The document discusses the primary healthcare (PHC) movement which began in 1977 with the goal of universal health coverage. The key principles of PHC established at the Alma-Ata Conference in 1978 include accessibility, community participation, and multisectoral involvement. There are 8 essential components of PHC including health education, nutrition, water/sanitation, maternal/child care, immunization, disease control, treatment, and essential drugs. India's health system is based on a three-tier structure with PHC provided through village health units, subcenters, and primary health centers.

1. Hanuman Ram Bishnoi
Faculty, All India Institute of Medical
sciences Jodhpur

2.  THE PHC MOVEMENT OFFICIALY BEGAN IN 1977, WHEN
THE 30th
WORLD HEALTH ASSEMBLY ADOPTED
RESOLUTION ACCEPTING THE GOAL OF ATTAINING A
LEVEL OF HEALTH THAT PERMITTED ALL CITIZENS OF
THE WORLD TO LIVE SOCIALY & ECONOMICALY
PRDUCTIVE LIVES. AT THE INTERNATIONAL
CONFERENCE IN 1978 IN ALMA ATA, USSR, IT WAS
DETERMINED THAT THIS GOAL WAS TO BE MADE
THROUGH “ PRIMARY HEALTH CARE”. THIS
RESOLUTION BECAME KNOWN BY THE SLOGAN “
HEALTH FOR ALL BY THE YEAR 2000”. & CAPTURE THE
OFFICIAL HEALTH TARGET FOR ALL OF THE MEMBER
NATIONS OF THE WHO.

3.  ‘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 CONFERENCE(1978)

4.  THERE ARE 8 ESSENTIAL COMPONENTS
1. EDUCATION CONCERNING PREVAILING HEALTH
PROBLEMS AND THE METHODS OF PREVENTING AND
CONTROLLING THEM.
2. PROMOTION OF FOOD SUPPLY AND PROPPER NUTRITION.
3. AN ADEQUATE SUPPLY OF SAFE WATER AND BASIC
SANITATION.
4. MATERNAL AND CHILD HEALTH INCLUDING FAMILY
PLANNING
5. IMMUNIZATION AGAINST MAJOR INFECTIOUS DISEASES
6. PREVENTION AND CONTROL OF LOCALLY ENDEMIC
DISEASES.
7. APPROPRIATE TREATMENT OF COMMON DISEASES AND
INJURIES.
8. PROVISION OF ESSENTIAL DRUGS.

5.  EQUITABLE DISTRIBUTION
 COVERAGE AND ACCESSIBILITY
 COMMUNITY PARTICIPATION
 MULTISECTORAL APPROACH
 APPROPRIATE TECHNOLOGY
 HUMAN RESOURCE
 SERVICES BY COMMUNITY HEALTH WORKERS AND
TRADITIONAL HEALTH PRACTIONERS
 REFERAL SYSTEM
 LOGICSTICS OF SUPPLY
 THE PHYSICAL FACILITIES
 CONTROL AND EVALUATION

7. HEALTH EDUCATION
 ORGANISING APPROPRIATE HEALTH
EDUCATIONAL PROGRAMMES ACCORDING TO
NEEDS OF THE COMMUNITY.
 COLLABORATING AND CO-ORDINATING WITH
INTRA –DISCIPLINARY AND INTER-DISCIPLINARY
TEAMS.
 HEALTH EDUCATION TO SCHOOL CHILDREN
REGARDING PREVENTION AND MANAGEMENT
OF VARIOUS HEALTH PROBLEMS.

8. FOOD SUPPLY AND PROPER NUTRITION
 SURVEILLANCE AND CASE FINDING THROUGH
USE OF GROWTH CHART IN CHILDREN.
 MAKING PROVISION FOR SUPPLY OF IODISED
SALT,VITAMIN A SUPPLIMENTS,FOOD SUPPLIMENTS
IN COLLABORATION WITH OTHER MEMBERS OF THE
HEALTH TEAM FOR PREVENTION AND CONTROL OF
MALNUTRITION.
 TAKES SUITABLE MEASURES FOR PREVENTION AND
CONTROL OF DIARRHOEL DISEASES ,INTESTINAL
PARASITES AND OTHER DISEASES AFFECTING
ABILITY TO UTILISE FOOD.
 TEACHING COMMUNITY MEMBERS TO COOK THE
SUPPLIMENTORY FOOD FOR MALNOURISHED
CHILDREN.
 TEACH PEOPLE TO ADOPT BASIC SANITARY SKILLS.
 MAINTAIN GROWTH CHART.

