PRIMARY HEALTH CARE Key Strategy to Achieve the Goal:

Partnership with and Empowerment of the people –

PRIMARY HEALTH CARE permeate as the core strategy in the effective
PHC is an essential health care based on practical, provision of essential health services that are
scientifically sound and socially acceptable methods community based, accessible, acceptable, and
and technology made universally accessible to sustainable, at a cost, which the community and the
individuals, families in the community by means government can afford.
acceptable to them, through their full participation and
at a cost that the community and country can afford to Objectives of Primary Health Care
maintain at every stage of their development in the
spirit of self-reliance and self-determination. ● Improvement in the level of health care of
the community
HISTORY OF PHC ● Favorable population growth structure
● International Conference for Primary Health ● Reduction in the prevalence of
(Sept. 6 -12, 1978) in Alma Ata, USSR (Alma preventable, communicable and other
Ata Conference) disease.
● LOI 949, PHC adopted in the Philippines (Oct. ● Reduction in morbidity and mortality rates
19, 1979) Pres Ferdinand Marcos Sr especially among infants and children.
● Alma Ata Declarations of PHC ● Extension of essential health services
● Health as Basic Fundamental Right Global with priority given to the underserved
Burden of Health inequalities sectors.
● Economic and Social Development ● Improvement in Basic Sanitation
● Government responsibility for the health of ● Development of the capability of the
their people community aimed at self- reliance.
● May 1977 -30th World Health Assembly ● Maximizing the contribution of the other
decided that the main health target of the sectors for the social and economic
government and WHO is the attainment of a development of the community.
level of health that would permit them to lead
a socially and economically productive life by Mission
the year 2000.
● September 6-12, 1978 – First International ● To strengthen the health care system by
Conference on PHC in Alma Ata, Russia increasing opportunities and supporting the
(USSR) The Alma Ata Declaration stated that conditions wherein people will manage their
PHC was the key to attain the “health for all” own health care.
goal
● October 19, 1979 – Letter of Instruction KEY PRINCIPLES OF PHC
(LOI) 949, the legal basis of PHC was signed 1. 4 A’s = Accessibility, Availability, Affordability &
by Pres. Ferdinand E. Marcos, which adopted Acceptability, Appropriateness of health services.
PHC as an approach towards the design, ● The health services should be present where
development and implementation of programs the supposed recipients are. They should
focusing on health development at community make use of the available resources within
level. the community, wherein the focus would be
more on health promotion and prevention of
illness.
HEALTH FOR ALL by the year 2000 - Universal goal
of PHC 2. Community Participation
THEME: “Health in the Hands of the people by ● heart and soul of PHC
2020”
3.People are the center, object and subject of
This policy agenda of “health for all by the year 2000” development.
technically, was a global strategy employed in ● Thus, the success of any undertaking that
achieving aims at serving the people is dependent on
three main objectives: people’s participation at all levels of
(1) promotion of healthy lifestyles decision-making; planning, implementing,
(2) prevention of diseases monitoring and evaluating. Any undertaking
(3) therapy for existing conditions. must also be based on the people’s needs
and problems (PCF, 1990)
Definition of Primary Health Care ● Part of the people’s participation is the
● essential health care made universally partnership between the community and the
accessible to individuals and families in the agencies found in the community; social
community by means acceptable to them, mobilization and decentralization.
through their full participation and at cost that ● In general, health work should start from
the community can afford at every stage of where the people are and building on what
development. they have. Example: Scheduling of Barangay
● a practical approach to making health benefits Health Workers in the health center
within the reach of all people.
● an approach to health development, which is Barriers of Community Involvement
carried out through a set of activities and ★ Lack of motivation
whose ultimate aim is the continuous ★ Attitude
improvement and maintenance of health ★ Resistance to change
status ★ Dependence on the part of community people
★ Lack of managerial skills
Goal of Primary Health Care
● HEALTH FOR ALL FILIPINOS by the year 4. Self-reliance
2000 AND HEALTH IN THE HANDS OF THE ● Through community participation and
PEOPLE by the year 2020. cohesiveness of people’s organization they
● An improved state of health and quality of life can generate support for health care through
for all people attained through SELF social mobilization, networking and
RELIANCE. mobilization of local resources. Leadership
and management skills should be developed
among these people. Existence of sustained
 health care facilities managed by the people ○ People
is some of the major indicators that the ○ Government
community is leading to self-reliance. ○ Private sector.
● Multi-sectoral approach
5. Partnership between the community and the ○ communication, cooperation, and
health agencies in the provision of quality of life. collaboration among various sectors
● Providing linkages between the government ○ Intra-sectoral linkages –within the
and the non government organization and health sector, among members of the
people’s organization. health team and among health
agencies
6. Recognition of interrelationship between the Inter-sectoral linkages – between
health and development health sector and other sectors of
● Health - Is not merely the absence of society.
disease. Neither is it only a state of physical ○ Community participation
and mental well-being. Health being a social ○ Equitable distribution of
phenomenon recognizes the interplay of health resources
political, socio-cultural and economic factors ○ Appropriate technology
as its determinant. Good Health therefore, is ○ Technology that is suitable to
manifested by the progressive improvements the community that will use it.
in the living conditions and quality of life
enjoyed by the community residents MAJOR STRATEGIES OF PRIMARY HEALTH
● Development - is the quest for an improved CARE
quality of life for all. Development is 1. Elevating Health to a Comprehensive and
multidimensional. It has political, social, Sustained National Effort.
cultural, institutional and environmental ● Attaining Health for all Filipino will require
dimensions (Gonzales 1994). Therefore, it is expanding participation in health and health
measured by the ability of people to satisfy related programs whether as service provider
their basic needs. or beneficiary. Empowerment to parents,
families and communities to make decisions
7. Social Mobilization of their health is really the desired outcome.
● It enhances people participation or ● Advocacy must be directed to National and
governance, support system provided by the Local policy making to elicit support and
Government, networking and developing commitment to major health concerns through
secondary leaders. legislations, budgetary and logistical
considerations.
8. Decentralization
● This ensures empowerment and that 2. Promoting and Supporting Community
empowerment can only be facilitated if the Managed Health Care
administrative structure provides local level ● The health in the hands of the people brings
political structures with more substantive the government closest to the people. It
responsibilities for development initiators. This necessitates a process of capacity building of
also facilities proper allocation of budgetary communities and organization to plan,
resources. implement and evaluate health programs at
their levels.

