14 Components of Primary Health Care (2026 Update)

This article explains 14 priority service areas of primary health care, hereby known as components or elements. These include the eight minimum activities identified in the Alma-Ata Declaration, with six additional areas reflecting the wider scope of modern PHC.

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. For professionals and policymakers, this knowledge can enhance your efficiency in healthcare delivery and policy-making & implementation, respectively.

This post simplifies the 14 components or service areas of primary health care (PHC) in a way to enhance the understanding of the reader for better performance, be it a public health student, healthcare professional, or health policymaker.

Read the comprehensive article below or download the complete 14 Components of Primary Health Care as a free PDF

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 can include vaccinations, lifestyle modifications, or medications to prevent the onset of disease.

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, serving as the foundation of a health system in which patients are directed to specialized care when needed.

Referral: This is a process by which a healthcare provider directs a patient to another specialist or health service provider 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”.¹Primary Health Care: 25 Years of the Alma-Ata Declaration – Paho.org .

This concept was introduced in the Declaration of Alma-Ata on the 12th of September, 1978. This declaration was the post-conference proceedings from a joint conference by the WHO and the UNICEF (United Nations Children’s Fund) in Alma-Ata, Russia (now Almaty, Kazakhstan; no longer in Russia).²World Health Organization. (1978). Declaration of Alma-Ata. International Conference on Primary Health Care, Alma-Ata, USSR, 6–12 September 1978. Retrieved from https://www.who.int/publications/i/item/WHO-EURO-1978-3938-43697-61471

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. The aim was to provide comprehensive healthcare under one roof, known as the “Healthcare under one roof” concept.³Ibid. World Health Organization. (1978). Declaration of Alma-Ata. International Conference on Primary Health Care, Alma-Ata, USSR,

Breaking Down the PHC Definition

The comprehensive definition of Primary Health Care (PHC) was thoughtfully designed to encompass the primary goal of the conference (Ensure health for all universally). It also brings together strategic efforts to achieve this goal, as you will see in the breakdown 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. This is to ensure effectiveness and sustainability through affordability and 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) cannot be achievable if essential healthcare is not available to everyone regardless of socioeconomic status, geographical location, etc. Targeting the individual and families also reflects the need to provide healthcare services as close to places where people live and work, further 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 is higher motivation and ownership when the community is allowed to fully participate in the development of PHC.

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: Self-reliance and self-determination encourage communities to develop their essential healthcare systems using their local resources and expertise without overt reliance on external aid or interventions. This also promotes sustainability in public healthcare.

How Many Components Does PHC Have?

You may encounter different numbers of components depending on the source, but the Alma-Ata Declaration identified eight (8) minimum essential services. However, the current WHO framework organizes PHC into three broad interrelated components, including comprehensive integrated health services, multisectoral policies and actions, and community and people empowerment.⁴World Health Organization. (2025, December 5). Primary health care. https://www.who.int/news-room/fact-sheets/detail/primary-health-care

Section VII, subsection 3 of the original 1978 Alma-Ata Declaration stated 8 service areas, including: 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.⁵World Health Organization. (1978). Declaration of Alma-Ata. International Conference on Primary Health Care, Alma-Ata, USSR, 6–12 September 1978. Retrieved from https://cdn.who.int/media/docs/default-source/documents/almaata-declaration-en.pdf

A post-Alma-Ata Global Conference on Primary Health Care held in October 2018 in Astana, Kazakhstan, emphasized gender-sensitive services and people-centredness. The outcome of this was a renewal of commitment to comprehensive healthcare and broadening of the vision towards universal health coverage, and introduction of 5 additional service areas: prevention and control of non-communicable diseases, mental health care, primary dental health, eye care, and rehabilitation and palliative care (making a total of 13 priority service areas).⁶World 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 https://iris.who.int/bitstream/handle/10665/328123/WHO-HIS-SDS-2018.61-eng.pdf

Later on, several countries introduced the 14th service area—care of the elderly (geriatric care)—recognizing the special needs of aging populations as part of essential healthcare for all groups. Thus, while the components of PHC remain 8 in number according to the official Alma-Ata Declaration, 6 additional priority service areas have been introduced.

The 14 Components of Primary Health Care

According to the Alma-Ata Declaration, there are 8 components of PHC. More recent additions from the Astana Conference and consensus were not termed additional components. A more preferred terminology for the components and newly added services is priority service areas of Primary Health Care.

However, for academic and policy-related reasons, this section combines the eight original Alma-Ata activities with the newly introduced six priority areas. This 14-part classification is a practical synthesis rather than an official WHO list of PHC components.

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, 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 calorie- 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.⁷World 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. ⁸World 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, antenatal care, safe motherhood, and management of birth-related conditions like pre-eclampsia and antepartum haemorrhage.

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.⁹World 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, their 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 medicines, adequate and well-functioning health facilities, and well-trained health workers to cater for common injuries and diseases.¹⁰World Health Organization. Essential medicines

For effectiveness, 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 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, noncommunicable 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. 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.

