(PDF) Primary Health Care: An Overview

Primary Health Care in Action notes
Module 1: Intro into primary health care
Health: WHO (1986) defines it as a state of complete physical, mental, and social wellbeing and not
merely the absence of disease or infirmity.
Social determinants of Health: Factors that determine health and wellbeing. → Social wellbeing,
economic wellbeing, environmental wellbeing, life satisfaction, spiritual wellbeing.
Social determinants of health
- Employment and working conditions.
- Gender, culture
- Health services, resources
- Health practices, coping skills.
- Social environments
- Physical environments
- Education, literacy
- Social support networks
- Healthy child development
- Biology, genetic characteristics
6 dimensions of health
- Physical
- Social
- Intellectual
- Environmental
- Spiritual
- Emotional
Origin of PHC
1978, The World Health Organisation (WHO), began the concept of “Health for ALL”, by the
year 2000, and Declaration of Alma Ata.
Aim: Create social justice about how countries distribute their resources of Health.
(1978) Declaration of Alma Ata: states that health is a “fundamental human right” and is a
“world-wide social goal.”

Principles of PHC
Access equity, empowerment health literacy, community participation, cultural sensitivity,
cultural safety, intersectoral collaboration, health promotion, appropriate technology →
adaptable to local needs, acceptable to those using, maintained by people themselves, using
affordable resources.
Intersectoral collaboration: Joint action taken by health and other government sectors as well as
representatives from private, voluntary, and non-profit groups to improve health of populations
performing different roles for same purpose.
Primary Health Care: Essential care made universally acceptable to families and individuals in the
community by means acceptable to them through their full participation and at a cost the
community can afford.
Primary Health Care Primary Care
- Incorporates 6 PHC principles
- Holistic (various) focus on health
promotion and disease prevention:
treatment, cure, rehab
- It is a SOCIAL MODEL OF HEALTH
- Intersectoral collaboration between all
sections
- It is a comprehensive global health care
(McMurray & Clendon, 2015)
- A component of PHC
- 1st point of contact a person has with
the health system.
- Essentially about care for sick or injured
individuals based in the community.
- Allied health, nursing care, therapist
(e.g., medical care)
- Selective health care (McMurray &
Clendon 2015)
Module 2: Social Determinants of Health
Education
Provides individuals with the knowledge and skills to solve problems and take control of their life
circumstances + job opportunity, income security, job satisfaction.
Employment/working conditions.
Shapes social position provides sense of purpose, identity, social contacts, personal growth.
Early/Healthy child development (ECD)
ECD involves physical, social, emotional, and language/cognitive → influences wellbeing, obesity,
mental health, heart disease, competence in literacy and numeracy, criminality, economic
participation.
Socioeconomic position
- People from poorer social/economic circumstances are at great risk of poor health, higher
rates of illness, disability and death and lives shorter lives.
- Indicators such as education, occupation and income define socioeconomic position
(Galobardes et al. 2006, AIIHW, 2016)

Occupation
Higher education and income levels → increased likelihood of higher status occupation → high
income.
Income
Greater access for goods and services that provide health benefits such as housing, food, additional
health care options, healthy pursuits.
Gender
Implementing human rights.
Culture
A person’s upbringing, background, traditions, customs, and the beliefs of their family or community
→ influence how they may think, feel, act and value.
Social support networks
Provide sources to cope, find work.
Physical environment
Contaminants in water, air, food, soil
Biology/genetics
Age, sex, inherited conditions
Health services
Barriers include→ cost, availability, insurance, language.
Social environments
Share resources together, bond, values, norms, social stability, diversity, cohesiveness can help risk
to health.
Behavioural risk
Tobacco, alcohol, illicit drugs, less exercise
Social gradient: Research studies have shown that there is a ‘social gradient’ in health, whereby
those employed at successively higher levels have better health than those on lower levels.

Module 3: Health Promotion
Ottawa Charter (1986)
The process of enabling people to increase control over and improve their health (WHO, 1998).
- Introduced at the first international conference on Health promotion in 1986 in Ottawa, Canada.
Aim: Emphasise importance of promoting health at a global level, for Health for ALL (HFA). SOCIAL
JUSTICE.
Fundamental prerequisites:
1. Peace
2. Shelter
3. Education
4. Food
5. Income
6. A stable ecosystem
7. Sustainable resources
8. Social justice and equity
→ Advocate, enabling (reduce difference in health status), mediate.
Strategies of the Ottawa Charter
- Strengthen community action.
- Develop personal skills.
- Build healthy public policy.
- Create supportive environments.
- Reorient health services.
- Enable, mediate, advocate.
Multi-level Health promotion
1. Upstream: Promoting, maintaining Health e.g., Vaccination, education
2. Midstream: Appropriate treatment, protection from harm or disability after illness, injury,
screening.
3. Downstream: Rehabilitation, coping (managing health/illness)
Strategies for Global Health (Labonte, 2008)
Access to resources → fundamental human right
Human security instead of national security
Reframe globalisation.
Regulate global market forces so its people centred.
Develop public policy based on a vision of the world where people matter→ social justice.
Develop a global contact.