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3. Primary Health Care.pptx but excrete not significantly

The document outlines the historical development, definition, principles, and components of Primary Health Care (PHC) as established by the World Health Organization. It discusses the evolution of health strategies from vertical disease control to an integrated approach emphasizing community involvement, equity, and preventive care. The challenges of implementing PHC, particularly in developing countries like Ethiopia, are also highlighted, including infrastructure gaps and inadequate resource allocation.

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Unit Three Primary Health Care (PHC) By: Nejib Sufian(BSc, MA, MPHN) 1
Objectives • To describe the historical development of PHC • Definition of PHC • To discuss on Principles and components of PHC • To identify possible problems in implementing PHC 2
PHC Historical Development • The World Health Organization (WHO), established in 1948. • Major objective: The attainment by all people of the highest possible level of health. • Due to political and socio economic factors the various health care approaches implemented in different countries between 1948 and 1978 did not enable WHO to meet the stated objectives. 3
PHC Historical Development… Strategies used by WHO - In the 1950s the vertical health service strategy which included: - mass campaigns and - specialized disease control programs for selected communicable diseases, such as control of malaria, tuberculosis and venereal diseases. - But it was found to be expensive and unsuccessful. 4
PHC Historical Development… • Later In the mid 1950s the concept/strategy of Basic Health Service came into practice. • This approach gave more attention to rural areas through construction of health centers and health stations providing both preventive and curative care. • In the early 1970s integration of the specialized disease control programs with the basic health services was emphasized. 5
PHC Historical Development… • All these approaches were disease oriented based on high cost health institutions requiring advanced technology to solve the health needs of the people, and thus ultimately failed to reach the desired goal. • Specially in developing countries where their health problems required emphasising on health promotion and preventive care, the strategies applied did not make much impact on the health status of the population. 6
PHC Historical Development… The evaluation of these strategies during 1950s and 1970s showed the following: • The health status of millions of people in the world at that time and even today is unacceptable. • the health status of the majority of people in disadvantaged areas of most countries of the world remained low. • The organised limited health institutions failed to meet the demands of those most in need of health services. • The health services often created in isolation neglecting other sectors such as education, agriculture, water, communication etc. • Health institutions stressed curative services with lacking priority to preventive, promotive and rehabilitative care. 7
PHC Historical Development… These situations called for WHO and UNICEF in the early 70s to seriously and critically re-evaluate and re-examine existing policies, approaches and options in health. Thus, the magnitude of health problems and inadequate distribution of health resources called for a new approach and the Concept of PHC. In 1977 the WHO set a goal of providing “Health for All by the year 2000” which aims at achieving a level of health that enables every citizen of the world to lead a socially and economically productive life. The strategy to meet this goal was later defined in the 1978 WHO/UNICEF joints meeting at Alma-Ata USSR. In this meeting it was declared that the PHC strategy become a core policy to meet the goal of “Health for all by the Year 2000”.8
Primary health care Definition :– PHC is essential health care based on practical, scientifically sound, and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self reliance and self determination.’ (WHO, 1978) 9
PHC Definition… Terms in the definition: • Essential health care: Health care provided through PHC is basic, indispensable and vital. • Scientifically sound: The strategy we use in implementing PHC should be scientifically explainable and understood. • Socially acceptable methods and technology: should be accepted by the local community and to consider the local value, culture and belief. • Universally accessible: The PHC approach is to bring health care as close as possible to where people live and work in order to guarantee universal accessibility to the individuals, family 10
PHC Definition… • Community involvement: Community can achieve better health status through their own efforts and the health workers role is to help them identify their problems and to point out methods for dealing with the problems. • Self-reliance and Self-determination: able to support yourself, being independent understanding your own needs and trying to minimize problems. Knowing when and for what purpose to turn to others for support and cooperation. 11
Principles of primary health care • Equity • Intersectoral collaboration • Community involvement • Appropriate technology • Emphasis to promotion and prevention • Decentralization 12
I. Equity • Providing equal health care to all groups of people according to their needs. • giving highest priority to those with greatest health needs • Services should be physically, socially, and financially accessible to everyone 13
II. Intersectoral collaboration • It means a joint concern and responsibility of different sectors • Which sector must be collaborated? Important to:- • Save resources (effective use of resources) • Identify community needs together 14
III. Community involvement The communities should be actively involved in: • The assessment of the situation • Definition/identification of the problems • Setting of priorities • Planning, implementation, monitoring and evaluation and management of development programs 15
IV. Appropriate Technology Methods- procedures - techniques, equipments used are; • Scientifically valid • Adapted to/based on local needs • Acceptable by the professionals • Acceptable by the community 16
Criteria of Appropriateness • Effective:-must work and fulfill its purpose • Culturally acceptable and valuable:- must fit into the hands, minds and lives of its users • Affordable:-affordable cost by the major/ whole community • Environmentally accountable:- should be environmentally harmless • Measurable:-needs proper and continuing evaluation if 17
V. Emphasis on health promotion and prevention • Promotive: addresses basic causes of ill health at the level of society. • Preventive: reduces the incidence of disease by addressing the immediate and underlying causes (risks) at the individual level. • Curative: reduces the prevalence of disease by stopping the progression of disease among the sick. • Rehabilitative: reduces the long-term effects or complications of a health problem. 18
VI. Decentralization • Bringing decision making away from the national or central level and closer to the communities served & to field level providers of services • It reflects Community participation 19
PHC COMPONENTS 20
PHC COMPONENTS… 8 essential elements: 1. Health Education concerning prevailing health problems and the methods of preventing and controlling them 2. Provision of Essential Drugs 3. Immunization against the major infectious diseases 4. MCH/FP 5. Appropriate Treatment of common diseases & injuries 6. Adequate supply of safe water & basic sanitations 7. Communicable diseases control 8. Promotion of Food supply and proper nutrition Source: WHO, 1978. 21
PHC COMPONENTS… • additional elements incorporated in the Ethiopian context; 1. Oral health 2. Mental health 3. The use of Traditional Medicine 4. Occupational health 5. HIV/AIDS 6. URTI 7. AYRH 22
Major problems in the implementation of PHC in Ethiopia • Absence of infrastructure at the district level • Difficulty in achieving inter-sectoral collaboration • Inadequate health service coverage and mal-distribution • Inadequate resource allocation • Absence of clear guidelines or directives on how to implement PHC • Presence of harmful traditional practices • Absence of sound legal rules to support environmental health activities • Weak community involvement in health 23
Thank you! 24