Primary Health Care

Primary health care is the accessible, community-based foundation of a health system and usually provides people's first contact with organised health services. It combines health promotion, disease prevention, basic treatment, rehabilitation and palliative support, while coordinating care across higher levels. It is broader than merely treating minor illness at a primary-level facility.

Core functions

Primary health care addresses common health needs near where people live, making care timely, continuous and affordable.

• It provides health promotion and disease prevention through health education, immunisation, screening, nutrition support and sanitation-related action.
• It offers basic diagnosis, treatment, essential medicines, maternal and child health services, and follow-up for communicable and non-communicable diseases.
• It maintains continuity of care across the life course and supports rehabilitation, geriatric care and palliative care.
• Its community orientation enables early outbreak detection, local health planning and action on social and environmental determinants of health.

Integration across the health system

Fragmentation occurs when programmes, providers and levels of care function in separate silos, leaving patients to navigate them without coordination. Primary health care reduces it by serving as a regular point of contact that integrates services and connects communities with hospitals and public health programmes.

• Primary care manages common and uncomplicated conditions; secondary care provides specialist and hospital services, while tertiary care handles highly specialised or complex cases. An effective referral system directs patients to the appropriate level.
• A continuing relationship, follow-up and usable patient records help different providers coordinate treatment, reducing duplicated investigations, conflicting prescriptions and interruptions in care.
• Counter-referral enables patients returning from hospitals to receive medicines, monitoring and rehabilitation near their homes, thereby preserving continuity after specialist treatment.
• In rural India, Sub-Centres and Primary Health Centres form the principal primary-level network, while Community Health Centres function as referral institutions with specialist services.
• Effective referral requires transport, records, diagnostics and adequately staffed hospitals, and it reduces avoidable congestion and costs at higher facilities.
• The National Health Policy, 2017 prioritises comprehensive primary care and proposes allocating at least two-thirds of government health expenditure to primary care.

Early detection of maternal mental disorders

Regular antenatal and postnatal contacts allow primary care workers to notice emotional or behavioural changes early, including symptoms that women or families may not independently report.

• Frontline and primary-care workers can provide mental health education, reduce stigma, ask about symptoms and psychosocial difficulties, and encourage timely help-seeking.
• Screening and basic assessment can identify women needing counselling, closer monitoring or treatment before symptoms seriously affect maternal functioning and care of the infant.
• Workers can involve families in support, maintain confidential follow-up and recognise warning signs, such as risk of self-harm, severe disturbance or inability to care for oneself or the infant.
• Severe, persistent or complex conditions require prompt referral, while primary care can continue follow-up after specialist assessment.