Primary Health Care

Often abbreviated as PHC,

Primary medical care is the field of medicine that provides first-contact,

comprehensive curative, and preventive health care services. These services
are delivered by primary health care teams that include physicians,
community health nurses, village health workers, and other health
professional. Primary care or generalist physicians the family physicians,
general internists, and general pediatricians. Family physicians are the only
generalist physicians trained to care for patients of all ages. Because of their
ability to provide comprehensive, continuous care to patients of both sexes
and all ages and to cost effectively integrate preventive and curative care,
family physicians are well suited to address comprehensive primary health
care needs of people in developed and developing nations.
Family physicians are generalists trained at the postgraduate level to address
the majority of primary health care needs of patients of all ages in the
communities they serve.
Health FOR ALL (1977)
The world health assembly decided in 1977 that the main social
targets of the governments and WHO in the decades ahead should be the
attainment of "Health for all" by the years 2000. The attainment by all
people of the world "a level of health that will permit them to lead socially
and economically productive life".

ALMA - ATA DECLARATION (1978):

An international conference in Alma-Ata (USSR) issued a declaration

which stated that "Primary Health Care" is the key to attain HF A. The
WHO defined the Primary Health Care” as "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 the country can afford to maintain at every stage of their development in
the spirit of self-determination" (Alma Ata international conference
definition) It 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 constitutes the first element of a
continuing health care process.

Essential health care is the health care which would meet the actual “health
needs” of the community, categorized in broad terms as promitive,
preventive, curative rehabilitative care and hence, it is comprehensive. The
need for continuity in care of the population starting from the intra-uterine
life to the terminal care (womb to tomb) is the second essentiality; the third
qualification is to provide a satisfactory quality of care compatible to
processional and community expectations .Thus

(i) comprehensive
(ii) continuous
(iii) Compatible quality is the basic essentialities in the delivery of
primary health care.
Elements of PHC:
1- Education concerning prevailing health problems and the methods of
preventing and controlling them.
2- Promotion of food supply and proper nutrition.
3- Provision of comprehensive maternal and child health care.
4- Immunization of children against major communicable diseases.
5- Prevention and control of locally endemic diseases.
6- Provision of adequate supply of safe water and basic sanitation.
7- Appropriate treatment of common diseases and injuries.
8- Provision of essential drugs.
The first three elements in the above list are basically promotive
services, the middle three preventive and the last two with rehabilitative
services would form the classical curative care.
Libyan element of PHC:
1 -school health.
2 -mental health.
3- occupational health.
4-health care of elderly &handicapped
PHC principles:
The above mentioned eight services indicated as elements, are to be
organized and delivered on the basis of the principles of
1-Equity in distribution (fair sharing): It must be shared equally by all
people irrespective of their ability to pay, and all must have access to health
services.
2-Appropriate technology ,use of growth chart ,oral rehydration therapy
3-multisectoral approach involves, in addition to the health sector, all related
sectors and aspects of national and community development, in particular
agriculture, animal husbandry, food, industry, education, housing, public
works, communications and other sectors; and demands the coordinated
efforts of all those sectors
4-Community participation, which when considered in its totality with
accessibility and affordability, would lead to the PHC approach in the
delivery of health care
Organization of Health care Services in Libya.
First (Primary) level:
The 1st level of health services in Libya is P.H.C which is delivered through
primary health centers A,B,C and outpatient departments or polyclinics.99%
of health problems solved at this level
Services:
Type of health centre Staff Services
Basic health care units Providing curative
A(population 2,500) 2doctors,3 nurses care
B(population 5,000) 4 doctors,8 nurses also
C(population 7,5000) 6 doctors,12 nurse Dental ,MCH and
pharmacy
PHC(population 10,000) 8-12 doctors Curative care
11-24 nurses and MCH services
open 12 hrs/day auxiliary health Dental services
worker Pharmacy services
Laboratory services
Polyclinics(polulation50,000) 12-24 doctors Curative care
48-96 MCH services
24hrs/day nurses+auxiliary Dental services
health worker Pharmacy
Lab ,X –ray
Minor OT
All emergencies transferred where ever possible to the nearest rural
hospital .

Secondary or intermediated level: District hospitals its dealing with a

more complex health problems. Its comprises of essentially curative care.
Tertiary or central or university Level: Regional & specialized hospitals
(centers) and rehabitation center .This level required specific specialists, and
needs specific workers and facilities.