Primary Health Care

PRIMARY HEALTH CARE; DEFINITION,
PRINCIPLE, COMPONENTS AND

Strategies for implementation of PHC
BY
DR EJIKEM P
COMMUNITY MEDICINE
RHEMA UNIVERSITY
COURSE OUTLINE
• INTRODUCTION OF PHC.
• DEFINITION OF PHC
• OBJECTIVES OF PHC.
• PRINCIPLES OF PHC
• COMPONENTS
• STRATEGIES FOR THE IMPLEMENTATIONS OF PHC.
• CHALLNGES OF PHC IN NIGERIA.
Introduction
 Health care services has been in existence prior to 1978.
These services failed to provide quality health care to the people until
the birth of primary health care(PHC).
The introduction of PHC followed a joint WHO- UNICEF international
conference held in Alma Ata ( USSR) in 1978.
The conference declared ‘the existing gross inequality in health system of
the people between developed and developing countries.
The Alma Ata declearation gave rise to the ‘Health for all by the year
2000.
It further proclaimed PHC as a way to achieve health for all.
Introduction continued
The aim of PHC was to provide general health service of preventive, promotive,
curative and rehabilitative services.
It also gave rise to remarkable achievements in the major health indicators globally.
One of which is the increase in life expectancies increasing by over 10 years of what
it was in 1978 and the risk of dying between age five falling by 2/3rd.
That PHC to serve as the entry point of the health care system.
However, PHC has been bedeviled with a number of problems which accounted for
the non attendants of health for all by th e year 2000.
Definition of 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 the
community and country can afford to maintain at
every stage of their development in the spirit of self
reliance and self determination. (WHO)1978
Objectives of PHC
 To make health service accessible and available to all people
wherever they live or work.
To tackle the health problem causing the highest mortality and
morbidity at a cost that the community can afford.
To ensure that whatever technology used must be within the ability
of the community to use effectively and maintain.
To ensure that in implementing health programs, the community
must be fully involved in planning the delivery and evaluation of the
services in the spirit of self-reliance.
Principles of PHC
 EQUITABLE DISTRIBUTION;
 This is the first key principle of primary health care.
 Emphasis is on health services been shared equally by all people irrespective of
their ability to pay (rich, poor,urban or rural)
 Individuals must have access to health services.
 A successful PHC services will require adequate numbers and distribution of
trained physicians, nurses, allied health professions, community health workers
and others working as a health team.
 Currently health services are mainly in towns and inaccessibility to majority of
population in the developing world.
Principle of primary Health care
Community participation;
PHC coverage cannot be achieved without the involvement of
community in planning, implementation and maintenance of health
service.
comprehensive health care relies on the involvement of individuals,
families and community in the promotion of their own health.
Inter –sectorial collaboration
Comprehensive/ holistic approach to PHC entails the involvement of

other sectors to collaborate with the health sector to meet the health
needs of the people.
Such sectors like agriculture, education, food industry, ministry of
housing, communication etc.
Sectorial approach recognition that health cannot be improved by
intervention within just the formal health sectors.
Other sectors are equally important in promoting the health and self
reliance of the community.
It refers to the delivery of health care services in an integrated way.
Appropriate technology
Appropriate technology;
This is the use of a scientifically sound technology that is adaptable to
local needs.
Acceptable to those who use them
A technology that can be maintained by the people in keeping with
the principle of self reliance.
It involves the use of cheaper, scientifically valid and acceptable
equipments and technique.
Components of PHC
 Education concerning prevailing health problems and the methods of preventing and
controlling them.
 Promotion of food supply and proper nutrition.
Adequate supply of safe water and basic sanitation.
 Maternal and Child health care including family planning.
Immunization against the major infectious diseases.
 Prevention and control of locally endemic diseases.
Appropriate treatment of communicable diseases and injuries.
Provision of essential drugs.
 Community mental health.
 Dental health.
Strategies for the implementation
of PHC in Nigeria
 Nigerian health system is saddled with some peculiarities which is
linked to its cultural and religious beliefs.
Strategies to the implementation of PHC must take into consideration
these cultural and religious diversities
The Implementation of PHC is primarily through services carried out
in the health center and during home visits.
These services are related to the components of PHC services.
This strategies includes; community mobilization, service integration,
health research, capacity building and non governmental and
international collaboration.
Community mobilization/Advocacy
This is the process of arousing the interest of the people and encourage them
to participate actively in finding solutions to their problem.
Community mobilization includes ; community entering and community
dialogue and
Community entering where important stakeholders are engaged to obtain
necessary permission to carry out programs and services.
Community dialogue provides opportunity for community members to make
their imputs into the planning, implementation, and evaluation of the
program.
Advocacy is the process of making information /communicating the relevance
of the PHC services to community leaders and opinion leaders
Principles of PHC Contd;
Advantages of community mobilization/advocacy
1.Owership of the program
2. Sustainability
3. Resource mobilization
4. Cost minInization
5. Utilization of the services
Service integration
 This is the provision of two or more PHC services on the same platform by the
same team most at time simultaneously
Example of integrated services includes; Integrated management of childhood
illness( IMCI),Integrated maternal newborn child health( IMNCH) ,Maternal
new born and child week (MNCHW) Immunization plus days(IPDs)
Advantages
Enhancing efficacy
Prevents duplication of services
Reduce wastage of resources
Ensure compliance by clients/ patients.
Health research
There has been a global call to the implementation of evidenced based medicine.
This can only be archived through a systematically research to identify health related
problem and their determinants.
According to Nigeria's natural strategic health developments plan (NSHDP 2010-2015)
The govt of Nigeria at all level should invest 1% of her health expenditure on research.
Advantage
Identifying community health needs
Identify the community area of strength and weakness
Appropriate deployment of scarce resources
To inform policy making for program planning /implementation
Capacity building
Manpower development is an important ingredient to quality health
care delivery
Primary health care workers requires continuous education to
effectively deal with constantly changing health care need.
This will help to provide quality health services
It will also help to maintain vibrant health work force
capacity building will increase the workers job satisfaction and
improve output..
Non governmental and interternational
collaboration
 The cost of providing comprehensive and quality health care to all

citizen is enormous and should not be borne by the government alone.
 the non governmental organizations and civil societies has been
employed and should be encouraged.
The world Federation of Public Health associations(WFPHA.1978)
underscores the importance of this collaboration.
They support PHC services with funding, capacity building, operational
research and technical assistance.
Some of the supporting NGOs in Nigeria includes; UNICEF, Pathfinders
international, society for family health etc
Challenges of PHC IN NIGERIA
Poor financing ( infrastructure, materials etc)
Ignorance
 lack of trained manpower/ poor renumeration.
Lack of political will.
Accessibility to health service point.
Health workers attitude
Clients perception of the quality of services rendered at the health
Centre.
Late referals.
ASSIGNMENT
•WHAT CADRE OF WORKERS ARE

IN THE PRIMARY HEALTH CARE
FACILITY??????????

Primary Health Care

Uploaded by

Copyright:

Available Formats

Primary Health Care

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Primary Health Care

Uploaded by

Copyright:

Available Formats

PRIMARY HEALTH CARE; DEFINITION,

PRINCIPLE, COMPONENTS AND

Comprehensive/ holistic approach to PHC entails the involvement of

 The cost of providing comprehensive and quality health care to all

•WHAT CADRE OF WORKERS ARE

You might also like