Objectives By the end of this unit you should be able to: • Explain the concepts and background of rural health, primary health care and community based health care. • Describe the Principles, pillars and strategies of Primary Health Care. • Describe the elements of Primary health Care and their implementation in Kenya; • Describe how to organise PHC activities in relief programs; • Discuss community financing in primary health care; • Explain the challenges faced in PHC implementation. 3.1 Concepts and Background of PHC in Kenya The development and organization of health systems based on primary health care concept was stimulated by three important events of which Kenya was a signatory. These were 1) The observation by the 1977 World Health Assembly that there were a lot of injustices and inequalities in the distribution of health resources in many parts of the world (particularly in the developing world). 2) Adoption of the Alma Ata Declaration in 1978 of Health For All by the year 2000 by all WHO member countries. 3) Adoption in the same Alma Ata Conference of Primary Health Care strategy as the means of achieving the goal of Health for All by year 2000. In the 1977, World Health Assembly, the Government of Kenya along with other member states of WHO, endorsed the worldwide social objective of The attainment by all people of the world by the year 2000 of a level of health that will permit them to lead a socially and economically productive life (WHO, 1977 ). However, many countries in the developing world recognised the fact that it was not possible in the foreseeable future for them to achieve this worldwide social objective. This was because many lacked the resources needed to develop and run health services. They needed to adopt a strategy that allowed them to use the available resources to give some benefit to everyone and provide special attention to those at high risk. So, the member
2 Governments endorsed the Primary Health Care strategy for the provision of health services for all. The concept of “ health for all ” was in Kenya long before the concept of primary health care came into being . The strategy for the implementation of PHC was adopted by the Kenya Government to provide health services to its population, majority (80%) of who live in the rural areas. The Definition of Primary Health Care What do you remember about the PHC concept? Review your knowledge by doing the following activity. Write down the definition of Primary Health Care? Compare your definition with that given in the following discussion. In 1978, the Alma Ata international conference on primary health care defined primary health 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 country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination. In addition, It forms an integral part
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- primary health care