Primary health care basic concepts
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بسم الله الرحمن الرحيم Primary Health Care Basic Concepts. Health . “A state of complete physical, mental and social wellbeing and its not merely the absence of disease or infirmity” WHO 1946. Concepts of health care . Provision of services by health personnel It includes:

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بسم الله الرحمن الرحيم Primary Health Care Basic Concepts

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Primary health care basic concepts

بسم الله الرحمن الرحيم

Primary Health Care

Basic Concepts


Health

Health

“A state of complete physical, mental and

social wellbeing and its not merely the

absence of disease or infirmity”

WHO 1946


Concepts of health care

Concepts of health care

  • Provision of services by health personnel It includes:

    • Prevention

    • Diagnosis

    • Treatment

    • Rehabilitation

    • Promotion


Levels of health care

Levels of Health Care

  • Primary health care

  • Secondary health care

  • Tertiary health care


Levels of health care1

Levels of Health Care

Primary health care

  • The “first” level of contact between the individual and the health system.

  • The closest to the people.

  • Cover all people with essential care.

  • Addresses the main health problems in the community, providing preventive and curative services.

  • A majority of prevailing health problems can be satisfactorily managed.

  • Provided by the primary health centers.


Levels of health care2

Levels of Health Care

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.


Primary health care basic concepts

PHC history

PHC appeared as a concept since 1975 in the 25th conference for WHO

Health for All by the year 2000 (Assembly) -1977

International Conference on Primary Health Care (Alma – Ata) -1978


Phc history wha 1977

PHC history 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)


Health for all

Health for All

  • 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

Fundamental Principles for Health for All

  • Health is fundamental human rightand a worldwide social goal

  • Health is an integral part of development

  • The existing gross inequality in the health status of people is of common concern to all countries and must be drastically reduced.

  • People have the right and the duty to participate individually and collectively in the planning and implementation of their health care

  • Governments have a responsibility for the health of their people

  • Countries must become self-reliant in health matters.

  • Fuller and better use must be made of the world’s resources to promote health and development.


Alma ata conference 1978

Alma-Ata Conference (1978)

  • proclaimed PHC as way to achieving HFA


Primary health care

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 care1

Primary Health Care

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 country can

afford to maintain at every stage of their

development in the spirit of self-reliance

and self-determination.

Alma Ata declaration, 1978


Principles of primary health care

Principles of Primary Health Care

1.Equitable Distribution: 

Health services should be available to each and every one in the community – not depend on one’s capability to pay for the services (rich & poor) Rural or urban

2.Appropriate Technology: 

Appropriate technology is one which is – scientifically sound, adapted to local needs, acceptable to those who apply it and to those on whom it is applied, within the resources which can be afforded by the community and the nation.

Examples of appropriate technology are Oral rehydration therapy DOTS and Immunization programme


Principles of primary health care1

.

Principles of Primary Health Care

3.Inter-Sectoral Coordination: 

in addition to the health sector, all related sectors in particular agriculture, animal , food, industry.

4.Community Participation: 

While most of the efforts in providing health care come from the Ministry of health, the system of primary health care should be based on full participation and involvement of the community in planning, implementation and evaluation.


The basic requirements for sound phc

The Basic Requirements for Sound PHC

  • Appropriateness

  • Availability

  • Adequacy

  • Accessibility

  • Acceptability

  • Affordability

  • Assessability


Appropriateness

Appropriateness

  • Appropriateservice is provided according to essential human needs, priorities and policies.


Adequacy

Adequacy

  • Sufficient volume of care to meet the need and demand of a community

  • Adequate attention to all aspects of a medical problem, including prevention, early detection, diagnosis, treatment, follow up measures, and rehabilitation.


Affordability

Affordability

  • The cost should be within the means and resources of the individual and the country.


Accessibility

Accessibility

  • Geographic, economic, cultural accessibility


Acceptability

Acceptability

  • Acceptability of care depends on a variety of factors, including 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

  • Availability of medical care means that care can be obtained whenever people need it.


Assessability

Assessability

  • Assessebility means that medical care can be readily evaluated.


Main elements of phc

Main Elements of PHC

  • Health Education concerning prevailing health problems and the methods of preventing and controlling them;

  • Promotion of food supply and proper nutrition;

  • An adequate supply of safe water and basic sanitation.


Main elements of phc1

Main Elements of PHC

  • Maternal and child health care, including family planning

  • Immunization against the major infectious diseases

  • Prevention and control of local endemic diseases

  • Appropriate treatment of common diseases and injuries

  • Provision of essential drugs


Secondary elements of phc

(secondary) elements of PHC

• Mental Health

• Care of elderly

• Occupational Health

• School Health

• Reproductive Health

• Adolescent Health


Elements of phc cont

Elements of PHC (cont.)

Primary Health Care

Preventive services

Curative services

Outpatient clinic (referral)

General services

Care of vulnerable groups

Laboratory services

Dispensary

Health education

Maternal &child health s.

First aid and emergency

services

Monitoring of environment

School health services

Prev.&control of endemic diseases

Geriatric health services

Occupational health services


Primary health care benefits

Primary Health Care - Benefits

  • PHC focuses on keeping people healthy & addressing illness early so as to increase probability of cure

  • 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 a stable economy

  • PHC is Cost-effective


Why phc is cost effective

Why PHC is Cost-effective?

  • Reduces the disease burden. Effectively addressing the most common health needs (70% - 90% of health services).

  • Produce economic savings. improving family health by prevention, close services and sustainable follow up.

  • Assure greater equity. Geographically, Financially, and culturally accessible to local communities

  • Efficient allocation of resources (Spending 1 US$ in PHC saving 10 US$ to the government)

  • Operationally sound ,cheap and simple knowhow.

  • Fund raiser tool, attract the community to finance & participate in provision of health services.


Comparison between primary secondary health care costs

Comparison between Primary & Secondary health care costs


Problems that impede the implementation of phc in sudan

Problems that impede the implementation of PHC in Sudan

  • The burden of communicable and non-communicable diseases is rising which put more demand on PHC services.

  • Inequitable distribution of health care services

  • Shortage of qualified human resources.

    4. Inadequate PHC level management capacity.

    5. Absence of sustainable financial mechanism for PHC services.

    6. The focus of government spending on hospitals leading to an unbalanced health system. Most of the government health expenditure is directed to the secondary and tertiary hospitals


Population health expenditure inverted pyramid

Population & Health Expenditure (Inverted Pyramid)


Primary health care basic concepts

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