5 ELEMENTS TO ACHIEVE THE GOAL OF PHC 3. Increasing Efficiencies in the Health Sector
1. Reducing exclusion and social disparities in ● Using appropriate technology will make
health. services and resources required for their
2. Organizing health services around people’s needs delivery, effective, affordable, accessible and
and expectations. culturally acceptable. The development of
3. Integrating health into all sectors human resources must correspond to the
4. Pursuing collaborative models of policy dialogue. actual needs of the nation and the policies it
5. Increasing stakeholder participation. upholds such as PHC. The DOH will continue
to support and assist both public and private
RATIONALE FOR ADOPTING PRIMARY HEALTH institutions particularly in faculty development,
CARE enhancement of relevant curricula and
● Magnitude of Health Problems development of standard teaching materials.
● Inadequate and unequal distribution of health
resources 4. Advancing Essential National Health Research
● Increasing cost of medical care ● Essential National Health Research (ENHR)
● Isolation of health care activities from other is an integrated strategy for organizing and
development activities managing research using intersectoral,
multidisciplinary and scientific approach to
TWO LEVELS OF PRIMARY HEALTH CARE health programming and delivery.
WORKERS
Barangay Health Workers – trained community
health workers or health auxiliary volunteers or EQUITABLE DISTRIBUTION OF HEALTH
traditional birth attendants or healers. RESOURCES
Intermediate level health workers - include the 2 DOH PROGRAMS TO ENSURE EQUITABLE
Public Health Nurse, Rural Sanitary Inspector and DISTRIBUTION
midwives.
1. Doctor to the Barrio (DTTB) Program
KEY PRINCIPLES OF PHC ● the deployment of doctors to municipalities
● Accessibility, affordability, acceptability, that are w/o doctors.
and availability Programs offered: ● deployed to unserved, economically
1. Botika ng Bayan and Botika ng Barangay - Was depressed 5th or 6th class municipalities for
establish to promote equity in health by ensuring 2 years.
availability, and accessibility of affordable, safe and 2. Registered Nurses Health Enhancement and
effective, quality essential drugs to all. Local Service (RN HEALS)
● Support mechanisms - ● training and program for unemployed nurse
Three major entities:
 ● deployed to unserved, economically
depressed municipalities for 1 year

APPROPRIATE TECHNOLOGY

Health technology Criteria for Appropriate

includes: Health Technology
● tools ● Safety
● drugs ● Effectiveness
● methods ● Affordability
● procedures and ● Simplicity
technique ● Acceptability
● people’s technology ● Feasibility and
● indigenous Reliability
technology ● Ecological effects
● Potential to
contribute to
individual and
community
development