9. WATER SUPPLY AND PROPER SANITATION
 IN CO-ORDINATION WITH OTHER RELATED
SECTORS CONDUCT SURVEY AND IDENTIFY
RESOURCES OF SAFE WATER AND TO CARRY OUT
PROPPER ANALYSIS OF WATER.
 ENCOURAGE PEOPLE TO CONSTRUCT
HOUSEHOLD AND COMMUNITY
LATRINE,COMPOSTING FACILITIES AND SOAKAGE
PITS.

10. MATERNAL AND CHILD HEALTH
INCLUDING FAMILY PLANNING
 ANTENATAL,PRENATAL ,PERINATAL AND
POST NATAL CARE

11. IMMUNISATION
 WORK FOR THE SUCCES OF NATIONAL
IMMUNISATION PROGRAMME.
 PLAN IMMUNISATION PROGRAMMES FOR
INFANTS AND CHILDREN.
 EDUCATE COMMUNITY REGARDING
IMMUNISATON.

12. PREVENTION AND CONTROL LOCALLY
ENDEMIC DISEASES
 COLLECT THE RECORD DATA ABOUT
COMMUNICABLE DISEASES,PROVIDE CARE
FOR THE ILL,OFFER HEALTH
EDUCATION,VISIT AND FOLLOW-UP CASES
AND PROVIDE SURVIELLANCE OVER THE
TARGET POPULATION TO ENSURE THAT
COMMUNICABLE DISEASES ARE
ERADICATED OR CONTROLLED.

13. TREATMENT OF MINOR AILMENTS
 PROVIDE EMERGENCY AND PRIMARY CARE.
 PROVIDE POSSIBLE CARE AND REFER TO
HIGHER HEALTH CENTRE AND HOSPITALS
FOR FURTHER TREATMENT.

14. PROVITION OF ESSENTIAL DRUGS
 THE COMMUNITY HEALTH NURSE HAS TO
PRODUCE AND KEEP AND ALSO UTILISE
WHENEVER NECESSARY ESSENTIAL DRUGS
TO TREAT MINOR AILMENTS.
 AWARE ABOUT THE RESOURCES AND
FACILITIES FOR GETTING ESSENTIAL DRUG
TO INFORM CLIENTS WITHIN A SHORT
DISTANCE.

15. OTHER ROLES:
 NURSE AS A DIRECT CARE PROVIDER
 NURSE AS A TEACHER AND EDUCATOR
 NURSE AS A SUPERVISOR AND MANAGER
 NURSE AS A RESEARCHER AND MANAGER

16. IN INDIA HEALTH INFRASTRUCTURE IS BASED
ON 3 TIER SYSTEM OF SERVICES PROVIDED
AT THREE LEVELS:
1. PRIMARY HEALTH CARE
2. SECONDARY HEALTH CARE
3. TERTIARY HEALTH CARE

17. PHC SERVICES ARE BEING RENDERED
THROUGH
THE PRIMARY HEALTH CENTER, SUB CENTERS
AND VILLAGE HEALTH CENTERS
 VILLAGE HEALTH UNIT FOR 1:1000
POPULATION
 SUB CENTER 1:5000 POPULATION
 PRIMARY HEALTH CENTER 1:30000
POPULATION

18.  FACILITIES AT VILLAGE LEVEL
 FACILITIES AT PRIMARY HEALTH CENTER LEVEL
i. MEDIACL CARE
ii. MCH AND FAMILY PLANNING
iii. SAFE WATER SUPPLY AND BASIC SANITATION
iv. PREVENTION AND CONTROL OF LOCALLY ENDEMIC
DISEASES
v. COLLECTION AND REPORTING OF VITAL STATISTICS
vi. EDICATION ABOUT HEALTH AND NUTRITION
vii. IMPLEMENTATION OF ALL NATIONAL HEALTH PROGRAMS
viii.REFERRAL SERVICES
ix. TRAINIGN OF VHGs, HW (MALE & FEMALE), HA (MALE &
FEMALE), LOCAL DAIS, ETC.

19. DISTRICT HEALTH AND FW CENTER
DISTRICT HOSPITAL
COMMUNITY HEALTH CENTER
1:100000 POPULATION
PRIMARY HEALTH CENTER
1:30000 POPULATION
SUBCENTER
1:5000 POPULATION
VILLAGE HEALTH UNIT
1:1000 POPULATION
TEACHING
HOSPITALS
SUPER
SPECIALITY
HOSPITALS
REGIONA
L
HOSPITA
LS
INSTITUTIO
NS
TIERS OF
DELIVERY
PRIMARY HEALTH
CARE
SECONDARY
HEALTH CARE
TERTIARY
HEALTH CARE