Primary Health Care PHC By Prof Dr Nashwa

Primary Health Care (PHC) By Prof. Dr. Nashwa Nabil Kamal

definition It is the first level of contact of individuals, the family and community with the national health system, bringing health care as close as possible to where people live and work, and constitutes the first element of a continuing health care process. "

Alma Ata Declaration (1978) An international conference in Alma Ata issued a declaration which stated that “Primary Health Care” is the key to attain health for all (HFA)

The concept of primary health care Essential health care: is the health care which would meet actual health needs of the community. Acceptable methods: accepted by all people Affordable health care: Affordability means PHC services are to be provided within the available resources Accessible health care (geographicalsocial)

Elements of PHC There are eight elements of PHC. 1. Promotive services: 1. 1. Education concerning prevailing health problems and the methods of preventing and controlling them 1. 2. Promotion of food supply and proper nutrition. 1. 3. Provision of comprehensive maternal and child health care.

. 2. Preventive services: 2. 1. Immunization of children against major communicable diseases. 2. 2. Prevention and control of locally endemic diseases. 2. 3. Provision of adequate supply of safe water and basic sanitation. 3. Curative care: 3. 1. Appropriate treatment of common diseases and injuries. 3. 2. Provision of essential drugs.

PHC principles: 1. Equity in distribution: Equity means services to all people and more services to the needy and vulnerable groups. The health services (not necessarily health centers) have to be dispersed into the farthest remote rural areas and into the deepest parts of the underserved urban population. Accessibility has to be improved either by increasing the number of health facilities, by improving transport conditions, or by organizing outreach services

2 -Appropriate Technology: Appropriateness means that besides being (i) scientifically sound (ii) acceptable to those who apply it and those for whom it is used (iii) applicable for health professional use and for self-use. Scientifically sound acceptable technology has to fulfill certain criteria such as the sensitivity, cost, easy to apply (use) and maintain, culturally acceptable, capable of being adapted and further developed locally.

3 - Multispectral approach: The developmental efforts of each sector are complimentary to other and hence, individual sectors cannot function in isolation. This coordination may have to be extended to other government and private health sectors to ensure uniformity and equity and also at times to avoid duplication in health services.

4 -Community participation: Social awareness and community selfreliance are the key factors in human development and such as the people have both the right and duty to participate in the process for the improvement and maintenance of health

PHC services PHC used to deliver vertical programs including: Maternal health, reproductive health &family planning, Child health, Care of elderly and Occupational health. A health office (HO) is part of some PHC facilities, especially in rural areas.

A regular PHC unit delivers the following services: � Health education is included in all programs. Health education plan is done by the PHC team on monthly basis to cover regular and emerging issues. Outreach health education services are provided by the Raeda Refeya (RR) and sometimes by nurses. � Supervision of food establishments and the food handlers. � Monitoring the environment and collecting water samples to be sent for laboratory examination � Immunization as part of different programs, vaccination campaigns as planned by MOH.

� Premarital counseling for future couples. � All components of maternal, child and reproductive health services. � Screening tests as part of the PHC programs or as required by MOH. � Implementing surveillance as required by MOH. � Investigation of outbreak/ epidemics under the direction of higher MOH level. � Basic laboratory investigations � Primary curative care services � First aid services (stabilize and refer) � Minor surgery (e. g. circumcision and sutures)

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