The 14 Components of Primary Health Care Explained

Whether you are a public health student, healthcare professional, or health policymaker, understanding the key components of primary health care as proposed by the World Health Organization is important. For the student at any level, a thorough knowledge of these components can help you ace your public health examinations and satisfy your examiners. While for professionals and policy makers, it can enhance the efficiency of care and strategic/efficient policy-making, respectively.

This post seeks to simplify your knowledge and understanding of the 14 components of primary health care (PHC), to enhance your performance as a public health student, healthcare professional, or health policy maker.

To get a downloadable PDF for the components of primary health care, click here now. Otherwise, read on below.

Definition of Terms

Health education: Health education is the process of disseminating information regarding health-related topics to individuals and communities to improve their understanding of health-related behaviors and interventions that put them at risk of diseases and how to prevent them.

Health promotion: Health promotion is the process of enabling people to increase control over, and improve, their health. It focuses not only on individual behavior but also on the broader social and environmental factors that influence their health. Health promotion in PHC involves health education, policy adoption and implementation, community-based initiatives, and programs aimed at enhancing well-being throughout the community.

Prophylaxis: Prophylaxis refers to preventive measures or treatments used to prevent disease or health issues before they occur. This could include vaccinations, lifestyle modifications, or the use of medications to prevent the onset of diseases.

Primary care: This is regarded as the first point of contact for individuals seeking healthcare services. It involves comprehensive, accessible, and continuous care provided by a primary care physician or healthcare provider, and is regarded as the foundation of a health system where patients are directed to specialized care if needed.

Referral: This is a process by which a healthcare provider directs a patient to another specialist or service for further assessment, diagnosis, or treatment that is beyond their scope of practice, in terms of skill, facility, or manpower.

Essential drugs: These are the most effective, safe, and cost-efficient medicines that satisfy the priority health needs of a population

What is Primary Health Care (PHC)

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”.^[1]Primary Health Care: 25 Years of the Alma-Ata Declaration – Paho.org .

This concept was introduced in the Declaration of Alma-Ata, which was the proceedings from a joint conference by the WHO and the UNICEF (United Nations Children’s Fund) on the 12th of September, 1978, in Alma-Ata, Russia (now Almaty, Kazakhstan; no longer in Russia). This conference brought together 134 countries and 67 international organizations, with the primary goal of achieving an acceptable level of “Health for all by the year 2000″ through a fuller and better use of the world’s resources.^[2]World Health Organization. (1978). Declaration of Alma-Ata. International Conference on Primary Health Care, Alma-Ata, USSR, 6–12 September 1978. Retrieved from … Continue reading

Components of the Primary Health Care Definition

The PHC definition was thoughtfully put together to encompass the primary goals of the conference as well as the strategic efforts to achieve these goals. Let’s break down the definition below.

Primary Health Care (PHC) is:

i. Essential healthcare: It is essential healthcare because it emphasizes the provision of health services that cater to the most common health needs and problems of a given country or group of people through preventive, promotive, curative, rehabilitative, and palliative services.

ii. Based on practical, scientifically sound, and socially acceptable methods and technology: Primary healthcare prioritizes practical interventions and solutions that are scientifically sound or evidence-based, as well as being realistic and effective within the local context with respect to local culture, beliefs, and preferences. These are to ensure effectiveness both in the effectiveness of the interventions and in building community trust and participation.

iii. Made universally accessible to individuals and families: This takes into account that universal health care (or health for all) will not be achievable if essential healthcare interventions are not made available to everyone regardless of socioeconomic status, geographical location, etc. Delivering healthcare to individuals and families reflects the need to provide such services as close to where people live and work, thus promoting community-based solutions.

iv. Through their full participation: This encourages active participation of the community in the planning, implementation, and maintenance of health care programs. It is based on the belief that there will be higher motivation and a feeling of ownership of the project when the community is allowed to fully participate in the activities of the PHC. This can potentially enhance sustainability.

v. At a cost that the individual and community can afford: This emphasizes the need to prioritize cost-saving strategies for sustainable healthcare without imposing undue financial burden on individuals or nations.

vi. At every stage of their development: This recognizes the dynamic nature of health needs and resources as a community develops socially and economically. Sustainable primary health care must, thus, be based on flexible interventions that can be adapted to every level of a nation’s development.

vii. In the spirit of self-reliance and self-determination: This encourages communities to develop their essential healthcare systems using their local resources and expertise without overt reliance on external aid or interventions. By inculcating self-determination and self-reliance into primary health care, sustainability is more attainable.

