Primary Health Care v. Primary Care: Community Nursing Role

Introduction

Primary Health Care and Primary Care are commonly confused, and most people use them to mean the same thing. This is since both sectors offer basic services related to health care. It is relevant to distinguish the two service providers to determine the causes of inequities and propose valuable practices in the health sector. Primary health care has a focus to reduce health care inequalities and providing health care to the disadvantaged while primary care is concerned with individual care. This paper will discuss the distinctions between primary health care and primary care and the roles played by community nurses concerning PHC and PC.

Definitions

According to the Public Health Agency of Canada (2011), primary health care (PHC) has broad activities that work to promote the health of members of the community and those services they engage in are pragmatic, scientific and acceptable globally. It also implies health care that can be implemented at every stage of its progress. Therefore, it is a technique used by a country to provide health care to people in a manner that would not make them strain financially and socially. One can therefore not define it as the provision of health care to the poor or the less fortunate but promotes amalgamation of health services so that it produces development in the society, leadership commitment and collaboration among several sectors of the economy (MacLean et al., 2011).

Primary care (PC) on the other hand is used by health experts to describe professionals that patients consult in a health care framework. McGinnis M., et al (2002) stated that these professionals can be practitioners within primary care, family doctors, general doctor or depending on the need of a patient; he or she may seek assistance from a pharmacist or a nurse. About the condition of the patient, the professional may refer a patient for secondary or tertiary care. Small hospitals at the community level offer secondary care while big hospitals offer tertiary care which treats complicated conditions.

Discussion of PHC and PC

Socrates (2002) argued that distinguishing between PHC and PC is a challenge because of the overlapping roles though the Alma-Ata conference gave some guidance. The main aim of the conference was to make sure that everybody gets access to quality and affordable health care. One of the strongest statements made in the conference that formed the basis of defining primary care and primary health care is that ‘health is a human right to which international commitments should be made.’ The participants of the conference expand the definition of primary health to include the means and technology by which health care is made available in an affordable and participatory way to the community. Primary health care would include educating members of the community about existing health problems and how to prevent and control them. It involves all aspects of disease control in the health sector in the community and the nation at large.

Department of Human Services (2001) argued that PHC relies on assumptions of PC practitioners such as doctors, lab technicians and community health nurses. Other non-trained medical professionals play a big role in providing public health care too. People of a country should appreciate efforts made to invest in health activities, prevention and control. PHC can be an important approach to settle these issues. It provides the basis upon which we can put emphasis on the wellness of people’s health rather than illness, support education for everybody and offer equal opportunities in health care. From the discussion, it is evident that primary health care serves a wide area in health care compared to primary care.

Primary care happens in a setting where a professional health worker interacts in an organized manner with a patient. According to the world health organization (2022), Primary Care is the first service directly available to the public. On many occasions, it is personalized management of an individual’s illness carried out on appointments with physicians. The relation between the services offered in primary care and primary health care is that professionals in primary care offer advisory services to patients when dealing with them according to the disease they are suffering from. Therefore, it is impossible to conclude that, primary care professionals do not offer primary health care. When a government strategizes to improve and make it easy for access to professionals in the health sector, then it is said to be a ‘Primary Care strategy.’ These would work for the good of all citizens and in a broader view, would be seen as a ‘Primary Health Care strategy’ by the government to improve health services.

The most outstanding difference between the two concepts is that primary health care gives a chance to many stakeholders to participate in all aspects of society that relate to health care. Through this participation, people become empowered and act along to ensure prevention and formulation of strategies that are acceptable in the community. The approach in Primary health care is to shift focus on reliance on health care professionals to an individual’s dependence on the attainment of good health. Service providers in primary care are focused on early detection of disease, prompt treatment with high chances of referral to hospitals.

WHO (2008) noted that several reforms have been proposed to change how primary care is delivered to people across the United States, Canada and Britain. The reforms have been targeted at improving service provision, cost management and research in primary care. According to some health experts, primary care is critical in health care because an alteration in primary care has an overall effect on the objectives of health care. These changes are being directed towards the collaboration of medical practitioners informing general practices and leaner budgeting that is friendly to the community. The results of partnership among primary care practitioners promote values of primary health care. A successful partnership is achieved among professionals if they hold with high esteem the values and structures of primary care and primary health care (Simmons, 2009).

