Chapter 3-CHN

Challenges included the high cost and inaccessibility of medical equipment, a lack of specialists to operate complex technologies, and the disregard for traditional beliefs about health and illness that have spiritual significance in many communities.

In response to the health challenges faced by developing countries, the World Health Organization (WHO) introduced the Primary Health Care (PHC) concept, unveiled on September 12, 1978, at the Alma Ata conference in Kazakhstan. Supported by 134 countries, the “Alma Ata Declaration” aimed for “Health for All.”

The PHC concept emphasizes social justice, accessibility, and community involvement, focusing on tailoring health services to meet the needs and preferences of local populations.

The Declaration of Alma Ata defines “Primary Health Care” as essential health care that is practical, scientifically sound, and socially acceptable. It should be universally accessible, affordable, and involve full community participation. Serving as the first point of contact within the national health system, PHC aims to bring health services closer to individuals and communities, focusing on promoting health, curing diseases, and providing rehabilitation.

The ultimate goal of primary health ”care ‘is the attainerheat services for all It is for this reason that World Health Organization (WHO), has identified five key elements to achieving this goal:

1.      Reducing exclusion and social disparities in health (universal coverage reforms);

2.      Organizing health services around people’s needs and expectations (service delivery reforms);

3.      Integrating health into all sectors (public policy reforms);

4.      Pursuing collaborative models of policy dialogue (leadership reforms); and

5.      Increasing stakeholder participation.

Eight Essential Components of Primary Health Care

E Education about prevailing health problems and methods of preventing and controlling them.

Public education is vital for primary health care. By teaching people about health problem prevention and control, and encouraging their involvement, the World Health Organization helps prevent the spread of disease on an individual level.

L Prevention and control of locally endemic diseases.

Preventing and controlling local diseases is vital for primary health care. Disease patterns vary by location, so tailored measures are essential to reduce infection rates effectively.

E Provision of essential drugs

Providing essential drugs like antibiotics helps prevent infections from worsening, reducing the spread of diseases and making communities safer overall.

M Maternal and child health care; including family planning

Providing comprehensive health care to children and mothers, including counseling on family planning and safe sex, is crucial for primary health care. This approach helps those at greatest risk and ensures future generations can thrive and contribute globally.

E Expanded immunization against major infectious diseases

By administering global immunizations, WHO works to wipe out major infectious diseases, greatly improving overall health globally.

N Promotion of food supply and proper nutrition

Nutrition is a vital part of health care. The World Health Organization works to prevent malnutrition, starvation, and related diseases.

T Appropriate and accessible treatment of common diseases and injuries

Access to appropriate medical care for treating diseases and injuries is vital in primary health care. Early treatment prevents complications and reduces the need for more expensive, extensive medical interventions later on.

S Adequate supply of safe water and basic sanitation

A supply of clean, safe drinking water, and basic sanitation measures regarding trash, sewage and water cleanliness can significantly improve the health of a population, reducing and even eliminating many preventable diseases.

Pillars of Primary Health Care

Primary health care is essential for balancing socioeconomic disparities and promoting community improvement. It ensures all individuals and families have priority access to fundamental health care that is scientifically sound and universally acceptable.

1.      Community participation: Community participation is a key approach for meeting health care needs. It involves local people in decision-making, planning, and program implementation, ensuring they address the community’s specific needs. Health is a shared responsibility, involving individuals, families, and the community, along with the government. Universal primary health care coverage requires active community involvement.

2.      Intersectoral coordination: involves the collaboration of multiple specialized agencies to achieve a common goal. Improving health requires efforts beyond the formal health sector, including agriculture, education, housing, public works, and more. Effective communication, cooperation, and collaboration within the health sector (intrasectoral) and between health and other sectors (intersectoral) are crucial for promoting community health and self- reliance.

3.      Appropriate technologies: Appropriate healthcare technologies are vital for making healthcare services more accessible and available. These technologies should be scientifically sound, adaptable to local needs, acceptable to those using and receiving them, and maintainable by the community with affordable resources. This approach emphasizes using cost-effective, scientifically valid equipment and techniques rather than expensive, sophisticated options beyond the community’s means.

4.      Support mechanism made available: Support mechanisms are crucial in primary health care to ensure essential health care is accessible globally. These mechanisms, which include people, government, and private sectors (like NGOs and churches), enhance quality of life and provide resilience against challenges, ensuring a robust health care system.

Some references, add an additional pillar of PHC, which is the equal distribution of health resources. Healthcare services must be equally shared by all the people of the community irrespective of their race, creed or economic status. This concept helps to shift the accessibility of healthcare from the cities to the rural areas where the most needy and vulnerable groups of the population live.

Its goal is to optimize population health and reduce disparities by ensuring equal access to services for all subgroups. Primary care is the initial patient interaction with a health professional, encompassing health promotion, disease prevention, maintenance, counseling, education, and diagnosis and treatment of acute and chronic illnesses across various settings.

Primary Care

Primary care and primary health care are terms often used interchangeably but represent different concepts. According to the WHO, primary care is a care model focused on first-contact, accessible, continuous, comprehensive, and coordinated person-centered care.

1.      First contact accessibility creates a strategic entry point for and improves access to health services.

2.      Continuity promotes the development of long-term personal relationships between a person and a health professional or a team of providers.

3.      Comprehensiveness ensures that a diverse range of promotive, protective, preventive, curative, rehabilitative, and palliative services are provided.

Table 3.2 Differences between Primary Health Care and Primary Care