PRIMARY HEALTH CARE

(PHC)
 PRIMARY CARE
- includes health promotion, disease prevention, health
maintenance, counseling, patient education and diagnosis
and treatment of acute and chronic illness in different health
settings (American Association of Family Medicine)
 refers to the first contact of a person with a professional
 a model of nursing care that emphasizes continuity of care
 nursing care is directed towards meeting all the patient’s
need.

CONCEPTS OF PRIMARY CARE

  PHC PC
Focus of client family and community individual
Focus of care promotive and preventive curative
Decision-making community-centered health worker driven
process
Outcome self-reliance reliance on health workers
Setting for services rural-based satellite clinics; mostly urban places;
community health centers hospital, clinics
Goal development and absence of disease
preventive care
PRIMARY HEALTH CARE (PHC)
WHO 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.
 1. PHC as a goal.

2. PHC as a strategy.

3. PHC as a philosophy.

THREE DIMENSIONS OF PHC

 SEPTEMBER 6-12, 1978 - first International Conference for
PHC at Alma Ata, USSr, Russia
L.O.I. 949 - legal basis for PHC in the Philippines
- signed by Pres. Ferdinand Marcos
- THEME : Health in the Hands of the People by 2020
Definition - the essential care made universally accessible to
individuals and families in the community through their full
preparation.
Universal Goal - Health For All by the Year 2000
- this is achieved through community and individual
self-reliance
BRIEF HISTORY AND LEGAL BASIS
Key Strategy to Achieve the
Goal:

Partnership with and

Empowerment of the people
 Objectives of Primary Health Care
• Improvement in the level of health care of the community
• Favorable population growth structure
• Reduction in the prevalence of preventable, communicable and other
disease.
• Reduction in morbidity and mortality rates especially among infants and
children.
• Extension of essential health services with priority given to the
underserved sectors.
• Improvement in Basic Sanitation
• Development of the capability of the community aimed at self- reliance.
• Maximizing the contribution of the other sectors for the social and
economic development of the community.

OBJECTIVES OF PHC
The concept of 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 the
government can afford.

PRIMARY HEALTH CARE

A strategy, which focuses responsibility for health on the
individual, his family and the community. It 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. It
also recognizes the interrelationship between health and
the overall political, socio-cultural and economic
development of society.

PRIMARY HEALTH CARE

 The recent PHC Summit held on February 23-24,
2006 has showcased the various
community managed health activities that has
successfully placed health in the
hands of the people in this country.

PRIMARY HEALTH CARE

MISSION

• To strengthen the health care system by

increasing opportunities and supporting
the conditions wherein people will
manage their own health care.
 Rationale for Adopting Primary Health Care

• Magnitude of Health Problems

• Inadequate and unequal distribution of health
resources
• Increasing cost of medical care
• Isolation of health care activities from other
development activities

PRIMARY HEALTH CARE

Two Levels of Primary Health Care
Workers

• Barangay Health Workers 

• Intermediate level health workers

PRIMARY HEALTH CARE

KEY PRINCIPLES
1. 5 A’s :
A.Accessibility - distance/travel time required to get to a health care
facility/services. The home must be w/in 30 min. from the Brgy. health
stations

B.Affordability - consideration of the individual, family, community and

government can afford the services
-the out-of-pocket expense determines the affordability of
health care.
-in the the Philippines, government insurance is covered
through PhilHealth
 C. Acceptability - health care services are compatible with the
culture and traditions of the population.

D. Availability - is a question whether the health service are offered

in health care facilities or is provided on a regular and organized
manner.

E. Appropriate –connotes the use of technology based on

expressed needs of people that are not scientifically address
their needs employing local/indigenous resources that can be
sustained over time.
.
KEY PRINCIPLES
 2. Community participation - a
process in which people identify the
problems and needs and assumes
responsibilities themselves to plan,
manage, and control.

KEY PRINCIPLES
 3. People are the center, object and subject of
development.

