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Primary Health Care :

Primary Health Care Dr. Alshimaa mohsen Assistant Lecturer Community Medicine

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Introduction Primary health care (PHC) became a core policy for the World Health Organization with the Alma-Ata Declaration in 1978 and the ‘Health-for-All by the Year 2000’ Program. The commitment to global improvements in health, especially for the most disadvantaged populations, was renewed in 1998 by the World Health Assembly. This led to the ‘Health-for-All for the twenty-first Century’ policy and program, within which the commitment to PHC development is restated.

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Primary Health Care (PHC) PHC is: Essential health care made accessible to all individuals and families by being acceptable and appropriate through their full participation and cost that the community\people and country can afford .

The Principle of PHC:

The Principle of PHC Essential Accessible Affordable Acceptable Appropriate

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PHC The “first” level of contact between the health sector and public. Essential PHC Includes preventive, curative and health promotion services.

Accessible :

Accessible Provided to all people with no barriers to get services. There are three dimensions for accessibility: Geographic accessibility. Social accessibility. Financial accessibility.

Affordable :

Affordable People can pay for cost of utilization of the service.


Acceptable To people. Feel importance of PHC to their health needs. No barrier to receive the service.

Appropriate :

Appropriate PHC services meet the health needs of the population.

Characteristics of PHC:

Characteristics of PHC Reflect and response to economic, socio-cultural and political conditions of the country and its population based on relevant experience and research. 2. “Address the main health problems in the community.

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3. Involves inter-sectoral cooperation of all related sectors at the national, regional and local levels. community participation and mobilization for active involvement and self-reliance in solving the health problems. 5. Included at least eight elements.

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6. System support through coverage of all people with essential health care, scientifically sound services and affordable health technology. 7. PHC provided by health team including physicians, nurses, midwives, auxiliaries, dentists, pharmacists and community workers.

The Eight Elements of PHC:

The Eight Elements of PHC Health Education concerning prevailing health problems their preventing and control. 2. Promotion of food supply and proper nutrition. 3. Basic sanitation and safe water supply.

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4. Maternal and child health care, including family planning. 5. Immunization against the major infectious diseases. 6. Prevention and control of locally endemic diseases. 7. Appropriate treatment of common diseases and injuries

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8. Basic laboratory services and provision of essential drugs. 9. Training of health guides, health workers and health assistants. 10. Referral services.

Primary Health Care Services:

Primary Health Care Services Curative Care Services at the PHC level Management of common non-complicated health problems. Treatment of childhood illness e.g. IMCI for ARI, diarrhea and fevers. Control of infectious diseases outbreaks and epidemics.

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4. First aid, emergency and life-saving services. 5.Management of chronic of non communicable diseases( DM and hypertension). 6.Control of endemic priority diseases ( TB, Hepatitis). 7.Conduction of minor surgery. 8.Referral of needy cases and follow up.

Preventive Activities at the PHC level:

Preventive Activities at the PHC level Implementation of Expanded program of Immunization (EPI). Early detection of neonatal problems. Early detection of mental disorders. Screening for high risky pregnancy. Screening for reproductive malignancies ( breast, cervix).

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6. Screening for TB, parasitic infestations. 7.Providinf FP Services. 8. Referral of identified problems to prevent complications.

Health Promotion Services:

Health Promotion Services Health Education and counseling. Supplementation with micronutrients. Family planning activities ( information, education and communication). Growth monitoring of the children. Food safety measures and care of food handlers.

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6. Supporting environmental sanitation activities. 7. Outreaching of people in the remote areas to raise health awareness.

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Human Life Cycle and PHC Services The human life cycle consists of specific stages linked together transitional events. Each stage has its own characteristics, health risks, health needs and required services. The health care system has the responsibility for providing health promotion, preventive and curative care needed by all family and community members at different stages of the human life cycle.

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Life Cycle approach in Health Care Preconception stages. Fetal Life stage. Breast dependence and preschool age stages. School age and adolescence stages. Age of production and reproduction. Aging stage.

Health Office Services:

Health Office Services Registration of births. Registration of deaths and giving permissions for burial. Prevention and control of infectious diseases through: Notification of infectious diseases. Monitor the process of isolation of cases and terminal disinfection.

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Apply the control measures for contacts of cases. Apply the control measures to the community. 4. Issue leaves for the diseased individuals. 5. Registration of the immunization activities and follow up the dropouts. 6. Providing immunization services as in case of vaccination of pilgrims by meningococcal vaccines.

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7. Monitor the environmental conditions including water supply, food sanitation and other sanitation measures. 8. Participation in the survey studies. 9. Participation in physical checkup, periodic examination and record keeping for special population categories e.g. food handlers.

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