A brief description of Public Health (PH) and Primary Health Care (PHC)

1. CONCEPT OF
AND
Col Zulfiquer Ahmed Amin
M Phil, MPH, PGD (Health Economics), MBBS
Armed Forces Medical Institute (AFMI)

2. PUBLIC HEALTH

4. Essential Services of PH

5. Public Health Fundamentals
5 Ps of Public Health (expansion from the 3 Ps)
– Prevention (individual and community-focused)
– Promotion (voluntary, education, advocacy)
– Protection (policies/regulations; enforcement)
– Population-based (communities, groups)
– New 5th P: Preparedness (e.g., bioterrorism,
natural disasters, pandemics)

7. History of Public Health

8. Early Public Health

13. (1100 to 1453 AD)
Disease was viewed as divine
punishment for the sins of man

14. -Crusaders’ noble knights boasted of bathing no more than four times a year.
-In marked contrast, the Muslims put a premium on cleanliness and dietary
regime.
-The ritual cleansing of the body precedes each of the five daily prayers, a
requirement that sparked the development of sophisticated public-water
projects and ingenious engineering techniques.
-Religious law proscribed a number of unhealthy practices, including the
consumption of alcohol.
-A large collection of sayings and practices ascribed to the Prophet Muhammad,
later collated as the The Medicine of the Prophet, provided a general blueprint
for healthy living and abstemious behavior.
-Arabs translated all available Greek books of science and philosophy,
-Teaching hospital, the first built in Damascus in 707.
-The leading Arab philosophers—Avicenna, and Maimonides—were all great
physicians.

15. (14th to the 17th century)
(1514-1564)
(1578-1657)
(1624–1689)
(1818-65) (Early pioneer of antiseptic procedures)
(1749-1823) Pioneer of smallpox vaccine
(1632–1723)

16. (A social reformer)
(Legislating on the sanitary
conditions of England
and Wales)

18. Phases of Public Health

19. -First phase of public health, following soon after the industrial
revolution.
-Advocated sanitary action to deal with health problems caused
by environmental factors.

21. 2.

23. To establish Health For All by 2000 AD by means of Primary health Care
(1980-2000 AD)4.

24. Health For All

25. (2003)
(1983)
(1976)
(Most frequenting
Since 1995)

27. Concepts of

28. Levels of Care
• Primary health care
• Secondary health care
• Tertiary health care

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

30. Secondary health care
• More complex problems are dealt with.
• Comprises curative services
• Provided by the district hospitals
• The 1st referral level
Tertiary health care
• Offers super-specialist care
• Provided by regional/central level institution.
• Provide training programs

31. WHAT IS PRIMARY HEALTH CARE

32. There are 8 elements of primary-health care (PHC):
E– Education concerning prevailing health problems and the
methods of identifying, preventing and controlling them.
L– Locally endemic disease prevention and control.
E– Expanded program of immunization against major
infectious diseases.
M– Maternal and child health care including family planning.
E– Essential drugs arrangement.
N– Nutritional food supplement, an adequate supply of safe and
basic nutrition.
T– Treatment of communicable and non-communicable disease
and promotion of mental health.
S– Safe water and sanitation.
Essential Elements of Primary Health Care

34. Attributes of
(5 As)

35. PRINCIPLES OF PRIMARY HEALTH
CARE
• EQUITABLE DISTRIBUTION
• COMMUNITY PARTICIPATION
• INTERSECTORAL COORDINATION
• APROPRIATE TECHNOLOGY
• DECENTRALISATION

41. FIVE COMMON SHORT COMINGS OF
HEALTH CARE DELIVERY
• INVERSE CARE: More inclined to the rich.
• IMPOVERISHING CARE: Healthcare expenditure
makes one poor.
• FRAGMENTED AND FRAGMENTING CARE: Too
much specialties, interfere with COMPREHRNSIVE
care.
• UNSAFE CARE: Hospital Acquired Infection.
• MISDIRECTED CARE: Less budget for preventive
services which can tackle 70% of cases of ill-
health.