INTRODUCTION
Efforts to develop a comprehensive Primary Health Care (PHC) policy started in the 1970s, it
was not until the late 1980s that actionable strategies emerged, emphasizing decentralization,
intersectoral collaboration, and community participation in health.
Based on the Alma Ata declaration of 1978, Primary health care (PHC) is defined 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.
DEVELOPMENT OF THE PRIMARY HEALTH CARE
In 1965there was the centralization of the health system. By 1979 complete creation of greater
than 250 rural health units took place.1983, decentralization of decisions i.e. district focus for
rural development.1988-guideline for primary health care implementation through user fees to
raise funds and increase community participation in the primary health care.1989-national
development plan .1994-Kenya health policy framework which is a first policy document for
health.1999-first national health sector strategic plan .by 2004 the user fee was reduced for
primary health care facilities.2005-second national health sector strategic plan(.KEPH )and
community introduced as service delivery level.2006 the first community health strategy
developed.2010.2012the devolution of health to counties.2012-public finance management act
was enacted.2013-free maternity services policy and removal of all user fees for primary health
care and in 2018-universal health care was introduced.
OBJECTIVES OF THE PRIMARY HEALTH CARE
a) Improving maternal, neonatal, child, and adolescent health as well as ensuring
appropriate care for the elderly.
b) Control of major communicable diseases, including HIV, Tuberculosis, and
malaria as well as neglected tropical diseases and preventable eye, ear, and dental
conditions.
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, c) Effectively fighting the epidemic of non-communicable diseases such as
cardiovascular diseases, diabetes, respiratory diseases, and cancers
d) Combating the rapidly rising burden of mental health illness
e) Support the provision of comprehensive integrated and evidence-based primary
health care services.
f) To boost the participation of the community with the government and community
sectors to improve the health of the community
g) Provide reasonable and timely access to primary health care services
h) To establish, within available resources, primary health care teams and networks.
PILLARS OF THE PRIMARY HEALTH CARE
a) Equitable distribution
b) Community participation
c) Intersectoral coordination
d) Appropriate technology
e) Decentralization
THE ELEMENTS OF PRIMARY HEALTH CARE AS AGREED DURING THE ALMA ATA
DECLARATION
1. Education on health problems and how to prevent and control them.
2. Development of effective food supply and proper nutrition.
3. Maternal and child healthcare, including family planning.
4. Adequate and safe water supply and basic sanitation.
5. Immunization against major infectious diseases.
6. Local endemic disease control.
7. Appropriate treatment of common diseases and injuries.
8. Provision of essential basic medication.
As a country, Kenya added four more elements, which include the following:
1. Dental health
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