11. 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.

12. Primary eye care

Primary health care has 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.

13. Rehabilitation and palliative care

Rehabilitation is the systematic process of helping people regain or maintain physical, mental, and social functioning following an illness, injury, disability, or medical treatment. On the other hand, palliative care involves improving the quality of life of people with serious or life-threatening illnesses through pain alleviation, as well as physical, spiritual, and psychosocial support.

Integrating these services into primary health care helps provide specialized care to injured or recovering patients beyond the limits of physical wellness. This further consolidates the modern WHO definition of health.

14. Primary geriatric care

Geriatric care is an important priority area that was introduced to recognize the special needs of older people. This is in line with the modern PHC framework, which integrates people-centredness and the need for specialized care for all groups following a life-course approach.

By including geriatric care in primary health care, there is enhanced healthcare for aging populations at a price that individuals, communities, and nations can afford to pay at every stage of their development.

Types of Primary Health Care

PHC is often categorized into two broad types: Selective and Comprehensive PHC, reflecting the different scopes of coverage and implementation by individual countries.

Selective PHC has to do with targeting a limited set of high-impact interventions for the greatest immediate health gains. On the other hand, Comprehensive PHC targets the full range of the Alma-Ata and post-Alma-Ata goals for wider coverage over a period of time. Most modern health systems, including Nigeria’s, blend elements of both selective and comprehensive PHC in their health policy framework.

Aims and Objectives of Primary Health Care

The core objectives of PHC include: making essential healthcare universally accessible and affordable; promoting disease prevention and health education; ensuring community participation in healthcare decisions; achieving equitable distribution of health resources; and ultimately working toward the WHO’s goal of Universal Health Coverage.

Principles (Pillars) of Successful PHC Implementation

The goals of primary health care laid down as components would not be achievable if there is no strategic plan to achieve them. This is where the principles or pillars of successful primary health care implementation come in.

PHC activities are focused on integrated health services that meet people’s needs throughout their lives, provide solutions to the broader determinants of health, and initiate interventions that empower individuals, families, and communities to take charge of their health. The laid-down pillars for achieving these include the following:¹¹IAPSM Gujarat Chapter. 2013. Primary Health Care

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. The creation and acquisition of the appropriate technology for improved screening, diagnosis, and treatment of common illnesses and diseases is vital to successful PHC implementation.

The 4As of Primary Health Care

The 4As of primary health care are tools or a framework used to evaluate PHC implementation at any given point in time. They are four qualities that determine how effectively or successfully the components of PHC have been delivered in practice.

The 4As of PHC include the following:

• Accessibility: Providing health services within reasonable geographic reach.
• Availability: Making services present when needed.
• Affordability: Offering health services at costs the community can bear.
• Acceptability: Providing culturally and socially appropriate care.

PHC is said to be efficient in a country if essential health care is accessible, available, affordable, and acceptable to the majority of the population.

How Successful is Primary Health Care so Far?

There has been a disparity between the goals of primary healthcare and where we are currently, but these goals are still achievable. The challenges are related to how well the principles or pillars have been consolidated in most countries, with political will being one of the strongest determinants.

Through PHC, an estimated 75% of the project’s health gains can be achieved from the Sustainable Development Goals for the year 2030. Also, scaling up primary health care interventions across low- and middle-income countries could save over 60 million lives and increase average life expectancy by 3.7 years by 2030, WHO reported.¹²World Health Organization. Primary Health Care. March 2025. But the implementation of the goals laid down by Primary Health Care remains thwarted largely due to a lack of political will to sustain PHC.

For example, Nigeria’s National Primary Health Care Development Agency (NPHCDA) is the governing body responsible for implementing PHC nationally. Most other countries have a similar government agency. And with an already-established, well-centralized health policy implementation agency, political will remains the only thing left to catalyze PHC and sustainable health in most countries.

In addition, other pillars like community participation, intersectoral participation, etc., should be embraced. Policymakers and public health leaders should prioritize interventions and programs that incorporate primary health care into the culture of individuals, families, and their communities.

Frequently Asked Questions

Conclusion

Primary health care remains the foundation of an equitable and sustainable health system. Understanding its components and essential service areas is important for effective policymaking and implementation.

The eight essential activities (or components) identified in the Alma-Ata Declaration established a practical minimum for addressing common health needs through health education, nutrition, safe water and sanitation, maternal and child health care, immunization, etc. However, PHC has continued to evolve in response to changing health needs of individuals and populations.

The Astana Declaration reaffirmed the principles of Alma-Ata and broadened the scope to include people-centred care across the life course. Under this broader vision, countries may expand their primary health care service packages to include all 14 priority service areas, including noncommunicable diseases, mental health, oral and eye care, rehabilitation, palliative care, and geriatric care.

Ultimately, the success of PHC is not determined by how many components or services a country adopts; rather, it depends on whether essential care is available, accessible, affordable, and acceptable to the communities. Strong political will is needed to drive the other principles/pillars of primary health care implementation.