This Fact Sheet includes definitions, position statements and suggested reading about primary health care (PHC) as well as outlining the differences between comprehensive and selected PHC. And as a hard copy it can be disseminated at conferences and workshops or around the office

Lunnay, Belinda Kate

McIntyre, Ellen

Oliver-Baxter, Jodie

Flinders Academic Commons

What is  pr imary heal th  care?Primary health care (PHC) is the first level of contact individuals, families and communities have with the health care system.In Australia, PHC: incorporates personal care with health promotion, the prevention of illness and community development includes the interconnecting principles of equity, access, empowerment, community self-determination and inter-sectoral collaboration encompasses an understanding of the social, economic, cultural and political determinants of health.1A commonly used definition of Australian PHC is:Primary health care is socially appropriate, universally accessible, scientifically sound first level care provided by health services and systems with a suitably trained workforce comprised of multi-disciplinary teams supported by integrated referral systems in a way that: gives priority to those most in need and addresses health inequalities maximises community and individual self-reliance, participation and control involves collaboration and partnership with other sectors to promote public health.Comprehensive primary health care includes health promotion, illness prevention, treatment and care of the sick, community development, and advocacy and rehabilitation.2The World Health Organization (WHO) Alma-Ata declaration of 1978, defined PHC 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.It forms an integral part both of the country’s health system, of which it is the central function and main focus, and of the overall social and economic development of the community. 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.3Austral ia’s  PHC S trategyIn 2010, the National Primary Health Care Strategy was introduced, incorporating a set of building blocks and priority areas to be addressed by Australian governments to improve health outcomes. This culminated in the National Health Reform Agreement 2011. Subsequently the national government worked with state and territory governments to develop a National Primary Health Care Strategic Framework. The Strategy takes a broad view of comprehensive primary health care, extending beyond the ‘general practice’ focus of traditional Australian Government responsibility. It accounts for the importance of community-based PHC to respond to the needs of local communities by focusing on the integration of PHC with specialist care and other health sectors including acute care, aged care and Indigenous health services.The yourHealth website http://www.yourhealth.gov.au is the Australian Government’s key portal of health reform information. This website contains updates on national health reform progress and delivery and health reform publications.Belinda Lunnay, Ellen McIntyrei Updated: Jodie Oliver-Baxteriii Director, PHCRIS ii Research Fellow, PHCRISTable 1: Differences between comprehensive and selective PHC Comprehensive PHC Selective PHCView of health Positive wellbeing Absence of diseaseLocus of control over health Communities and individuals Health professionalsMajor focus Health through equity and community empowerment Health through medical interventionsHealth care providers Multidisciplinary teams Doctors plus other health professionalsStrategies for health Multi-sectoral collaboration Medical interventionsSource: Rogers W, Veale B. (2000). Primary Health Care: a scoping report. Adelaide: National Information Service, Department of General Practice,  Flinders University (p. 18).Knowledge  Dissemination  Promotion  Participation  Divisions  General practice  Evaluation  ResearchI n t e g r a t i o n    P r i m a r y  h e a l t h  c a r e    P o l i c y    C a p a c i t y    P a r t n e r s h i p s    K n o w l e d g e  E xc h a n g eFact SheetPrimary Health Care MattersDis t inguishing be tween pr imary care and pr imary heal th  careThe terms primary health care and primary care are terms often used interchangeably. The structures and practices of the primary care sector are not necessarily compatible with notions of comprehensive primary health care. Primary care is an essential part of comprehensive primary health care, but the later extends beyond medical service provision to encompass a whole-of-system response to reducing the effects of disadvantage on health outcomes. Primary care refers to a person’s first point of contact with the health system and involves the management of a person’s illness or disease condition in a service that is typically contained to that care setting. This first point of contact usually includes the general practitioner or family physician. Primary health care extends beyond the biomedical model of care to a social model of health based on the philosophy that for