This document discusses primary health care (PHC), including its definition, levels, concept, elements, and principles. PHC is defined as essential health care that is scientifically sound, socially acceptable, and universally accessible to communities at an affordable cost. It focuses on health promotion and disease prevention through community participation and appropriate technologies. The principles of PHC are equitable distribution of services, community participation, coordination between health and other sectors, and an emphasis on prevention over treatment.

1. Presented by -
Rajat Hegde

2. CONTENTS
 Introduction
 Levels of health care
 Concept
 Definition
 Elements
 Principles
 Summary
 References

3. INTRODUCTION
• Health has been declared as a fundamental human right.
• Hence, the governments all over the world strive to expand and
improve their healthcare services.
What is Health Care …?!
• These are the services provided to individuals or communities by
agents of the health services or professions, for the purpose of
promoting, maintaining, monitoring or restoring health.
‘HEALTH CARE IMPLIES MORE THAN MEDICAL CARE’

4. LEVELS OF HEALTH CARE
1
• Primary care level
2
• Secondary care level
3
• Tertiary care level

5. TERTIARY LEVEL HEALTH CARE
• This level of health care is provided at the state/regional/central
level institutions. E.g. Medical College Hospitals, Regional
Hospitals.
• It is more specialized level, requires specific facilities and
attention of highly specialized health workers.
• These institutions serve as referral units for primary and
secondary levels.
• They also serve as teaching institution for education and training
of various categories of health care professionals.

6. SECONDARY LEVEL HEALTH CARE
• At this level, more complex problems are taken care which
require secondary level of preventive services and curative
services.
• These services are provided at district hospitals and
community health centres.
• The cases which cannot be handled at PHC are referred
over here.

7. PRIMARY HEALTH CARE (PHC)
• It’s the first level of contact between the recipient of care and
health care delivery system.
• Majority of the problems are dealt at this level.
• In India, primary health care service is provided by primary health
centres and their subcentres through:
1. Multipurpose health workers
2. ANM (Auxiliary Nurse Midwife)
3. ASHA (Accredited Social Health Activist)
• In urban areas, these services are given by maternal child health
and family welfare centres, and dispensaries.
4. Anganwadi workers
5. Village health guides

8. CONCEPT OF PHC
• The concept of primary health care came into existence on
September 12, 1978, following a Joint WHO-UNICEF
International Conference at Alma-Ata (USSR).
• Earlier synonyms: “basic health services”, “first contact care”,
“easily accessible care”, ”services provided by generalists”.
• The services provided are:
1. Simple and efficient with regard to cost, techniques, and
organization.
2. Readily accessible to those concerned and contributes to
improving the living conditions.

9. DEFINITION OF PHC
• Primary health care is defined as “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 the country can afford to maintain at every stage of their
development in the spirit of self-determination.

10. ELEMENTS / COMPONENTS OF PHC
Health education
Group discussion
Potable safe drinking water
Programs-Swachh Bharat
Abhiyan
Food safety
Equal distribution
Mid-day meal program
Care should be taken from
antenatal period to child
birth.
Vaccines against TB, measles,
mumps, polio, Hep B
Like malaria,
worm manifestations
Anti-malarial treatment
Dog bite
Tetanus
RTA (Minor Injuries)
Provision of essential drugs:
Birth control pills
Nutrition supplements

11. PRINCIPLES OF PHC
1. Equitable Distribution
2. Community Participation
3. Intersectoral Coordination
4. Appropriate Technology
5. Focus On Prevention

12. 1. EQUITABLE DISTRIBUTION
• It means that health care services must be shared equally by all
people irrespective of their ability to pay, and all must have access
to it (be it rich/poor, urban/rural).
• ‘Social Injustice’: At present, health services are mainly
concentrated in major towns and cities resulting in inequality of
care to the people in rural areas and urban slums.
• This failure is due to inaccessibility.
• Thus, PHC aims to redress this imbalance by shifting the centre of
gravity of health care system from cities (where 3/4th health
budget is spent) to the rural areas ( where 3/4th of the population
lives).

13. 2. COMMUNITY PARTICIPATION
• Essential ingredient of PHC – involvement of individuals, families
and communities in promotion of their own health and welfare.
• In India, this has been tried successfully using village health
guides and trained dais.
• They provide primary health care by overcoming cultural and
communication barriers, in ways that are acceptable to community.
• This was greatly influenced by experience in China where
community participation was in the form of bare-foot doctors.

14. 3. INTERSECTORAL COORDINATION
• It is necessary to coordinate with other sectors for achieving
goals because no sector can achieve its goals in isolation.
• An important element of intersectoral approach is planning –
planning with other sectors to avoid unnecessary duplication of
activities..
• This requires a strong political will.

15. 4. APPROPRIATE TECHNOLOGY
• It implies the use of appropriate methods, techniques and
equipments which are scientifically sound and simple, and
adaptable to local needs.
• E.g. Neem stick and mango leaf for tooth brushing are effective
when used in a proper way.

16. 5. FOCUS ON PREVENTION
• Health services should not be only curative but should also
promote health and healthy lifestyles with emphasis on prevention.

17. SUMMARY
• Till now, we have discussed about primary health care under
the contents - introduction, levels of health care (primary,
secondary and tertiary), concept, definition, elements and
principles of PHC.

18. REFERENCES
• Park’s textbook of Preventive and Social Medicine.
• Soben Peter’s Essentials of Public Health Dentistry.