About Primary Health Centre

1. Dr. Amol Koshti MD (Ayu)
Associate Professor
Department of Swasthavritta
SSAC Kalol

3. Health care
 It is defined as multiple services rendered to individuals,
families or communities by the agents of health services
or professionals for the purpose of promoting,
maintaining, monitoring or restoring health

4. Levels of Health Care
Tertiary level
Secondary level
Primary level

5. Three tier system
• Primary health center
• Sub-center
Primary
• Community health center
• Taluka hospitals
secondary
• District hospitals
• Medical college hospitals
• Apex hospitals - AIIMS
Tertiary

6. Primary level of Health Care
 Grass root level
 Direct contact
 Services are provided by PHC, sub
centers, Village health guides,
Anganwadi workers & trained Dais
Individuals
Health
system

7. Secondary level of Health Care
 Health services by Specialist doctors
 More complex problems are taken care
off
 Also serve as FIRST REFERRAL UNITS

8. Tertiary level of Health Care
 Health services by Specialist & super
specialist doctors
 Services are provided by Apex hospitals
(AIIMS), Medical College Hospitals

10. Definition
 Primary health care is defined as an essential
health care made universally accessible to
individuals and acceptable to them, through
their full participation and at a cost the
community or country can afford

11. Attributes
 Essential health care
 Means basic, essential services
 Universally accessible
 Should be reachable to all segments of population
 Acceptable
 Services are provided in such a way that people should
accept them
 Community participation
 Active participation of people of the community

12. Attributes
 Affordability
 Services must be Cost effective
 Adaptability
 Services should be flexible to suit given situations
 Availability
 Round the clock presence of services
 Appropriateness
 Should be relevant to the needs and demands of
people

13. Attributes
 Closeness
 Availability of services at individual door steps
 Continuity
 Services provided from womb to tomb
 Comprehensiveness
 Services should be preventive, promotive, curative
and rehabilitative to community
 Co-ordinativeness
 Services require co-operation of various health
related departments

14. Elements of Primary Health Care
 Education concerning prevailing health problems and
methods of identifying, preventing and controlling them
 Promotion of food supply and proper nutrition
 Adequate supply of safe water and basic sanitation
 Maternal and child health care including family planning

15.  Immunization against the major infectious diseases
 Prevention and control of locally endemic diseases
 Proper treatment of common diseases
 Provision of essential drugs
Elements of Primary Health Care

16. Principles of Primary Health Care
Equitable distribution
Community participation
Intersectoral co-ordination
Appropriate technology

17. Equitable distribution
 PHC services should be provided to all people
irrespective of caste, creed, community, rich-
poor
 It’s the “Key principle” of PHC services

18. Community participation
 By the people – Of the people – For the people
 Health providers are selected locally, trained locally and
provide service locally

19. Advantages of Community participation
 Cost effective
 Better Acceptance
 Greater commitment of people results in success of
health care services
 Health awareness becomes integral part of village life
 Health workers get greater support for their activities
 Less dependence on government
 Quality of health care improves

20. Intersectoral Co-ordination
Health
sector
Education
Transport
Municipal
bodies
Voluntary
agencies
Agriculture
Fisheries
Animal
husbandry
Information
&
broadcasting

21. Appropriate technology
 Simple
 Scientifically sound
 Practically adaptable
 Culturally acceptable
 Economically cheaper
 Operationally convenient

22. Organizational framework of
health care systems
1. Public health sector
A. Primary health care
a. Primary health centers
b. Sub-centers
B. Hospitals
a. Community health center/ Taluka hospitals
b. District hospitals
c. Apex hospitals/ medical college hospitals
C. Other agencies
a. Employees’ state insurance hospitals
b. Central govt. health schemes
c. Railway hospitals
d. Defence hospitals

23. Organizational framework of
health care systems
2. Private sector
A. Private hospitals, polyclinics, nursing homes
B. GP Clinics
3. Indigenous systems of medicine
A. Ayurveda
B. Yoga
C. Unani
D. Siddha
E. homeopathy
4. Voluntary health agencies
5. National health programmes

24. Primary Health Care
 WHO’s global target:
HEALTH FOR ALL BY 2000 AD

25. Primary
health care
Village level
Village
health guide
Dais
Anganwadi
worker
Sub center
level
PHC level

26. Three tier system
Village level
Sub-center level
PHC level

27. Village level
 Grass root level
 Not by medical personnel but by Non
medical personnel such as village health
guide, traditional birth attendant (Dais) &
Anganwadi workers

28. Village level
 Village health guide scheme
 Training of local Dais
 ICDS Scheme - Anganwadi worker (AWW)

30. Village health guide scheme
 Launched on 2nd October 1977
 1986 govt. of India – Male health guide replaced by
Female health guide

31. Village health guide (VHG)
 Non governmental, Voluntary worker for health
 One VHG for each village/ 1000 population
 She must be permanent, local resident of village
 Must be literate to read write & maintain records
 Must be acceptable to all sections of society
 Must be willing to do community health work for 2-3
hr/day

32.  VHG is given training for 3 months on basic aspects
of health such as personal hygiene, sanitation, health
education, first aid, ORT etc
 Stipend – Rs. 200 /month
 After training she is awarded with certificate and
given a manual describing her responsibilities and a
medical kit

33. Duties of VHG
 Guides village people on health
 Creates awareness on family welfare services,
immunization , sanitation, personal hygiene, use of
ORT etc

35. Training of local Dais
 Importance
 Age old practice of conducting delivery by dais is prevalent
 Their skills are acceptable by people
 Not only rural but some urban people also take their help
 Female health worker may not be available always to conduct
delivery in her area
 About 90% deliveries are normal and do not require services of
specialist
 Dais can be trained locally in PHCs
 Their training can improve the quality of MCH services
 This helps in community participation

36.  Dais are trained for 1 month with stipend of Rs 300/-
 During training she must conduct at least 2 deliveries
under guidance
 After training she is given certificate and maternity kit
 Maternity kit
 Sterile gauze , Cotton, Clean blade
 Sterile thread, bowl, soap, Antiseptic lotion,
 Plastic sheet, tincture iodine, enema-can

37.  Training on
 Anatomy of reproductive system
 Physiology of pregnancy & labor
 Observation of danger signals
 Conducting delivery by observing five cleans
 Five cleans –
 Clean hands
 Clean surface
 Clean blade
 Clean ligature
 Clean cord clamp

38. Integrated Child Development Services

40. Anganwadi worker (AWW)
 Local lady
 Studied upto 10th standard
 1 for 1000 population
 To provide basic health services mainly to mothers
(antenatal, postnatal) and children below 6 yr age
 Trained for 4 months in various aspects of health ,
nutrition & child development

41. Duties of Anganwadi worker
 Preparing & serving supplementary food
 Growth monitoring of children
 Health & nutrition education to mothers
 Non formal education to children in the form of toys,
play, songs etc
 Referral services
 Maintains records