Primary

Health Care
Mr. John Michael M. Pitoy, B.S.N., R.N.
PART I:
Introduction
HEALTH is a complete state of
physical, mental, and social well being,
not merely the absence of disease or
infirmity. (W.H.O.)
DETERMINANTS OF HEALTH

1. Income and Social Status
2. Education
3. Physical Environment
4. Employment and Working Conditions
5. Social support network
6. Culture
7. Genetics
8. Personal behavior and coping skills
9. Health services
10. Gender



PRIMARY HEALTH CARE






> W.H.O. defines PHC as essential health care made
universally accessible to individuals and families in the
community by means acceptable to them through their full
participation and at a cost that the community and country
can afford at every stage of development.






It was declared during the First International Conference
on Primary Health Care held in Alma Ata, Russia on
September 6-12, 1978 by W.H.O.

GOAL: Health for All by the year 2000. This was adopted
by the Philippines through L.O.I. 949 signed by President
Marcos on October 19, 1979.

THEME: Health in the Hands of the People by 2020.






ELEMENTS/COMPONENTS OF PRIMARY
HEALTH CARE





Environmental Sanitation (Adequate Supply of
Safe Water and Good Waste Disposal)
Control of Communicable Diseases
Immunization
Health Education
Maternal and Child Health and Family Planning
Adequate Food and Proper Nutrition
Provision of Medical care and Emergency
Treatment
Treatment of Locally Endemic Diseases
Provision of Essential Drugs





FOUR CORNERSTONES/PILLARS OF
PRIMARY HEALTH CARE



Active Community Participation

Intra and Inter-sectoral Linkages

Use of Appropriate Technology

Support Mechanism made Available.




TYPES OF PRIMARY HEALTH CARE
WORKERS



Three Levels

1. Village or Barangay Health Workers or
Grassroot (V/BHWs)

> Refers to trained community health workers or
health auxillary volunteer or a traditional birth attendant
or healer.
2. Intermediate Level Health Workers

> General medical practitioners or the assistants.
Public Health Nurse, Rural sanitary Inspectors and
midwives may compose these groups.


3. First Line Personnel

> The specialists (Oncologist,
Cardiologist, Nephrologist and
others)





Concepts on PRIMARY HEALTH CARE

o PHC is characterized by partnership and empowerment of
the people that shall permeate as the core strategy in the
effective provision of essential health services that are
community based, accessible, acceptable, and sustainable
at a cost which the community and government can afford;

o A strategy which focuses responsibility for health on
individual, his family and the community;

o Includes the full participation and active involvement of the
community towards the development of self-reliant people,
capable of achieving an acceptable level of health and well-
being.


FOCUS OF PRIMARY HEALTH CARE





Health Education;
Local Endemic Diseases;
Expanded program on immunization;
Maternal and child health services-Integrated Comprehensive;
Essential Drugs and Herbal plants;
Nutritional Health Services (PD 491): Creation of nutrition council of
the Philippines;
Treatment of Communicable and Non communicable Diseases;
Sanitation of the environment (PD 856): Sanitary Code of the
Philippines;






5 As of HEALTH CARE according to
PRIMARY HEALTH CARE





Accessibility;
Attainability;
Affordability;
Acceptability; and
Adequacy.







LEVELS OF HEALTH CARE
REFERRAL SYSTEM



National Health Services,
Medical Centers. Teaching
and Training Hospitals
Regional Health Services,
Regional Medical Centers
and Training Hospitals
Provincial/ City Health
Services Provincial/ City
Hospitals
Emergency/District
Hospital
Rural Health Unit
Community Hospitals and health
centers, Private Practitioners,
Puericulture Centers
Barangay Health
Stations
MILLENIUM DEVELOPMENT
GOALS (E.A.P.R.I.C.E.D.)

1. Eradicate extreme poverty and hunger
2. Achieve universal primary education
3. Promote gender equality and empower women
4. Reduce child mortality
5. Improve maternal health
6. Combat HIV/AIDS, malaria and other diseases
7. Ensure environmental sustainability
8. Develop a global partnership for development
NON HEALTH
RELATED
UNANG YAKAP
PUBLIC HEALTH defined as the science and art of
preventing disease, prolonging life, promoting health and
efficiency through organized community effort for the
sanitation of the environment, control of communicable
diseases, the education of individuals in personal
hygiene, the organization of medical and nursing
services for the early diagnosis and preventive treatment
of disease, and the development of the social machinery
to ensure everyone a standard of living adequate for the
maintenance of health, so organizing these benefits as to
enable every citizen to realize his birthright of health and
longevity. (Dr. C.E. Winslow)
PUBLIC HEALTH- art of applying science in the
context of politics so as to reduce inequalities
in health while ensuring the best health for the
greatest number. (W.H.O.)



CORE BUSINESS OF PUBLIC
HEALTH (D.I.H.H.P.)

1. Disease control
2. Injury prevention
3. Health protection
4. Healthy public policy including those
in relation to environmental hazards
such as in workplace, housing, food,
water and etc.
5. Promotion of health and equitable
health gain





ESSENTIAL PUBLIC HEALTH
FUNCTIONS

1. Health situation monitoring and analysis.
2. Epidemiological surveillance/disease prevention and
control.
3. Development of policies and planning in public health.
4. Strategic management of health systems and services for
population health gain.
5. Regulation and enforcement to protect public health.
6. Human resources development and planning in public
health.
7. Health promotion, social participation and empowerment.
8. Ensuring the quality of personal and population based
health services.
9. Research, development and implementation of innovative
public health solutions.






PUBLIC ELEMENTS

People
Government
Environment



TARGET POPULATION

Individual
Family
Community


PART II:
Philippine Health
Care Delivery
System



TWO SYSTEMS






PUBLIC SECTOR


Financed through a tax-
based budgeting system at
both national and local
levels.

