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What is primary health care, how is it different from primary care and and how can nurses incorporate the principles of primary health care nursing into their practice?
Firstly, what do we mean by primary health care? In 1978, the World Health Organization (WHO) held a conference at Alma-Ata in Russia, called the International Conference on Primary Health Care. WHO member nations accepted the Alma-Ata Declaration, which called for urgent and effective action to develop and implement primary health care throughout the world.
Primary health care was defined as essential health care based on scientifically sound and socially acceptable methods and technology, that was accessible to all people in a community at a cost the community and country could afford.
It was an approach to health that went beyond traditional systems of hospital care and concentrated on health equity. It drew on ideas of prevention, reduction of health disparities, collaborative models of health provision (ie participation by communities in decision-making) and integrating health into all social sectors through public policy reform.1
Primary health care is a wide-ranging concept that requires us to view our entire system - including public health, primary care, acute care, health policy and the wider housing, social, food and technology systems - as part of an approach to improving health. In Aotearoa, the terms "primary care" and "primary health care" are frequently used interchangeably, but they are not the same. Primary care is part of primary health care, more often than not referring to care provided in general practice and pharmacy. But providing primary care does not necessarily mean we use a primary health care approach to our practice.
In 2001, the Ministry of Health published the Primary Health Care Strategy, which outlined a comprehensive system of first-line access to health care in New Zealand.2 Nurses were at the forefront of the strategy and the profession held high hopes for a change in the way health services were provided. We hoped nurses would become the primary providers of first-line health care to all New Zealanders.
In 2012, I gave a presentation at the College of Primary Health Care Nurses conference, where I argued for the pirmary health care approach - that nurses needed to consider the social determinants of health as...