Daisy B.

Itchock
 Objectives:
Ø Students should know how to:
1-Define PHC
2-Describe the concept of PHC and how it
relates to basic health services
3-List the elements and principles of PHC
4-Define the promotive services
5-Define the preventive services
6-Define the curative care services
 WHO-UNICEF
held international conference in 1978 at Alma-
Ata (USSR),the governments of 134 countries
and many voluntary agencies called for a
revolutionary approach to health care.

The Alma-Ata conference called for acceptance

of the WHO goal for Health for All(HFA) by the
year 2000 and proclaimed primary health care
as a way to achieving Health for all.
• Primary Health Care (PHC) was declared during the
First International Conference on Primary Health
Care held in Alma Ata, Russia on September 6-12,
1978 by the World Health Organization (WHO).
• The goal was “ Health for All by the Year 2000 ”.
• This was adopted in the Philippines through Letter
of Instruction (LOI) 949 signed by President Marcos
on October 19, 1979 and has an underlying theme
of “ Health in the Hands of the People by 2020 .”
This approach has influenced many countries
including the Philippines.
• Its innovativeness is indicated by the call for
participatory development management since
community members are expected to take an
active role in managing their own health
requirements, instead of depending on the
government.
• PHC also gives importance to the participation of
various sectors of government and the private
sector in local health activities.
The Alma-Ata Conference defined
PHC as follows:
"Primary health care is 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 the community & country can afford to
maintain at every stage of their development in the
spirit of self determination".
• PHC is equally valid for all countries, although
it takes varying forms in each of them.
• The concept of PHC has been accepted by all
countries as the key to the attainment of
HFA(Health For All).
• It is accepted as an integral part of the
country's health system.
Ø It is essential health care which is based on practical,
scientifically sound and socially acceptable methods and
technology.
Ø It should be rendered universally, acceptable to individuals
and the families in the community through their full
participation.
Ø Its availability should be at a cost which the community and
country can afford to maintain at every stage of their
development in a spirit of self reliance and self-development.

Ø It requires joint efforts of the health sector and other health-

related factors, via., education, food and agriculture, social
welfare, animal husbandry, housing, rural reconstruction, etc.
 Primary Health Care

Community-
Based

Affordable Accessible

PHC

Acceptable Sustainable

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 Framework

People
Empowerment

“Health for All

Filipinos by the
Year 2000 and
Health in the
Hands of the
People by 2020”

Partnership

8/28/2021 12
 Elements (components) of PHC

Although specific services provided will vary in

different countries & communities, the Alma-
Ata Declaration has outlined 8 essential
components of PHC
8 essential components of PHC

1. Health education concerning

prevailing health problems & the
methods of preventing &
controlling them.
2. Promotion of food supply & proper
nutrition.
8 essential components of PHC

3. An adequate supply of safe

water & sanitation.
4. Maternal & child health care.
8 essential components of PHC

5. Immunization against major

infectious diseases.
6. Prevention & control of locally
endemic diseases.
8 essential components of PHC

7. Appropriate treatment of
common diseases & injuries.
8. Provision of essential drugs.
Control of Communicable Diseases
Offers Health Education
Maternal and Child Care
Provision of Medical Care and Emergency Treatment
Offers “Immunization”
Nutrition and Food Supply
Environmental Sanitation
N “Family Planning”
Treatment of Locally Endemic Diseases
Supply and Proper Use of Essential Drugs

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• The first three elements are
promotive services.
• the middle three are
preventive services.
• the last two services are
curative care services.
 The concept of PHC
• involves an effort to provide the rural
population in developing countries with at
least the basic minimum of health services.
The list can be modified to fit local
circumstances
For example some countries have
specifically included:
-Mental health
-Physical handicaps.
-Health and social care of the elderly.
 PHC principles
vThe mentioned eight services indicated
as elements, are to be organized &
delivered on basis of the principles of :
1- Equity in distribution.
2- Appropriate technology.
3- Multisectoral approach.
4- Community participation.
1. Equitable distribution.
The first key principle in the PHC strategy is
equity or equitable distribution of health
services.
Health services must be shared equally by all
people irrespective of their ability to pay.
 1. Equitable distribution

PHC aims to re-adress this imbalance by:

