Primary Health Care
It is ESSENTIAL health care based on practical, scientifically sound & socially acceptable methods & technology
made universally accessible to individuals & families in the community.
Through the participation at a cost that the community & country can afford, to maintain at every stage of their
development in the spirit of self- reliance & self determination.
It is an integral part of the health system & the social & economic development of the com.
It is the Ist level of contact of individuals & the family with national health system.
PHC as declared by Alma-Ata is essential health care of individuals, families & all population
according to their needs.
Involving the com. In the planning is very vital.
Five principles of the PHC are:
Covering people according to their needs.
Services are promotive, preventive, curative, & rehabilitative.
Services should be effective, culturally acceptable, affordable & manageable.
Involving com.
Approaching the other sectors.
Elements of PHC & services
1.
Health Education:
It is a process by which people learn, change their health behavior & attitudes. It is a process that informs,
motivates, & helps people to adopt & maintain healthy practices & life styles.
--Each individual of a health team needs to assume the role of a health educator. It should be given in every health
set- up as well as in the com.
Planning & implementing the prog.
Problem identification.
Cause identification.
Needs of people iden.
Specific behavior iden.
Locate the area.
Select target group.
Design & test proper H.E. Messages.
Clarify the duties & tasks.
Make the H.E. program.
Schedule H.E. Activities.
Carry out the activities,
Record, evaluate the results.
Methods, materials & sites of H.E.
We may use lecture, discussion, demonstration, no one method is affected for all situations
Such materials should be used in H.E. as flip charts, flannel graphs, posters.
 H.E. could be carried out in the health institutions, com. Meeting places, schools, homes & mosques.
2.
Promotion of proper nutrition:
Nutrition is important factor influencing the quality of life; infant mortality is one of the problems of under nutrition,
or either affecting the growth & development.
Nut. & its requirements are important to all pregnant, lactating woman, children as well as adults. Inadequate diet
leads to mal nutrition. & for children who are already mal nourished becomes further worse. So supplying food will
cure this condition.
PHC objectives regarding nutrition
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3.Promotion of activities that improve food supply. (family level)
4.Correction of faulty food habits
Treatment & prevention of nut. Disorders (anemia,V.A. deficiency)
Prevention & management of infectious diseases. (diarrhea, ARI)
Role of PHC team
Assessing & defining the problem, by surveying the com. & plan the work.
Determining of nutritional status.
Minimizing the known risk factors.
Detect of early signs of malnut.
Educate the family.
Individual level action.
3. Environmental Health:
Term describes the all living & non- living things & conditions around people. It has a direct influence on the
health.
The aim in PHC. Are to prevent diseases related to unsafe drinking water, lake of sanitation, & to improve quality
of life.
Activities related to environmental health
Promotion of hygiene.
Provision of safe drinking water supply.
Proper system of excreta disposal.
Food quality control.
Control of vectors, flies…
Arranging “cleaning campaigns”.
Training of local workers, H volunteers.
Intra- secrotal coordination.
The com. should be educated to: assess their env. Needs, how to meet the needs, implement, continue the initial
activities, & periodically evaluate the env. Health activities.
4.Maternal Health:
Objectives:
1. To promote the health of the mother by maintaining the health of the fetus, as well as well- being of the mother.
2. To reduce maternal mortality & morbidity.
The main activities:
1. Antenatal care. The objective is to promote, protect & maintain the health of the pregnant lady, & fetus leading
to delivery.
 Activities includes the following

Identify the pregnant woman in the comm..
Follow the pregnant by home visiting; encourage her to come to the h. centre periodically for examinations &
necessary tests.

Identification of risk factors in the mother &fetus.

Advice on personal hygiene, sleep, exercise, & child care.

Educate on nutrition of pregnant woman.

Administration of tetanus toxoid.

Decide about the place of delivery to match the needs of woman & newborn
child.

