Family Medicine and Community Health II
PRIMARY HEALTH CARE
Dr. Joseph A. Jao
Overview
I. Background
II. Objectives of Primary Health Care
III. Alma Ata declaration
IV. Concept of Primary Health Care
V. Principles of Primary Health Care
VI. Primary Health Care Approach
VII. Levels of Primary Health Care Workers
VIII. Primary Health Care vs Primary Care vs
Primary Prevention
IX. 5 Common Shortcomings of Health Care
Delivery
X. Primary Health Care Reforms
BACKGROUND
CURRENT WORLD STATUS
Ø Health status of millions of people in the world is
unacceptable, particularly in the developing countries
Ø More than half of the population of the world does not
have the benefit of proper health care
Ø Inadequate and inequitable distribution of health
resources between and within countries
• Health resources and manpower are devoted
to the liking of developed countries and
urban areas in developing countries
• Rural areas have less focus in giving health
resources and manpower
INTERNATIONAL CONFERENCE ON PHC ALMA ATA,
RUSSIA, SEPTEMBER 12, 1978
Ø Health is a fundamental right: it must be delivered to
ALL
• The government must set rules and policies to
ensure access to all health care services for all
individuals
Ø New approach to health and health care to close the
gap between the “haves” and “have nots”
Ø Achieve equitable distribution of health resources:
it should be evenly distributed and accessible to all
even in rural and grass-root areas
Ø Attain a level of health for all the citizens of the world
that will permit them to lead a socially and
economically productive life
Ø Urging the world community to protect and promote
the health of all people of the world
OBJECTIVES OF PRIMARY HEALTH CARE
1) Promote and maintain health among people
2) Develop community leadership and initiatives:
members of the community must be responsible for
their own health
3) Provide relevant health and health-related
services
ALMA ATA DECLARATION
I. HEALTH IS A FUNDAMENTAL RIGHT
Ø Fundamental right: a basic and foundational right
related to national law; right bestowed by the
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Supreme Court to receive constitutional protection
against government interference
Ø Government: provide health and health-related
services to its constituents
Ø Most important worldwide social goal in the attainment
of highest possible level of health
Ø Health is a state of complete physical, mental and
social well-being, and not merely the absence of
disease (WHO)
II. THE EXISTING GROSS INEQUALITY IN THE HEALTH
STATUS OF THE PEOPLE IS POLITICALLY, SOCIALLY,
AND ECONOMICALLY UNACCEPTABLE
Ø The gap of developed and developing countries must
be closed in order to avoid the “haves” and “have
nots” within countries
Ø Common concern to all countries
III. ECONOMIC AND SOCIAL DEVELOPMENT IS OF BASIC
IMPORTANCE TO THE FULLEST ATTAINMENT OF
HEALTH FOR ALL
Ø Health is an unending cycle: by having good health,
social interactions and economic capabilities to
provide for your basic needs will be easier to grasp
• By being sick, a stigma will be formed in the
minds of the people around them, rendering them
incapable to socialize and contribute to the
society à this will cause them to prioritize 3
things: food, shelter and clothing à health will not
be prioritized
Ø Essential in the protection and promotion of the health
of the people
Ø “Health for all by the year 2000”
• All people of the world should attain a level of
health to be able to lead a socially and
economically productive life
• Health is to be brought within reach of everyone
in a given country
• Holistic concept calling for efforts in agriculture,
industry, education, housing, and communication
as much as in medicine and public health
Different sectors of the society indirectly affect medicine
and public health
Ex. Education: people who is not well-educated on a
certain disease will think of different misconceptions
regarding the disease
Lack of infrastructures and roads also hinder the delivery of
health services to rural areas
IV. THE PEOPLE HAVE THE RIGHT AND DUTY TO
PARTICIPATE INDIVIDUALLY AND COLLECTIVELY IN THE
PLANNNG AND IMPLEMENTATION OF HEALTH
Ø Community participation: process by which
individuals and families assumes responsibility for
their own health and welfare and for those of the
community, and develop the capacity to contribute to
their and the community’s development
• Enable them to become agents of their own
development instead of passive beneficiaries of
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PRIMARY HEALTH CARE
Dr. Joseph A. Jao
developmental aid: training and education must
be prioritized in order for them to realize and
• End result: self-reliance (able to stand and
provide on their own) and self-determination
(capacity to decide on what to do on their own
health)
ü By the end of the delivery of health
service, people must not exhibit total
dependence (“nakasandal sa pader”).
