Definition of Primary Health Care
Most of the health a nation enjoys is made far from the big hospitals. This is the idea that says so.
A mother in a village outside Gusau walks forty minutes to the health post with her feverish baby on her back. The community health worker tests the child for malaria, starts treatment, weighs him, notices he has missed a vaccine and gives it, and reminds the mother about the borehole the ward committee is fixing. No specialist, no scanner, no theatre. Yet in one short visit, five different threats to that child's life were handled. That visit is primary health care, and by the end of this course you will be able to explain exactly why it is built the way it is.
The Concept of Health
Before defining primary health care, be clear about the word in the middle. The World Health Organization's Constitution (in force since 1948) defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
Notice what that definition does. It refuses to equate health with "not sick". A man who is free of malaria but has no clean water, no job and no peace of mind is not, by this definition, fully healthy. Primary health care was designed to act on all of those things, not only on illness.
The Alma-Ata Definition of Primary Health Care
The standard definition comes from Article VI of the Declaration of Alma-Ata (1978). Learn it word for word; it is the most-quoted sentence in this course:
Primary health care is essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination.
The same article goes on to say that PHC is the first level of contact of individuals, the family and community with the national health system, bringing health care as close as possible to where people live and work, and that it is the first element of a continuing health care process.
Worked example
Unpacking the Alma-Ata definition, phrase by phrase
Each phrase carries an idea that later becomes a principle of PHC. Read them slowly.
- 1 Essential health care
The basic care everyone needs (safe delivery, immunisation, treatment of common illness), not every possible service.
Primary Health Care as the First Level of Contact
Two ideas sit inside the word primary. It means first (the first point of contact) and it means most important (the foundation on which everything else stands). Do not confuse primary health care with "primary care" in the narrow sense of a doctor's clinic. PHC is a whole approach: services plus the social action (water, food, education) that keeps people well.
Pause & think
A state builds a modern specialist hospital in its capital but closes three rural health posts to pay for it. Using the Alma-Ata definition, which words are being ignored?
Quick check
Did it land?
Spotted a mistake?