Primary health care
E.Vermeulen
Definition of primary health care.
Primary Health Care as defined by the
World Health Organization in 1978 is:
Essential health care; based on practical,
scientifically sound, and socially acceptable
method and technology; universally
accessible to all in the community through
their full participation; at an affordable cost;
and geared toward self-reliance and self
determination.
Eight essential components for
PHC:
1.Education for the identification and prevention /
control of prevailing health challenges
2. Proper food supplies and nutrition; adequate supply
of safe water and basic sanitation
3. Maternal and child care, including family planning
4. Immunization against the major infectious diseases
5. Prevention and control of locally endemic diseases
6. Appropriate treatment of common diseases using
appropriate technology
7. Promotion of mental, emotional and spiritual health
8. Provision of essential drugs
(WHO & UNICEF, 1978).
Basic conditions/terms for effective
PHC
Fair
 Acceptable
 Affordable
 Accessible
 Effective

Definition of rehabilitation

A goal-orientated and time limited
process aimed at enabling an impaired
person to reach an optimum mental,
physical and/or social functional level, thus
providing him/her with the tools to
change his/her life. It can involve
measures intended to compensate for a
loss of function or a functional limitation
and other measures intended to facilitate
social adjustment or readjustment.
Community Based Rehabilitation
Community-based rehabilitation (CBR) focuses on
enhancing the quality of life for people with
disabilities and their families, meeting basic needs
and ensuring inclusion and participation. CBR was
initiated in the mid-1980s but has evolved to
become a multi-sectoral strategy that empowers
persons with disabilities to access and benefit from
education, employment, health and social services. CBR
is implemented through the combined efforts of people
with disabilities, their families, organizations and
communities, relevant government and non-government health,
education, vocational, social and other services.
(WHO)
Levels of the National Health System

First (entry) level - Clinics
Clinics

Manned by qualified primary healthcare
nursing personnel, physiotherapists and/or
other rehabilitation personnel.

Second level – community health centres
Community health centres
manned by doctors, nursing personnel,
pharmacists, physiotherapists and/or
other rehabilitation personnel. Maternity
services are usually available at these
centers.
Third level – District Hospitals
District hospitals

Manned by doctors, nursing personnel,
dentists, social worker/s, dieticians,
physiotherapists and/or other
rehabilitation personnel. Emergency care
is usually available here.
Fourth level – Regional hospitals
•
The first step to more specialised service
and long term patient care.
Fifth level – Tertiary Hospitals
Tertiary hospitals

providing the most specialised medical
services, such as heart-, brain-, abdominal-,
pediatric-, obstetric- or spinal surgeries
and the like.
Care provided by physiotherapists
at al levels of PHC
Promotive care
 Preventative care
 Curative/therapeutic care
 Rehabilitative care

Promotive care
Promote health care at all levels
 Education programmes directed at
achieving and maintaining healthy living,
efficient function and optimal quality of
life.
 Promotive care is also directed at the
maintenance of optimal health in the
already diseased or disabled.
 Examples......

Preventative care
TYPES OF PREVENTION:
 Primary prevention: prevention of
disease in a susceptible or potentially
susceptible population through specific
measures such as general health
promotion efforts.
 Secondary prevention: efforts to
decrease the duration of illness, severity
of disease through early diagnosis and
prompt intervention
Preventative care cont’d
Tertiary prevention: includes efforts to
decrease the degree of disability and
promote rehabilitation and
restoration of function in patients with
chronic and irreversible diseases
 Examples of each type of prevention?

Curative/therapeutic care
Assess and treat musculoskeletal,
respiratory and neurological conditions.
 Examples....

Rehabilitative care
Intervention measures taken to
implement treatment, self management
and educational programmes breaking the
chain of impairment, disability or
handicap.
 Restoration of optimal physical and
functional independence.