Health care is generally
given for free at the point of
service.










PRIVATE SECTOR


Market-oriented

Profit and/or Non-profit
providers

Health care is paid through
user fees at point of service.










PHILIPPINE DEPARTMENT OF HEALTH







Three specific roles (L.E.A.):

1. Leadership in Health.

> Served as national policy and regulatory institution from
which the local government units, non-government organizations
and other members of the health sector involved in social
welfare and development will anchor their thrusts and directions
for health.

> Provide leadership in the formulation, monitoring and
evaluation of national health policies, plans and programs.

> Serve as advocate in the adoption of health policies, plans
and programs to address national and sectoral concerns.










2. Enabler and Capacity Builder.


> Innovate new strategies in health to improve the
effectiveness of health programs, initiate public discussion on
health issues and undertaking and disseminate policy research
outputs to ensure informed public participation in policy
decision making.

> Exercise oversight functions and monitoring and evaluation
of national health plans, programs and policies.

> Ensure the highest achievable standards of quality health
care, health promotion and health protection.










3. Administrator of Specific Services.


> Manage selected national health facilities and hospitals
with modern and advanced facilities that shall serve as national
referral centers and, selected health facilities at sub-national
levels that are referral centers for local health systems.

> Administer direct services for emergent health concerns
that require new complicated technologies that it deems
necessary for public welfare; administer special components of
specific programs like tuberculosis, schistosomiasis, HHIV-
AIDS, in as much as it will benefit and affect large segments of
the population.

> Administer health emergency response services, including
referral and networking system for trauma, injuries and
catastrophic events, in cases of epidemic and other widespread
public danger, upon the direction of the President and in
consultation with concerned LGU.





The Philippine
Department of
Health


Department of Health is the principal
health agency in the Philippines;

It is responsible for ensuring access to
basic public health services to ALL
Filipinos through the provision of quality
health care and regulation of providers
of health goods and services;




The DOH is both a stakeholder in the
health sector and a policy and
regulatory body for health;

As a major player, DOH is a technical
resource, a catalyzer for health policy
and a political sponsor and advocate for
health issues in behalf of the health
sector;

The DOH shall provide assistance to local
government units (LGUs), Peoples
organization and other members of civic
society in effectively implementing programs,
projects and services that will:
1. Promote the Health and well-being of
every Filipino;
2. Prevent and Control diseases among
populations at risks;




3. Protect individuals, families and
communities exposed to hazards and risks
that could affect their health; and

4. Treat, manage and rehabilitate
individuals affected by disease and
disability.




ROLE: To fulfill its responsibilities under this mandate, the
DOH shall serve as the:

1. Lead agency in articulating national objectives for
health to guide the development of local health
systems, programs and services;

2. Direct service provider for specific programs that
affect large segments of the population, such as
tuberculosis, malaria, schistosomiasis, HIV-AIDS,
and other emerging infections, and micronutrinte
deficiencies;


3. Lead agency in health emergency response
services, including referral and networking
systems for trauma, injuries and catastrophic
events;
4. Technical authority in disease control and
prevention;
5. Lead agency in ensuring equity, access and
quality of health care services through policy
formulation, standards development and
regulations;


6. Technical oversight agency in charge of
monitoring and evaluating the implementation
of health programs, projects, research, training
and services;

7. Administrator of selected health facilities at
sub-national levels that act as a referral centers
for local health systems: tertiary and special
hospitals, reference laboratories, training
centers, centers for health promotion, centers
for disease control and prevention, regulatory
offices among others;


8. Innovator of new strategies for responding to emerging
health needs;

9.Advocate for health promotion and healthy life styles for the
general population;

10. capacity-builder of local government units, private sector,
non-government organizations, peoples organizations,
national government agencies, in implementing health
programs and services through technical collaborations,
logistical support, provision of grant and allocations and other
partnership mechanisms;
11. Lead agency in health and medical
research;

12. Facilitator of the development of health
industrial complex in partnership with the
private sector to ensure self-sufficiency in the
production of biologicals, vaccines and drugs
and medicines;

13. Lead agency in health emergency
preparedness and response;
14. Protector of standards of excellence in
the training and education of health care
providers at all levels of the health care
system;

15. Implementor of the National Health
Insurance Law; providing administrative
and technical leadership on health care
financing.










DEPARTMENT OF HEALTH
VISION






A global leader for attaining better health
outcomes, competitive and responsive health
care system, and equitable health financing
(2030)


The DOH is the leader, staunch, advocate and
model in promoting health for all in the
Philippines.






DEPARTMENT OF HEALTH
MISION





To guarantee equitable, sustainable and
quality health for all Filipinos especially the
poor, and to lead the quest for excellence in
health.





BASIC HEALTH SERVICES UNDER
D.O.H.





Health Education;
Local Endemic Diseases;
Expanded program on immunization;
Maternal and child health services-Integrated Comprehensive;
Essential Drugs and Herbal plants;
Nutritional Health Services (PD 491): Creation of nutrition council of
the Philippines;
Treatment of Communicable and Non communicable Diseases;
Sanitation of the environment (PD 856): Sanitary Code of the
Philippines;






FOCUS OF HEALTH SERVICES
UNDER D.O.H.





Drug Abuse Control program
Oral Health Services/Dental
Hospitals are centers for wellness not for
illness





SENTRONG SIGLA MOVEMENT



Was established by DOH with LGUs having a logo
of a sun with 8 rays and is composed of four
pillars:

1. Health Promotion
2. Granted Facilities
3. Technical Assistance
4. Awards: cash, plaque, and certificate