Concept of Primary Health Care

Definition of PHC (Alma – Ata declaration)

       
      The concept of ‘Primary health care’ was adopted at an International Conference in 1978 at alma Ata in the then USSR, which was jointly sponsored and organized by WHO  and UNICEF. In its declaration, popularly known as “The Alma Ata Declaration”, the International Conference defined primary health care as follows:

         
      “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 to maintain at every stage of their development in the spirit of self - determination”

Elements of primary health care (PHC)

  

    E = Education about health problems and their control.

    L = Local disease control

    E = EPI (Expanded programme on immunization)

    M = MCH based family planning

    E = Essential drugs provision.

    N = Nutrition

    T = Treatment of common diseases

    S = Sanitation

Health for All by the Year 2000 (HFA/2000)

  

   Definition: The member countries of WHO defined HFA/2000 as – “attainment by all the people of the world by the year 2000 AD of a level of health that will permit them to lead a socially and economically productive life.”

Global Indicator of HFA/2000

   The WHO has established 12 global indicators as the basic point of reference for assessing the progress towards HFA. These are:

1. Endorsement of HFA strategy as a policy at the highest political level.

2. Establishment of a mechanism for the involvement of people in implementing the strategies.

3. At least 5% of GNP is to be spent on health.

4. Allocation of reasonable percentage of national health expenditure to be devoted to local health care, i.e., at the level of first contact with health services, like health centre care and not secondary level hospital care.

5. Equitable distribution of health resources in terms of facilities and manpower as well as geographically (urban, rural) groups of population wise e.g. , women, children.

6. Formulation and updating of national strategies and explicit resources allocation in support of implementation through mobilization of internal and external resources.

7. Availability of primary health care to the entire population with at least the following:

     (i) Safe water at home or within 15 minutes walking distance and adequate sanitary facilities at home or in the immediate vicinity.

    (ii) Immunization against EPI target diseases e.g., diphtheria, whooping cough, measles poliomyelitis and tuberculosis.

   (iii) Local health care including availability of at least 20 essential drugs within an hour’s travel or walk.

   (iv) Antenatal care and child birth as well as caring of children up to at least 1 year of age by trained health personnel.

8. Nutritional status of children:

    (i) At least 90% of newborn have birth weight of at least 2500gm.

   (ii) At least of 90% of children have a weight for age that correspond to the standard prescribe by WHO.

9. Infant mortality rate of all identifiable subgroups is below 50 per 1000 live births

10. Life expectancy at birth is over 60 years.

11. Adult literacy rate for both sexes exceeds 70%.

12. The GNP per capita exceeds US $ 500.

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