Primary Care

vs
Primary Health Care
MUNAR, NITURA, PASCUA, PAYUMO, PEREZ, POLURU,
QUIAMBAO
By definition:
Primary Health Care (PHC)
● Broader whole-of-society approach to health that
aims at ensuring the highest possible level of
health and well-being and their equitable
distribution by focusing on people’s needs
and as early as possible along the continuum
from health promotion and disease prevention to
treatment, rehabilitation and palliative care, and
as close as feasible to people’s everyday
environment
Primary Care
● Key process in a health system that provides
promotive, protective, preventive, curative,
rehabilitative, and palliative services throughout
the life course
● Model of care that supports first-contact,
accessible, continuous, comprehensive and
coordinated person-focused care
By aims/goals

Primary Health Care (PHC) Primary Care

● Ensures people receive quality

comprehensive care- ranging from ● Aims to optimize population health and
promotion and prevention to treatment, reduce disparities across the population
rehabilitation and palliative care- as close by ensuring that subgroups have equal
as feasible to people’s everyday access to services
environment
 Primary Health Care (PHC)
Three components
● Primary care and essential public health functions as
a core of integrated health services
● Multisectoral policy and action
● Empowered people and communities
Vision in the 21st century: Towards UHC and the SDGs.
Rooted in a commitment to social justice, equity, solidarity
and participation. Based on the recognition that the
enjoyment of the highest attainable standard of health is
one of the fundamental rights of every human being without
distinction
Primary Care
Five core functions
● First contact accessibility creates a strategic entry point
for and improves access to health services
● Continuity promotes the development of long-term
personal relationships between a person and a health
professional or a team of providers
● Comprehensiveness ensures that a diverse range of
promotive, protective, preventive, curative, rehabilitative,
and palliative services are provided
● Coordination organizes services and care across levels
of the health system and over time
● People-centered care ensures that people have the
education and support needed to make decisions and
participate in their own care
 Primary Health Care (PHC) Primary Care

● Focus of resources on health care services for ● Primary focus on treatment

Essentiality
the majority/ preventive health care and restoration

Community participation ● Client directed ● Provider directed

● Occurs among health care

● Includes collaboration among health,
Intersectoral collaboration professionals, members of
employment, education clients and other sectors
health care team

● Limited availability to
● Universal availability and eligibility to health care
Access medically oriented health care
services and resources
services

● Focus on individual being able

● Collective decision making and action;
Empowerment to obtain resources for
redistribution of power
self-care

WHO. (2021). Primary health care. Retrieved January 29, 2023 from https://www.who.int/news-room/fact-sheets/detail/primary-health-care?fbclid=IwAR1ESAMY
wIrdAz9SKR2d9Zw7VkDxVEdq07LsuY2runVuERwC6y1x0XUvJs

WHO. (2021). Primary care. Retrieved January 29, 2023 from

https://www.who.int/teams/integrated-health-services/clinical-services-and-systems/primary-care?fbclid=IwAR0YLePS1qfqij9iyC1jQD_8Scldo3Slmka93S1SyWY45IRluN
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 Models of
Primary
Health Care
MUNAR. NITURA, PASCUA, PAYUMO, PEREZ, POLURU,
QUIAMBAO
01 Hospital- or Clinic-based
PHC Model
● This is sometimes referred to as the "health TO the people" model, which is characteristically
authoritarian in nature.
● Health is regarded to be the sole responsibility of doctors, while community members are viewed
as mere recipients of health care.
● In the context of current Philippine culture, this model is best exemplified by free medical missions
(usually spearheaded by local politicians as short-term remedies for long-standing medical
problems), which perpetuate the dependence of "poor or needy communitv members on dole-outs
from the "rich and powerful." Hence, no significant change in the community is expected using this
PHC model.
.

Leopando, Z. E. (2014). Textbook of Family Medicine (1st ed., Vol. 1). C

and E Publishing, Inc.