Components of Primary Health Care

In the original documentation of the Alma-Ata Declaration, eight (8) components were identified in Section VII, Sub-section 3. These include: health education concerning prevailing health problems and the methods of preventing and controlling them; promotion of food supply and proper nutrition; an adequate supply of safe water and basic sanitation; maternal and child health care, including family planning; immunization against the major infectious diseases; prevention and control of locally endemic diseases; appropriate treatment of common diseases and injuries; and provision of essential drugs. ^[3]World Health Organization. (1978). Declaration of Alma-Ata. International Conference on Primary Health Care, Alma-Ata, USSR, 6–12 September 1978. Retrieved from … Continue reading

In 2018, a 40-year-post-Alma-Ata Global Conference on Primary Health Care was held in Astana, Kazakhstan, between 25 and 26 October 2018, emphasized a policy shift from the Alma-Ata Goals (which was targeted to achieve its goals by 2000) to a much larger Universal Health Coverage (SDG 3.8) of the Sustainable Development Goals of the United Nations. This marked the subtle expansion to the 14 components of Primary Health Care. ^[4]World Health Organization. (2018). Declaration of Astana. International Conference on Primary Health Care, Astana, Kazakhstan, 25–26 October 2018. WHO/HIS/SDS/2018.61. Retrieved from … Continue reading

Five new components were added to the expanded version in the Astana Conference. These include mental health care, primary dental health, eye care, rehabilitation services, and health promotion and community participation. Due to the emphasis on gender-sensitive services and people-centeredness, several regions and countries later incorporated the 14th component, care of the elderly, especially due to the special needs of aging populations and the need to provide specialized care to all groups.

The 14 Components of Primary Health Care

Having seen much about the history of Primary Health Care, its components, and how they have evolved, let’s now see the 14 components of Primary Health Care and their explanations.

1. Health Education about prevailing health problems

Health education involves disseminating the right health information to people to lead to healthier lifestyles and better health overall. This recognizes that most health outcomes can be linked to our activities relating to our life, habits, environment, and choices.

Health education inculcates information on the prevention, treatment, and control of diseases in a community, through media like mass media, health talks, group discussions, demonstrations, role-play, community drama, and other traditional media based on what the community and nation can afford to provide.

By identifying risk factors and mitigating them, individuals and families can prevent diseases and aligning with the primary aim of preventive care. For example, an anti-smoking or handwashing campaign in a community can significantly reduce lung-related and feco-oral/food-borne diseases, respectively.

2. Promotion of food supply and proper nutrition

Adequacy of food and proper nutrition are major pillars of health for people of all ages. Good nutrition is essential for healthy growth, development of the organs, and maintenance of the immune system. For example, Vitamin A fortification prevents night-blindness, and calories or protein-deficient diets result in the marasmus and kwashiorkor spectrum of diseases in children.

Thus, emphasizing proper nutrition and promotion of adequate food supply is an important move towards achieving essential care. This highlights nutritional interventions like food supplementation, food fortification, and provision of adequate food to susceptible groups within the community.