Rather they must be able to think and decide
for their well-being (“nakatayo sa sariling
paa”)
• In order for them to participate, the team must be
RESPONSIVE to their needs
• Felt needs (What do THEY think they need) vs
perceived needs (What do WE think they need)
ü Felt needs are more important therefore we
must consult with them in order for us to
provide these needs à this can lead to
participation of the community, making them
responsible for their own health
• Avoid “dole outs”, mendicancy (the practice of
begging, “pahingi nga”)
V. GOVERNMENTS HAVE THE RESPONSIBILITY FOR THE
HEALTH OF THE PEOPLE BY PROVISION OF ADEQUATE
HEALTH AND SOCIAL MEASURES
Ø Main social target: attainment of all people of the
world by the year 2000 of a level of health that will
permit them to lead a socially and economically
productive life
Ø Primary health is the key to attaining this target
VI. DESCRIPTION OF PRIMARY HEALTH CARE
Ø Essential health care based on practical,
scientifically sound, and socially acceptable methods
and technology made universally accessible to
individuals and families in the community through their
full participation and at a cost that the community
and country can afford to maintain at every stage of
development in the spirit of self-reliance and self-
determination
• Essential health care: basic health services that
should be delivered or available from the most
urbanized areas to most rural areas
• Acceptable: conforms with their knowledge,
beliefs, attitudes and practices
• Universally accessible: available to all 24/7
• Full participation: full role to all constituents
• Can afford: the individual must not weigh if
he/she should buy medicine or food
• Self-reliance and self-determination: end result
st
Ø 1 level of contact between the individual, the family,
and the community and the national health system
bringing health care as close as possible to where the
people live and work
Ø THEREFORE, primary health care is an essential
health care that is acceptable, accessible, community
based that will lead to self-reliance and self-
determination
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VII. PRIMARY HEALTH CARE
Ø 7.a: Evolves from the economic condition and political
characteristics of the country and its communities and
based on the application of relevant results of social,
biomedical and health services and public health
experiences
Ø 7.b: Addresses the main health problems in the
community
• Providing promotive, preventive, curative,
rehabilitative, and supportive/palliative services
à comprehensive services mostly focused on
promotive and preventive services
Ø 7.c: PHC includes: ELEMENTS (Education, Local
Endemic Disease Control, Expanded Immunization
Education, Maternal and child health including family
planning, Essential drugs, Nutrition, Treatment of
Common Diseases, Sanitation)
1) Education on prevailing health problems and
methods of preventing and controlling them
2) Proper nutrition and promotion of food supply
3) Adequate supply of safe water and basic
sanitation
4) Maternal and child health including family
planning
5) Immunization against the major infectious
diseases
6) Prevention and control of locally endemic
diseases (e.g. malaria, schistosomiasis,
leptospirosis, filariasis)
7) Appropriate treatment of common diseases and
injuries (e.g. control of acute respiratory diseases
and diarrheal diseases)
8) Provision of essential drugs
Ø 7.d: Involves in addition to the health sector, all
related sectors, and aspects of national and
community development
• Demands coordinated efforts of all sectors
• Agriculture, animal husbandry, industry,
education, housing, public works, communication
and other sectors
Ø 7.e: Requires and promotes maximum community and
individual self-reliance and participation making fullest
