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8/13/2019 Strategies of PHC
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Strategies of
Primary Health Care
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Levels of Care
Primary health care
Secondary health care
Tertiary health care
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Primary health care
The first level of contact between the
individual and the health system. Essential health care (PHC is !rovided.
" ma#ority of !revailing health !roblems canbe satisfactorily managed.
The closest to the !eo!le.
Provided by the !rimary health centers.
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Secondary health care
$ore com!le% !roblems are dealt with.
Com!rises curative services
Provided by the district hos!itals The &st referral level
Tertiary health care
'ffers su!ers!ecialist care
Provided by regional)central level institution.
Provide training !rograms
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What is Primary Health Care?
PHC is essential health care that is a socially appropriate,universally accessible, scientifically sound first level care provided bya suitably trained workforce supported by interated referral systemsand in a way that ives priority to those most in need, ma!imisescommunity and individual self"reliance and participation and involves
collaboration with other sectors# $t includes the followin%
health promotion
illness prevention
care of the sick advocacy
community development
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Primary Health Care (PHC)
PHC is:
Essential health care based on practical,
scientifically sound and socially acceptable
methods and technology made universallyaccessible to individuals and families in the
community through their full participation and at
a cost that community and the country can afford
(Alma-Ata, !"#$
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Principles for PHC
PHC based on the followin principles %
Social e&uity
'ation"wide coverae
Self"reliance
$nter"sectoral coordination
People(s involvement in the plannin andimplementation of health prorams
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Principles of PHC
The )*+ -eclaration of .lma".ta proposed a setof P/$'C$PL0S for primary health care# PHC should%
)# 1/eflect and evolve from the economic conditions and socio"
cultural and political characteristics of the country and itscommunities, and be based on the application of therelevant results of social, biomedical and health servicesresearch and public health e!perience2
3# 1.ddress the main health problems in the community,providin promotive, preventive, curative and rehabilitativeservices accordinly2
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4# 1$nvolve, in addition to the health sector, allrelated sectors and aspects of national andcommunity development, in particular ariculture,animal husbandry, food, industry, education,
housin, public works,5# 1Promote ma!imum community and individualself"reliance and participation in the plannin,orani6ation, operation and control of primary
health care, makin fullest use of local, national andother available resources7 and to this end developthrouh appropriate education the ability ofcommunities to participate2
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8# 19e sustained by interated, functional andmutually"supportive referral systems, leadin to theproressive improvement of comprehensive healthcare for all, and ivin priority to those most in need2
:# 1/ely, at local and referral levels, on healthworkers, includin physicians, nurses, midwives,au!iliaries and community workers as applicable, aswell as traditional practitioners as needed, suitablytrained socially and technically to work as a healthteam and to respond to the e!pressed health needsof the community#2
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Core .ctivities for PHC
There is a set of C;/0 .CT$
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)# 0ducation concernin prevailin healthproblems and the methods of preventin
and controllin them
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3# Promotion of food supply and propernutrition
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4# .n ade&uate supply of safe water andbasic sanitation
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5# =aternal and child health care, includinfamily plannin
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8# $mmuni6ation aainst the ma>or infectiousdiseases
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:# Prevention and control of locally endemicdiseases
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+# .ppropriate treatment of commondiseases and in>uries
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# 9asic laboratory services and provision ofessential drus#
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*# Trainin of health uides, health workersand health assistants#
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)# /eferral services
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=ental health
Physical handicaps
Health and social care of the elderly
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WH; Strateies of PHC
)# /educin e!cess mortality of poor marinali6edpopulations%
PHC must ensure access to health services for the mostdisadvantaed populations, and focus on interventions
which will directly impact on the ma>or causes of mortality,morbidity and disability for those populations#
3# /educin the leadin risk factors to human health%
PHC, throuh its preventative and health promotionroles, must address those known risk factors, which are thema>or determinants of health outcomes for localpopulations#
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4# -evelopin Sustainable Health Systems%
PHC as a component of health systems must develop inways, which are financially sustainable, supported by politicalleaders, and supported by the populations served#
5, -evelopin an enablin policy and institutional environment%
PHC policy must be interated with other policy domains,and play its part in the pursuit of wider social, economic,environmental and development
policy#
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The 9asic /e&uirements for Sound PHC
@the .(s and the 4 C(sA
.ppropriateness
.vailability
.de&uacy
.ccessibility
.cceptability
.ffordability
.ssessability
.ccountability Completeness
Comprehensiveness
Continuity
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.ppropriateness
*hether the service is needed at all in
relation to essential human needs+!riorities and !olicies.
The service has to be !ro!erly selected
and carried out by trained !ersonnel inthe !ro!er way.
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.de&uacy
The service !ro!ortionate to
re,uirement. Sufficient volume of care to meet the need
and demand of a community
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.ffordability
The cost should be within the means
and resources of the individual and thecountry.
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.ccessibility
-eachable+ convenient services
eogra!hic+ economic+ culturalaccessibility
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.cceptability
.cceptability of care depends on a varietyof factors, includin satisfactory
communication between health careproviders and the patients, whether thepatients trust this care, and whether the
patients believe in the confidentiality andprivacy of information shared with theproviders#
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.vailability
.vailability of medical care means that
care can be obtained whenever peopleneed it#
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.ssessability
.ssessebility means that medical care can
be readily evaluated#
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.ccountability
.ccountability implies the feasibility of
reular review of financial records bycertified public accountants#
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Completeness
Completeness of care re&uires ade&uate
attention to all aspects of a medicalproblem, includin prevention, early
detection, dianosis, treatment, follow up
measures, and rehabilitation#
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Comprehensiveness
Comprehensiveness of care means that
care is provided for all types of healthproblems#
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Continuity
Continuity of care re&uires that the
manaement of a patient(s care over timebe coordinated amon providers#
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To Summari6e
Primary health care is an approach that%
Bocuses on the person not the disease,
considers all determinants of health $nterates care when there is more than
one problem
ses resources to narrow differences
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Borms the basis for other levels of health
systems
.ddresses most important problems in thecommunity by providin preventive,
curative, and rehabilitative services
;rani6es deployment of resourcesaimin at promotin and maintainin
health#
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TH"/0 1'2