Topic - Primary Health Care Subject - Community Health Nursing Short Notes for ANM, GNM, B.Sc.Nursing, P.B.B.Sc.Nursing

1. PRIMARY
HEALTH
CARE
Ms. Leena Ghag Sakpal.
Nursing Tutor

2. INTRODUCTION
• Medical care: personal services provided directly by physicians.
• Health care : Integrated care including preventive, promotive,
curative, rehabilitative services for individuals from womb to tomb.
• Health care includes medical care.
- Primary level [primary health centre, sub centre]
- Secondary level [community health centre, district hosp.]
- Tertiary level [Regional hospital, medical college hospital]

3. Primary Health Care
• Village level [grass root level]
• First level of contact between health system and individual
• Provided by –Village health guide Traditional birth attendant/dai
Anganwadi workers ASHA

4. Secondary health care
• The First referral level.
• More complex problems are dealt with.
• Comprises curative services.
• Provided by the district hospitals
Tertiary health care
• Offers super-specialist care.
• Provided by regional/central level institution.
• Provide training programs.

5. EVOLUTION
OF PRIMARY
HEALTH CARE
The Alma-Ata Conference
• International conference on primary
health care.
• Conducted from 6-12th September
1978 at Alma Ata.
• Milestone in the history of public
health.
• Key to the attainment of the goal of the
Health for All.

6. PRIMARY HEALTH CARE
• Primary health care is a popular phrase which has come into practice, in
the field of health after the Alma-Ata Conference (1978) and is an
evidence of the measures of health services.
• Before this conference, synonymous terms like Basic Health Services,
First Contact Care and Easily Accessible Care were in use.
• Primary health care is the first level of contact from which interaction
among individual, family and the health services begins.
• All the countries recognize the concept of primary health care.
• “Health For All” is not only an integral part of it, but also the key to
achieve this goal.

7. Characteristics of Primary Health Care
• The “first” level of contact between the individual and the health
system.
• Essential health care (PHC) is provided.
• Most prevailing health problems can be satisfactorily managed.
• The closest to the people.
• Provided by the primary health centers.

8. The Basic Requirements for Sound PHC (the 8 A’s and the 3 C’s)
• Appropriateness
• Availability
• Adequacy
• Accessibility
• Acceptability
• Affordability
• Assessability
• Accountability
• Completeness
• Comprehensiveness
• Continuity

9. DEFINITION
“ 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.”
- Alma Ata Declaration.

10. ELEMENTS
E Education for Health
L Locally endemic disease control
E Expanded programme of immunization
M Maternal and Child health
E Essential Drug availability
N Nutrition
T Treatment
S Safe Water and sanitation

11. PRINCIPLES
• Equitable Distribution
• Community Participation
• Appropriate Technology
• Focus on Prevention
• Multisectoral Co-ordination

12. Equitable Distribution
• This principle states that primary health care
should be available to all individuals, family and
community without any discrimination of age,
sex, religion, area, caste, color, money etc.
• Primary health care based on the concept of
social justice; availability of health care system
to poor.
• People living in rural areas are the main target of
the primary health care.

13. Community Participation
• Primary health care is by the people and
for the people therefore, active
participation of individual, family and
community is necessary.
• It is difficult to achieve the goals of
primary health care if the support of local
community is not available.
• Local community should be participated
in the planning, execution and
maintenance of primary health care.

14. Appropriate Technology
• In primary health care only, those techniques
should be used which are, suitable to local
requirements, socially acceptable, within the
financial limits and scientifically recognized.
• Only locally available technologies should be
used in PHC instead of costly equipments.
• e.g., Oral Rehydration Therapy.

15. Focus on Prevention
• Main focus of primary health is not
the treatment but prevention of
disease and iti is a part of all the
constituents of health services.
• e.g., Immunization, Health
education on healthy habits.

16. Multisectorial Coordination
• The joint efforts are requires
for providing primary helath
care.
• Proper coordination among
medical fiels, agriculture,
housing, nutrition , public
works, communication and
education should be planned
properly to provide effective
health care services.

17. RESPONSIBILITY OF NURSE
In 1984, following responsibilities were bestowed upon nurses by the expert
committee of World Health Organization for taking care of primary health:
• Assessing the health level of individuals and community.
• Activating the participation of the community and encouraging the individuals
to participate.
• Providing treatment in emergencies and taking care of the general health.
• Referring the patients to specialists.
• Keeping eye on the epidemics.
• Training and supervision of health workers.
• coordinating with other health programmes.
• Observing the process of primary health care.