use of local, national and other available resources
and develop the ability of communities to participate
• Planning, organization, operation, and control of
primary health care
• Develops through education
Ø 7.f: Sustained by integrated, functional and mutually
supportive referral systems, leading to progressive
improvement of comprehensive health care for all and
giving priority to those most in needs
Ø 7.g: Relies on health workers including physicians,
nurses, midwives, auxillaries (community health
workers) and community workers as well as traditional
practitioners as needed
• Suitably trained and technically works as a health
team
• Responds to the health needs of the community
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Dr. Joseph A. Jao
VIII. ROLE OF THE GOVERNMENT
Ø All governments should formulate national policies,
strategies, and plan of action to launch and sustain
primary health care as part of a comprehensive
national health system and in coordination with other
sectors
• Exercise political will
• Mobilize the country’s resources
• Use external resources rationally
IX. ALL COUNTRIES SHOULD COOPERATE IN THE SPIRIT
OF PARTNERSHIP AND SERVICE TO ENSURE PHC FOR
ALL PEOPLE
Ø Joint effort of WHO/UNICEF report from PHC
constitutes a solid basis for the further development
and operation of PHC throughout the world
X. AN ACCEPTABLE LEVEL OF HEALTH FOR ALL
PEOPLE OF THE WORLD BY THE YEAR 2000 CAN BE
ATTAINED THROUGH A FULLER AND BETTER USE OF
WORLD’S RESOURCES
Ø A considerable amount is spent on armaments and
military conflicts à a suggested decrease on these
funding should be prioritized and dedicate it to health
services
Ø Genuine policy of independence, peace, détente and
disarmament
Ø Release additional resources devoted to peaceful
arms and acceleration of social and economic
development
CONCEPT OF PRIMARY HEALTH CARE
Ø Involves an effort to provide the rural population in
developing countries with at least the basic minimum
of health services (ELEMENTS)
Ø The list can be modified to fit local circumstances
Ø Some countries have included the following:
mental health, oro-dental health, physical handicaps/
rehabilitation, health and social care of the elderly
PRINCIPLES OF PRIMARY HEALTH CARE
EQUITY/ EQUITABLE DISTRIBUTION
Ø Health services must be shared by all people
irrespective of their ability to pay and all (rich or poor,
urban or rural) must have access to health services
(promotive, preventive, curative, rehabilitative,
supportive/ palliative)
Ø Universally available to all regardless of location (even
in geographically inaccessible depressed areas)
Ø To ensure equity, accessibility has to be improved by
• Increasing the number of health facilities
• Improving transport conditions
• Organizing outreach services, thus substituting
one when the other is not available
COMMUNITY PARTICIPATION
Ø Members of the community are encouraged to
participate in making decisions about their own health,
in identifying the health needs of the community, and
in considering the merits of alternative approaches to
addressing those needs
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Ø Community diagnosis/health profile through survey:
contains demographic profile, health indicators, health
resources, health manpower, and determinants of
health à this must be presented to the community
and they will have to identify the health problems and
needs of their community based on the data
presented à these will be prioritized by the
community and the health team and evaluate the
outcome of the action plan
Ø In community participation, there must be a
continuing effort to secure meaningful
involvement in:
1) Planning
2) Implementation
3) Maintenance of health services
4) Evaluation of health services
5) Maximum reliance on local resources (e.g.
