this short article I am going to display the current situation of Primary
Health Care services in my country Libya and talk about some of the
pitfalls that need to be fixed in order to improve the Primary Health Care
outcome as it is the core of all other health services.
In order to give a true
definition to primary care we need to describe the different types of health
care services we deliver to patients, in addition, we must identify who are the
primary care providers whether they were physicians or non-physicians’ health
According to the American
Academy of Family Physicians AAFP there are five definitions related to primary
care services, the first definition is Primary Care which is the care provided
by physicians specifically trained for, it includes health promotion, disease
prevention, health maintenance, counseling, patient education, diagnosis and
treatment of acute and chronic
illnesses, the second definition is Primary Care Practice which serves as the
patient’s first point of entry into the health care system, the third
definition is Primary Care Physician who is a specialist in Family Medicine,
internal medicine or pediatrics who provides definitive care to the
undifferentiated patients at the first point of contact, the fourth definition
is Non-Primary Care Physicians providing Primary Care Services, and the fifth
definition is Non-physicians Primary Care Providers.
In the recent years the role
of primary care has expanded in Libya in terms of providing centers, where
there is currently approximately 1177 primary care facilities across the
country, but not in terms of training
physicians to become PCP specialists, Libya is an intermediate level income
country where the majority of its income comes from petrochemical industry,
overall, the health services has changed from a high prevalence of infections
and significant morbidity and mortality rates due to infection to one where
morbidity and mortality is more often linked to non-communicable chronic
diseases, and this shows that the health care services has improved. For
example, the immunization coverage for tuberculosis is more than 97% and more
than 95% for measles.
Despite all these improvements
in primary health care services I still believe that there is a huge gap in
comprehending the exact role of a Primary Care Provider in terms of their
importance in the general structure of health care and also knowing the limits of
primary care services, for example a PCP must know when to refer their patients
to the next level of health care service, and from my point of view this
pitfall is due to the lack of a well-structured training program.
The increasing burden of
chronic illnesses raises the importance of the role of primary care providers
to educate patients about self-care, enabling activation and supporting chronic
care. But unfortunately for many primary care providers in Libya supporting
self-management and patients’ activation has not been part of their training,
moreover, it is not part of how they understand their roles as clinicians some
do not embrace the strategies that involve partnering with patients to improve self-management
and supporting patient behavior changes and do not see this as an important
part of their role.
There is growing body evidence
that involving patients in their own management would result in better health
outcomes and lower costs.
In conclusion, in order to
improve our health care services outcome, we must give the appropriate
attention towards Primary Health Care and its role in enhancing the public
health outcome and the improvement should not just be by increasing the number
of institutions but also by providing a high-quality training programs to all
primary care providers.