Thus, the success of any undertaking that aims at

serving the people is dependent on people’s
participation at all levels of decision-making; planning,
implementing, monitoring and evaluating. Any
undertaking must also be based on the people’s needs
and problems (PCF, 1990)

KEY PRINCIPLES
 Barriers of Community Involvement

• Lack of motivation
• Attitude
• Resistance to change
• Dependence on the part of community
people
• Lack of managerial skills

KEY PRINCIPLES
 4. Self-reliance

Through community participation and

cohesiveness of people’s organization they
can generate support for health care through
social mobilization, networking and
mobilization of local resources. 

KEY PRINCIPLES
 5. Partnership between the community
and the health agencies in the provision
of quality of life.

Providing linkages between the government

and the nongovernment organization and
people’s organization.

KEY PRINCIPLES
 6. Recognition of interrelationship between the
health and development
Health- Is not merely the absence of disease. Neither is it only a state of
physical and mental well-being. Health being a social phenomenon
recognizes the interplay of political, socio-cultural and economic factors as
its determinant. Good Health therefore, is manifested by the progressive
improvements in the living conditions and quality of life enjoyed by the
community residents (PCF,
Development- is the quest for an improved quality of life for all.
Development is multidimensional. It has political, social, cultural,
institutional and environmental dimensions (Gonzales 1994). Therefore, it is
measured by the ability of people to satisfy their basic needs.

KEY PRINCIPLES
 7. Social Mobilization
It enhances people participation or governance, support
system provided by the Government, networking and
developing secondary leaders.

8. Decentralization
This ensures empowerment and that empowerment can
only be facilitated if the administrative structure provides
local level political structures with more substantive
responsibilities for development initiators.

KEY PRINCIPLES
8 Essential Elements of Primary Health Care
E - Education for health
L - Locally endemic disease control
E - Expanded program for immunization
M - Maternal and child health including
responsible parenthood
E - Essential drugs
N - Nutrition
T - Treatment of communicable and
noncommunicable diseases
S - Safe water and sanitation
 1. Education for Health
 
This is one of the potent methodologies for
information dissemination. It promotes the
partnership of both the family members and
health workers in the promotion of health as
well as prevention of illness.
Elements of Primary Health Care
2. Locally Endemic Disease Control
The control of endemic disease focuses on the prevention of its
occurrence to reduce morbidity rate. Example Malaria control and
Schistosomiasis control.

3. Expanded Program on Immunization

This program exists to control the occurrence of preventable
illnesses especially of children below 6 years old. Immunizations on
poliomyelitis, measles, tetanus, diphtheria and other preventable
disease are given for free by the government and ongoing program
of the DOH

Elements of Primary Health Care

4. Maternal and Child Health and FP
The mother and child are the most delicate members of the
community. So the protection of the mother and child to illness
and other risks would ensure good health for the community.

5. Environmental Sanitation and Promotion of Safe Water

Supply
Environmental Sanitation is defined as the study of all factors in
the man’s environment, which exercise or may exercise
deleterious effect on his well-being and survival.

Elements of Primary Health Care

6. Nutrition and Promotion of Adequate Food Supply
One basic need of the family is food. And if food is properly
prepared then one may be assured healthy family.

7. Treatment of Communicable Diseases and Common

Illness
The diseases spread through direct contact pose a great risk
to those who can be infected. 

Elements of Primary Health Care

8. Supply of Essential Drugs

This focuses on the information campaign on the utilization

and acquisition of drugs. In response to this campaign, the
GENERIC ACT of the Philippines is enacted. It includes the
following drugs: Cotrimoxazole, Paracetamol, Amoxycillin,
Oresol, Nefidipine, Rifampicin, INH (isoniazid)
and Pyrazinamide, Ethambutol, Qunine, Streptomycin,
Albendazole

Elements of Primary Health Care

Major Strategies of Primary Health Care
1. Elevating Health to a Comprehensive and
Sustained National Effort.
Attaining Health for all Filipino will require expanding
participation in health and health related programs whether as
service provider or beneficiary. Empowerment to parents,
families and communities to make decisions of their health is
really the desired outcome.
 2. Promoting and Supporting Community
Managed Health Care

The health in the hands of the people brings the

government closest to the people. It necessitates a
process of capacity building of communities and
organization to plan, implement and evaluate health
programs at their levels.

