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Concept of PHC

There are three levels of health care: primary, secondary, and tertiary. Primary health care is the first level of contact and provides essential care through primary health centers. Secondary health care handles more complex issues through district hospitals. Tertiary care offers specialized treatment through regional institutions. The primary health care approach focuses on prevention, community participation, and equitable access to services. Nurses play an important role in delivering primary health care and promoting health at the community level.

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sunielgowda
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293 views

Concept of PHC

There are three levels of health care: primary, secondary, and tertiary. Primary health care is the first level of contact and provides essential care through primary health centers. Secondary health care handles more complex issues through district hospitals. Tertiary care offers specialized treatment through regional institutions. The primary health care approach focuses on prevention, community participation, and equitable access to services. Nurses play an important role in delivering primary health care and promoting health at the community level.

Uploaded by

sunielgowda
Copyright
© © All Rights Reserved
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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Levels of Care

Primary

health care
Secondary health care
Tertiary health care

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.

Secondary health care


More

complex problems are dealt with.

Comprises
Provided
The

curative services

by the district hospitals

1st referral level

Tertiary health care


Offers

super-specialist care

Provided

institution.

Provide

by

regional/central

training programs

level

Introduction
The

on

concept of Primary health care is based

practical,
scientifically

sound and
socially acceptable
methods and technology.

Such

care is delivered in multiple settings,


such as

community

nursing centers,
health maintenance organizations, and
community based clinics.

Primary health care

Primary health care is the strategy


evolved to achieve Health for All by 2000
AD by the International Conference on
primary health care.
1978 in Alma-Ata

Definition
"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."

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

GENESIS OF PRIMARY HEALTH CARE:


The
Bhore
Committee
(1946)
recommended
The Alma-Ata Declaration:
Conference in 1978.
adopted
by representatives of 134
governments

The declaration of Alma Ata stated that


primary health care includes at least:
education

- health problems and methods


of preventing controlling them

promotion
an

of food supply and proper nutrition

adequate supply of safe water and basic


sanitation

MCH,

family planning;
immunization
prevention and control of endemic diseases;
appropriate treatment of common diseases
and injuries; and
Provision of essential drugs.

The concept of primary health care


involves
effort

to minimum of health services.

mental

health, physical handicaps, and the


health and social care of the elderly

The

primary health care approach - at the


community level - improving the health status
of the population

THE PRIMARY HEALTH CARE


PHILOSOPHY:
1.Health is fundamentally related to availability
and distribution of resources
not just health resources such as doctors, nurses,
clinics, medicines,
but also other socio-economic resources such as
education, water supply and food supply.

2. Health is an integral part of overall


development.
Thus factors, which influence health are social,
cultural and economic as well as biological
and environmental.

3. Achievement of better health requires much


more involvement of people themselves as
individuals, families and communities, in
taking action on their own

PRIMARY HEALTH CARE STRATEGY:


The need for change in the Health care
system
b) Intersectoral Action for Health
c) Individual and collective responsibility
for health
d) PHC as a level of Health care
a)

Elements of primary health care


E

: Ensure safe water supply


L : Locally endemic diseases control
E : EPI / UIP
M : Maternal and child health.
E : Environment sanitation
N : Nutritional services - nutrition & food supply
T : Treatment of minor ailments
S : School health services.

The Basic Requirements for Sound PHC (the


8 As and the 3 Cs) / Characteristics
Appropriateness

Assessability

Availability

Accountability

Adequacy
Accessibility

Completeness

Acceptability

Comprehensiveness

Affordability

Continuity

Appropriateness

Service

- in relation to essential human


needs, priorities and policies.

The

service - properly selected and


carried out by trained personnel in the
proper way.

Adequacy
The

service proportionate to requirement.

Sufficient

- care to meet the need and


demand of a community

Affordability

The

cost should be within the means and


resources of the individual and the
country.

Accessibility
Reachable,

convenient services
Geographic,
economic,
accessibility

cultural

Acceptability
Acceptability

of care
depends on a variety of factors
satisfactory communication between health
care providers and the patients,
whether the patients trust this care, and
whether
the patients believe in the
confidentiality and privacy of information
shared with the providers.

Availability
Availability

of medical care means that care


can be obtained whenever people need it.

Assessability
Assessebility

means that medical care can be


readily evaluated.

Accountability
Accountability

implies the feasibility of


regular review of financial records by
certified public accountants.

Completeness
Completeness

of care - attention to all aspects


of a medical problem, including
prevention,
early detection,
diagnosis,
treatment,
follow up measures, and
rehabilitation.