manpower, money, materials)
INTERSECTORAL COORDINATION/ COOPERATION
Ø Health and well-being is linked to both and economic
and social policy
Ø Needed to establish national and local health goals,
health public policy, and the planning and evaluation
of health services
Ø Ensures that providers from different discipline
collaborate and function interdependently to meet the
health needs of health care consumers and their
families
APPROPRIATE TECHNOLOGY
Ø Technology that is scientifically sound, adaptable to
local needs, and acceptable to those who apply it and
those for whom it is used, and that can be maintained
by the people themselves in keeping with the principle
of self-reliance with the resources the community and
the country can afford
Ø Health technology are required for
1) Diagnostic maneuvers
2) Therapeutic maneuvers
3) Disease prevention
4) Disease control
5) Health promotion
Ø Models of care are appropriately adapted to both
economic and social policy
Ø Consideration of alternatives to high-cost and high-
tech services (e.g. herbal medicine)
Ø Recognized the importance of developing and testing
innovative models of health care and disseminating
the results of research related to health care
PRIMARY HEALTH CARE APPROACH
Ø Focuses on the person, not the disease (people-
centered); considers all determinants of health
Ø Integrates care when there is more than one problem
Ø Organizes deployment of resources aiming at
promoting and maintaining health
Ø Addresses most important problems in the community
by providing promoting, preventive, curative,
rehabilitative and palliative services
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 Family Medicine and Community Health II
PRIMARY HEALTH CARE
Dr. Joseph A. Jao
LEVELS OF PRIMARY HEALTH CARE WORKERS
VILLAGE/ GRASSROOT/ BARANGAY HEALTH WORKERS
Ø First contact of the community and initial links of
health care: available 24/7
Ø Provide simple curative and preventive health care
measures promoting healthy environment
Ø Participate in activities geared towards the
improvement of socio-economic level of the
community like food production program
Ø Community health workers, volunteers, or traditional
birth attendants
INTERMEDIATE LEVEL HEALTH WORKERS
Ø First source of professional health care/ primary
care providers
Ø Attends to health problems beyond the competence of
the village workers
Ø Provide support to front-line health workers in terms of
supervision, training, supplies, and services
Ø Medical practitioners, nurses, and midwives
Ø They can be in the barangay clinic, private clinics,
OPD section in the hospital etc.
FIRST LINE HOSPITAL PERSONNEL
Ø Provide back-up services for cases that require
hospitalization
Ø Establish close contacts with intermediate level health
workers or village health workers
Ø Physicians with specialty, nurses, dentists,
pharmacists, and other health professionals
PRIMARY HEALTH CARE VS PRIMARY CARE VS
PRIMARY PREVENTION
PRIMARY HEALTH CARE
Ø Describes an “approach to health policy and services”
provision and which has a defining characteristic –
“the relationship between patient care and public
health functions”
Ø Includes all services that play a part in health such as
income, housing, education, and environment
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PRIMARY CARE
Ø Health Canada: refers to the element within primary
health care that focuses on health care services,
including health promotion, illness and injury
prevention, and the diagnosis and treatment of illness
and injury
Ø Family doctor types of services delivered to
individuals
Ø Barbara Starfield, 1998: Level of a health service
system that provide entry into the system for all new
needs and problems (undifferentiated problems that
first time to be consulted), provides person-focused
care, provides care for all and coordinates and
integrates care
LEVEL OF CARE
PRIMARY LEVEL OF CARE
Ø First level of contact between the individual and
the health system: entry point to all health care
services
Ø Essential health care (PHC) or “health at your door
step” is provided
Ø A majority of prevailing health problems can be
satisfactorily managed
Ø The closest to the people
Ø Provided at village level (barangay health workers)
and through primary health care centers
Ø The measures of health promotion are taken at
maximum effort (rural health units and barangay
health centers)
Ø People are made self-reliant
SECONDARY LEVEL OF CARE
Ø More complex problems are dealt with
Ø Comprises of curative services