STRATEGIES OF PHC
3. Increasing Efficiencies in the Health Sector

Using appropriate technology will make services and

resources required for their delivery, effective,
affordable, accessible and culturally acceptable. The
development of human resources must correspond
to the actual needs of the nation and the policies it
upholds such as PHC.

STRATEGIES OF PHC
4. Advancing Essential National Health Research

Essential National Health Research (ENHR) is an

integrated strategy for organizing and managing
research using intersectoral, multi-disciplinary and
scientific approach to health programming and
delivery.

STRATEGIES OF PHC
1. Active community participation
2. Intra and inter-sectoral linkages
3. Use of appropriate technology
4. Support mechanism made available

Four cornerstones/pillars in PHC

1. Knowledge and Capacity Building
2. Human Resources for Health
3. Financing
4. Technology

Determinants of success for PHC

Types of PHC workers that vary in different
communities depending upon:
 Available health manpower resources
 Local health needs and problems
 Political and financial feasibility
1. Village or Barangay Health Workers
2. Intermediate level health workers

2 Levels of PHC workers:

UNIVERSAL HEALTH CARE
(UHC)
UNIVERSAL HEALTH CARE (UHC), ALSO
REFERRED TO AS KALUSUGAN
PANGKALAHATAN (KP)
is the “provision to every Filipino of the highest
possible quality of health care that is accessible,
efficient, equitably distributed, adequately funded,
fairly financed, and appropriately used by an
informed and empowered public”
VISION: Filipinos are among the healthiest people
in Southeast Asia by 2022, and Asia by 2040.

MISSION: To lead the country in the development

of a productive, resilient, equitable, and people-
centered health system.

VISION AND MISSION OF DOH

1) Better Health Outcomes.

2) A more responsive health system.

3) A more equitable healthcare financing.

3 STRATEGIC GOALS OF UHC

 1. FINANCING

2. SERVICE DELIVERY

3. REGULATION

4. GOVERNANCE

UHC’S FOUR PILLARS

 The Aquino administration puts it as the availability
and accessibility of health services and necessities for all
Filipinos.

It is a government mandate aiming to ensure that

every Filipino shall receive affordable and quality
health benefits. This involves providing adequate
resources – health human resources, health facilities, and
health financing.
UNIVERSAL HEALTH CARE (UHC), ALSO REFERRED TO AS KALUSUGAN
PANGKALAHATAN (KP)
February 2019 – ratification of republic Act 11223 “An Act
Instituting Universal Health Care for All Filipinos,
Prescribing Reforms in the Health Care System, and
Appropriating Funds Therefor
 “To provide all Filipinos access to
comprehensive and cost-effective health
care that covers all spectrums of
services.” These includes promotive,
preventive, curative, rehabilitative and
palliative care.

OBJECTIVES OF UHC
1) Financial risk protection through expansion in
enrollment and benefit delivery of the
National Health Insurance Program (NHIP);
2) Improved access to quality hospitals and
health care facilities; and
3) Attainment of health-related Millennium
Development Goals (MDGs).

UHC’S THREE STRATEGIC THRUSTS

FINANCIAL RISK PROTECTION
Protection from the financial impacts of health
care is attained by making any Filipino eligible
to enroll, to know their entitlements and
responsibilities, to avail of health services, and
to be reimbursed by PhilHealth with regard to
health care expenditures.

UHC’S THREE STRATEGIC THRUSTS

IMPROVED ACCESS TO QUALITY
HOSPITALS AND HEALTH CARE
FACILITIES
Improved access to quality hospitals and
health facilities shall be achieved in a
number of creative approaches.

UHC’S THREE STRATEGIC THRUSTS

ATTAINMENT OF HEALTH-RELATED MDGS
Further efforts and additional resources are to be applied on public health
programs to reduce maternal and child mortality, morbidity and mortality from
Tuberculosis and Malaria, and incidence of HIV/AIDS.
The organization of Community Health Teams (CHTs) in each priority population
area is one way to achieve health-related MDGs.
Provision of necessary services using the life cycle approach. (family planning,
ante-natal care, delivery in health facilities, newborn care, and the Garantisadong
Pambata package)
Better coordination among government agencies, such as DOH. DepEd, DSWD,
and DILG, would also be essential for the achievement of these MDGs.

UHC’S THREE STRATEGIC THRUSTS