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Unit 2 Primary Health Care (PHC) : 1 HSMMRB-2011
Unit 2 Primary Health Care (PHC) : 1 HSMMRB-2011
HSMMRB-2011
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Unit objectives
At the end of this chapter, the student is able to:
Describe the historical development of PHC.
Identify the philosophy, principles, components and
strategies of PHC.
Analyze the situation in the Ethiopian context.
Adopt PHC for the year 2000 and beyond.
Identify the Global indicators for monitoring and
evaluation of the Health for All strategy.
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Primary Health Care
Definition
It is an essential health care based on practical,
scientifically sound and socially acceptable methods
and technology, made universally accessible to
individuals and families in the community through
their full participation and at a cost that the community
and the country can afford
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Primary Health Care
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Historical development of PHC . . . . ..
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Historical development of PHC . . . . .
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Principles of PHC
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1. Inter sectoral collaboration
B/c the causes of ill health are not limited only to factors
related to the health sector.
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Which sectors must collaborate?
Education for literacy,
Income supplementation,
Clean water, sanitation, and improved housing,
Ecological sustainability,
More effective marketing of products,
Construction of roads and water ways,
Enhanced roles of women, are changes that may have
substantial impact on health
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2. Community Participation
• Is the process of assuming responsibility by individuals
and families for developing capacity to contribute to their
health and the community's development
• Problem identification
• Implementing,
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4.Equity (Equitable distribution)
Possible definition of equity include:-
• Equal health
• Equal access to health care according to need
• Equal utilization of health care according to need
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5. Focus on prevention and promotion of health
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6.Decentralization
The Purpose is to :
• Bring decision making to the communities served and to
field level providers of services, making it more
appropriate.
• Enhance multisectoral collaboration at the lower service-
delivery level.
• Enhance the ability to tap new sources for financing
health care.
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The PHC philosophy
1. Equity and justice = Effective PHC
• Ensures equitable distribution of resources and health care
for all the citizens to lead productive life.
• Makes an important contribution to greater social justice and
equity by Narrowing the gap B/n the "have's and the "have
not's".
• If all cannot be served those most in need should have priority.
2. Individual and community self reliance =
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The PHC strategy . . . . ..
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PHC - The level of care
Central referral
Central National & teaching H/L 30 care 30 Prevention
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The Eight elements of PHC (WHO/UNICEF 1978)
1. Health education
2. Provision of food supply and nutrition
3. Water supply and basic sanitation
4. Expanded program on immunization
5. Maternal and child health including family planning
6. Prevention and control of locally endemic disease
7. Appropriate treatment of common disease and injuries
8. Provision of essential drugs
1. Political constrains
• Problem in political commitment to reallocate and
decentralize resources,
2. Professional constrains
• Less emphasis given to prevention
• Less commitment from professionals
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Challenges faced in the implementation of (Global)
3. Experience constraints
• Experiences of project success only in some countries,
4. management problems
• Decreased budget for public sector
• Low success in achieving intersectoral and programs
collaboration
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PHC in Ethiopia included
A. Absence of infrastructure
B. Failure to achieve intersectoral collaboration
C. Inadequate health service coverage
D. Inadequate resource allocation
E. Absence of clear guidelines on how to implement PHC
F. Absence of sound legal rules to support environmental
health activities = Lack of enforcement
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Major problems in implementation of . . . . . . . .
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Approaches in PHC
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Approaches in PHC
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Approaches in PHC . . . . . . .
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Equity in the provision of health care
What is equity ? Is the faire distribution of the costs of health
services and benefits obtained from their use among different
groups in the population
Possible definition of equity include:-
• Equal health
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Two major types of equity . . . . . .
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Equity in the provision of health care
Note
• Good health is widely perceived as a basic human right
• Provision of cost-effective health service to the poor is
an effective and socially acceptable approach to poverty
reduction
• This in turn closes the gap between ‘’the haves and
don’t haves’’
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