ELEMENTS/COMPONENTS OF PRIMARY HEALTH

CARE
E – Education for Health
L - Locally Endemic Disease Control
E – Expanded Program for Immunization
M -Maternal and Child Health including responsible
parenthood
E – Essential Drugs
N - Nutrition
T – Treatment of Communicable and
NonCommunicable Disease SANTALUBBY
S – Safe water Sanitation LUBBY SANTA
FOUR CORNERSTONES/PILLARS IN PRIMARY NASTY BULBA
HEALTH CARE
1. Active Community Participation MEDICAL PLANT PREPARATION
2. Intra and Inter-sectoral Linkages 1. DECOCTION - boiling the plant material in
3. Use of Appropriate Technology water for 20 min.
4. Support mechanism made available 2. INFUSION - plant material is soaked in hot
PHC IS NOT A PRIMARY CARE water for 10 - 15 minutes.
3. POULTICE - directly apply plant material on
the affected part, usually in bruises, wounds
and rashes.
4. TINCTURE - mix the plant material in alcohol.

ALTERNATIVE HEALTH CARE MODALITIES

R.A. 8423 - Traditional and Alternative Medicine

Act of 1997 (Juan Flavier)
 HEALTH PROMOTION AND LEVELS OF STRATEGIC THRUSTS
PREVENTION The attainment of the goal of UHC is through the
● Health promotion - activities enhance pursuit of three strategic thrusts:
resources directed at improving well-being. 1. Financial risk protection through expansion in
● Disease prevention - activities protect NHIP enrollment and benefit delivery
people from disease and effects of disease. 2. Improved access to quality hospitals and
health care facilities
LEAVELL AND CLARK’S THREE LEVELS OF
PREVENTION 3. attainment of the health-related MDGs
1. Primary Prevention- relates to activities
directed at preventing a problem before it To achieve the three strategic thrusts, six strategic
occurs by altering susceptibility or reducing instruments shall be optimized:
exposure for susceptible individuals. 1. Health financing - instrument to increase
2. Secondary Prevention- early detection and resources for health that will be effectively
prompt intervention during the period of early allocated and utilized to improve the financial
disease pathogenesis. protection of the poor and the vulnerable sectors.
-implemented after a problem has begun but 2. Service delivery – instrument to transform the
before signs and symptoms appear and health service delivery structure to address
targets populations who have risk factors variations in health service utilization and health
(Keller). outcomes across socioeconomic variables.
3. Tertiary prevention- targets populations that 3. Policy, standards, and regulation – instrument
have experienced disease or injury and to ensure equitable access to health services,
focuses on limitations of disability and essential medicines, and technologies of assured
rehabilitation. quality, availability and safety.
-aims to reduce the effects of disease and 4. Governance for health – instrument to establish
injury and to restore individuals to their the mechanisms for efficiency, transparency, and
optimum level of functioning. accountability, and prevent opportunities for fraud.
5. Human resources for health – instrument to
ensure that all Filipinos have access to
professional health care providers the appropriate
level of care.
6. Health information – instrument to establish a
modern information system that shall:
a. Provide evidence for policy and
program development;
b. Support for immediate and efficient
provision of health care and
management of province-wide health
systems.

PUBLIC HEALTH PROGRAMS

1. Reproductive and maternal health: pre-pregnancy

services and care during pregnancy, delivery, and
postpartum period
2. Expanded Garantisadong Pambata (child health):
advocacy for exclusive breastfeeding in the first 6
HEALTH SECTOR REFORM: UNIVERSAL HEALTH months of life, newborn screening program,
immunization, nutrition services, and integrated
CARE
management of childhood illness.
● Universal Health Care (UHC), also referred to 3. Control of communicable disease such as
as Kalusugan Pangkalahatan (KP), is the tuberculosis, mosquito-borne diseases, rabies,
“provision to every Filipino of the highest schistosomiasis, and sexually transmitted
possible quality of health care that is infections
accessible, efficient, equitably distributed, 4. Control of noncommunicable or lifestyle diseases
adequately funded, fairly financed, and 5. Environmental health
appropriately used by an informed and
empowered public”
● The Aquino administration puts it as the
availability and accessibility of health services
and necessities for all Filipinos.
● It is a government mandate aiming to ensure
that every Filipino shall receive affordable and
quality health benefits. This involves providing
adequate resources – health human
resources, health facilities, and health
financing.
● UHC was built upon strategies of two previous
platforms of reform: the initial Health Sector
Reform Agenda and FOURmula One for
health.

GOALS AND OBJECTIVES

1. Better health outcomes
2. Sustained health financing, and
3. A responsive health system by ensuring that all
Filipinos, especially the disadvantaged group,
have equitable access to affordable health care.