Primary health care (PHC) aims to make essential health care accessible and affordable to all by bringing services as close to communities as possible. It was established as the key to attaining universal health goals at the 1978 Alma-Ata Conference. PHC focuses on prevention, community participation, and coordination between health and other development sectors using appropriate technologies. The principles of PHC emphasize equity, addressing rural health needs, social justice, and access to services for all.

3. Health is influenced by a number of
factors such as adequate food, housing,
basic sanitation, healthy lifestyles,
protection against environmental hazards
and communicable diseases. It is thus
clear that health care implies more than
medical care. It embrace a multitude of
services provided to the individuals or
communities by the agents of the health
services or profession, for the purpose of
promoting, maintaining, monitoring or
restoring health.

4. OVERVIEW:
 May 1977- 30th World Health Assembly
decided that the main health target of the
government and WHO is the attainment of
health that would permit them to lead a
socially and economically productive life by
the year 2000.
September 6-12,1978- First International
Conference on PHC in Alma Ata, Russia
(USSR). The Alma Ata Declaration stated
that PHC was the key to attain the ‘Health for
All’ goal.

5.  October 19, 1979- Letter of Instruction (LOI)
949, the legal basis of PHC was signed by the
President. Ferdinand E Marocs, who adopted
PHC as an approach towards the design,
development and implementation of programs
focusing on the health development at
community level.

6. Primary Health Care is an essential
health care made universally
accessible to individuals and
acceptable to them through their full
participation and at the cost the
community and country can afford.
-WHO

7.  Improvement in the level of health care of the community.
 Favorable population growth structure.
 Reduction in the prevalence of preventable, communicable
and other diseases.
 Reduction in morbidity and mortality rates especially among
infants and children.
 Extension of essential health services with priority given to
the underserved sectors
 Improvement in basic sanitation.
 Development of capability of the community aimed at self
reliance.
 Maximizing the contribution of the other sectors for social
and economic development of the community.

8. Magnitude of health problems
Inadequate and unequal distribution of
health resources
Increasing cost of medical care
Isolation of health care activities from
other development activities.

9.  The concept of Primary Health Care is not new to
India. The Bhore committee in 1946 gave the
concept of Primary Health Center as a basic unit, to
provide an integrative curative and preventive health
care to the rural population with emphasis on
preventive and promotive aspects of health care.

10.  Affordable by the country and
community
 Universally accessible to all the citizens
of our country.
 Available to all irrespective of rural or
urban, rich or poor community.
 Socially acceptable based on practical
and scientifically sound technology.
 Accountable to health care agencies of
the country.

11.  E- Education for Health.
 L- Locally endemic diseases control.
 E- Expanded programme on immunization.
 M- Maternal and child health and family health.
 E- Environmental sanitation and adequate water
supply.
 N- Nutrition and promotion of adequate food
supply.
 T- Treatment of communicable diseases and
common illness.
 S- Supply of essential drugs.

12. Equitable
Distribution
Community
participation
Intersectoral
coordination
Appropriate
technology
Focus on
prevention

13.  The first principle in the PHC is the equity and
equitable distribution of health services, i.e. health
services must be shared equally by all the people
irrespective of their ability to pay and all must have
access to health services.

14. It is based on social justice.
The people living in rural area
are the main target of Primary
Health Care
PHC aims to redress the
imbalance by shifting the
center of gravity of health care
system from cities to the rural
areas and thus bring services
as near people’s home as
possible

15. The involvement or participation of
individuals, families and
communities in promotion of their
own health and welfare is an
essential ingredient of PHC.
Thus, the community should
participate in the planning,
implementation and maintenance of
health services.

16. Health for all cannot be achieved by the
health sector alone. For successful
implementation of primary health care,
coordination of other sectors is necessary
e.g agriculture, animal husbandry, food
industry, education, housing, sanitation,
communication etc.
The joint efforts of all of these
fields are required to provide primary
health care.

17. The technology used in primary health
care should be scientifically sound, safe,
socially acceptable, suitable to local
requirement and within the financial
limits and should be locally available.

18.  Preventive and promotive services rather than
curative services should be the central focus of
PHC.
 There are four levels of prevention in health care:
1. Primodial prevention (Health education)
2. Primary prevention (Health Promotion and
Specific Protection)
3. Secondary prevention (Early detection and
Treatment)
4. Tertiary prevention (Disability Limitation and
Rehabilitation)

21.  Assessing the health level of
individuals and community.
 Activating the participation of
community and encouraging the
individual to participate.
 Providing treatment in emergencies
and taking care of general health.

22.  Referring the patients to the specialists.
 Keeping an eye on epidemics
 Training and supervision of the health workers
 Coordinating with other health program
 Monitoring the progress of primary health care.

23. The primary health care was similar to the concept of
basic health services in India which was proposed by
Bhore Committee in 1946 and was implemented by
the Government of India after independence through
successive five year plan.
Primary Health Care is the first level of contact
to individuals, families and community with health
care delivery system. It is the care given to the
people, at first level contact at community level
where they live and work, thus bring health care
closer to the people where they live.

24. Gill.KK “ Textbook of Community
Health Nursing-I” first edition, CBS
publisher, page no :22-25.
GM Veerabhadrappa “ A Short Textbook
of Community Health Nursing” volume
2, first edition, jaypee brothers medical
publishers, page no 59-63.