Concepts of Primary Health Care – PHC

• Fundamental Health Services: Care designed to address the most prevalent health needs within a community, empowering individuals to lead productive lives both socially and economically.

• Sound and Practical Methods: Employing healthcare strategies and technologies that are evidence-based and capable of effectively resolving the health challenges within a specific community.

• Accessible Health Care: Ensuring health-promoting services within the community are readily available and can be reached easily by all individuals and the community as a whole.

• Comprehensive Community Involvement: Fostering a sense of ownership within the community regarding their health and well-being. This means actively including community members in all aspects of health initiatives – from organization and planning to implementation, monitoring, and evaluation – to ensure services are culturally appropriate and sustainable.

• Affordable Health Care: Maintaining healthcare costs and ongoing maintenance expenses at a level that is manageable for both the community members and the country’s financial resources.

• Community Independence: Building the community’s capacity for self-sufficiency, fostering confidence and trust in their ability to move from being passive recipients of aid to active collaborators with governmental, non-governmental, and donor organizations. This supports the community’s and government’s ability to maintain PHC activities independently.

• Community Decision-Making: Empowering the community to make independent choices and take action on matters directly impacting their health and overall development.

• Integrated Approach: Encouraging collaboration across various sectors to work together towards the socio-economic advancement of the community, with health as a central focus for promoting well-being and facilitating referrals when needed.

Introduction to primary health care

Historical Background of PHC

In 1976, Dr. Halfdan T. Mahler of Denmark, then the Director-General of the World Health Organization (WHO), proposed the aspiration of “health for all by the year 2000” during the World Health Assembly.

A significant international conference on primary health care convened in Alma-Ata, which was then the capital of the Kazakh Soviet Socialist Republic within the Soviet Union (now Almaty, Kazakhstan). This conference brought together approximately 300 delegates representing 134 governments and 67 international organizations from across the globe.

Subsequently, the Thirty-second World Health Assembly in Geneva in 1979 formally adopted the principles of the Alma-Ata declaration (WHO, 1978). This declaration outlined a foundational set of actions considered indispensable for effective implementation, which later became the core components of PHC.

The primary healthcare approach, aimed at achieving Health For All by the year 2000 (HFA/2000), received global endorsement from participating nations at the World Health Organization and UNICEF conference in Alma-Ata, USSR (WHO, UNICEF, 1978).

Definition According to World Health Organization WHO:

The World Health Organization (WHO) defines Primary Health Care (PHC) as fundamental healthcare rooted in practical, scientifically valid, and socially acceptable methods and technologies. This care is made universally accessible to individuals and families within the community through their complete participation and at a cost that both the community and the nation can sustainably support throughout their development, embodying the principles of self-reliance and self-determination.

Primary Health Care implementation is tailored to the specific context of each community, considering:

• The unique health requirements of the local population.

• The availability of healthcare professionals and resources.

• The community’s geographical setting.

• The proximity to other healthcare facilities in the region.

Levels of PHC

Primary health care

• Represents the initial point of contact between individuals and the healthcare system.

• Focuses on providing essential healthcare services (PHC).

• Addresses and effectively manages the majority of common health issues.

• Operates at the closest proximity to the population.

• Services are typically delivered through primary health centers and outreach programs.

• Staffing includes nurses, clinical officers, and community health workers/volunteers.

• In Uganda, this encompasses Health Centers up to level III (HC III), private clinics, and community-based medical centers affiliated with faith-based organizations.

Secondary health care

• Manages more complex and specialized health problems.

• Primarily involves curative healthcare services.

• Delivered through district hospitals and higher-level health centers.

• Serves as the first formal referral level within the healthcare system.

• Involves assessments and treatment provided by physicians and healthcare teams, including the capacity for minor surgical procedures.

• Examples in Uganda include Health Centre level IV facilities (HC IV), Kampala Capital City Authority (KCCA) hospitals, and district-level hospitals.

Tertiary health care

• Offers highly specialized and advanced medical care.

• Provided by regional and national level healthcare institutions.

• Often includes specialized training programs for healthcare professionals.

• Features specialists who are responsible for delivering care and performing major surgical interventions.

• In Uganda, this includes Regional Referral Hospitals, all regional and national hospitals with teaching and training functions, and National Referral Hospitals, along with specialized medical centers.

Concepts of Primary Health Care – PHC

1. Fundamental Health Services: Care designed to address the most prevalent health needs within a community, empowering individuals to lead productive lives both socially and economically.

2. Sound and Practical Methods: Employing healthcare strategies and technologies that are evidence-based and capable of effectively resolving the health challenges within a specific community.

3. Accessible Health Care: Ensuring health-promoting services within the community are readily available and can be reached easily by all individuals and the community as a whole.

4. Comprehensive Community Involvement: Fostering a sense of ownership within the community regarding their health and well-being. This means actively including community members in all aspects of health initiatives – from organization and planning to implementation, monitoring, and evaluation – to ensure services are culturally appropriate and sustainable.

5. Affordable Health Care: Maintaining healthcare costs and ongoing maintenance expenses at a level that is manageable for both the community members and the country’s financial resources.

6. Community Independence: Building the community’s capacity for self-sufficiency, fostering confidence and trust in their ability to move from being passive recipients of aid to active collaborators with governmental, non-governmental, and donor organizations. This supports the community’s and government’s ability to maintain PHC activities independently.

7. Community Decision-Making: Empowering the community to make independent choices and take action on matters directly impacting their health and overall development.

8. Integrated Approach: Encouraging collaboration across various sectors to work together towards the socio-economic advancement of the community, with health as a central focus for promoting well-being and facilitating referrals when needed.