Primary Health Care - Goals and Principles

Goals and Principles

The ultimate goal of primary health care is better health for all. The WHO has identified five key elements to achieving that goal:

• reducing exclusion and social disparities in health (universal coverage reforms);
• organizing health services around people's needs and expectations (service delivery reforms);
• integrating health into all sectors (public policy reforms);
• pursuing collaborative models of policy dialogue (leadership reforms); and
• increasing stakeholder participation.

Behind these elements lies a series of basic principles identified in the Alma Ata Declaration that should be formulated in national policies in order to launch and sustain PHC as part of a comprehensive health system and in coordination with other sectors:

• Equitable distribution of health care – according this principle, primary care and other services to meet the main health problems in a community must be provided equally to all individuals irrespective of their gender, age, caste, color, urban/rural location and social class.
• Community participation – in order to make the fullest use of local, national and other available resources. Community participation was also a reaction to unsustainable vertical health-approaches which refers to when a wealthier country funds a poorer country's health care. This model is unsustainble while a grass roots, community based Primary Health Care system is sustainable due to its emphasis on self-sufficiency.
• Health workforce development – comprehensive health care relies on adequate numbers and distribution of trained physicians, nurses, allied health professions, community health workers and others working as a health team and supported at the local and referral levels.
• Use of appropriate technology – medical technology should be provided that is accessible, affordable, feasible and culturally acceptable to the community (e.g. the use of refrigerators for vaccine cold storage). Appropriate technology, which is the concept of health tool that is used for socioeconomic development, is the opposite to medical elitism. Some example of un appropriate technology include disease-oriented technology and urban hospitals. The former referred to such technology as body scanners or heart-lung machines. These machine are rarely used or needed by the poor. Urban hospital are institution created in developing countries. These hospitals only served and benefited a minority but draw a large share of scares source and manpower.
• Multi-sectional approach – recognition that health cannot be improved by intervention within just the formal health sector; other sectors are equally important in promoting the health and self-reliance of communities. These sectors include, at least: agriculture (e.g. food security); education; communication (e.g. concerning prevailing health problems and the methods of preventing and controlling them); housing; public works (e.g. ensuring an adequate supply of safe water and basic sanitation); rural development; industry; community organizations (including Panchayats or local governments, voluntary organizations, etc.). Health work was no longer a short-lived intervention but an on-going process of improving people's live conditions in poor. There should be a link, which had political implications, between health and development. Health is a tool that helped people that increase their life, and it should not be the result of improved economic.