Ø Provided by district hospitals
Ø The first referral level
TERTIARY LEVEL OF CARE
Ø More specialized specific facilities and attention of
highly specialized health workers
Ø Provided by regional/ central level institutions
Ø Provide training programs
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PRIMARY HEALTH CARE

Dr. Joseph A. Jao

QUATERNARY LEVEL OF CARE Ø Nursing care for patients needing continuous and
Ø Considered as an extension of tertiary care specialized critical care
Ø Even more specialized and highly unusual
Ø Experimental medicine and procedures as well as
highly uncommon and specialized surgeries

LEVELS OF PREVENTION
PRIMARY PREVENTION
Ø Caters to the prepathogenesis period of the natural
history of the disease
Ø Prepathogenesis period: initial interaction of the
agent, host, and environment producing a stimulus
DOH TYPES OF HOSPITAL • This will cause imbalance between these 3 à a
LEVEL 1 HOSPITAL dynamic readjustment is needed in order for
Ø Emergency hospital these 3 to be in equilibrium
Ø Initial treatment of cases that require intermediate Ø Health promotion and specific protection
treatment and that provides primary care for prevalent SECONDARY PREVENTION
diseases in the area Ø Period of pathogenesis: will start with the presence
Ø General medicine, pediatrics, minor surgeries, and of first signs and symptoms and may either end with
non-surgical gynecology recovery, disability of death of the patient
Ø Primary clinical laboratory, pharmacy, and first level Ø Early diagnosis and prompt treatment and disability
radiology limitation
Ø Nursing care for patients needing minimal
supervised care TERTIARY PREVENTION
Ø Rehabilitation
LEVEL 2 HOSPITAL
Ø Non-departmentalized hospital
Ø General medicine, pediatrics, surgery, anesthesia,
obstetrics, and gynecology
Ø First level radiology, secondary clinical laboratory,
pharmacy
Ø Nursing care for patients needing intermediate
supervised care

LEVEL 3 HOSPITAL
Ø Departmentalized hospital
Ø All clinical services provided by level 2 hospitals
Ø Specialty clinical care
Ø Tertiary clinical laboratory, pharmacy and second
level radiology
Ø Nursing care for patients needing total and
intensive care

LEVEL 4 HOSPITAL
Ø Teaching and training hospital
Ø All clinical services provided by level 3 hospitals
Ø Specialized forms of treatments, intensive care and TONY DANS, 2016
surgical procedures Ø Primary health care: health philosophy that lessen
Ø Tertiary clinical laboratory, third level radiology, health inequities, promote universal access and self-
pharmacy reliance

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 Family Medicine and Community Health II
PRIMARY HEALTH CARE
Dr. Joseph A. Jao
• Includes public health, interventions, UHC,
multisectoral roles and environment
Ø Primary care: a healthcare system that provides
holistic/first contact steward of health care that
includes the curative aspects of health care
Ø Primary prevention: focused on healthy people (vs.
secondary and tertiary prevention) that includes
vaccination, check-ups, lifestyle advise, and treatment
of risk factors
Ø Why focus on a primary care system?
• Without primary care, primary health care
becomes an abstract idea
• Without primary care, no one will deliver primary
prevention
5 COMMON SHORTCOMINGS OF HEALTH CARE
DELIVERY
INVERSE CARE
Ø People with the most means consume the most care,
whereas those with the least means and greatest
health problems consume the least
Ø Public spending on health services most often
benefits the rich more than the poor
IMPOVERISHING CARE
Ø Whenever people lack social protection payment for
care is largely “out-of-pocket” at the point of service
which can lead to catastrophic expenses
Ø Over 100 million people annually fall into poverty
because they have to pay for health care
FRAGMENTED AND FRAGMENTING CARE
Ø Excessive specialization of health care providers and
the narrow focus of many disease control programs
discourage a holistic approach to the individuals and
the families they deal with and do not appreciate the
need for continuity of care
Ø Health services for the poor are often highly
fragmented and severely under-resourced
UNSAFE CARE
Ø Poor system design is unable to ensure safety and
hygiene standards
Ø Medication errors and other avoidable adverse effects
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MISDIRECTED CARE
Ø Resource allocation clusters around curative services
neglecting the potential of primary prevention and
health promotion
Ø Health sectors lack the expertise to mitigate the