3. Adequate supply of safe water and basic sani­tation

The WHO reports that about 1 million people are estimated to die each year from diarrhea as a result of unsafe drinking water, sanitation, and hand hygiene, noting that drinking unsafe water could be linked to several diseases, including diarrhea, cholera, dysentery, typhoid, and polio.^[5]World Health Organization. Drinking Water. September 2023. Available at https://www.who.int/news-room/fact-sheets/detail/drinking-water

The link between water adequacy, water safety, basic sanitation, and disease can also be seen in the transmission of communicable infections/infestations like scabies, trachoma, guinea worm, schistosomiasis, malaria, etc. Thus, the provision of adequate and safe water and basic sanitation can indeed be instrumental in reducing disease burden (morbidity and mortality) across communities and nations of the world.

4. Maternal and child health care, including family planning

The World Health Organization recognizes that maternal mortality is unacceptably high in many parts of the world, and these deaths are largely preventable. Every pregnancy and birth is unique, and maternal deaths are preventable through timely management by skilled health professionals working in a supportive environment. ^[6]World Health Organization. Maternal Health. Available at https://www.who.int/health-topics/maternal-health

Addressing inequalities that affect health outcomes, especially sexual and reproductive health rights, is fundamental to ensuring that women have access to respectful and high-quality maternity care. Components of maternal health care include family planning services, safe abortion services, ante-natal care, safe motherhood, and management of birth-related conditions like pre-eclampsia, antepartum.

In addition, maternal health significantly impacts children’s health, which is why they are often discussed together. Child health care interventions include childhood immunization, prevention and treatment of childhood illness, including nutritional services, water safety, etc.

5. Immunization against the major communicable diseases

Immunization is one of the most impactful and cost-effective public health interventions, averting over 4 million deaths yearly. Several communicable diseases affecting children and adults are vaccine-preventable. These include several childhood killer diseases like polio, yellow fever, diphtheria, tetanus, etc.^[7]World Health Organization. Immunization. WHO Regional Office for Africa

Immunization and vaccination played an important role in the widespread eradication of polio globally. In addition, immunization brings children and families into contact with health systems, creating an avenue for detecting other health problems that may be overlooked. Thus, ensuring universal access to vaccines and immunization is a critical entry point for universal health coverage (UHC).

6. Prevention and control of locally endemic diseases

Locally endemic diseases are those affecting a significant proportion of the population (usually more than 10%), who are exposed to the same predisposing factors. Examples of such conditions include endemic goitre, which is common in highland areas with low soil and water levels of iodine, and malaria, which is endemic in sub-Saharan Africa and parts of India.

By targeting the risk factors common to the individuals, locally endemic diseases can be effectively controlled through health promotion, health education, effective prophylaxis, vector control, and effective treatment of sick individuals; hence, its inclusion as a core component of primary health care.

7. Appropriate treatment of common diseases and injuries

Primary health services would not be complete without the treatment of common diseases and injuries. This involves the provision of essential medicine, adequate and well-functioning health facilities, and well-trained health workers, to cater for common injuries and diseases.^[8]World Health Organization. Essential medicines

For effectiveness, the Primary Health Care was established as the first point of call for common diseases and injuries, followed by a referral process to higher strata of health care, including the secondary and tertiary care. By sitting at the base of the health strata, primary health care can effectively provide optimal primary care to individuals and families in all communities.

8. Provision of essential drugs

Essential drugs are the most effective, safe, and cost-efficient medicines that satisfy the priority health needs of a population. These include medications needed for prophylaxis and treatment of common illnesses and diseases, specifically selected for every population, community, or country.

In line with this, the WHO introduced and defined the “Essential Medicines List as a list of minimum medicine needs for a basic health-care system, listing the most efficacious, safe, and cost-effective medicines for priority conditions.” Countries adapt the WHO global reference medicine list to suit their specific health needs, priorities, and cost, to provide universal care to all individuals and their families.

9. Prevention and control of non-communicable diseases

In addition to infectious diseases, communicable diseases make up the health burden of every community or nation. Non-communicable diseases like hypertension, diabetes, hypertension, cancer, arthritis, etc., can be prevented and controlled through interventions like health education, health promotion, and effective treatment.