 Community-oriented
02 PHC Model
● In this model, the guiding principle is "health FOR the people, which is typically paternalistic in nature.
Health is now viewed as the joint responsibility of doctors and other health professionals, but
community members are still regarded as mere potential beneficiaries of health care.
● In this model, community members are consulted on what may be done in the community, but the
final decision is still dependent on health professionals. This PHC model, which is described to be
deceptive at times, may result in behavioral change among the community members. Many health care
workers utilize this model during their initial visit to communities that they intend to develop.
Community diagnoses are conducted, wherein home visits and interviews of key community figures in
a specific locality are staged. People's opinions and points of view are taken into consideration, but
their participation ends with the initial interaction and consultation with the health care workers.

Leopando, Z. E. (2014). Textbook of Family Medicine (1st ed., Vol. 1). C and E Publishing, Inc.
 The following can be regarded as the five essential features of COPC:

1. The use of epidemiologic and clinical skills as complementary functions and should be of as
high a standard as possible.
2. Definition of the population for which the service is or feels responsible. This is the target and
denominator population for surveillance and care and for the measurement of health status
and needs and the evaluation of the service.
3. Defined programs that are based on epidemiologic findings to deal with the health problems of
the community or its subgroups, within the framework of primary care.
● May involve health promotion, primary or secondary prevention, curative, alleviative or
rehabilitative care, or any combinations of these activities.
4. Involvement of the community in the promotion of its health.
5. Accessibility that is not limited to geographic accessibility but that refers also to the absence of
fiscal, social, cultural, communication, or other barriers.

Institute of Medicine (US) Division of Health Care Services; Connor E, Mullan F, editors. Community Oriented Primary
Care: New Directions for Health Services Delivery. Washington (DC): National Academies Press (US); 1983. Community
Oriented Primary Care: Meaning and Scope. Available from: https://www.ncbi.nlm.nih.gov/books/NBK234632/
 Community- based PHC
03 model
● This model is described to be democratic, signifying "health WITH the people." Active discussion,
planning, and decision-making processes regarding community health issues are now shared by
the health professionals and community members, who are recognized as partners in health care.
● This supportive approach to PHC helps people find ways to gain more control over their lives,
which can eventually lead to social change.
● A "five-star" family physician, functioning as a social mobilizer, may organize community
assemblies or caucuses to discuss social issues in the area.
● Community members are not only consulted, but they have active participation in the
identification and prioritization of health problems. In the process, they join in looking for
possible solutions to their own community's problems

Leopando, Z. E. (2014). Textbook of Family Medicine (1st ed., Vol. 1). C and E Publishing, Inc.
 ● Community-based primary health care (CBPHC) covers the broad range of primary prevention (including
public health) and primary care services within the community including:
○ Health promotion and disease prevention
○ Diagnosis, treatment, and management of chronic and episodic illness;
○ Rehabilitation support
○ End of life care.
● CBPHC involves the coordination and provision of integrated care provided by a range of health providers.
● It is delivered in a way that is person- and population-centred and responsive to economic, social,
language, cultural and gender differences.
● These approaches do not necessarily address the downstream determinants of health, like food or
housing, but rather explicit health care and education.
● Important to population health strategies because it addresses some of the key barriers many high-risk
patients face:
○ Healthcare access is often cost-prohibitive for patients
○ Public health messaging may not be accessible for all patients
○ Physical healthcare facilities may not be accessible for patients
○ Trust in traditional healthcare institutions is often left wanting, especially among ethnic minority and
traditionally oppressed populations community-based health hinges on the input and expertise of
community members.

Community-Based Primary Health Care - CIHR. (2017, March 24). Canadian Institutes of Health Research. Retrieved February 1, 2023, from
https://cihr-irsc.gc.ca/e/43626.html

The Difference Between Community Health, Community-Based Health. (2020, June 16). PATIENT CARE ACCESS NEWS. Retrieved February 1, 2023, from
https://patientengagementhit.com/news/the-difference-between-community-health-community-based-health
 Community- managed
04 PHC model
● This is the highest and most liberating PHC model with the greatest level of people
participation, as it denotes "health BY the people."
● Health has now evolved to become the responsibility of every individual in the
community. Hence, people are regarded as managers of their own health programs and
activities. Because people are aware of their own potential, they tend to become
self-reliant, which can subsequently result in a structural change in the community.
● Thus, community members need not rely on professional health workers to address their
basic medical and health needs.
● Examination of the four models reveals that they need not be mutually exclusive of each
other because they represent a continuum. However, it is only in a community-managed
PHC model where "health in the hands of the people" is technically and fully achieved

