2. OBJECTIVES
The student will be able to,
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
3. INTRODUCTION
Primary health care approach had its
inception in the year 1978 following an
international conference at Alma –ATA in
USSR.
Primary health care is equally applicable for
all the countries from most to the least
developed countries have accepted primary
health care as the vital part of the health
system.
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4. DEFINITION
“Primary Health Care is essential health care
made universally accessible to individuals &
acceptable to them, through their full
participation & at a cost the community &
country can afford ”.
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5. ELEMENTS OF PRIMARY HEALTH
CARE
The Alma-Ata conference outlined 8 essential components of primary health care.
Education concerning prevailing health problems and the methods of preventing and
controlling them.
1. Education and information concerning prevailing health problems and methods
of preventing and controlling them
2. Promotion of food supply and proper nutrition.
3. An adequate supply of safe water and basic sanitation.
4. Maternal and child health care, including family planning.
5. Immunization against major infectious diseases.
6. Prevention and control of locally endemic diseases.
7. Appropriate treatment of common diseases and injuries.
8. Provision of essential drugs.
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6. PRINCIPLES OF PRIMARY
HEALTH CARE
1. Equitable distribution.
2. Community participation.
3. Intersectoral coordination.
4. Appropriate technology.
5. Focus on Prevention
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7. EQUITABLE DISTRIBUTION
The first key principle in the primary health care strategy is equity
or equitable distribution of health services.
Health services must be shared equally by all people irrespective
of their ability to pay, and all must have access to health services.
At present health services are mainly concentrated in the major
towns and cities resulting in inequality of care to the people in
rural areas.
The worst hit are the poor and the needy and vulnerable groups of
the population in rural areas and urban slums.
This has been termed as social injustice.
8. The failure to reach the majority of the people is
due to inaccessibility.
Primary health care aims to redress this
imbalance by shifting the centre of gravity of the
health care system from cities to the rural areas
and bring these services as near people’s homes
as possible.
9. Community participation
Health of the people is not just the responsibility of
central and state government alone.
Involvement of people in the development process
voluntarily and willingly is vital component of
primary health care.
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10. There must be a continuing effort to
secure meaningful involvement of the
community in planning, implementing &
maintenance of health services, besides
maximum reliance on local resources
such as manpower, money & materials.
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11. Best example for community participation is
introduction of village Health Guides” & “Trained
Dais” using people from local community. It is an
essential feature of primary health care in India.
• China had set his fore front strategy by
introducing community participation in the from
of “bare foot doctors” .
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12. INTERSECTORAL COORDINATION
There is an increasing realization of the fact that the components
of primary health care cannot be provided by the health sector
alone.
The declaration of Alma-Ata states, primary health care involves
in addition to the health sector, all related sectors and aspects of
national and community development, in particular agriculture,
animal husbandry, food, industry, education, housing, public
works, communication and other sectors”.
This requires strong political will to translate values into action,
an important element in intersectoral approach is planning –
planning with other sectors to avoid unnecessary duplication of
activities.
13. Appropriate technology
Appropriate technology has been defined as
“technology that is scientifically sound,
adaptable to local needs, & acceptable to
those who apply it & for those whom it is
used & that can be maintained by the people
themselves in keeping with the principles of
self reliance with the resources the
community & country can afford
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14. Cont..
The term appropriate is emphasized because
in some countries luxurious hospitals that are
totally inappropriate to the local needs, are
built, which absorb a major part of the
national health budget, effectively blocking
many improvement in general health
services.
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15. Focus on Prevention
Prevention is the core strategy of primary
health care. Community health nurses focus
on health promotion and health maintenance
activities for which they engage in primary
,secondary and tertiary level of preventive
care activities.
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16. ROLE OF NURSE IN PRIMARY
HEALTH CARE
WHO study group in 1985 highlighted the
following roles and functions of nurses in
primary health care.
1. Direct care provider
The nurse provide direct care to individual,
families and community with reference to 8
elements of primary health care
Ex:MCH Care
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17. Health educator & teacher
In order to promote health, prevent disease, regain and
maintain health, the nurse educates individuals, families
and community at large about healthful behavior, sanitary
environment, prevention of diseases etc., she educates
family members to take care of the sick in her absence and
also other preventive measures.
As a teacher, she trains other health workers such as
ANMs, health Guides, Village Dais
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18. Good planner & care manager
The nurse working for primary health care
makes assessment of health needs, health
problems of individuals, families and
community.
The nurses involves individuals, families and
community in planning and implementing of
the care.
She makes referrals when
required.
She maintains the record of care given and
evaluates the effectiveness of the same.
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19. Guide & supervisor
As a nurse engaged in providing
primary health care, she is expected
to supervise, guide and help other
personnel in providing care, planning
health services for families and for the
community.
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20. Specific functions-PHC
Assessment of health needs and health problems of
individuals and community.
Provide integrated comprehensive primary health care
service related to 8 essential elements.
Mobilize involvement of individuals, families and
community in providing primary health care.
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21. Surveillance of locally endemic diseases.
Monitoring and analysis of health condition to determine
the progress in primary health care.
Training and supervision of health workers.
Working in collaboration with other socioeconomic
sectors.
Maintenance of accurate, complete and up-to-date records
of health care services rendered
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22. REFERENCES
1. Shyamala, D. ( 2018). Text book of community
health nursing –II , 1st edition, CBS Publishers
2. Neelam Kumari,(2011) A textbook of community
health nursing –II First Edition,
S vikas & Company Medical publisher .
3. K.PARK, (2019).Textbook of Preventive and
Social Medicine, 25rd edition , Banarsidas Bhanot
Publishers.
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