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Primary healthcare and its challenges

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As defined by Wikipedia, Primary healthcare (PHC) refers to “essential health care” that is based on “scientifically sound and socially acceptable methods and technology” which make universal health care accessible to all individuals and families in a community. Primary healthcare to some extent is based on the full participation of the individuals involved , and is delivered at a cost that the community and the country can afford to maintain. In short, primary healthcare is the basic health care that is rendered to a community or a group of people in a way such that it is tailored to meet their needs and be affordable and sustainable, taking into consideration their social and economic lives, access to health services and lifestyle in general. In delivering primary healthcare, many problems arise. Ranging from inequitable distribution of health care, to lack of community participation and underdevelopment of health workforce and related resources.

Basically, inequitable distribution of health care is the major problem facing PHC. There are actually some communities that are totally cut off from basic healthcare facilities. In some areas, no hospital, or even a clinic exists. Thus, the only time health professionals are seen is when there is a major health campaign, or there has been a major health issue. On a normal day, people have to travel distances, some very long distances, to access a healthcare facility, a health professional. This defeats the whole idea of primary health care.

Another major problem facing PHC is the lack of community participation. As mentioned earlier, PHC is tailored to meet the needs of a specific community, therefore the participation of the community is very essential. In some communities, people do not cooperate with the health professionals for various reasons, be it cultural, social or religious. Some people choose to stay at home and address their health problems the traditional way. They only go to the clinic when the problem has escalated and the traditional ways have become of less or no effect. Therefore, health professionals almost always have to deal with diseases that have reached serious stages. This makes the whole healthcare process more complicated. With some people too, after visiting the clinic, they do not comply with the various prescriptions given them.

Occasionally, health facilities may be present, communities may give their support, but there arises another problem : underdevelopment of health workforce and related resources. This problem is one that plagues many countries, especially in the developing world. Usually, the various health training institutes try to modify their curriculum to be update with the current happenings, but what about the professionals already on the field? Very few of them get to receive in-course training and attend refresher workshops. Therefore, they remain at post with their outdated and less effective knowledge and methods. Also, health professionals often have to manage mediocre resources to deliver the expected service to the people. Many hospitals lack basic infrastructure such as beds, not to mention current technological devices used for healthcare. Therefore, healthcare facilities are often under-resourced, human and infrastructure-wise.

Clearly, these problems and many others that we face in our communities impede the process of primary healthcare. The government and other stakeholders (non-governmental organizations, World Health Organization etc.) must step up their efforts in ensuring quality and affordable universal healthcare is available for all. In doing this, certainly there must be policies to strengthen primary healthcare, as it is a major pillar of universal healthcare. Sir Winston Churchill, a former British prime minister once said “ the greatest assets of any nation are its healthy citizens.” Attention must be given to primary healthcare, and now!

By Isaac Narh

The writer is a L. 200 Physician Assistant student of the University of Cape Coast

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