Primary Health Care 6.

Socio-economic influences-
families in lower income group are
Optimum Level of Functioning the ones mostly served
● The modern concept of health Example:
refers it to the “optimum level of ➔ Unemployed, underemployed, lack
functioning” (OLOF) of individuals, of education, lack of decent
families and communities which is housing
affected by several factors in the
ecosystem, as follows;
Primary Health Care (PHC)
Factors
1. Political factors- politics have “essential health care made universally
power and authority to regulate the accessible to individuals & families in the
community by means of acceptable to them
environment or social climate
through their full participation & at cost that
For example:
the community & country can afford at every
➔ Laws or legislative acts are often stage of development”
related to promoting safety and
people empowerment. ❖ Primary health care (PHC) is the
first level of contact for individuals,
2. Behavioral factors- a person’s level the family, and the community with
of functioning is affected by certain the national health system and
habits while their lifestyle, health “address the main health problems
care and child rearing practices are in the community, providing health
determined by their culture and promotion, preventive, curative, and
ethnic heritage. rehabilitative services accordingly”

3. Hereditary factors- understanding History of Primary Health Care

of genetically-influenced diseases
and genetic risks May 1977 - The 30th World Health
Assembly adopted resolution WHA 30:43
4. Health care delivery system-
primary health care is a partnership ● This resolution decided that the
approach to the effective provision main social target of governments
of essential health services that are and of WHO should be attainment
community-based, accessible, by all the people of the world by the
acceptable, sustainable, and year 2000 a level of health that will
affordable. permit them to lead a socially and
economically productive life.
5. Environmental influences- the
menace of pollution,
communicable diseases due to
poor sanitation, poor garbage
collection, smoking, utilization of
pesticides.
Alma Ata Declaration, 1978 Underlying theme of (before / previous)
September 6-12, 1978
➔ Health for all by year 2000 (WHO,
● “The conference strongly reaffirms 1978)
that health is a fundamental
human right” ➔ “Health in the hands of the people
by 2020”
● “The existing gross inequality in the
health status of the people Declaration of Astana
particularly between developed 25-26 OCtober 2018 - Astana Kazakhstan
and developing countries as well as
within countries is politically, ● On the 40th anniversary of the
socially, and economically Alma-Ata declaration, global health
unacceptable”. leaders and stakeholders returned
to Kazakhstan to renew the
● International Conference on promise of primary health care as
Primary Health Care was held this the most effective and efficient
year in Alma Ata, USSR means to achieve universal health
coverage (WHO, 208)
● The conference came up with what
is known popularly as the Alma Ata ● Aim to meet all people’s needs
Declaration, which represents a across the life course through
global ideal, a new vision about comprehensive, preventive,
how to achieve world health promotive, curative, rehabilitative,
services and palliative care.
● The declaration stated that
primary health care is the key to Global health leaders commit to:
attaining the health-for-all goal.
● Make bold political choices for
● The global goal as stated in the health across all sectors
Alma Ata Declaration is Health for
all by the year 2000 through ● Build sustainable primary health
self-reliance care

● The health for all goals does not ● Empower individuals and
mean however that nobody will be communities
sick or disabled anymore. Nor does
it mean that health care ● Align stakeholders to support
professionals will provide care for national policies, strategies and
everybody in the country or the plans.
world for all their existing ailments.
What is PHC (New Consensus) PHC’s goal is anchored in the Vision of
DOH
● A whole of society approach to
health that aims to ensure the ★ Filipinos are among the healthiest
highest possible level of health and people in Southeast Asia by 2022,
wellbeing and their equitable and Asia by 2040
distribution by focusing on people’s
needs and preferences (as Mission
individuals, families, and ★ To strengthen the health care
communities) as early as possible system by increasing opportunities
along the continuum from health & supporting the condition wherein
promotion and disease prevention people will manage their own
to treatment, rehabilitation and health care.
palliative care, and as close as
feasible to people’s everyday
environment.
Legal Basis of PHC in the Philippines
● Primary Health Care is a strategy to
ensure that there is effective October 19, 1979
provision of essential health
services that are community-based, ● The president of the Philippines
accessible, acceptable, and (Ferdinand Marcos) issued letter of
sustainable Instruction (LOI) 949 which
mandated the Ministry of Health to
● Multiple sectors working together adopt Primary Health Care as an
to bring care closer to home with approach towards design,
the involvement of the community development, and implementation
of programs, which focus health
development at the community
A primary healthcare approach includes level
three components:
Universal Declaration of Human Rights,
1. Meeting people’s health needs Article 25, Section 1
throughout their lives
● “Everyone has the right to a
2. Addressing the broader standard of living adequate for the
determinants of health through health and well-being of himself
multisectoral policy and action and of his family, including food,
clothing, housing, and medical care
3. Empowering individuals, families, and necessary social services and
and communities to take charge of the right to security in the event of
their own health. unemployment, sickness, disability,
old age, widowhood, or lack of
livelihood.”
Philippine COnstitution of 1987, Article Four Cornerstones / Pillars in Primary
XIII, Section 11 Health Care

● “ The state shall adopt an 1. Active communication

integrated and comprehensive participation
approach to health development
which shall endeavor to make 2. Multi Sectoral linkages
essential goods, health and other
social services available to all the 3. Use of appropriate technology
people at affordable cost. There
shall be a priority for the needs of 4. Support mechanism made
the underprivileged sick, elderly, available
disbled, women, and children. The
state shall endeavor to provide free Community Participation
medical services to paupers.
● A process in which people identify
WHO (1995) the problems and needs and
assume responsibilities themselves
● Governments have a responsibility to plan, manage and control.
for the health of their people which
can be fulfilled only by the provision ● People should take a role or
of adequate health and social contribute, for example people
measures. should be part of the planning
process.