adverse effects on health from other sectors and
make the most of what these other sectors can
contribute to health
2008 WHO REPORT
Ø Health Systems do not spontaneously gravitate
towards PHC values, in part because of a
disproportionate focus on specialist, tertiary care,
often referred to as “hospital-centrism”
Ø Dr. Margaret Chan: revisits the ambitious vision of
PHC as a set of values and principles for guiding the
development of health systems
Ø The report defined 4 sets of reforms that reflect a
convergence between the values of PHC, the
expectations of citizens and the common performance
challenges that cut across all contexts
• Universal coverage reforms: to improve health
quality
• Service delivery reforms: to make health
systems people-centered
• Leadership reforms: to make health authorities
more reliable
• Public policy reforms: to promote and protect
the health of communities
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Dr. Joseph A. Jao
PHC REFORMS
UNIVERSAL COVERAGE REFORMS
Ø Ensures that health systems contribute to health
equity, social justice and the end of exclusion
• Ensures availability
• Eliminate barriers to access
• Organize social protection
SERVICE DELIVERY REFORMS
Ø Reorganize health services as primary care around
people needs and expectations and make them more
socially relevant and more responsive to the changing
world
Ø “People-centered” care: putting people first
Ø 4 features of good care
• People-centeredness
• Comprehensive and integration
• Continuity of care
• A personal relationship with well-identified,
regular and trusted providers
Ø Organizing primary care networks accordingly
• Shifting the entry point: brining care closer to
the people
• Shifting accountability: responsibility for a well-
identified population
• Shifting power: the primary care team as the
hub of coordination
PUBLIC POLICY REFORMS
Ø Secure healthier communities
• Integrating public health actions with primary care
• Pursuing public health policies across sectors
LEADERSHIP REFORMS
Ø Replace disproportionate reliance on command
and control on one hand, and laissez-faire
disengagement of the state on the other
• Inclusive, participatory, negotiation-based
leadership
• Recognize the key role and responsibilities of
government
• Inclusive leadership from command and control to
steer-and-negotiate
• Matching growth in health expenditure with
massive reinvestment in capacity for leading and
governing the health sector
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RESOLUTION GIVEN IN WHA62 IN GENEVA (05/22/09)
Ø “To train and retain adequate numbers of health
workers, with appropriate skill-mix, including primary
health care nurses, midwives, allied health
professionals and family physicians, able to work in a
multidisciplinary context, in cooperation with non-
professional community health workers in order to
respond effectively to people’s health needs”
GLOBAL CONFERENCE ON PRIMARY HEALTH CARE,
ASTANA, KAZAKHSTAN (OCTOBER 25-26, 2018)
“From Alma Ata towards Universal Health Coverage and
the Sustainable Development Goals”
Ø Envision
1) Governments and societies that prioritize,
promote, and protect people’s health and well-
being
2) Primary health care and health services that are
high quality, safe, comprehensive, accessible,
available, and affordable for everyone and
everywhere
3) Enabling and health conducive environments in
which individuals and communities are
empowered and engaged in maintaining and
enhancing their health and well-being
4) Partners and stakeholders aligned in providing
effective support to national health policies,
strategies and plans
I. STRONGLY AFFIRM COMMITMENT TO THE
FUNDAMENTAL RIGHT OF EVERY HUMAN BEING TO THE
ENJOYMENT OF THE HIGHEST ATTAINABLE STANDARD
OF HEALTH WITHOUT DISTINCTION OF ANY KIND
Ø Commitment in particular to justice and solidarity
Ø Underline the importance of health for peace, security,
socioeconomic development and their
interdependence
II. STRENGTHENING PHC IS THE MOST INCLUSIVE,
EFFECTIVE, AND EFFICIENT APPROACH TO ENHANCE
PEOPLE’S PHYSICAL, MENTAL AS WELL AS SOCIAL
WELL-BEING
Ø Cornerstone of a sustainable health system for
universal health coverage (UHC) and health-related
sustainable development goals (SDG)
III. IN SPITE OF REMARKABLE PROGRESS IN THE LAST
40 YEARS, PEOPLE IN ALL PARTS OF THE WORLD STILL
HAVE UNADDRESSED HEALTH NEEDS
Ø Remaining healthy is challenging for many people,
particularly the poor and people in vulnerable
situations
Ø It is ethically, politically, socially and economically
