Primary Health Care: Concept, Elements, Principles, and Role of Nurses, Study notes of Public Health

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CONCEPT OF PRIMARY

HEALTH CARE

Prepared By Krupa Mathew. M, Assistant Professor

OBJECTIVES

The student will be able to,  define primary health care  list out the elements of primary health care  explain the principles of primary health care  detail the roles and responsibility of community health nurse in primary health care

DEFINITION

“Primary Health Care is essential health care

made universally accessible to individuals &

acceptable to them, through their full

participation & at a cost the community &

country can afford ”.

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ELEMENTS OF PRIMARY HEALTH CARE The Alma-Ata conference outlined 8 essential components of primary health care. Education concerning prevailing health problems and the methods of preventing and controlling them.

1. Education and information concerning prevailing health problems and methods of preventing and controlling them
2. Promotion of food supply and proper nutrition.
3. An adequate supply of safe water and basic sanitation.
4. Maternal and child health care, including family planning.
5. Immunization against major infectious diseases.
6. Prevention and control of locally endemic diseases.
7. Appropriate treatment of common diseases and injuries.
8. Provision of essential drugs. 5

EQUITABLE DISTRIBUTION  The first key principle in the primary health care strategy is equity or equitable distribution of health services.  Health services must be shared equally by all people irrespective of their ability to pay, and all must have access to health services.  At present health services are mainly concentrated in the major towns and cities resulting in inequality of care to the people in rural areas.  The worst hit are the poor and the needy and vulnerable groups of the population in rural areas and urban slums.  This has been termed as social injustice.

 The failure to reach the majority of the people is due to inaccessibility.  Primary health care aims to redress this imbalance by shifting the centre of gravity of the health care system from cities to the rural areas and bring these services as near people’s homes as possible.

There must be a continuing effort to secure meaningful involvement of the community in planning, implementing & maintenance of health services, besides maximum reliance on local resources such as manpower, money & materials. 10

Best example for community participation is introduction of village Health Guides” & “Trained Dais” using people from local community. It is an essential feature of primary health care in India.

• China had set his fore front strategy by introducing community participation in the from of “bare foot doctors”. 11

Appropriate technology Appropriate technology has been defined as “technology that is scientifically sound, adaptable to local needs, & acceptable to those who apply it & for those whom it is used & that can be maintained by the people themselves in keeping with the principles of self reliance with the resources the community & country can afford 13

Cont..

 The term appropriate is emphasized because

in some countries luxurious hospitals that are

totally inappropriate to the local needs, are

built, which absorb a major part of the

national health budget, effectively blocking

many improvement in general health

services.

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ROLE OF NURSE IN PRIMARY HEALTH CARE

 WHO study group in 1985 highlighted the

following roles and functions of nurses in

primary health care.

1. Direct care provider

 The nurse provide direct care to individual,

families and community with reference to 8

elements of primary health care

 Ex:MCH Care

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Health educator & teacher

 In order to promote health, prevent disease, regain and

maintain health, the nurse educates individuals, families

and community at large about healthful behavior, sanitary

environment, prevention of diseases etc., she educates

family members to take care of the sick in her absence and

also other preventive measures.

 As a teacher, she trains other health workers such as

ANMs, health Guides, Village Dais

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Guide & supervisor As a nurse engaged in providing primary health care, she is expected to supervise, guide and help other personnel in providing care, planning health services for families and for the community. 19

Specific functions-PHC  Assessment of health needs and health problems of individuals and community.  Provide integrated comprehensive primary health care service related to 8 essential elements.  Mobilize involvement of individuals, families and community in providing primary health care. 20