Summary on History, Definition and Principles of Primary Health Care.

2. CONTENTS
• Introduction
• Evolution
• Definition of primary health care
• Characteristics of Primary health care
• Essential elements
• Principles

4. HISTORY
• The concept of 'Primary Health Care' came
into existence, following a Joint WHO -
UNICEF International Conference at Alma
Ata, USSR (present day Kazakhstan), on 12th
September 1978.

6. • Delegates to the conference expressed "the
need for urgent action by all governments, all
health and development workers, and the
world community to protect and promote the
health of all the people of the world….“
• Alma-Ata put HEALTH EQUITY on the
international political agenda for the first
time.
• And a way of approaching this equity was
through Primary Health Care.

7. • The PHC concept paper was prepared under
the guidance of Kenneth Newell, Director of
WHO’s Strengthening of Health Services
Division.

8. • Primary health care is an approach to health
care, which integrates at the community level
all the factors required for improving the
health status of the population.
• The services provided are,
- Simple and efficient with regard to cost,
techniques, and organization,
- Readily accessible to those concerned and
contributes to improving the living conditions
of individuals, families and the community as
a whole.

9. • WHO, in the year 1977 launched its HEALTH
FOR ALL, BY THE YEAR 2000 strategy.
And on 12th September 1978, the Alma -Ata
conference called for acceptance of the WHO
goal of Health for All by 2000 and proclaimed
primary health care as a way to achieving
Health for All.

10. • Primary health care is the first level of contact
of individuals, the family and the community
with the national health system, where
essential health care is provided.

11. CONCEPT
Primary health care is essential health care
based on practical
scientifically sound
socially acceptable methods and technology
made
universally accessible to individuals
and families in the community through
their full participation and at a cost ,
the community and country can afford to
maintain at every stage of its
development in a spirit of self-reliance
and self determination

13. • Thus, it is based on social equity, nation-wide
coverage, self-reliance, inter sectoral
coordination, and people's involvement in
the planning and implementation of health
programs in pursuit of common health goals.
• This approach has been described as "health
by the people" and "placing people's health
in people's hands".

14. Basically, the concept involves a concentrated
effort to provide the rural population of
developing countries with at least the bare
minimum of health services.

15. CHARACTERISTICS
1. It is essential health care, which is based on
practical, scientifically sound and socially
acceptable methods and technology.
2. It should be rendered universally acceptable to
individuals and the families.
3. Its availability should be at a cost, which the
community and country can afford to maintain
at every stage of their development in a spirit of
self-reliance and self-development.

16. 4. It requires joint efforts of the health sector and
other health related sectors like, education, food
and agriculture, social welfare, animal husbandry,
housing, etc.
5. Reflects and evolves from the economic
conditions and socio-cultural and political
characteristics of the country.
6. Based on the application of the relevant results
of social, biomedical and health services research
and public health experience

17. 7. Addresses the main health problems in the
community, providing promotive, preventive,
curative and rehabilitative services.
8. Relies on health workers, including
physicians, nurses, midwives, auxiliaries,
community workers, as well as traditional
practitioners, suitably trained socially and
technically to work as a health team.

18. ELEMENTS / COMPONENTS

19. 1. Education about 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 infectious diseases.
6. Prevention and control of endemic diseases.
7. Appropriate treatment of common diseases and
injuries.
8. Provision of essential drugs.

21. PRINCIPLES

22. 1. Equitable Distribution
• First key principle
• Health services must be
shared equally by all
people irrespective of
their ability to pay, and all
(rich or poor, rural or
urban) must have assess
to the health services.

23. At present, health services are mainly
concentrated in major towns and cities, and
the worst hit are the needy and vulnerable
groups of population in rural areas and urban
slums and this is termed as 'social injustice'.
• Primary health care aims to shift the centre
of gravity of health care system from cities to
rural areas and bring these services to as near
the people's homes as possible.

24. 2. Community participation:
• The involvement of individuals, families, and
communities in promotion of their own health
and welfare.

25. • That is, the community must involve in the
planning, implementation and maintenance of
health services, besides maximum reliance on
local resources such as manpower, money and
materials.

26. • In India we have village health guides and
trained dais (mid-wives).
• They provide primary health care b
overcoming cultural and communicatio
barriers, in ways that are acceptable to th
community.

27. • In China, 'community participation is in the
form of bare-foot doctors'.

28. 3. Intersectorial coordination
(Multisectoral approach):
• This is basically, planning with the other
sectors to avoid unnecessary duplication of
activities.

29. • “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".

31. • The major reason for lack of success of many
oral health programs is the fact that they
operate in isolation, separate from general
health care structure.
• Oral health could better be integrated into
general health programs by tackling common
causes, by including oral health in general
health education.

32. 4. Appropriate technology:
• Appropriate technology has been defined:
- "technology that is scientifically sound,
- adaptable to local needs,
- acceptable to those who apply it and those
for whom it is used,
- that can be maintained by the people
themselves in keeping with the principle of
self reliance with the resources the
community and country can afford".

33. • This applies to using costly equipments,
procedures and techniques when cheaper,
scientifically valid and acceptable ones are
available.

34. • The technology should also be:
# Effective
# Acceptable to those who apply it
# Acceptable to those who use it
# In keeping with local culture
# Capable of further development
# Simple to design and use
# Easily understood by people
# Easily understood by health volunteers

35. 5. Focus on prevention:
• This means that the health services should
however not only be curative but should also
promote health and healthy lifestyles with
emphasis on prevention.
• Eg: immunization

36. In Summary
• We have seen,
- the origins of PHC
- definition
- Characteristics
- Elements
- And functions of PHC in any country.