LEARNING OUTCOMES
By the end of
this lecture students should be able to:
Explain the
concept of primary health care.
Describe the
conditions recommended to enable efficient primary health care.
Develop an
understanding of the use of health indicators to explain between-country
differences in population health, which are used to measure the effectiveness
of Primary health care and health systems.
Discuss the
concept of community development.
ABOUT PRIMARY HEALTH CARE
At least
half the world’s population still lacks access to essential health services. About
800 million people spend more than 10 per cent of their household budget on
health care, and almost 100 million people are pushed into extreme poverty each
year because of out-of-pocket health expenses 1.
Against
such a backdrop, primary health care is able to cover 80-90 percent of people’s
health needs across their lifetime, improve health outcomes, life expectancy
and provide improved quality of care2. This includes prevention, treatment, rehabilitation, and palliative care.
Primary health care can also target
specific health care needs such as target specific conditions and health care
needs such as cardiovascular disease, mental health, oral health, sexual health,
drug and alcohol treatment etc.
Additionally, special populations such as Indigenous populations, people
living below the poverty line income, migrants, can sometimes better served
through primary health care.
Primary health care consists of scientifically sound, culturally acceptable, economically affordable health services that leads to greater self-reliance and empowerment of communities. The active participation of the community is foundational to successful primary health care program.
By providing care in and through the community, primary health care can address the health needs of individuals and their families as well as of public health and the needs of defined populations3. Primary health care also addresses the broader determinants of health through multisectoral policy and action;
Primary health care is the cornerstone of an effective health system and the key to achieving universal coverage.
REFERENCES:
1. WHO & World Bank. Tracking universal health coverage: 2017 global monitoring report [internet]: World Health Organization and the International Bank for Reconstruction and Development / The World Bank 2017 [Available from: https://www.who.int/healthinfo/universal_health_coverage/report/2017/en/].
2. World Health Organization. The global conference on primary health care,
Astana 2018 [Available from: http://www.who.int/primary-health/conference-phc/Primary-health-care-brochure.pdf].
3. World Health Organization. Primary health care [internet] 2021
[Available from: https://www.who.int/health-topics/primary-health-care#tab=tab_1]
HISTORICAL CONTEXT OF PRIMARY HEALTH CARE
What is the historical context of primary
health care? What are the events that preceded the birth of the primary
health care movement leading to the Alma Ata Conference in 1978? As you watch
this video, think about the current context of health, disease and health care
needs of people. Is the primary health care model relevant to the current
context?
WHAT IS PRIMARY HEALTH CARE?
Before we delve deeper into primary health care,
let us clarify concepts. We often hear the terms ‘primary care’ and ‘primary
health care’. Are these two terms one and the same? Is there a difference
between primary care and primary health care? Watch this video to clarify your
understanding. We will also review the definition of primary health care here.
COMPREHENSIVE PRIMARY HEALTH CARE: CASE STUDY – SAVAR PROJECT, BANGLADESH
In this section, we will examine the Savar
project in Bangladesh, known as Gonoshasthaya Kendra today. The Savar project was one of the first
experiments in primary health care globally and one of the case studies that
informed the discussions of the global community in Alma Ata in 1978.
SELECTIVE PRIMARY HEALTH CARE
As we saw
in the previous segment, a hallmark of the primary health care approach is its comprehensiveness. However, a dismal global economic outlook, the
Washington Consensus, and the structural adjustment programs that followed saw a
transition in perspectives on primary health care and the ascendancy of the
concept of selective primary health care. Check out the video below to review
the differences between comprehensive and selective primary health care
approaches.
PRIMARY HEALTH CARE OR PRIMARY CARE IN DEVELOPED COUNTRIES
The above
discussions focused on the review of primary health care in the context of
low-and-middle-income countries (LMICs).
In this segment we look at the specific health needs of developed
countries – of aging populations, multimorbidity, chronicity, and related
complex health care needs, to review how primary care or primary health can be
integrated and comprehensive. We also examine a case example from Finland to
understand how primary health care can be adapted to different contexts, specifically high income countries, to meet
the individual and populations health needs of that area.
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We hope you enjoyed learning about primary
health care in practice. See you at the tutorials! 🌿