From the definition of primary care, it is evident that it does not involve community empowerment programs. According to the Department of Health Provincial Government of the Western Cape (2011), PC practitioners have an intention of preventing diseases. During the consultation process in primary care, a patient is most likely to be advised on prevention at primary, secondary or tertiary levels. Concerning prevention, a patient is advised on specific habits that are not related to social or environmental conditions that caused the illness. This education is given to an individual in a personalized approach with the physician though some primary care experts engage in group education to collect views about health services in colleges and workplaces (Matheson, 2002).

Durie (2002) argued that, as a result of using the social model, PC serves a wide area in the community in providing health care. PHC experts argue that the basic needs of people must be met for them to gain good health. In addition to basic needs, World Health Organization (2005) also categorizes maternal, child health care and immunization as part of PHC. In PHC, innovative solutions and ethics relevant to health care are employed to meet global satisfaction.

Overlapping roles

As discussed above, the working principle of primary health care revolves around values and strategies that work for the good of the people. However, the success of PHC depends on collaboration with primary care practitioners to challenge community and organizational barriers to health. PHC experts work closely with PC professionals to change the physical and social environment for healthcare improvement. Practitioners of PHC propose the need for efficient, reasonably priced and easy to access primary care advocacy though their approach to primary care issues differs (Secretariat, WHO, 2011). The main task of PHC is to do away with barriers to disease control. Therefore, the two sectors (PHC and PC) must collaborate to improve the service delivery of health services. Collaborations could be done by holding joint seminars and strategies to discuss conventional approaches to issues in health care. Through these approaches, it is evident that partnerships among these sectors are valuable for health care delivery. Some of the roles of PHC and PC practitioners that seem to overlap include the following roles in the community; they both educate patients to adopt practices that minimize illness, both sectors must collaborate to produce best practices that promote health care, both of them are sensitive to people’s health (Socrates, 2002).

Impact on service delivery

Concerning primary care and primary health care practices, community nurses should approach health matters with equal knowledge although specialization may be required. The initial intention of community nursing is to provide a single service to the community but has expanded over the years to include the services they offer to the public and individuals. As much as they embrace new advances in their field, they remain loyal to their foundations of service. Among the roles they engage in the community is providing PC and PHC services which they offer in schools, religious institutions, hospitals and homes. The roles of all community nurses overlap since they all have a common goal of solving the health problems of patients. The setting in which they offer their services may be different, but they all serve a common purpose be it a school nurse, hospital nurse, church nurse or even and home nurse. Their priority is to provide PHC which they consider a priority of solving health problems. They directly impact the lives of community members by offering medication, sickness prevention, promotional activities and research on trends related to health care. They offer caring services to the patients, educating members of the community, acting as consultants for common people and referring patients for further treatment.

Despite the differences that prevail between Primary care and Primary health care, they impact positively the community. Kawachi, (2004) argued that the main purpose of primary care is to improve the health of an individual. General physicians, nurses’ other staff in primary care offer these services and propose referrals to other primary care facilities such as laboratories, screening and dieting. They also offer recommendations to secondary facilities for further treatment. Hagard (2004) argues that the difference in service delivery in PC and PHC is since PHC addresses community health problems while PC addresses individual health problems. This has a positive impact on the community health due to the following facts: it can be deliberated upon and in partnership with other sectors, it can offer advisory services to other sectors on health-related issues, and it can advise government agencies on best practices in planning and health delivery (McGinnis et al., 2002).

For many years, sharp differences in PHC and PC were a drawback to effective health service delivery. Benefits are being manifested as a result of collaboration between them as the inequality gap in health care has been greatly narrowed between the higher income earners and lower-income earners (Rehydration Project, 2011).

Conclusion

The overall goal of PHC and PC is to improve the health of people. The two sectors should strive to reduce inequalities in health care and institute changes in the health sector so that: PHC plays a big role in health services, community health services are part of PHC, provide a wide variety of medical services that benefit the population and make collaborations with groups of the same interest.

References

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