Primary Health Care (PHC) is a foundational concept and a holistic approach to health, not merely an institution or scheme, that serves as the first level of contact between individuals and the national healthcare system. It encompasses promotive, preventive, curative, rehabilitative, and palliative services, addressing not just illness but also the social determinants of health.
The concept was formally established by the Declaration of Alma-Ata on September 12, 1978, at the International Conference on Primary Health Care in Alma-Ata, USSR (now Kazakhstan). The declaration was a response to the gross inequality in health status globally and the failure of centralized, curative-focused systems, aiming for the goal of "Health for All" by the year 2000.
PHC works by providing essential health care that is practical, scientifically sound, and made universally accessible through community participation and at an affordable cost. In India, the mechanism traditionally relies on a three-tier structure: Sub-Centres (SCs), Primary Health Centres (PHCs), and Community Health Centres (CHCs), with a PHC established for a population of 30,000 in plain areas.
PHC is the cornerstone of India's healthcare strategy and is essential for achieving Universal Health Coverage and the health-related Sustainable Development Goals (SDGs). It connects directly to the National Health Policy (NHP) of 1983 and the overarching National Health Mission (NHM).
A major recent change occurred with the launch of the Ayushman Bharat Comprehensive Primary Health Care Programme in 2018. This scheme transformed existing PHCs and SCs into Health and Wellness Centres (HWCs), now renamed Ayushman Arogya Mandirs (AAMs), with over 1.86 lakh centres operational. This transition expanded the service package to include screening for non-communicable diseases, mental health support, and the integration of AYUSH practices, moving from selective care to comprehensive primary healthcare.