What is Primary Health Care? What are levels of Primary Health care?

1. Primary
Health Care
[Community Health
Nursing]
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2. 2
DEFINITION
Principles of primary health care
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2
Levels of primary health Care3
áÌç®ÑÇä»âðTABLES OF CONTENTS:
Elements of of primary health care4
Role of Nurse in primary health Care5

3. Definition:
• “Primary health care is essential health care
• made universally accessible to individuals
• and acceptable to them,
• through their full participation and at a
• cost that the community and country can
afford.”
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4. • Definition: (Remember this five points
in definition)
1. Essential health care:
2. universally accessible:
3. acceptable:
4. participation:
5. not costly:
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5. Principles of primary health care:
• A WHO expert committee (1984) recognized
and involved five basic principles in the
definition of primary health care. They are:
1. Equitable distribution
2. Community involvement
3. Appropriate technology
4. Focus on prevention
5. Multi-sectoral approach
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6. • [1] Equitable distribution:
• That is health services should be reached
to all sections of society.
• Special attention is given to the needy or
vulnerable people.
• This has been called as social justice.
• For example: Rural community and
Urban community, there should be
balance of health care.
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7. • [2] Community involvement:
• As we know that, primary health care is
for the people and by the local people.
• So, the people like village health guide,
dias should be involved from community.
• They will participate in the planning,
implementation and maintenance of
health services of their villages.
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8. • [3] Appropriate technology:
• Instead of going in for costly methods of
healthcare, equipment and technology used
must be useful, effective and socially
acceptable,
• They should not be very expensive; as for
example (ORS) oral rehydration therapy.
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9. • [4] Multi-sectoral approach:
• The basic tenet of primary health care is that
health cannot be achieved by the health
sector alone.
• It requires the joint efforts of other
government and private sectors such as
agriculture, education, social welfare, etc.
• So other sectors should be involved for
speedy and effective health care.
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10. • [5] Focus on Prevention:
• The importance is given on prevention.
• All the elements of primary health care
should focus on prevention of health
problems in community.
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11. LEVELS OF PRIMARY HEALTH CARE:
• Primary health care is divided in following three
levels to reach each and every person in
community and provide effective healthcare.
1. Primary level- (sub-centre level)
2. Secondary level (Primary Health centre)
3. Tertiary level (Community Health Centre)
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12. • [1] Primary level:
• To reach every person in any part, sub centres are
established in villages.
• Primary level care starts from sub centres.
• Established and 100 % financed by: NRHM
(National Rural Health Mission)
• First time village person meet health worker
here.
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13. • Staff at sub-centre: total-3 staff
1. Health worker Male-1
2. Health worker female-1
3. And Volunteer female-1
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14. • [2] Secondary level:
• From sub centre, patient comes at Primary Health
Centre (PHC).
• It is also called 1st referral level
• It is first contact place for patient with doctor.
• Staff at PHC: there are total 15 staff at one PHC
• Head of PHC is medical office or doctor.
• Capacity of beds is 4 to 6 beds
• 1 PHC has to look after 6 sub-centres
• Comes under state government
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15. Primary Health Centre:
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16. • [3] Tertiary level:
• This is also called second referral level.
• From PHC, patient is referred to Community
health Centre ( CHC)
• Total staff at CHC are:30, including following.
1. Specialist doctors – 4
2. Physician-1
3. Surgeon-1
4. Gynaecologist-1
5. Paediatrician-1
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17. • Additional as per need are-3
• Ophthalmic surgeon, anaesthetist and public
health manager
• 1 - CHC got referrals from 4 - PHC
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Sub centre:
Primary Health
Centre (PHC):
Community
Health Centre
(CHC):
Level of
Care
1 1 2
Population
(Plain)
5,000 30,000 1,20,000
Population
(Hill)
3,000 20,000 80,000
Numbers of
Staff
3 15 30
Maintanance
Authority
Central
Government
State
Government
State
Government

19. Population Norms:
• 1 Doctor – population of 3500
• 1 nurse – population of 5000
• 1 HW / Male - Female – population of 5000
• 1 Pharmacist – population of 10,000
• 1 Lab Technician – population of 10,000
• 1 Train Birth Assistant – population of 1000
• 1 ASHA worker – population of 1000
• 1 Village Health Guide – population of 1000
• 1 Angan-vadi worker – every 400-800 population
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20. ELEMENTS/ FUNCTIONS OF
PRIMARY HEALTH CARE:
• According to the Alma-Ata declaration, the
primary health care includes at least 8 elements.
• International Conference held on Primary Health
Care at Alma-Ata city of USSR on 12 September
1978 to protect people and community from
diseases.
• They should be implemented in proper effective
manner.
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21. 1. Education: Education about prevailing
health problems and methods of preventing
and controlling such problems.
2. Locally disease: Prevention and control of
local endemic diseases
3. Essential drugs: Provision of essential
drugs.
4. Maternal and Child health : Maternal
and child health care and family planning
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22. 5. EPI : (Expanded programme on
Immunization) Immunization against
major infectious diseases
6. Nutrition: Promotion of food supply and
proper nutrition
7. Treatment: Appropriate treatment of
common diseases and injuries
8. Safe water: Adequate supply of safe water
and basic sanitation.
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23. Role of nurses in primary health care:
• In many countries, nursing and midwifery
personnel are providing primary health care.
• Nursing curricula have been revised to
reflect the role of nurse in primary health
care.
• A WHO expert committee in 1984 has
defined the role of nurses in primary
healthcare as follows
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24. 1. Health promotion: Assessing the health
status of individuals and communities
2. Community involvement: Involvement of
ASHA, Anganwadi worker, village health
guide and dias in primary health
programmes.
3. Treatment : Providing treatment of chronic
illnesses and other diseases. In case of any
emergencies, making referrals to other
centres for treatment.
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25. 4. Public health : taking care of infectious
diseases in community, and keep records of
that.
5. Education : Training and supervising health
workers
6. Collaboration : For quick referral,
collaboration with other department is
required.
7. Evaluation : Monitoring progress in primary
health care
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26. 8. MCH : Maternal and child health care
including care of mothers during
antenatal and postnatal period, care of
child, vaccination etc.
9. Research: participate in research
activities in communities for health care.
10.Rehabilitation: rehabilitation of patients
with chronic illness and other problems.
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27. RECAPE
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Equitable distribution1
PRINCIPLES OF PRIMARY HEALTH CARE:
Community Participation2
Appropriate Technolgy3
Multi-sectoral approach4
Focus on prevention5

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PRIMARY LEVEL1
LEVELS OF PRIMARY HEALTH CARE:
SECONDARY LEVEL2
TERTIARY LEVEL3

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1
ELEMENTS OF PRIMARY HEALTH CARE:
E Education
2 L Locally disease
3 E Essential drugs
4 M Maternal and Child Health
5 E E P I
6 N Nutrition
7 T Treatment
8 S Safe Food

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