• Shifting the centre of gravity of the health
care system from cities (where three-quarters
of the health budget is spent) to → rural
areas (where three-quarters of the people
live).
• Bring these services as near people's home as
possible.
 Equity means:
1.Services to all
2.More services to needy & vulnerable

i.e. while continuing to provide essential health

care for all the population irrespective of social,
economical & cultural preferences, extended
care is to be provided to the "high risk" groups in
the community either within the health centers
or by referral from the health centers to a higher
level of care (hospital).
 -The population to be served must be known.
The vulnerable groups are to be identified &
reached.
For ensuring equity:
- The health services (not necessarily health
centers) have to be dispersed into:
ØThe farthest remote rural areas.
ØThe deepest parts of the underserved urban
population.
 Thus, 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.
PHC aims to:
- Correct imbalance in accessibility
- Bring health services as near to people's
homes as possible.
- To achieve this, PHC is supported by higher
level of health care to which patients can be
referred for extended care.
Involvement of individuals,
families, & communities in
promotion of their own health &
welfare.
2. Community participation
There must be:
A continuing effort to secure meaningful involvement of the community in:
• Planning.
• Implementation.
• Maintenance of health services.
• Evaluation of health services.
• Maximum reliance on local resources such as:
ü Manpower.
ü Money.
ü Materials.
 Principles of PHC
2. Community participation
ØUniversal coverage by PHC cannot be achieved
without the involvement of the local
community.
ØIn short, PHC must be built on the principle of
community participation (or involvement).
3. Intersectoral coordination.
There is an increased realization of the fact that
the components of PHC cannot be provided by
the health sector alone.
3. Intersectoral coordination
Definition:
" technology that is scientifically sound,
adaptable to local needs, & acceptable to those
who apply it & those for whom it is used, &
that can be maintained by the people
themselves in keeping with the principle of self
reliance with the resources the community &
country can afford“.
4. Appropriate Technology
Health technologies are required not only for:
• Diagnostic maneuvers.
• Therapeutic maneuvers.
• But also for:
• Disease prevention.
• Disease control.
• Health promotion.
4. Appropriate Technology
Though it is commonly perceived that person who is going to apply it
is a trained health professional, in PHC practice there are instance
where technology may have to be applied by:
• Individual.
• Family.
• Community.
ü e.g. use of tooth brush, eye glasses, domestic water filters,
domestic pest control, etc·
• So, technology should be applicable for "self use".
4. Appropriate Technology

So, the simplicity of the technology is always

desirable; examples of such are:
1-ORS in diarrheal disease control.
2-Breast feeding in spacing.
3-Weighing for growth monitoring… etc.
 Appropriate Technology

- method used to provide a socially and environmentally acceptable

level of service or quality product at the least economic cost.
Criteria:
Safe Example:
Acceptable
Feasible
Effective
Scope-wise
Affordable
Complex

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10 Medicinal Plants:
Bawang-anti cholesterol
Ulasimang-Bato-lowers uric acid
Bayabas- antiseptic; diarrhea
Lagundi-cough, asthma, and colds
Yerba Buena- toothache, pain, and arthritis
Sambong- renal calculi
Ampalaya- diabetes mellitus
Niyog-niyogan- anti-helminthic
Tsaang-Gubat- diarrhea
Akapulko- fungal infection RA 8423: utilization of
medicinal plants as
alternative for high cost
8/28/2021
medications 40
It runs through all the elements of primary
health care.
 Primary health care and community health
nursing

v Primary health care emphasizes the development of universally

acceptable, affordable and accessible essential health services that
are community-based and emphasizes health promotion and
maintenance, self reliance and community participation in decision
making about health.
v There is a link between community health nursing and primary
health care. Both incorporate community based practice,
involvement of the community in health care decisions, a focus on
disease prevention and health promotion and use of an
interdisciplinary approach in planning and implementing appropriate
solutions to health problems.
v To implement the primary health care concept, nurses must focus on
the prevention of disease and the promotion of health, as well as on
care of the actually ill and those in need of rehabilitation.
v Assessing the health status of individuals and
communities.
vMobilising community involvement.
vProviding integrated health care including the
treatment of emergencies, and making referrals.
vMaintaining epidemiological surveillance.

vMonitoring progress in primary health care.