Principles and Concepts of Primary Health Care (PHC)

Question 1

Define Primary Health Care.

Answer 1

Primary Health Care (PHC) is a comprehensive and society-wide approach that aims at ensuring the highest possible level of health and well-being with equitable distribution by addressing everyone’s needs as early as possible across the continuum of care—from health promotion and disease prevention to treatment, rehabilitation, and palliative care—delivered as close as feasible to individuals’ everyday environments.

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 the country and community can afford.

Question 2

Briefly discuss the history of PHC.

Answer 2

Before 1978, existing health services were failing to provide quality health care to the people globally, and different alternatives and ideas explored failed to establish a well-functioning system.

To tackle this issue, the Alma-Ata conference, a joint WHO-UNICEF international conference with 134 countries and other agencies in participation, was held in Alma-Ata (USSR) in 1978.

The conference declared “The existing gross inequality in the health status of people, particularly between developed and developing countries, as well as within countries is politically, socially and economically unacceptable,” and called for a revolutionary approach to health care.

Thus, the Alma-Ata conference called for acceptance of WHO goal of ‘Health for All’ by 2000 AD, and proclaimed Primary Health Care (PHC) as the way to achieve it.

Thus, the concept of PHC was brought to life globally in 1978.

Question 3

Mention 9 objectives of PHC.

Answer 3

1. To increase programs and services that promote the healthy growth and development of children and youth.
2. To boost the collaboration between the community, government, and local organizations to enhance the health of the community.
3. To develop community satisfaction with the PHC system.
4. To support and advocate for healthy public policy within all sectors and levels of
   government.
5. To provide reasonable and timely access to primary health care services.
6. To apply the standards of accountability in professional practice.
7. To establish, within available resources, primary health care teams and network.
8. To support and encourage the implementation of provincial public health policies and direction.
9. To support the provision of comprehensive, integrated, and evidence-based primary health care services

Question 4

What are the principles of PHC?

Answer 4

Social equity
Nation-wide coverage
Inter-sectorial coordination
People’s involvement
Self-reliance

SNIPS

Question 5

Discuss the 4 pillars of PHC

Answer 5

1. Community partcipation: this is a process in which community people are engaged and participate in making decisions about their own health. It involves the participation of the community people in identifying the health needs of the community, decision making, planning and execution of health programs. Without this, the programs cannot run smoothly and PHC cannot be universally achieved.
2. Inter-sectorial coordination: Inter-sectorial coordination is essential in providing effective health services, as health is affected by various factores beyond health care, such as education, housing and nutrition. The involvement of specialised agencies, private sectors and public sectors is important to achieve a well-functioning health care system.
3. Appropriate technology: Appropriate technology refers to using cheaper, scientifically valid and acceptable equipment and techniques.
   This technology is required to be scientifically sound, adaptable to local needs, acceptable to the community people and accessible, affordable and maintainable by community resources.
4. Support mechanisms: This is a foundational principle of Primary Health Care (PHC) aimed at ensuring a comprehensive and sustainable approach to improving health and quality of life. It involves the establishment of structures and resources that provide holistic support—covering personal, physical, mental, spiritual, and instrumental aspects of health care.
   Primary health care depends on an adequate distribution of healthcare providers, such as pharmacists, physicians, nurses and allied health professionals working as a health team.

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Question 6

Appropriate healthcare technolgies are expected to be:

Answer 6

1. Scientifically reliable and valid
2. Adapted to local needs
3. Acceptable to the community
4. Accessible and affordable by local resources

Question 7

Mention 8 elements of PHC.

Answer 7

1. E Education about prevailing health problems and their prevention and control
2. L Prevention and control of locally endemic diseases
3. E Provision of essential drugs
4. M Maternal and child health care
5. E Expanded immunisation against major infectious diseases
6. N Promotion of proper nutrition
7. T Appropriate treatment for common diseases and injuries
8. S Sanitation and adequate supply of safe water

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Question 8

List 5 etended elements of PHC in the 21st century.

Answer 8

• Extended options of immunisation
• Reproduction health needs
• Provison of essential technologies
• Health promotion
• Food safety and provision of selected supplements
• Prevention and control of non-communicable diseases

Question 9

Highlight the importance of PHC.

Answer 9

i. Focuses on “Health for all”
ii. Promotes equity or equality
iii. Easily accessible by all
iv. Encourages community participation
v. Advocates health promotion and focuses on prevention and early intervention
vi. Improves safety, performance and accountability
vii. It’s an integral part of the countries socio-economic development

Question 10

Highlight 7 challenges of implementing PHC.

Answer 10

1. Inadequate staffing or distribution of health workers
2. Inadequate technology and equipment
3. Inadequate financial support in health care programs
4. Lack of community participation
5. Lack of inter-sectorial collaboration
6. Poor infrastructural conditions
7. Challenging geographic accessibility
8. Concentrated focus on curative services, rather than preventive and promotive services

Question 11

Mention 7 mitigation measures for ensuring effective PHC.

Answer 11

1. Promoting problem-oriented research in health management systems
2. Developing a planning process to define objectives and set targets by prioritising communities most at risk
3. Developing quality assurance by the development of various metrics and standards
4. Development of clinical guidelines, including essential drug lists
5. Collaboration of health departments to perform their role in health activities
6. Attributing more priority to health on the agenda of district development
7. Encouraging community participation by rapport building, effective communication and sharing of objectives.