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Lecture#4. Primary Health Care (PHC)

This is related to primary health care

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Muhammad Noman
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14 views

Lecture#4. Primary Health Care (PHC)

This is related to primary health care

Uploaded by

Muhammad Noman
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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Primary Health Care(PHC)

Dr. Ishfaque Ali


MBBS,MSPH
Lecturer , Community Medicine Department,
Gambat Medical College.
Learning Objectives:

By the end of the session, students will be able to:


 Describe Philosophy and historical perspective of PHC in the
context of Alma-Ata declaration
 Define Primary Health Care (PHC)
 Describe the fundamental Principles of PHC
 Enumerate the essential Components(elements) of PHC
 Discuss PHC approaches (Selective versus Comprehensive)
 Challenges faced by PHC
 Primary Health care in Pakistan
PHC and Alma-Ata

PHC and Health for All (HFA) are part of the Alma-Ata
Declaration that marks the commitment of UN Member
countries towards achieving a more equitable health status
across the world, particularly in developing countries
Alma –Ata Philosophy of PHC
• Alma-Ata Declaration by WHO & UNICEF 1978
recognized
Health as a fundamental human right

• Introduced the concept of PHC (Equity, acceptability and


affordability)

• Provided a roadmap to achieve highest attainment of health by


year 2000 through:
• Political commitment
• Social and economical development
• Focus on Health promotion, education and
community empowerment
• Global co-operation and inter-sectoral collaboration
Primary Health Care(PHC)

“PHC is essential health care made universally


accessible to individuals and families in the
community by means acceptable to them, through
their full participation and at a cost that the
community and country can afford”.
Primary Health Care

• Essential health care made


– Universally accessible to individuals and families in
the community
– Acceptable
– Through their full community participation
– At a cost that the community and country can afford
Principles of Primary Health Care(PHC)

1- Equity or Equitable distribution of Health Services:


- Everyone is entitled to health care but according to need of people
irrespective of their ability to pay. Because need is always different
for different people.

2- Community Participation:
- It is referred to an approach which involves community in managing or solving
their own problems
- The involvement of individuals, families and communities in promotion of their
own health and welfare is an essential ingredient of PHC
Example: Trained Birth Attendants and Lady Health Workers in Pakistan
3- Intersectoral Coordination:
-Health cannot be attained by the health sector alone
-It requires coordination and cooperation between health
sectors and other health related groups e.g. Housing,
sanitation, food and agriculture, social welfare department

4- Appropriate Technology:
- Technology is appropriate when it fulfills
4 A’s
• Available
• Affordable
• Accessible
• Acceptable
PHC- Core Concepts
• Equity

• Effectiveness

• Efficiency
Essential Components of PHC
1. Health education and promotion
2. Promotion of nutrition, safe water and basic sanitation
3. Maternal and Child Healthcare(MCH) and Family
planning
4. Immunization
5. Prevention and control of locally endemic diseases
6. Appropriate treatment of common diseases and injuries
7. Promotion of mental health
8. Provision of essential drugs
• New components related to changing dynamics
Essential components of PHC
2 New components:

• Promotion of healthy lifestyles (exercise, diet, stop


smoking and alcoholism)

• Management of diabetes, CVD’s and HIV and


Tuberculosis
PHC Approaches

Selective PHC Comprehensive PHC

• Focuses on selected disease, • Focuses on a broad view of


matching certain criteria like health including social ,
high prevalence , high physical and mental well
morbidity , high mortality being but not only the one
disease or a selective
diseased group

• Mostly focused on vertical • More Focused on integrated


community programmes
programmes
Selective PHC Comprehensive PHC
• Package of a few selected • Package of all programs that
programs which are
epidemiologically and
are part of Primary health
socially effective (based on care
burden and feasibility)

• GOBIFF approach (Growth • All the components of PHC


Monitoring, ORS, Breast
feeding, Immunization,
Family Planning and Female
Education)
PHC organization in Health

• Governance (decentralization, stakeholder involvement,


regulation of private sector)

• Financial (minimize user fees, CBHI, incentives)

• Resources and Delivery (Training, outreach


services, services integration)
Challenges faced by PHC

• Debate between selective and comprehensive approach

• Involving communities

• Intersectoral collaboration (unwillingness to contribute in


health)

• Political commitment
Primary Health care in Pakistan

 In Pakistan PHC facilities are being offered


through
• Basic Health Units(BHUs)
• Rural Health Units (RHCs)
• Other facilities such as: Dispensaries,
Maternity and Child health centres and sub
centers.
Basic Health Unit-(BHU)
 A BHU serves 5000 to 10,000 population
 Services at BHU level includes:
• MCH services
• Childcare
• Immunization
• Diarrheal disease control
• Malaria control
• Child spacing
• Mental health and school health services
 A BHU is staffed by Medical Officer, a male and female
technician and support personnel.
Rural Health Unit(RHC)

 Each RHC has about 25 beds, a laboratory, X-ray, and provision for
minor surgery along with a dentist and sanitary inspector.
 Outreach services are provided primarily for MCH through training
birth attendants
 5 to 10 BHUs are linked with a RHC
 RHCs play a pivotal role and act as focal points in health system
 RHC is linked through Tehsil hospital(THQ) and District
Headquarters Hospital(DHQ)
 The system of BHUs, RHCs, THQs and DHQs is designated as “
Integrated Rural Health Complex”
Thank you

Any Questions?

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