health improvement to occur the social, political, environmental and economic determinants of illness must be addressed. This care is provided by a wider range of providers, services and functions.Austral ia’s  comprehensive approach to  PHCAustralia strives for a PHC framework based on a comprehensive definition of PHC that is distinguishable from selective PHC which focuses on treatment, rehabilitation and primary medical care (Table 1). A comprehensive approach to PHC takes into account the social determinants of health, health inequalities, health promotion, illness prevention, treatment and care of the sick, community development, advocacy, rehabilitation, inter-sectoral action and population health approaches.PHC posi t ion s tatementsVarious Australian PHC organisations have outlined their vision for Australia’s primary health care system. These include: Australian Medicare Local Alliance (AML Alliance) Australian National Preventative Health Agency (ANPHA)  Australian Medical Association (AMA) The Australian Nursing & Midwifery Federation (ANMF), Australian Primary Health Care Nursing Association (APNA) Public Health Association of Australia (PHAA)For links to their position statements visit: http://www.phcris.org.au/guides/about_phcResourcesAll of the hyperlinks provided in this Fact Sheet are available online at PHCRIS Getting Started Guides: Introduction to… Primary Health Care http://www.phcris.org.au/guides/about_phcPHCRIS Getting Started Guides: Introduction to… Australian health reform http://www.phcris.org.au/guides/health_reform.phpPHCRIS Getting Started Guides: Introduction to… Primary health care systems http://www.phcris.org.au/guides/phc_international.phpPHCRIS Getting Started Guides: Introduction to… Nursing and primary health care http://www.phcris.org.au/guides/nursing_and_phc.phpFur ther  readingPrimary care: an increasingly important contributor to effectiveness, equity, and efficiency of health services. Starfield, B. (2012).  SESPAS report 2012.Gac Sanit 26 Suppl 1: 20-26. http://www.gacetasanitaria.org/es/linkresolver/primary-care-an-increasingly-important/S0213911111003876/A renewed focus on primary health care: revitalize or reframe? Bhatia M, Rifkin S. (2010). Globalization and Health, 6:13 doi:10.1186/1744- 8603-6-13 http://w w w.globalizationandhealth.com/content/6/1/13The breadth of primary care: a systematic literature review of its core dimensions Kringos D, Boerma W, Hutchinson A, van der Zee J, Groenewegen P. (2010). BMC Health Services Research, 10:65. http://w w w.biomedcentral.com /content/pdf/1472-6963-10-65.pdfOperational definitions of attributes of primary health care: Consensus among Canadian experts Haggerty J, Burge F, Lévesque J, Gass D, Pineault R, Beaulieu M, Santor D. (2007). Annals of Family Medicine, 5(4), 36. http://w w w.annfammed.org/cgi /reprint/5/4/336Unravelling primary health care conceptual predicaments through the  lenses of complexity and political economy: a position paper for progressive transformation Felix-Bortolotti M. (2009). Journal of Evaluation in Clinical Practice. 15(5), 861-7. http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2753.2009.01274.x/pdfThe World Health Report 2008: Primary Health Care (Now more than Ever) World Health Organization. http://w w w.who.int/whr/2008 /en/Comprehensive Primary Health Care in Australia: findings from a narrative review of the literature. Hurley C, Baum F, Johns J, Labonte R. 2010 Australian Medical Journal, 1, 2, 147-152, Doi 10.4066/AMJ.2010.201 http://www.globalhealthequity.ca/electronic%20library/Comprehensive%20Primary%20Health%20Care%20in%20Australia.pdf National Health Reform Agreement 2011 Commonwealth of Australia (2010) http://www.health.gov.au/internet/publications/publishing.nsf/Content/NPHC-Strategic-Framework/$File/nphc_strategic_framework_final.pdfNational Primary Health Care Strategic Framework Commonwealth of Australia (2013) http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/report-primaryhealthReferences1 Keleher H. (2001). Why Primary Health Care Offers a more Comprehensive Approach to Tackling Health Inequalities than Primary Care. Australian Journal of Primary Health. 7(2), 57-61.2 Definition developed by the Australian Primary Health Care Research Institute (APHCRI) and cited in Primary Health Care Reform in Australia: Report to Support Australia’s First National Primary Health Care Strategy (September 2009).3 World Health Organization. (1978). Declaration of Alma Ata, International conference on PHC, Alma-Ata, USSR, 6-12 September, available from: www.who.int/hpr/NPH/docs/declaration_almaata.pdf (accessed January 2014).Primary Health Care MattersTo contact PHCRIS:w phcris.org.au  e phcris@flinders.edu.au PHCRIS Assist: 1800 025 882Publication date: February 2014I n t e g r a t i o n    P r i m a r y  h e a l t h  c a r e    P o l i c y    C a p a c i t y    P a r t n e r s h i p s    K n o w l e d g e  E xc h a n g e

Fact Sheet: Primary Health Care Matters

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