Definition and Elements of Primary Health Care

Following an international meeting in Alma-Ata, USSR, the idea of primary health care gained prominence in 1978. It is described as:

"Essential health care based on on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals & families in the community through their full participation & at a cost that the community & the country can afford to maintain at every stage of their development in the spirit of self reliance and self-determination."

Elements of Primary Health Care:

All nations agree that primary healthcare is essential to achieving the goal of "Health for All by the year 2000 AD." It is also recognized as a crucial element of the national healthcare system. Eight principles were outlined in the Declaration of Alma-Ata (1978), although they have been altered in various nations to take account of regional conditions. Therefore, Nepal has 10 PHC components, with mental and oral health added later as needed. The basic healthcare system in Nepal consists of the following components:

• Education concerning prevailing health problems and the methods of preventing and controlling them:

  • Because a person's first need is a need that is felt, health education should concentrate on genuine health issues. Therefore, the following topics should be presented in health education if the patient has diarrhea or dysentery:
    • Use of clean water for drinking and cooking, appropriate cleaning and cooking of fruits and vegetables prior to consumption.
    • Proper hand washing after using the restroom, before preparing food, and before eating.
    • Use properly wrapped meals instead of exposed or leftover items.
    • Use ORS solution if you have diarrhea.
  • A key part of the community health nurse's job is to work with multidisciplinary and multisectoral teams to plan suitable health education programs that address community needs.

• Promotion of food supply and proper nutrition:

  • As a community health nurse, it is our responsibility to encourage and counsel people on how to produce a range of inter-personal foods, prepare supplemental foods, prepare meals with a balanced diet, and choose foods in sufficient quantities and of high quality. The nurse also promotes healthy behaviors such as ensuring optimal child spacing, supporting prolonged breastfeeding, safe weaning practices, teaching children basic hygienic skills, and preventing endemic and epidemic diseases, among other things. The community health nurse is in charge of carrying out nutritional education programs, maintaining growth charts for nutritional monitoring, weighing infants and children, and working with other sectors to provide iodized salt, vitamin A supplements, food supplements, deworming, iron supplements, etc. She also instructs other community health professionals in nutrition.

• Adequate supply of safe water and basic sanitation:

  • The community health nurse's job is to educate the local population on how to clean drinking water, prevent contamination of rivers and wells, identify safe water sources, and encourage people to build latrines in their homes and communities. In areas with poor drainage systems, they also make provisions for composting facilities and septic tanks. The nurse must coordinate with other sectors to supply the community with safe water and to maintain proper sanitation. Due to a number of issues, including a lack of latrines, improper waste management practices, open field defecation, improper sewage disposal, sullage, and human excreta in rivers, the environmental sanitation is also very poor. As a result of people's ignorance of composting as a garbage disposal method, waste is growing.

• Maternal and child health including family planning: 

  • "Reduce the mortality & morbidity of mother, babies & children" was the mission statement developed in 1997 by the MCH & family planning Department of Republic Indonesia. Nepal pursues these objectives as well. The following three goals are part of it:
    • To encourage a mother's being in the best health possible during her pregnancy, birth, and childbearing years.
    • To encourage the highest possible state of health for babies and kids, with a focus on healthy eating and infection prevention.
    • To encourage improved family health by assisting parents in making plans for the number of children they hope to have. This can include guidance on how far apart to space children or when to employ family planning techniques.

• Immunization against the major infectious diseases:

  • The goal of vaccination is to protect against endemic and pandemic disease. The immunization of children worldwide against serious vaccine-preventable diseases has advanced significantly (measles, diphtheria, pertusis, hepatitis, tuberculosis, poliomyelitis and tuberculosis). Active immunization can readily prevent many diseases, although they frequently result in illness, disability, and death each year. Therefore, it is necessary for health posts, health centers, and other facilities to have a sufficient supply of vaccines. Maintaining the cold chain is also important.

• Appropriate treatment of common diseases and injuries:

  • Treatment for common illnesses and minor wounds should be provided at the health post level. Therefore, the health worker should be properly trained, and suitable equipment and medication should be provided. PHC, sub-health posts, and health posts should be established based on catchment area and population. Nurses' emergency and primary care services contribute to a decrease in morbidity and death.

• Provision of essential drugs:

  • To treat mild illnesses, the nurse should keep and use the necessary vital medications. Other healthcare professionals should also be aware of the facilities and resources for obtaining necessary medications. A list of national essential drugs for 2002 is created by the Department of Drug Administration to ensure proper drug use. To handle the crisis, the health center needs to have access to emergency medications.

• Prevention and control of locally Endemic Diseases:

  • Illnesses that are endemic to a particular region or nation are called those diseases. Diarrhoea, the common cold, influenza, TB, malaria, kalazar, parasites, etc. are endemic diseases in Nepal. These illnesses are easily spread and can be avoided. In order to prevent, control, and treat diseases, the nurse educates the population about how they spread. In order to control endemic diseases, the government of Nepal has developed a number of programs, including those to combat diarrheal illness, ARI, malaria, kalazar, leprosy, TB, AIDs/STI, etc. Nursing teams collect and record data, care for the sick, deliver medication on time, impart health education, visit and follow-up on cases, and undertake surveillance in risk populations as part of disease control and prevention.

• Mental Health:

  • A person should be physically, psychologically, and socially healthy, according to the WHO definition of health. A person with mental illness is powerless to do anything. The local nurse should impart knowledge on how to manage stress, prevent mental illness, and handle mentally ill individuals.

• Dental Health:

  • The PHC nurse should run school dental programs, provide health education on oral care, and provide treatment for oral and tooth issues because Nepalese people suffer from a variety of dental ailments. With the idea of total health, the dental health is introduced to the PHC component.

Keys to remember:

Essential Health Services in Primary Health Care (ELEMENTS):

• E- Education for Health
• L- Locally endemic disease control
• E-Expanded program for immunization 
• M - Maternal and Child Health including responsible parenthood
• E- Essential drugs
• N-Nutrition
• T-Treatment of communicable and non-communicable diseases
• S-Safe water and sanitation
• M-Mental Health
• D-Dental Health