unacceptable that inequity in health and disparities in
health outcome persists
Ø Promotive, preventive, curative, rehabilitative services
and palliative care must be accessible to all
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Dr. Joseph A. Jao
IV. MAKE BOLD POLITICAL CHOICES FOR HEALTH
ACROSS ALL SECTORS
Ø Reaffirm the primary role of governments at all levels
in promoting and protecting the right of everyone to
the enjoyment of the highest attainable standard of
health
Ø Promote multisectoral actions and UHC, engaging
relevant stakeholders and empowering local
communities to strengthen PHC
Ø Address social, economic, and environmental
determinants of health
Ø Aim to reduce risk factors by mainstreaming a Health
in All Policies approach
V. BUILD SUSTAINABLE PHC
Ø PHC implemented in accordance to national
legislations, contexts and priorities
Ø Strengthen health systems by investing on PHC
Ø Enhance capacity and infrastructure for primary care
prioritizing essential public health functions
Ø Prioritize essential public health functions
• Prioritize disease prevention and health
promotion
• Meet all people's health needs through the life
course comprehensive range of services
• Accessible, equitable, safe, of high quality,
comprehensive, efficient, acceptable, available
and affordable
 appropriate, traditional medicines, vaccines,
• Deliver continuous, integrated services that are
people-centered and gender sensitive

• Ensure a functional referral system between
primary and other level of care
VI. EMPOWER INDIVIDUALS AND COMMUNITIES
Ø Support the involvement of individuals, families,
communities and civil society through their
participation in the development and
implementation of policies and plans that have an
impact on health
• Promote health literacy
• Support people in acquiring knowledge, skills and
resources needed to maintain their health or the
health of those whom they care, guided by health
professionals
• Protect and promote solidarity, ethics and human
rights
• Increase community ownership
VII. ALIGN STAKEHOLDER SUPPORT TO NATIONAL
POLICIES, STRATEGIES AND PLANS
Ø Stakeholders: health professionals, academia,
patients, civil society, local and international partners,
agencies and funds, the private sector, faith-based
organization and others
Ø All stakeholders should align with national
policies, strategies and plans across all sectors
• Through people-centered, gender-sensitive
approaches
• Take joint actions to build stronger and
sustainable PHC towards achieving UHC
Ø Countries and stakeholders will work together in a
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spirit of partnership and effective development
cooperation while fully respecting national sovereignty
and human rights
THE SUCCESS OF PHC WILL BE DRIVEN BY THE
FOLLOWING
1) Knowledge and capacity building
ü Apply knowledge, including scientific as well
as traditional knowledge, to strengthen PHC,
improve health outcome and ensure access
to all people to the right care at the right time
and at the most appropriate level of care and
respecting their rights, needs, dignity and
autonomy
2) Human resources for health
ü Create decent work and appropriate
compensation for health professionals and
other health personnel working at the primary
health care level to respond effectively to
people's health needs in a multidisciplinary
context
3) Technology
ü Support strengthening and extending access
to a range of health care services through
the use of high quality, safe, effective and
affordable medicines, including, as
diagnostics and other technologies
4) Financing
ü Call on all countries to continue to invest to
PHC to improve health outcomes
ü Address the inefficiencies and inequities that
expose people to financial hardships
resulting from their use of health services by
ensuring better allocation of resources for
health, adequate financing of PHC and
appropriate reimbursement systems
ü Work towards the financial sustainability,
efficiency and resilience of national health
systems
ü Leave no one behind by providing access to
quality PHC services across the continuum
of care
Ø Primary care is sustenance of health and well-being
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consisting of
1) Multisectoral policy and action
2) Empowered people and communities
3) Primary care and essential public health functions
as the core of integrated health services

REFERENCES
Ø Dr. Jao’s lecture
Ø 2020 trans

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