10. Health promotion and community participation

Health promotion is the process of enabling people to increase control over, and improve, their health, while community participation involves actively engaging people in decisions about their own health, and health services are delivered. These two empower the individual to make better health decisions, both preventive and therapeutic.

Due to its influence in enhancing the health status of people within a community, health promotion and community participation were included among the essential components of primary health care.

11. Primary mental health

The primary mental health initiative involves the inclusion of basic mental health interventions and treatments in primary health care to make such services readily available to the community. Thus, individuals in the community can receive basic mental health care for minor issues, except those requiring specialized care.

12. Primary dental health

Primary dental health involves the provision of basic dental health services, including preventive, treatment, and rehabilitation services for common dental conditions. It aligns with the principle of addressing common health problems at the point closest to the individual and community.

13. Primary eye care

Primary health care had the aim of providing holistic healthcare under one roof, known as the “Healthcare under one roof” concept. In addition to providing primary mental and health care services, primary eye care involves interventions for common eye diseases and injuries. Through this inclusion in primary health care, such conditions can be effectively managed, except for more serious cases that require specialized care.

14. Primary geriatric care

With one of the central goals being the provision of people-centered care and due to the need to provide specialized care to all groups, including the elderly, primary geriatric care was created and adopted by some countries until it became a central component of the primary health care. It recognizes the special needs of aging populations and the peculiar problems of the elderly.

By including geriatric care into primary health care, there is enhanced healthcare for this population group at a price that the individuals, community, and nation can afford to pay at every stage of their development.

Principles of Successful PHC Implementation

Having laid down the components of primary health care is not enough without a strategic plan to achieve these goals. The activities of PHC are focused on integrated health services that meet people’s needs throughout their lives, provide solutions that address the broader determinants of health through multisectoral participation, and interventions that empower individuals, families, and communities to take charge of their health. ^[9]IAPSM Gujarat Chapter. 2013. Primary Health Care

To achieve these, the principles were established alongside, and these include the following:

1. Political will: The government of the day must be motivated to provide essential health care to the population at a cost the community and nation can afford.
2. Equitable distribution of resources: Every community or population should receive adequate resources that meet their specific needs. The resources needed by one group may not be the same for others, and this should be taken into account.
3. Community participation: Through effective community participation, primary healthcare can provide essential care to all individuals in the community irrespective of age, sex, and financial status.
4. Intersectoral participation: This emphasizes the importance of intersectoral participation in achieving the goals of primary healthcare. For example, involving the local agricultural sector can help meet the goal of providing adequate food and proper nutrition etc.
5. Appropriate technology: The incorporation of appropriate technology is necessary for the attainment of the various components of primary healthcare. There needs to be the incorporation of appropriate technology that improves screening, diagnoses, and treatment of common illnesses and diseases.

How Successful is Primary Health Care?

There might be a disparity between what primary healthcare can accomplish and how much we have attained so far. Through PHC, an estimated 75% of project health gains from the Sustainable Development Goals can be achieved. Scaling up primary health care interventions across low and middle-income countries could save 60 million lives and increase average life expectancy by 3.7 years by 2030, WHO reported. ^[10]World Health Organization. Primary Health Care. March 2025

In practice, many countries are lagging far behind in how much of the primary health care components they have achieved. The fire to achieve essential care has gradually faded over time, and this is largely due to a lack of political will to maintain primary health care.

In addition to political will, for PHC to be successful, other principles need to be upheld. These include community participation, intersectoral participation, etc. Policy makers and health leaders should prioritize interventions and programs that incorporate primary health care into the culture of individuals, families, and their communities.

Conclusion

To redefine, Primary Healthcare is essential healthcare based on practical, scientifically sound, and socially acceptable methods and technology made universally accessible to individuals and families at a cost that the community and country can afford to maintain at every stage of their development. We can agree that this definition is all-encompassing.

There are 14 components of primary health care adapted from the original 8 components created in the Alma-Ata Declaration. The success of primary health care is based on how well these goals have been achieved. And of course, it is achievable.