at least eight elements:-

A-Health education:

Health education is a social science that draws from the biological,

environmental, Psychological, physical and medical sciences to promote health
and prevent disease,

B- Provision of essential drugs

C- Immunization:

If a person immunized against a particular disease later comes into contact

with the disease-causing agent, the immune system is immediately able to
respond defensively

D- MCH/FP

F- Treatment of common diseases and injuries

F- Adequate supply of safe water

G- Communicable disease control

H- Food supply and proper nutrition

Additional elements incorporated after Alma Atta

I. Oral Health

Lecturer: Mohamed Mohamoud Duale (Akram) 2

Course: Community Health Development
J. Mental health

K. Use of tradition medicine

L. Occupational health

M. HIV (human immunodeficiency virus) / AIDS (acquired immunodeficiency

syndrome)

PRIMARY HEALTH CARE PRINCIPLES

Emphasized principles in PHC are

 Intersectoral collaboration – line ministries

 Community participation
 Appropriate technologies
 Equity
 Focused on prevention of disease and promotion of health

PRIMARY HEALTH CARE CHALLENGES

 There is rising cost of health care to levels incompatible with health

benefits observed
 Luck of excessive Medicalization and technicalities of HCS
 Extent of poor in developing countries is enormous

INDICATORS

Mortality is much higher than developing countries (IMR. Life expectancy)

Morbidity is also high
Over years very little has changed
Heterogeneous: mixture of public and nongovernmental activities to
provide modern and traditional activities
Free and low curative services

Lecturer: Mohamed Mohamoud Duale (Akram) 3

Course: Community Health Development
 Support of mental health hospitals, infectious control programs, water and
sanitation projects and other Public health activities
Allocations
Internal inefficiencies
Wasteful public programs of poor quality and inequity
Piecemeal effort to address identified problems
Luck of donor coordination
Week information system
Over centralization of resource
Lack of capabilities in key areas (health worker and drugs)

Lecturer: Mohamed Mohamoud Duale (Akram) 4

Course: Community Health Development