Leopando, Z. E. (2014). Textbook of Family Medicine (1st ed., Vol. 1). C and E Publishing, Inc.
● CMHPs, a form of primary health care (PHC) that emphasizes community empowerment to
address underlying causes of disease, were developed in response to the need to build
“self-reliance” and “self-determination” in economically disadvantaged communities.
● Specifically, health programs are mainly run by health professionals with predetermined health
objectives.
● Decision making was reserved to health professionals, in consultation with communities, who were
treated as “beneficiaries.”
● Community-based health programs treat the community as “partners in health care,” and are
designed and managed together with health professionals.
● Decision making in this set-up is shared by the community and the professionals.
● CMHPs, touted as “health by the people” are ideally guided by objectives that have been
designed by the community, in recognition of its health and socioeconomic needs. In this set-up,
community members are the decision makers, and health professionals from outside the
community are merely consulted.

Lam, H. Y., Sia, I. C., Lopez, J. C. F., Caragay, R. N., Estacio, Jr., L. R., Co, E. E. A., Madamba, J.
S., Abola, R. I. B., Maybituin, C. M., & Velasco, D. C. (2018). Community-managed Health
Programs for Better Health outcomes: Preliminary results of a community Participatory research in
Murcia and Isabel, negros occidental, Philippines. Acta Medica Philippina, 52(2).
https://doi.org/10.47895/amp.v52i2.445
 Thank
You!
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Community Medicine
vs.
Public Health
MUNAR, NITURA, PASCUA, PAYUMO, PEREZ, POLURU,
QUIAMBAO
1. What is the difference between
Community and Public Health?
Community Medicine
● Primary focus on the health and populations and
communities
● Personal service ethic, conditioned by awareness of
social responsibilities
● Emphasis on diagnosis and treatment, care for the
whole patient
● Encompases the study of health issues and
determinants in populations
● Evaluation of their effectiveness in promoting and
maintaining health and wellness in communities
● Multidisciplinary approach and the collaboration
of healthcare provides,governments,and
communities to achieve its goals and objectives
● Also plays an important role in disaster management
in the event of natural disaster or public health
emergencies
Public Health
● Primary focus on population
● Public service ethic, tempered by concerns for the
individual
● Emphasis on prevention, health promotion for the
whole community
● Public health paradigm employs a spectrum of
interventions aimed at the environment, human
behavior and lifestyle, and medical care
● Multiple professional identities with diffuse public image
● Lines of specialization organized, for example, by
analytic method (epidemiology, toxicology); setting
and population (occupational health, international
health); substantive health problem (environmental
health, nutrition)
 1. What is the difference between
Community and Public Health?
Community Medicine Public Health
● One of the key components of community medicine
is epidemiology, which is the study of distribution ● Biologic sciences central, stimulated by major threats
and determinants of health and disease in to health of populations; move between laboratory
populations. and field
● Community medicine is critical in ensuring that health ● Numeric sciences an essential feature of analysis and
services are accessible, equitable and training
sustainable. ● Social sciences an integral part of public health
● Prevents disease in communities by addressing education
factors such as environmental conditions,lifestyle ● Engineering relevant, especially systems analysis,
habits , and access to health operations management, sanitary engineering, and
● Some other integral parts of community medicine information technology
includes social and behavioral sciences, health ● Clinical sciences peripheral to professional training
policy and management and clinical preventive
● Rooted mainly in the public sector
services.
Fineberg, H. V. (2011, October 1). Public Health and Medicine. American Journal of ● Variable certification of specialists beyond
Preventive Medicine.
https://www.ajpmonline.org/article/S0749-3797(11)00514-9/fulltext?fbclid=IwAR12fL1xMP
professional public health degree
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