The document discusses primary health care (PHC), which was declared as an essential approach for achieving "Health for All" by 2000 at the International Conference on PHC in Alma-Ata in 1978. PHC aims to make essential health care universally accessible and affordable. It focuses on disease prevention, health promotion, and community participation through locally appropriate technologies. The key principles of PHC are equitable distribution, community participation, appropriate technology, intersectoral coordination, and prevention-focused care.

1. Primary health care
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2. Primary health care
• Health status of the people of the world cannot be
improved by single countries of world.
• Their should be combined efforts of all the concerned
countries.
• Realizing this truth in 1977 WHO’s 30th general
assembly decided “health for all” by 2000 A.D .
• WHO and UNICEF organized international conference
on PHC from 6th September to 12th Sept in 1978 in the
capital of Kazakhstan.(alma1Ata)
• It is the first level contact between the individual and
health care system where the essential health care are
provided to people.

3. • Nepal had signed the HFA 2000 document at
Alma-Ata in 1978 and had accepted primary
health care as being an effective methods by
which essential health care services should be
provided to the community people.
• “Primary health care is essential health
care made universally accessible to
individuals and acceptable to them,
through their full participation and at a
cost the community and country can
afford.”

4. • “It is also as essential health care based on
practical, scientifically sound, socially
acceptable methods and technology made
accessible to families and communities
through their full participation and at a cost
that country and community can afford to
maintain with full support of their self reliance
and determination.”
– Alma Ata, 1978

5. Principle of PHC
• Equitable distribution
• Community participation
• Appropriate technology
• Inter-sectoral coordination
• Focus on prevention

6. 1. Equitable distribution
According to this principle , primary health care
must be given to all individuals in equal
amount in community irrespective of their
gender, age, caste, color, urban, rural and
social classes.
2. Community Participation

7. Community Participation
• Community should participate in planning,
implementation and maintainance of health
services. It is needed to seek to solution
collectively for complicated social problems that
causes health problems.
Intersectoral Coordination
Health of the community cannot be improved by
intervention within just the health sector. It
requires joint effort of health sector and other
health related sectors.
Eg , education, agriculture, transport etc..

8. • Appropriate technology
Affordable, feasible technology should be
provided to the community for the promotion
of primary health care.
Eg ice box for volunteers for the purpose of
immunization.

9. Disease prevention and health promotion
• Providing training to human resources,
community and individuals on disease
prevention and health promotion.
• It focuses on prevention rather than cure.

10. Elements of PHC
• E- Essential drug supply
• L- Locally endemic disease control
• E- Expanded program on immunization
• M- Maternal and child health care and FP
• E-Education on health
• N- nutrition
• T- Treatment for minor illness
• S- Sanitation and safe drinking water supply

11. • Education concerning, prevailing health
problems and methods of preventing and
controlling them.
• Education programmes are to be organized for
different group of people, health education to
the community should be main function of
health worker.
• Promotion of food supply and proper
nutrition.

12. • Poor nutrition status of the people particularly
that of pregnant ,nursing mother, infant and
children can be improved by organizing
nutrition education programme in community.
• For eg, Nutrition health programme is one of
the priority program of government of Nepal.
3. Adequate supply of safe water and basic
sanitation

13. • Arrangement should be made for regular
purification of water. People at all level should
be educated on importance of proper
maintainance of water and use of safe water.
• Organize people for constructing household or
community latrine and make arrangement for
collection and disposal of waste.

14. Maternal and child health care including family
planning.
• ANC, delivery care and PNC are essential for
promoting maternal health.
• Community people should be educated for
utilizing these services from nearby health
institution
• Child health- Immunization, educate mother on
nutrition of child, trained health worker for
management of childhood illness.

15. • Family planning- Focuses on small family
promotion, mobilized community people for
using family planning services.
• Immunization against major infectious diseases.
• Prevention and control of locally endemic
diseases.
Some endemic diseases and disorders in the
country are known to cause public health
problems.

16. • Several national programme are in operation
for eradication and control.
• Health worker should be trained and
community people should be given education
on prevention and control of locally endemic
disease.
• Appropriate treatment of common diseases
and injuries.
• Along with available curative services, local
remedies should also be addressed.

17. • Provision of essential drugs.
Essential drugs are provided through health post
and primary health care centre.

18. • Declaration of Alma Ata
There are 10 declarations.
Declaration I
The conference strongly reaffirms that health is a
state of complete physical ,mental and social well
being and not merely the absence of diseases or
infirmity, is a fundamental human right and that
the attainment of the highest possible level of
health is a most important worldwide social goal
whose realization requires the action of many
other social and economical sectors in addition to
the health sector.

19. • Declaration II
The existing gross inequality in the health status
of the people particularly between developed
and developing countries as well as within
countries is politically, socially and
economically unacceptable and is therefore of
common concern to all countries.

20. • Declaration III
Economic and social development based on a new
international economic order, is of basic
importance to the fullest attainment of health for
all and to the reduction of the gap between the
health status of the developing and developed
countries.
The promotion and protection of the health of the
people is essential to sustained economic and
social development and contributes to a better
quality of life and to world peace.

21. • Declaration IV
The people have the right and duty to
participate individually and collectively in the
planning and implementation of their health
care.
Declaration V
Government have a responsibility for the
health of their people.

22. • A level of health should be attained by all the
people by 2000 to lead a socially and
economically productive life.
• Primary health care is the key to attaining this
target.
Declaration VI
Defn of primary health care
It is the first level of contact of individual, the family
and community with the national health system

23. • Bringing health care as close as possible to
where people live and work and constitues
the first element of a continuing health care
process.
• Declaration VII
• Elements of primary health care

24. Declaration VIII
• All government should formulate national policies
strategies and plan of action to launch and
sustain primary health care as a part of
comprehensive national health system
incordination with other sectors.
Declaration IX
All countries should cooperate in a spirit of
partnership and service to ensure primary health
care for all people.

25. • Declaration X
An acceptable level of health for all the people
of the world by the year 2000 can be attained
through a fuller and better use of world’s
resources, a considerable part of which is now
spend on military conflicts.

26. There are 22 recommendation of Alma Ata
Conference.
• Community participation in primary health
care.
• Contents of primary health care
• Comprehensive PHC at local level
• Coordination of health and health related
sector.

27. • Appropriate technology for health
• Administration and management of primary
health care.
• Essential drugs for PHC.
• Interrelationship between health and
development.
• Incentives for service in remote and neglected
zone.

28. • Logistic support and facilities for primary health
care.
• National commitment to primary health care.
• National strategy for primary health care.
• Resources for PHC.
• Loan and categories of health and health related
manpower for PHC.
• Support of PHC within the national health
system.

29. • Separate needs of vulnerable and high risk
group
• Role of national administration on PHC
• Technical Cooperation in PHC
• Training of health and health related
manpower in PHC
• International support for PHC
• Role of WHO and UNICEF in supporting PHC.