What is a Primary Health Centre and Its Services
Primary health care is the foundational level of health service delivery that provides first-contact, accessible, continuous, comprehensive, and coordinated person-focused care to individuals and communities. 1
Core Definition and Functions
Primary health care serves as the entry point into the healthcare system and operates through five essential core functions 1:
- First Contact Accessibility: Creates the initial entry point for care and improves access to health services for all populations 1
- Continuity: Promotes development of long-term personal relationships between patients and the healthcare team over time 1
- Comprehensiveness: Ensures delivery of diverse preventive, screening, diagnostic, treatment, rehabilitative, and palliative services 1
- Coordination: Organizes services and care across different levels of the health system and over time 1
- People-Centeredness: Supports patient autonomy over health decisions and provides person-focused rather than disease-focused care 1
Healthcare Providers in Primary Health Centres
Primary health centres are typically staffed by clinicians trained in family medicine, general internal medicine, or general pediatrics, including physicians, nurse practitioners, and physician assistants 1. Other specialists such as geriatricians and obstetrician-gynecologists may also practice primary care 1. The care model is team-based and multidisciplinary 1.
Services and Programs Provided
Individual-Level Services
Primary health centres provide comprehensive services to populations that often encounter barriers to healthcare access, including low-income working persons and families, immigrants and refugees, uninsured persons, homeless persons, the frail elderly, and poor women and children 1:
- Preventive Care: Health screening services, risk assessment, vaccination programs, and disease prevention strategies 1, 2
- Chronic Disease Management: Screening, diagnosis, and treatment of conditions like hypertension, diabetes, and cardiovascular disease 1
- Acute Care Services: Diagnosis and initial treatment of acute illnesses and injuries 1
- Behavioral Health Integration: Mental health services, substance abuse treatment, and behavioral counseling integrated into primary care 1
- Health Education: Patient and caregiver education about disease management, prevention, and community resources 1
Population-Level Functions
Beyond individual care, primary health centres address community health needs 2:
- Community Health Assessment: Identifying social determinants of health and health inequalities in the population served 1, 2
- Health Promotion Programs: Community outreach, health screenings at community sites, and population health management 1
- Referral Coordination: Linking patients with specialized services, social support services, and community resources 1
Organizational Structure
Community Health Centres
Community health centres represent a specific model of primary health care delivery that serves vulnerable populations 1:
- Provide federally supported health screening services for refugees and immigrants 1
- Offer integrated behavioral health services, with 70% providing mental health services and 55% providing substance use disorder treatment 1
- Maintain close working relationships with hospitals, clinical laboratories, and public health agencies 1
- Implement infection control practices to protect patients and staff 1
Facility Levels
In stratified health systems, primary health centres operate at different levels 1:
- Community Day Centres/Community Health Centres: Provide broad range of primary health care services, typically staffed by general practitioners, professional nurses, technicians, counselors, and community health workers 1
- Level One Facilities: Include basic diagnostic capabilities (X-ray, electrocardiography, laboratory services) with established protocols for acute and post-acute management 1
Key Characteristics of High-Quality Primary Care
High-quality primary care is whole-person, integrated, accessible, and equitable health care that addresses health and wellness needs across settings with sustained relationships 1:
- Person-Centered: Focuses on the individual's comprehensive health needs rather than isolated conditions 1
- Team-Based: Utilizes multidisciplinary teams including physicians, nurses, social workers, and community health workers 1
- Community-Aligned: Responsive to the specific needs and characteristics of the population served 1
- Affordable: Designed to provide cost-effective care that reduces overall healthcare expenditures 1
Impact on Health Outcomes
Primary health care has demonstrated benefits in multiple areas 2:
- Greater access to needed services 2
- Better quality of care delivery 2
- Greater focus on prevention and early intervention 2
- Early management of health problems before they become severe 2
- Effective organization and delivery of high-quality care for chronic non-communicable diseases 2
Common Pitfalls and Considerations
A critical distinction exists between "Primary Care" and "Primary Health Care": Primary Care describes narrower "family doctor-type" services delivered to individuals, while Primary Health Care is a broader approach that includes both individual services and population-level public health functions 3. This distinction is important for understanding the full scope of services that should be available.
Primary health centres must balance curative and preventive care demands, as patients often seek curative services more frequently despite prevention being a stated priority 4. Successful implementation requires adequate resource allocation, trained personnel with both clinical and social understanding of health determinants, and integration across the healthcare system 4.