Continuity
Continuity

of care requires that the


management of a patients care over time be
coordinated among providers.

FUNCTIONS OF
PRIMARY HEALTH CENTRE:
Medical

care

FUNCTIONS OF
PRIMARY HEALTH CENTRE:
Maternal

child health

FUNCTIONS OF
PRIMARY HEALTH CENTRE:
Control

of communicable disease

FUNCTIONS OF
PRIMARY HEALTH CENTRE:
Collection

and reporting of vital statistics

Immunization

services

Improvement

in environment sanitation.

School

health services.

Referral

services

National

health programmes

Prevention

of food adulteration practices.

Training

Programmes.

Principles of primary health care


Equitable

distribution
Community participation
Focus on prevention
Inter sectoral co-ordination
Appropriate technology

Equitable distribution:
Essential

health care facilities/services must

be,
Available for all
Accessible to all
Acceptable by all
Affordable by all

No

uncovered- exist in the rural/tribal/periurban areas.


Urban areas - political and socio economic
forces - enjoy the advantage of - health care
resources for many years

Social

equity - redistribution/preferential
allocation of resources to underserved areas.

Community involvement (Participation):


Community

participation means involvement


of the people in the development process
voluntarily and willingly.

Close

contact between health services and


the community is essential and should be a
two-way process.

Health

workers and the services must remain


responsive to the perceived and real health
needs of the people.

community

must understand the objectives


and constraints of the health system

Community

leaders can be particularly


valuable in mobilizing resources and
assisting health workers for effective
delivery of health care.

Various

community organizations and


social networks such as village development
committees, youth associations, religious
organizations etc.
for participation.

Focus on prevention:
Three

levels of prevention/intervention in
health care

Primary:
Secondary:
Tertiary:

Focus on prevention:
Primary:
Health

promotion
Specific protection

Secondary:
Early

detection/diagnosis
Treatment

Tertiary:
Disability

limitation
Rehabilitation

Intersectoral co-ordination:

Appropriate Technology:
association

of methods
techniques and
equipments

+
People

Appropriate means that the technology is


scientifically

sound
acceptable to those who apply it and to those
for whom it is used
compatible with local culture
understandable by the PHC workers and in
some instances even by individuals, family,
community
cost-effective

Seven Supporting Activities for


Primary Health Care:

PRIMARY HEALTH CARE


IN INDIA:
In

1977,
the Government of India launched a rural
health scheme, based on the principle of
placing

hands.

peoples

health

in

peoples

It

is the three tier system of health care


delivery in rural areas based on the
recommendation
of
the
Shrivastav
committee in 1975.

a) Village level:
universal

coverage and equitable distribution


of health resources.

(i) Village

health Guides
(ii)Local Dais
(iii)Anganwadi worker

(b) Sub-centre level:


one

male and one female multipurpose health


worker.

functions of sub-centre is,


mother and child health care,
family planning,
immunization,
IUD insertion and
simple laboratory investigations like routine
examination of urine for albumin and sugar.

(c) Primary health centre level:


The

Bhore committee in 1946 gave the


concept of a primary health centre as a basic
health unit,

to

provide, an integrated curative and


preventive health care to the rural population

(d) Community Health


centre:
1.

Population of 80,000 1, 20,000

2.

with 3-4 PHC.

3.

Specialized services, by the team of


specialist nurses & other Personnels.

4.

FRU

Role of nurse in primary health care:


Collaborator
Adviser
Consultant
Advocate
Preventor

of illness
Promoter of health
Care provider

Team

leader
Observer
Potentiator
Manager
Participant
Practitioner

Nurses role in the delivery of Primary


health care
Primary

health care providers


Professional competence
Interpersonal competence
Intraprofessional and Interprofessional
competence

contd
Multicultural

competence
Client and family
Health promotion
Disease prevention
Health protection
Technological resources
Community based practice

contd
Community

-oriented primary care


The community as a partner in primary
care
The nursing process and the delivery of
primary care services

CONCLUSION:
Health

promotion strategies are not limited to a


specific health problem, not at a specific set of
behaviors.
The primary health care should be community
based with the involvement of community.
It aims to provide a total package of health and
developmental
activities
in
a
community/nation.

To Summarize
Primary care is an approach that:
Focuses on the person not the disease,
considers all determinants of health
Integrates care when there is more than one
problem
Uses resources to narrow differences

Forms

the basis for other levels of health


systems
Addresses most important problems in the
community by providing preventive,
curative, and rehabilitative services
Organizes deployment of resources aiming at
promoting and maintaining health.

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