2. Intra – partum care:
It is provided for the efficient & safe delivery regardless to the place of delivery.
 The aim should be:
To conduct the delivery under aseptic conditions.
Minimum injury to mother & child.
Efficient dealing with complications & timely referral.
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The baby should be given to the mother immediately after the birth & breast –fed unless there is baby’s problem.
Post-Natal care:
The objective of it should be:
To prevent complications of the period.
To restore & maintain optimally the health of the mother & the newborn.
To provide H.E. to the mother & the family in connection with nutrition, with stress on
breast- feeding, personal hygiene, & child spacing.
To restore health of the following activities are carried out:
1. Frequent physical examination, at least twice during the first week & once a week later.
2. Health education on diet, exercise, personal hygiene, baby care, important of breast feeding.
3. Any anemia should be treated by prescribing appropriate medicines & dietary supplement.
4. Encourage the mother to get the child fully immunized & visit health institutions.
5. Child Health:
Objectives: 1. to protect & promote the health of the children by providing the needs in different
stages of growth & development.
To reduce the infant & child morbidity & mortality.
The problems of the newborn, infants, & children.
In the newborn:
Low birth- weight.
Difficulty in breathing.
Hypoglycemia.
In infant & children:
malnutrition
Respiratory infection.
The main activities of child health care:
Promote breast feeding.
Growth monitoring.
Control of diarrhoeal diseases.
Immunization against childhood dis.
6. School health programme:
Objectives: is to meet the physical, mental, & social needs & problems of school going children.
So that they grow, educated, physically & mentally healthy adults.
 Children as well work as a conversant to their own families when they send all the health messages.
Activities in school health:
Screening of school children to detect diseases & abnormalities.
Providing treatment.
Health education.
Immunization.
Proper sanitation.
Promoting recreational facilities.
Immunization against childhood diseases:
Objectives:
To sustain high imm. Coverage of children under one year.
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To eradicate polio.
To immunize all pregnant women.
To reduce incidence of EPI dis.
Vaccination found to reduce the morbidities & mortalities resulting from diphtheria, pertusis, &
others.
As it is very essential it is considered in the element of PHC.
Objectives of vaccination:
To minimize the morbidity & mortality due to the eight preventable dis.
To promote the growth & development of new generation of children.
To ensure that all children 0-1 year are protected against dis.
To continue the protection by giving booster doses.
To vaccinate all pregnant women.
The PHC workers must be knowledgeable & skilled about the following:
The vaccine & target with schedule.
Equipment & sterilization.
Correct technique of giving.
Counseling.
Motivating & conducting sessions.
Evaluating.
Diseases surveillance.
The PHC worker must ensure:
Availability of vaccines.
Availability of equipment.
Vaccine should be kept in proper condition & maintain cold- chain.
Be sure that all parents in the area recognize the importance of imm.
&all parents recognize the importance of bringing their children at the right time. It is the responsibility of the team
to follow up the drop-outs.
The health team supervisor should ensure the following:
The vaccine used & balance, stored in right temperature, health education is being carried out, number of those
fully vaccinated is correct, & others.
7. Control of diseases:
Aimed at maintain epidemiological surveillance of com. & non communicable dis.
Communicable diseases
One of the important causes of mortality & morbidity. E.g. malaria, tuberculosis. Controlling by education, advice
on hygiene, vaccinations & treatment.
Non communicable diseases
Aimed at prevent & reduce the prevalence & incidence of cardio-vascular dis.
Prevention of CHD avoids risk factors.
Detection of hypertension.
Treated sore throat.
Giving prophylactic treatment. Penicillin.
Participation of health professional in early detection.
Follow up therapy.
Referral as needed.
Control of diabetes
Objectives are to prevent complications, referred to the hospitals, well diagnosed & treat pt., maintain therapy, &
education.
Prevention & control of cancer
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Objectives: to reduce & prevent incidence, refer the suspected cases for investigation & treatment, & educate
people.
8.
Mental Health:
Objectives: promotion of M.H, prevention of M.I, provides treatment & rehabilitation, give M.H awareness.
Magnitude of the problem
Mental & neurological disorders are source of distress, affecting productivity & diminished quality of life.
The new models of treatment focused on the management at the PHC level.
Functions of the H. workers
Detect the cases.
Assess pt. treatment & refer.
Follow- up treatment by specialist.
M.H. Education
People have misunderstanding of the mental conditions, & because of that they seek assistance from those who claim
supernatural powers & this will delay the pt’s treatment.
The misunderstanding about this disease must be removed & a change in attitude must be brought about in the people
by proper health education.
Ways of passing information to the people
Marriage may put additional burden on the pt.
Use of Mental diseases are preventable.
After successful treatment a person can lead a normal life.
Not all sick parents brought- up sick children.
M.D is not infectious.
No need for magic to treat mentally ill pts.
People can be treated at home.
alcohol & narcotics for a long time leading to psychological distress.
9. Eye Health Care:
Objectives: to prevent & control blindness, reduce the same case which is related to cataract, glaucoma.
By prevent & promote good eye care to different population & increasing the health awareness, motivate them to
seek early help & treatment, gaining knowledge regarding personal hygiene, nutrition & sanitation.
At the primary clinics treatment & follow up conditions, assess for visual acuity.
10. Oral Health:
objective is to reduce oral health problems, (dental caries& periodontal diseases)
Role of the H. Worker.
Education on hygiene, holding tooth brush drills for school children. Screening of 6-7 years old children, & referral &
follow-up.
11. Treatment of common diseases & injuries
objectives are to handle proper management for diseases & injuries,
immediate diagnosis & treatment, refer to hospital for proper diagnosis & treatment, follow up maintenance therapy,
complying with treatment, and participate in the prevention of communicable & non communicable diseases.
12. Adequate supply & rational use of essential drugs:
Objectives: to ensure regular supply of safe & effective drugs, drugs that play role in protect, maintain, & restore
health, Essential drugs are those that used by people with proven efficacy & safety.
Criteria of essential drugs:
Thoroughly investigated.
Favorable & least toxic.
Therapeutic effect is greater.
The cost is less.
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Compliance is improved.
Role of the P.H.C team:
Education of the community. Comm. should educated about the misuse of drugs, correct some of the wrong believes,
most of the diseases are preventable, & advice against self-medication.
Management of drugs. Projecting the drug needs & procure them, storage of drugs, proper recording, arranging on
shelves, person responsible should make sure of the expire utilize first, keep an emergency stock of life- saving drugs,
provide full information regarding the use of the drugs.
Dangerous drugs such as narcotics, tranquilizers should be kept in a separate cabinet.
Keep emergency drugs as easy to be reached.
Generally do not prescribe drug that you do not know.
Keep vaccines & toxoids in cool chin condition.
13. Community Participation:
Involving in the self-care, health promotion, prevention, effective implementation.
To stimulate comm. involvement provide information, education,& communication with the public, contact a
known person, collect certain data, obtain a map
know certain information such as age distribution, occupation, focus attention on issues of majority of the people,
select support group.
14. Inter-sectoral Cooperation:
objectives. Are to involve other sectors like education, social welfare, woman & child development, agriculture, at
wilayat health committee.
The committee functions are to suggest future expansion of health services, plan & implement inter- sectoral
activities such as environmental health, community involvement in health promotion.
Role of the nurse providing PHC services
Assessing health status.
Mobilizing comm. Involvement.
Providing integrated H C.
Appropriate referral.
Maintaining epidemiological surveillance.
Training & supervising health workers.
Collaborating with other development sectors.
Monitoring progress.
Maintaining records & reports.
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