Objectives

• define primary health care

• list out the elements of primary health care
• explain the principles of primary health care
• detail the roles and responsibility of Community health
nurse in primary health care
Definition of primary health
care
Definition
Elements of primary health care
• E: Education for health
• L: locally endemic disease control
• E: Expanded programme of immunization
• M:Maternal and child health
• E: Essential drug availability
• N: Nutrition
• T: Treatment
• S:Safe water sanitation
Equitable distribution
---Health services must be shared by all people
---irrespective of their ability to pay
--Individual with more need Should have
more treatment.
--- Shifting the centre of gravity
health care system from cities to rural areas
Community participation
Involvement of the community in planning, implementation &
maintenance of health services
• Example- Village health guide, ASHA. Anganwadi workers, Bare foot
doctors (China), TBA
Appropriate technology
---Technology that is suitable to local need & socially
acceptable , within financial limit and scientifically
recognized.
◇ “Placing people’s health in people’s hand”
Example-
ORS (as i it is socially/ acceptable & financially
feasible instead of IV fluids)
Focus on prevention
.
Main Focus of primary health care is not the treatment
but the prevention.
New policy for
Primary Health Care
Primary health care
infrastructure
Infrastructure of Rural Primary Health
care
• Population coverage of health centers
Health centers Coverage of Coverage of
population living in population living in
plain areas hilly/tribal areas
Subcenters 5000 3000

Primary health center 30000 20000

Community Health 120000 80000

center
Structural shortcomings in rural Health
services
• Inappropriate selection of place for Health centre.
• Lack of maintenance of Health center.
• Lack of trained profession ( doctor, nurses) and other assistant
workers(paramedical staff)
• Shortage of budget for medicines and diagnostic equipments
• Improper arrangement of primary referral units.
• Insufficient safety and housing for the nurse and other health workers.
Infrastructure of Urban Health Care
Challenges in Urban Health Services
• Weak public health planning.
• Poor environment health
• Poor housing
• Contaminated water, poor sanitation.
• Overcrowded secondary and tertiary facilities and many slums do not have
primary health care facilities.
• Lack of awareness to access health facilities.
• BPL card based services.
 Responsibility of Nurses in Primary Health
Care
1.Assessing the health status of individual and
communities
2. Mobilizing community involvement.
3.providing integrated health care
4.Maintaining epidemiological surveillance
5. Training and supervising health workers.
6. Collaborating with with other development sectors
Previous year questions
Define Primary Health care (2)
Discuss the principles of primary health care (5)
• Discuss the role of community health nurse in
implementing primary health care .(8)

(2020,2016).
Bibliography
Keshav Swarnakar, Community Health Nursing , 4 th Ed,
N.R.Brothers, Page no :29-32, 757-759
• K.K.Gulanu, Community Health Nursing ( Principles &
Practical ) , 3rd Ed, Kumar Publishing House , page no : 501-
504
• Park .k, Park’s Textbook of Preventive and Social
Medicines,26th edition M/S Banasida Bhanot Publishers,
1167, prem Nagar Jabalpur-482001(MP)
• https://www.slideshare.net
Responsibility of Nurses in Primary Health
Care
• Care provider
• Collaborator
• Sensitive observer
• Concerned advisor
• Manager
• Motivator
• Leadership
• Education