Primary Health Care: Functions, Principles, Healthcare Institutes & Examples
Introduction to Primary Health Care (PHC)
Primary Health Care (PHC) is the foundation of any effective healthcare system. It refers to essential, accessible, community-based health services that meet the majority of a population’s health needs. PHC is usually the first point of contact between an individual and the healthcare system and focuses on prevention, health promotion, treatment, rehabilitation, and palliative care.
The concept of PHC was introduced globally through the Alma-Ata Declaration in 1978, which emphasized “Health for All.” Today, PHC remains the backbone of India’s healthcare system, especially in rural and underserved areas. By providing affordable, equitable, and continuous care, PHC helps reduce disease burden and improve community well-being.
What Is Primary Health Care?
Primary Health Care refers to basic health services delivered at the community level, ensuring universal health coverage and promoting healthy living. It is designed to provide:
Accessible services close to people’s homes
Affordable care for all socioeconomic groups
Comprehensive services focusing on prevention and cure
Continuous care throughout the life cycle
Community participation in healthcare programs
PHC addresses the majority of common health issues like infections, maternal and child health, nutrition, immunization, and management of chronic diseases.
Characteristics of Primary Health Care
Accessibility
PHC centers are located close to the community, especially rural areas.
Affordability
Services are either free or low-cost, ensuring no financial hardship.
Comprehensiveness
Includes preventive, promotive, curative, rehabilitative, and palliative services.
Continuity of Care
PHC follows a patient through different stages of life.
Community Participation
Involves ASHA workers, Anganwadi workers, local leaders, and community groups.
Intersectoral Coordination
Collaboration between health, education, sanitation, nutrition, and agriculture sectors.
Principles of Primary Health Care
Primary Health Care is based on the following essential principles:
1. Equitable Distribution
Every individual, regardless of income or location, should access basic health services.
2. Community Participation
People actively take part in planning and implementing health programs.
3. Intersectoral Coordination
Healthcare should work with sanitation, nutrition, water supply, and education departments.
4. Appropriate Technology
Use of affordable, effective tools such as ORS, vaccines, mosquito nets, etc.
5. Focus on Prevention
Preventing diseases is prioritized to reduce hospital load and healthcare costs.
Functions of Primary Health Care
Primary Health Care performs multiple essential functions to maintain community health:
1. Health Promotion
Health promotion includes health education and awareness activities such as:
Nutrition education
Promotion of breastfeeding
Personal hygiene education
Safe drinking water practices
Anti-tobacco and anti-alcohol awareness
Physical activity promotion
2. Disease Prevention
Preventive services reduce the spread of illnesses. These include:
Immunization programs
Disease surveillance
Maternal and child health care
Family planning and contraception services
Screenings for hypertension, diabetes, cancer, etc.
3. Curative Services
PHC provides treatment of common diseases such as:
Fever
Diarrhea
Respiratory infections
Minor injuries
Skin diseases
Management of chronic illnesses
4. Rehabilitative Services
Includes support and therapy for individuals recovering from illness, injury, or disability.
Physiotherapy referrals
Rehabilitation for TB and leprosy
Nutritional rehabilitation
5. Palliative Care
Supportive care for patients with life-threatening diseases:
Pain management
Psychological support
End-of-life care
6. Maternal and Child Health Services
A major role of PHC includes:
Antenatal care (ANC)
Postnatal care (PNC)
Safe delivery
Child growth monitoring
Immunization
7. Family Planning Services
PHC provides:
Contraceptives
Counseling
Sterilization referrals
8. Community Health Surveys
PHC workers gather information to track:
Disease outbreaks
Local health issues
Nutritional status of children
Components of Primary Health Care
According to the Alma-Ata Declaration, PHC consists of:
1. Health education
2. Promotion of food supply and nutrition
3. Adequate safe water and sanitation
4. Maternal and child health including family planning
5. Immunization
6. Prevention and control of endemic diseases
7. Treatment of common diseases
8. Provision of essential drugs
Institutes of Primary Health Care in India
Primary Health Care is delivered through multiple institutions including:
1. Sub-Centres (SCs)
First contact point between the community and health system
Staffed by ANM (Auxiliary Nurse Midwife) and Male Health Worker
Covers around 3,000–5,000 population
Services provided:
Immunization
Health education
Basic maternal and child health services
Family planning
2. Primary Health Centres (PHCs)
Provide integrated curative and preventive services
Staffed by Medical Officer, Staff Nurses, Pharmacist, Lab Technician
Covers 20,000–30,000 population
Services provided:
Outpatient care
Minor surgical procedures
Health promotion
Disease prevention
Treatment of common illnesses
3. Community Health Centres (CHCs)
30-bed hospitals acting as referral centers for PHCs
Covers 80,000–120,000 population
Equipped with specialists: physician, surgeon, obstetrician, and pediatrician
Services provided:
Emergency care
Surgery
Obstetric care
Laboratory and diagnostic services
4. Health and Wellness Centres (HWCs)
Launched under Ayushman Bharat, they offer:
NCD screening (diabetes, hypertension)
Mental health services
Telemedicine
Physiotherapy
Palliative care
5. Anganwadi Centres
Part of ICDS scheme, they provide:
Nutrition support
Preschool education
Maternal and child health services
6. Urban Primary Health Centres (UPHCs)
Located in towns and cities for urban slums and underserved areas.