Elements of Primary Health Care

Multi Sectoral Linkages

Appropriate Technology

● Method used to provide a socially

and environmentally acceptable
level of services or quality at the
least economic cost.
 ● Health technology includes tools, Examples: botika ng bayan, ligtas tigdas
drugs, methods, procedures, ang pinas
techniques; and people with
indegenous technology ❖ Community Based- delivered
where the people are
Support Mechanism
3 major sources: ❖ Sustainable-health services
should be successfully utilized,
➢ People maintained and continued

➢ Government ❖ Feasibility of use- possibility of

use at all times
➢ Private sector
❖ Effective

Key Principles ❖ Scope of technology is safe and

secure
4 A’s
● Accessibility
➢ Distance or travel time
required to get to the Types of Primary health care workers
healthcare facility or service
➢ Can be reached by the ● Various categories of health
majority of population workers make up the primary
health care team
● Affordability
➢ Inexpensive healthcare ● The type vary in different
services communities depending upon:
➢ Most health services are
covered by the government 1. Available health manpower
insurance system known as resources
Philhealth
2. Local health needs and
● Acceptability problems
➢ Compatible with the culture
and tradition with the 3. Political and financial
population feasibility.
➢ Meets the requirements and
needs in the area

● Availability
➢ Services / programs are
offered, provided on regular
basis in an organized
manner/
Two Levels of Primary Health Care Tertiary Prevention
Workers
● Restore a person to the highest
1. Grassroots of Village or Barangay level of functioning within limits of
Health workers ( V/BHWs ) disease. Prevent further
➔ This refers to trained deterioration from a fixed or
community health workers irreversible disease.
or health auxiliary volunteer
or a traditional birth ● Rehabilitation for people with fixed
attendant or healer irreversible disease

2. Intermediate level health workers Example:

➔ General medical ● Primary
practitioners or their ➢ Quit smoking
assistants, Public health ➢ Limit alcohol intake
nurse, rural sanitary ➢ Exercise regularly
inspectors, and midwives ➢ Reduce fat and increase
may compose these groups fiber in diet
➢ Take adequate fluids
Basic primary health care team: ➢ Complete immunization
- Physician
- Public health nurse ● Secondary
- Midwife ➢ Screening
➢ Early detection
➢ Early treatment
➢ Surveillance of disease
Levels of Prevention ➢ Contact tracing

Primary Prevention ● Tertiary

➢ Rehabilitative or prevention
● Decrease vulnerability: reduce risk of disability care
factors. Prevent disease and ➢ Helping client live
dysfunction. productively with limitations
➢ Self-monitoring blood
● Health promotion for healthy glucose
people ➢ Physical therapy after
cerebrovascular accident
Secondary Prevention

● Halt pathological process, shorten

duration and severity of disease

● Screening for early diagnosis for

people with undetected disease or
disability.
Levels of Health Care and Referral ● Complicated cases and intensive
System care requires tertiary care and all
these can be provided by the
Primary level of Care tertiary care facility.

● Is developed to the cities and the

municipalities. It is health provided
by center physicians, public health
nurses, rural health midwives,
barangay health workers, traditional
healers and others at the barangay
health stations and rural health
units.

Secondary level of care

● Is given by physicians with basic

health training. This is usually given
in health facilities either privately
owned or government operated
such as infirmaries, municipal, and First level - grassroots or village workers
district hospitals and out-patient
departments of provincial hospitals Second level - intermediate

● This serves as a referral center for Third level- first line personnel who are
the primary health facilities. specialists

● Secondary facilities are capable of The latter establish close contact with the
performing minor surgeries and village, or intermediate health workers to
promote continuity of care from the hospital to
perform some simple laboratory
community to home.
examinations

Tertiary level of care

What is Universal Health Coverage / Care

● Is rendered by specialists in health

● All people having access to quality
facilities including medical centers
health services without suffering
as well as regional and provincial
the financial hardship associated
hospitals, and specialized hospitals
with paying for care
such as the Philippine Health
Center

● The tertiary health facility is the

referral center for the secondary
care facilities.
Universal Health Care and its Aim The Universal Health Care Act of the
Philippines was signed last February
● Universal health care, also referred 2019
to as Kalusugan Pangkalahatan
(KP), is the “provision to every ● Health sector reform in the
Filipino of the highest possible Philippines has been accelerated by
quality of health care that is the passage of Republic Act 11223,
accessible, efficient, equitably more commonly known as the UHC
distributed, adequately funded, Law.
fairly financed, and appropriately
used by an informed and
empowered public.”

● The aquino administration puts it

as the availability and accessibility
of health service and necessities for
all filipinos

● It is a government mandate aiming

to ensure that every filipino shall
receive affordable and quality
health benefits

UHC’s Three Thrusts

To attain UHC, three strategic thrusts are
to be pursued, namely:

1. Financial risk protection through

expansion in enrollment and
benefit delivery of the national
health insurance program (NHIP)

2. Improve access to quality hospitals

and health care facilities

3. Attainment of health-related
sustainable development goals

● Financial efforts shall be provided

to allow immediate rehabilitation
and construction of critical health
facilities. In addition to that,
treatment packs for hypertension
and diabetes shall be obtained and
distributed to RHUs