Primary Health Care Definition, Goal, Principles and Strategies
The Alma Ata Conference defines Primary Health Care as essential health care
based on practical, scientifically sound and socially acceptable methods and
technology made universally, accessible to individuals and families in the community
by means of acceptable to them, through their full participation and at a cost that
community and country can afford to maintain at every stage of their development in
the spirit of self-reliance and self-determination. It forms an integral part of both the
country’s health system, of which it is the central function and the main focus and of
the overall social and economic development of the community.
Goal:
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The global goal as stated in the Alma Ata Declaration is Health for All by the
year 2000 through self-reliance.
Health begins at home, in schools and in the workplace because it is there
where people live and work that health is made or broken.
It also means that people will use better approaches than they do now for
preventing diseases and alleviating unavoidable disease and disability and
have better ways of growing up, growing old and dying gracefully.
It also means that here will be even distribution among the population of
whatever resources for health are available.
It means that essential health services will be accessible to all individuals and
families in an acceptable and affordable way.
Principles and Strategies:
1. Accessibility, Availability, Affordability and Acceptability of Health Services
o Strategies:
 Health services delivered where the people are
 Use of indigenous/resident volunteer health worker as a health
care provider with a ratio of one community health worker per
10-20 households
 Use of traditional (herbal medicine) with essential drugs.
2. Provision of quality, basic and essential health services
o Strategies:
 Training design and curriculum based on community needs and
priorities.
 Attitudes, knowledge and skills developed are on promotive,
preventive, curative and rehabilitative health care.
 Regular monitoring and periodic evaluation of community
health workers performance by the community and health staff.
3. Community Participation
o Strategies:
 Awareness, building and consciousness raising on health and
health-related issues.
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Planning, implementation, monitoring and evaluation done
through small group meetings (10-20 households cluster)
Selection of community health workers by the community.
Formation of health committees.
4.
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Establishment of a community health organization at the parish
or municipal level.
Mass health campaigns and mobilization to combat health
problems.
5. Self-reliance
o Strategies
 Community generates support (cash, labor) for health
programs.
 Use of local resources (human, financial, material)
 Training of community in leadership and management skills.
 Incorporation of income generating projects, cooperatives and
small scale industries.
6. Recognition of interrelationship of health and development
1. Strategies:
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Convergence of health, food, nutrition, water, sanitation and
population services.
 Integration of PHC into national, regional, provincial,
municipal and barangay development plans.
 Coordination of activities with economic planning, education,
agriculture, industry, housing, public works, communication
and social services.
 Establishment of an effective health referral system.
2. Social Mobilization
o Strategies
 Establishment of an effective health referral system.
 Multi-sectoral and interdisciplinary linkage.
 Information, education, communication support using multimedia.
 Collaboration between government and non-governmental
organizations.
3. Decentralization
o Strategies
 Reallocation of budgetary resources.
 Reorientation of health professional and PHC.
 Advocacy for political and support from the national leadership
down to the barangay level.
8 Essential Health Services in Primary Health Care (ELEMENTS)
7. E – Education for Health
8. L – Locally endemic disease control
9. E – Expanded program for immunization
10. M – Maternal and Child Health including responsible parenthood
11. E – Essential drugs
12. N – Nutrition
13. T – Treatment of communicable and non-communicable diseases
14. S - Safe water and sanitation
Primary health care is the first point of contact for individuals who are unwell and to promote
healthy lifestyles in order to prevent illness from occurring. Principles of primary health care are a
set of beliefs and values that revolve around equity and fairness for all, eliminating discrimination,
so that all people have access to primary health care whenever they need it. Under the principles,
primary care should be organized and distributed to minimize costs, so that health care is
affordable and accessible.
One of the overriding principles of primary health care is that it is the first point of contact for
people should they experience illness. If a patient has a bad back, he could utilize primary health
care by visiting a doctor or nurse. Principles of primary health care state that it must be accessible
by all people, regardless of factors such as socio-economic background, color, race or sexuality.
The World Health Organization (WHO) works towards helping countries to provide excellent
health care for all people. They set out goals and principles for primary health care for
organizations and communities to work towards, in their "Health for All" strategy. According to
these goals, no one should be excluded from receiving primary health care and social
discrimination should be eliminated. Medical care must be fairly distributed among all people, no
matter where they live or their social class.
Effective and regular training is a principle, along with developing the primary health care work
force. It also involves working with communities to make the most of the contributions
individuals can make to their own health and the health of their communities. People's needs
should be investigated and taken into account when organizing and distributing primary health
services. The needs of the patients are more important than the needs of the organization.
Further principles of primary health care include shaping public policy to reflect health care goals
so that there are guidelines and targets to work towards. "Healthy" public policy should be a part
of all sectors, for example in production of healthy food, in educating people on how to live
healthy lives, and in public amenities such as waste removal. Empowering people to keep healthy
is part of primary health care. Health promotion can prevent many illnesses from occurring in the
first place.
Those who use primary health care should be encouraged to have a say on how services are
provided. Technology is also taken into account, as it must be appropriate and affordable and not
push up the price of health care. Primary health care should be affordable to individuals and the
country as a whole so that it remains accessible and the very poor are not excluded.