PRIMARY HEALTH CARE (PHC)
THEORETICAL CONCEPTSCharacteristics of hospital curative care
1. Usually it is based on high technology or sophisticated technology which is costly to do and costly to maintain.2. It is limited to people whom visited hospitals usually complaining of advanced disease.
3. It does not interfere in any means in the process of disease genesis outside the walls of hospitals4. Although hospital care relieves pain in most cases, it does not always cure . Sometimes it adds disease to the those admitted (Nosocomial infection, iatrogenic diseases, provider mistakes)
5. The coverage by hospital care is usually limited to much-selected catchment's population.
6. In does not contribute a lot to the health of the general population. Health is related to many factors unrelated to hospital or medical care
Occupation Education
Nutrition Income
Health
Work conditions GeneticsEnvironment Others Medical cares Fertility
It is clear that the classical hospital – based cure oriented medical care is not the solution for the increasing health needs of the general population. A new approach was proposed and then practiced. That was the primary health care (PHC).The WHO adopted the PHC strategy and member states in 1978.
Definition of primary health care (PHC)Primary health care is essential health care made universally accessible to individuals and families in the community by means acceptable to them, through their full participation and at an affordable cost. It forms an integral part both of the country’s health care system and of the overall social and economic development of the community.
Primary health care stresses the provision of promotive, preventive, curative and rehabilitative care. In other words, it stresses the provision of comprehensive, continuing, practical and high quality care. It is not a second hand care and in no way it is intended to make the cost of care a burden on consumers.
Key features of PHC
It includes essential health care services:
a. MCH services including family planning.b. Adequate nutrition.
c. Environmental health.d. School health.
e. Control of communicable diseases.f. Curative care for common illnesses and injuries.
g. Health education.h. Compilation of vital and health statistics.
Accessibility. Care can be used when and where people needs arise.Acceptability. The accommodation of provider and consumer characteristics. A female doctor is certainly more acceptable to provide prenatal care from the sociocultural point of view.
Participation of people.
Integration: within the different components of the health care system and between the latter and other sectors.Effective two-way referral system.
Health education.Skills of the doctor working in PHC setting
A doctor working in a primary health care setting is described as “ the five star doctor” who is expected to be:a. Care provider,
b. Decision-maker.c. Communicator,
d. Communitye. Team member,
Supportive programmes of PHC
a. Health information system.b. Guide- lines, supervision and follow- up.
c. Continuing education.d. In- service training.
e. Effective referral system.Problems facing PHC
a. Financial. The expansion of the objectives of the health care system under the strategy of primary health care with the establishment of extensive network of health centres and other outreach services certainly requires much more money than that is needed for the concentrated hospital care.b. Administrative and technical. PHC centers require larger amount of, supplies, equipment,
drugs, transportation means etc.
In addition their work must be closely supervised. Guidelines must be available to all levels of health personnel.
c. Political. Success of PHC strategy depends on:
1. Political will2. Political commitments
PRIMARY HEALTH CARE IN IRAQPrimary health care as a strategy has been adopted in Iraq since Al-Ma-Ata declaration in 1978. An extensive network of health care institutions was established.
Health care is provided to all population through:
Mobile units for remote areas and in campaigns.Primary health centers.
District hospitals.General multispecialty hospitals.
Specialized referral hospitals.
Private clinics and hospitals.
Cooperative clinics.These sources provide health care, which varies in sophistication from basic essential care to highly advanced care.
The list of the essential services adopted in Iraq is not different from the list recommended by the World Health Organization (WHO). They are clearly defined in the Iraqi Public Health Law No. 89 for 1981.
A number of programmes, however, received special attention and a good deal of effort and resources has been and are being devoted to execute them on national level. They received international, national and local support.
The principal objectives of primary health care programmes are:
1. To reduce morbidity and mortality levels in population.2. To reduce morbidity and mortality levels in children aged less than five years and women in the reproductive age.
3. Specifically to reduce infant and childhood mortality which result from specific targeted diseases.
4. To improve people’s awareness and practices regarding health behaviour and childcare.
5. To encourage people participation in caring for their health and supporting health programmes.