PRIMARY HEALTH CENTREPRESENTED BY:Ms. Annu VermaRoll No- 1914713M.Sc. Nursing 1st year

INTRODUCTION The primary health centre occupies a key

position in the nation’s health care system. It provide an integrated curative and preventive health care to the rural population with emphasis on preventive and promotive aspects of health care.

INTRODUCTION …CONT Population covered by one PHC Rural populations in the plains - 30,000 In hilly, tribal & backward areas- 20,000

DEFINITIONS HEALTH Acc to WHO (1946), Health is defined as "a

state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity."

DEFINITIONS …CONT PRIMARY HEALTH CARE:1978 Alma-Ate defined the “primary health care is

essential health care made universally accessible to individuals and acceptable to them through their full participation and at a cost the community and country can afford.

DEFINITIONS …CONT PRIMARY HEALTH CENTRE Primary Health Centre is an

institution for providing comprehensives health care viz., preventive, promotive and curative services, to the people living in a defined geographical area.

PRIMARY HEALTH CARE The “first” level of contact between the

individual and the health system. Essential health care (PHC) is provided. A majority of prevailing health problems can

be satisfactorily managed. The closest to the people. Provided by the primary health centers.

SECONDARY HEALTH CARE More complex problems are dealt with. Comprises curative services Provided by the district hospitals The 1st referral level

TERTIARY HEALTH CARE Offers super-specialist care Provided by regional/central level institution. Provide training programs

PRINCIPLES OF PRIMARY HEALTH CARE

STATISTICS

Total PHC in India - 23,109 Total PHC in Haryana -425 Total PHC in Ambala -16 (Chaurmastpur, Bihta, Shahzadpur, Noorpur,

Patrehri, Ugala, Kurali, Samlehri, Panjokhara, Tharwa, Majri, Ambli, Nauhani, Mullana, Naggal, Brara, Boh)

The Basic Requirements for Sound PHC (the 8 A’s and the 3 C’s)

Appropriateness Availability Adequacy Accessibility Acceptability Affordability

Assessability Accountability Completeness Comprehensiveness Continuity

HISTORY AND EVOLUTION OF PRIMARY HEALTH CENTRE in INDIA In 1977, the government of India had launched a

Rural Health Mission, based on the principle of “placing the people health in people hands”.

PRIMARY HEALTH CENTRE in INDIA …CONT

BHORE COMMITTEE 1946: PHC a basic health unit to provide

integrated preventive and curative services to rural population.

one PHC/10 to 20,000 populations with 6 medical officers and 6 public health nurses and other supporting staff.

PRIMARY HEALTH CENTRE in INDIA …CONT

CENTRAL COUNCIL OF HEALTH: In 1953 ,recommended for establishment of

PHCs in community development blocks to provide comprehensive health care to rural population.

One PHC is for 1,00,000 population with little or no community involvement.

Poorly staffed and equipped, inadequately for covering the population.

PRIMARY HEALTH CENTRE in INDIA …CONT MUDALIAR COMMITTEE,1962: 1. Strengthening of existing PHCs and 2. One PHC for 40,000 populations.

SHRIVASTAV COMMITTEE-1975: Community health care should be provided by

health workers who are from the same community after proper training. So that people health is placed in people hands.

PRIMARY HEALTH CENTRE in INDIA …CONT NATIONAL HEALTH PLAN: As a signatory to the Alma-Ata declaration ,

India has proposed reorganization of primary health centers on the basis of one PHC for 30,000 populations in plain areas and 20,000 populations in tribal and hilly areas for more effective coverage.

STAFFING PATTERN Medical officer -1 Pharmacist -1 Nurse midwife - 1 Health worker F (ANM) -1 Block extension Educator -1 Health Assistant (F)/LHV -1

STAFFING PATTERN Health Assistant (M) -1 UDC and LDC -2 (1 each) Lab technician -1 Driver (if vehicle is there) -1 Class IV -4 Total 15

MEDICAL CARE

OPD services: 4 hours in the morning and 2 hours in the afternoon/evening. Time schedule will vary from state to state. Minimum OPD attendance should be 40 patients per doctor per day.

24 hours emergency services : appropriate management of injuries and accident,

MEDICAL CARE …cont First-aid, stabilization of the condition of

patient before referral. dog bite/ snake bite/scorpion bite cases,

and other emergency conditions; Referral services; In-patient services (6 beds).

MCH including family planning

ANTENATAL CARE Early registration of pregnancy and

minimum 3 antenatal check-up; Minimum laboratory investigations such as

hemoglobin, urine albumin and sugar. Nutrition and health counseling;

Antenatal care …cont Supplementation of folic acid and iron tablets

and tetanus toxoid immunization. Identification of high risk pregnancies and

appropriate management; Refer to other hospital in case of high

pregnancy beyond the management capability of medical officer in PHC.

INTRANATAL CARE 24 hours services for normal delivery; Promotion of institutional delivery; Conducting assisted deliveries including

forceps and vacuum delivery whenever required;

Manual removal of placenta and Appropriate and prompt referral for cases

needing specialist care.

POST –NATAL CARE

Within 48 hours of delivery and 2nd within 7 days through sub centers staff;

Initiation of breast-feeding of delivery within half-hour of delivery;

Education on nutrition, hygiene and contraction and

Provision of facilities under Janani Suraksha Yojana.

NEW BORN CARE

Essential new born care; Facilities and care for neonatal resuscitation

and Management of neonatal hypothermia and

jaundice.

CARE OF THE CHILD

Emergency care of sick child including Integrated Management of Neonatal and childhood Illness (IMNCI);

Care of routine childhood illness; Promotion of breast-feeding for 6 months; Full immunization of all infants and children

against vaccine preventable diseases as per guidelines and ;

Vitamin A prophylaxis.

TRAINING Initial and periodic training of paramedics in

treatment of minor ailments. Training of ASHAs. Training of ANM and LHV in antenatal care

and skilled birth attendance. Training of AYUSH doctor in imparting health

services related to National Health and Family Welfare programme.

NUTRITION SERVICES Diagnosis and

management of malnutrition , anemia and vitamin A deficiency and coordination with ICDS.

MONITORING AND SUPERVISION

Monitoring and supervision of activities of sub-centers through regular meetings/ periodic visits, etc.

Monitoring of all National Health Programmes.

Monitoring activities of ASHAs. Health assistant’s male and LHV should visit

sub-centers once a week.