Primary Health Care
Dr Aboelez Hassan
Ibrahem
Community medicine
department
جنيف
KAZAKHSTAN \ ALMA ATA
aAA
DEFINITION OF HEALTH
Health is state of complete ,physical, mental
and social wellbeing and not merely an
absence of disease or infirmity.
WHO 1948
CONCEPTS OF HEALTH CARE
Provision of services by health personnel It
includes:
Promotion
Prevention
Diagnosis
Treatment
Rehabilitation
LEVEL OF SERVICES
At community level ;
➢ Mid wives
➢ Community health workers
At health facilities;
➢ Medical assistance
➢ Doctors
PHC HISTORY
WHO’s Constitution 1946
Health for All by the year 2000 (Assembly) 1977
International Conference on Primary 1978
Health Care (Alma – Ata)
MILE STONES:
WHA 1977
The 30th World Health Assembly Comes with new
philosophies:
• Social justice and equity are essential for health
• Recognition of the role of community
participation
• The importance of the political will
• The relation between health and development
(health is essential for development and
development is essential for health)
HFA
The ideas concluded in the international
objective of Health for All
Definition of HFA: Attainment by all peoples of
the highest level of health that permit them to
lead socially and economically productive life
FUNDAMENTAL PRINCIPLES FOR HEALTH FOR
ALL
1. Health is fundamental human right and a worldwide social goal
2. Health is an integral part of development
3. The existing gross inequality in the health status of people is of
common concern to all countries and must be drastically reduced.
4. People have the right and the duty to participate individually and
collectively in the planning and implementation of their health care
5. Governments have a responsibility for the health of their people
6. Countries must become self-reliant in health matters.
7. Fuller and better use must be made of the world’s resources to
promote health and development.
ALMA-ATA CONFERENCE (1978)
proclaimed PHC
as way to
achieving HFA
PRIMARY HEALTH CARE
It is the first level of
contact of individuals,
the family and the
community with the
national health
system, bringing
health care as close
as possible to where
people live and work
PRIMARY HEALTH CARE (PHC)
• PHC
is 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 community and the
country can afford … (Alma-Ata, 1978)
PHC
Primary Health Care extends beyond the traditional
health sector and includes all human services which
play a part in addressing the inter-related determinants
of health.
Social Environments Employment /
Income & Social Status
Working Conditions
Culture Physical Factors Social Support Networks
Prenatal / Early Childhood
Level of Education
Experiences
PHC
It includes:
Primary Care (physicians, midwives & nurses)
Health promotion, illness prevention
Health maintenance & home support
Community rehabilitation
Pre-hospital emergency medical services
Coordination and referral to other areas of health
care
PRIMARY HEALTH CARE
Services are generally provided in the community
Some services are also provided in hospitals
PHC
Primary health care is an
approach that more broadly
addresses illness prevention
and health promotion.
It encompasses determinants
of health, such as the
influence of culture, education
and income on health and well-
being.
PRIMARY HEALTH CARE
Varies in each community
depending upon:
Needs of the residents;
Availability of health care
providers;
The communities geographic
location; &
Proximity to other health care
services in the area.
COST
PRIMARY HEALTH CARE - BENEFITS
PHC focuses on keeping people healthy & addressing
illness early so as to increase probability of cure
PHC is client focused
Individuals have access to appropriate care
Services are matched to community needs
Targeted services will have a positive impact on the
utilization of health and social services
Healthy communities with healthy people contribute
to stable economy
PRINCIPLES OF PRIMARY HEALTH CARE
Principled health care improvements required
based on Declaration of Alma Ata: 1978
Universal access
Health equity
Community
participation
Inter-sectoral actions
29
PRIMARY HEALTH CARE REFORM
Medical model Primary Health Care
Treatment Health promotion
Illness Health
Cure Prevention, promotion, cure
Episodic care Continuous care
Specific problems Comprehensive care
Individual practitioners Teams of practitioners
Health sector alone Intersectoral collaboration
Professional dominance Community participation
Passive reception Joint responsibility
E L E M E N T S OF PHC
E – Education
L – Local and endemic diseases prevention
E – Expand Program of Immunization ( EPI)
M– Maternal and child health including ( FP)
E - Essential drugs
N – Nutrition
T – Treatment of common diseases and injury
S - water and Sanitation
(SECONDARY) ELEMENTS OF PHC
• Mental Health
• Care of elderly
• Occupational Health
• School Health
• Reproductive Health
• Adolescent Health
Challenges of PHC
Lack of community participation
Lack of inter-sectoral collaboration
Lack of inter-country collaboration
Lack or misuse of human and material resources
Lack or Mismanagement
Lack of operational researches
PRIMARY HEALTH CARE
Working
together for
better health
THANK YOU
