Primary Health Care Packages

Getachew W/Yohannes(Ph.D)
 Session description

 This session is designed to update the knowledge of

the trainees on concepts of primary health care
service delivery and their efficiencies
 Learning objectives

 Define Primary Health Care and state its importance

 State the components of PHC service delivery
 Identify the role of PHC in addressing Universal
Health Coverage
 Discuss about primary Health Care Efficiency
 Brain storming questions

 Time allocated: 10 minutes

 How do you conceptually understand the primary
Health Care Service Delivery?
 What components of PHC services are lacking in your
health institution?
Introduction: Ethiopian Health Tire
System
 What is Primary Health Care?

 Primary Health Care is the lowest level of essential

health care that provided to the majority of the
population of Ethiopia at a cost that the country and
the community could afford.
 Adopted as a national strategy since 1976.
What were the special emphasis?

 Prevention and control of communicable diseases,

 The promotion of health and wellbeing of individuals
and families,
 Self-reliance and community participation
Principles of Primary Health Care

Accessibility (equal distribution):

 All the people of the community irrespective of their
race, creed or economic status must equally share
healthcare services.
 This concept helps to shift the accessibility of
healthcare from the cities to the rural areas
 Principles….

Community participation
 Meaningful involvement of the community in
planning, implementing and maintaining their health
services
 Through the involvement of the community,
maximum utilization of local resources, such as work
force, money and materials, can be utilized to fulfill
the goals of PHC.
 Principles..

Appropriate technology:
 Technology that is scientifically sound, adaptable to
local needs, and acceptable to those who apply it and
for whom it is used.
 Principles…

Inter-sectorial collaboration:
 To be able to improve the health of local people the
PHC programme needs not only the health sector, but
also the involvement of other sectors, like agriculture,
education and housing.
 Essential Packages of PHC

E – Education for Health

L – Locally endemic disease control
E – Expanded program for immunization
M – Maternal and Child Health including responsible parenthood
E – Essential drugs
N – Nutrition
T – Treatment of communicable and non-communicable diseases
S – Safe water and sanitation
Elements incorporated after Almata

 Oral Health
 Mental Health
 The use of traditional medicine
 Control of ARI
 Control of HIV/AIDS and other STDs
 Occupational health
The 21st century definition for PHC

 “PHC is a whole of society approach to health that

aims at ensuring the highest possible level of health
and wellbeing and their equitable distribution by
focusing on people’s needs and as early as
possible….
 The 21st century…

 along the continuum from health promotion and

disease prevention to treatment, rehabilitation and
palliative care, and as close as feasible to people’s
everyday environment.” (WHO and UNICE. A vision
for PHC in the 21st century: Towards UHC and the
SDGs).
Why is Primacy health care important?

 It is the corner stone of a sustainable health system

for UHC, Health related Sustainable Development
Goals (SDGs) and health security.
 PHC is the most inclusive, equitable, cost effective
and efficient approach to enhance peoples physical
and mental health as well as social wellbeing.
 Why…..?

 Across the world, investment in PHC improve equity

and access, health care performance, accountability
of health system, and health outcomes.
 PHC is also critical to make health systems more
resilient to situations of crisis, more proactive in
detecting early signs of epidemics and more prepared
to act early in response to surges in demand for
services.
 Why….?

 PHC is still the front door of the health system and

provides the foundation for the strengthening of the
essential public health functions to confront public
health crises such as COVID-19.
Primary Health Care Efficiency

 Efficiency: An attribute of performance measured by

examining the relationship between a specific
product of the health care system (also called an
output) and the financial value of the resources used
to create that product (also called inputs).
 A primary health care facility would be efficient by
maximizing output for a given set of inputs or to
minimize inputs used to produce a given output.
Primary Health Care Efficiency

 Some health centers had high spending but low

output, which may indicate inefficiency in resource
use such as over staffing relative to utilization rates.
 Other health centers appear to be more efficient with
low levels of spending relative to output
Mechanisms of increasing efficiency

 Conducting site visits to health facilities that were

found to be least and most efficient to understand
factors influencing findings.
 Improve data collection done by health facilities (this
will also facilitate in the improvement of the planning
and budgeting process).
 Identify areas to strengthen the information system
and improve data quality.
 Mechanism…

 Use the Service Provision Assessment Plus (SPA+)

survey data to conduct a more representative,
comprehensive efficiency analysis.
 Conduct analysis to estimate allocative efficiency for
health centers and primary hospital(Measuring
Efficiency of Public Health Centers in Ethiopia:
FMOH.2016).
 Small Group discussion

 Topic: PHC efficiency: how do you maximize outputs

within a given set of inputs?
 Objective: to enable participants develop a list of
mechanisms of increasing PHC service delivery
efficiency

 Time: 30 minutes
 Group number: 4-6
 Competency: Knowledge, communication skill
 Session Summary

 Primary health care (PHC) is considered the path or

mechanism for Ethiopia to achieve UHC as outlined in
the country’s 20-year health sector strategy,
“Envisioning Ethiopia’s Path towards universal health
coverage through Primary Health Care”.
 Session summary

 This strategy outlines strategic areas of focus to

ensure a quality and equitable health system that is
sustainable, efficient, and adaptable to meet the
health needs of a changing population between now
and 2035.