Examples of Primary Health Care Services
Example 1: Immunization Program
Vaccinations against measles, polio, hepatitis, and tuberculosis.
Example 2: Health Education in Schools
Awareness about hygiene, menstruation, nutrition, and mental health.
Example 3: Family Planning Camps
Distribution of contraceptives and counseling.
Example 4: Nutrition Programs
Midday meal scheme, ICDS nutritional supplements.
Example 5: Disease Screening
Checking BP, blood sugar, cancer screening.
Example 6: Outbreak Management
PHC teams investigate epidemics like dengue, malaria, cholera.
Importance of Primary Health Care
Reduces hospital burden
Promotes early disease detection
Cost-effective healthcare
Improves maternal and child health
Strengthens community participation
Reduces health inequalities
Enhances life expectancy
Challenges of Primary Health Care in India
Shortage of trained staff
Limited infrastructure in rural areas
High patient load
Lack of awareness about preventive health
Poor sanitation in many regions
Inadequate funding
Difficulty accessing remote areas
Government Initiatives Supporting PHC
Ayushman Bharat – Health and Wellness Centres (HWCs)
National Health Mission (NHM)
Janani Suraksha Yojana (JSY)
Universal Immunization Program (UIP)
Swachh Bharat Mission
Integrated Child Development Scheme (ICDS)
These programs aim to strengthen PHC by ensuring access, affordability, and quality care
Primary Health Care vs Secondary and Tertiary Care
Feature Primary Care Secondary Care Tertiary Care
Level First contact Referral services Advanced care
Focus Prevention & basic treatment Specialized services Super-specialty
Institutions SC, PHC, HWC District hospitals Medical colleges, AIIMS
Cost Low Moderate High
Examples Immunization, check-ups Surgery, advanced diagnostics Organ transplant
Conclusion
Primary Health Care (PHC) is the cornerstone of a healthy society. It ensures universal, affordable, and accessible healthcare for all. With its focus on prevention, health promotion, and community involvement, PHC reduces the burden on hospitals and improves overall well-being. Strengthening PHC institutions like Sub-Centres, PHCs, CHCs, and Health and Wellness Centres is essential for achieving universal health coverage in India.
As India continues to expand Ayushman Bharat and the National Health Mission, the future of PHC looks promising, ensuring health for all.
FAQs (Frequently Asked Questions) on Primary Health Care
1. What is Primary Health Care?
Primary Health Care refers to basic health services that provide prevention, treatment, and health promotion at the community level.
2. Who provides primary health care in India?
ANMs, ASHA workers, staff nurses, medical officers, and community health workers.
3. What are the main functions of PHC?
Health promotion, disease prevention, curative services, rehabilitation, and palliative care.
4. What is the population coverage of a PHC?
A Primary Health Centre covers 20,000–30,000 people.
5. What are examples of PHC services?
Immunization, maternal health care, disease screening, family planning, and treatment of common illnesses.
6. What is the role of Health and Wellness Centres?
HWCs offer comprehensive services including NCD screening, mental health care, and telemedicine.
7. Why is PHC important?
PHC is crucial for early detection, disease prevention, affordable healthcare, and reducing hospital burden.
8. What are the components of PHC?
Health education, immunization, water and sanitation, nutrition, treatment of common illnesses, etc.
9. What challenges does PHC face in India?
Shortage of staff, infrastructure gaps, high patient load, and lack of awareness.
10. How can PHC be improved?
Better funding, training, digital health systems, community awareness, and stronger government policies.