Primary Health Care

September 6-12, 1978

- First international conference for PHC at Alma Ata, USSR, Russia- resulted to The Alma Ata
Declaration

The Alma Ata Declaration

• Health is a basic fundamental right

• There exists global burden of health inequalities among populations
• Economic and social development is of basic importance for the full attainment of health for all
• Governments have a responsibility for the health of their people
LOI No. 949 of 1979 (legal basis for PHC in the
Philippines)
Signed by Ferdinand Marcos
Theme: Health in the Hands of the People by 2020

Definition of PHC: the essential 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 cost that the community and country can afford to maintain every stage of
their development in the spirit of self-reliance and self-determination.
Universal Goal: Health For All by Year 2000 Three main objectives:
- promotion of health lifestyle
- prevention of diseases
- therapy for existing diseases

The WHO has identified five key elements to achieving the goal of “health for all :
1. Reducing exclusion and social disparities in health (universal coverage)
2. Organizing health services around people’s needs and expectations (health service
reforms)
3. Integrating health into all sectors (public policy reforms)
4. Pursuing collaborative models of policy dialogue (leadership reforms)
5. Increasing stakeholders participation
The Alma Ata Declaration listed 8 essential health services, using the acronym ELEMENTS-
- E
o Education for health
- L
o Locally endemic disease control
- E
o Expanded program for immunization
- M
o Maternal and Child Health including responsible parenthood
- E
- Essential drugs
- N
- Nutrition
- T
o Treatment of communicable and noncommunicable diseases
- S
o Safe water and sanitation

Key Principles of PHC

1. 4 A’s of PHC
- Accessibility: distance/travel time required to get to a healthcare facility ; the home must be
within 30 minutes from the barangay health station
- Affordability: consideration of the individual, family, community and government can afford the
services; the out-of-pocket expense determines the affordability of healthcare; government insurance is
covered through PhilHealth
- Acceptability: health services are compatible with the culture and traditions of the population
- Availability: is a question whether the health service are offered in healthcare facilities or is
provided on a regular and organized manner
Examples:
- Botika ng Bayan and the Botika ng Barangay
- ensures the availability and accessibility of affordable essential drugs. It sells low-priced generic
home remedies, OTC and common anitbiotics
- Ligtas sa Tigdas and Pinas
- mass door-to-door measles immunization campaign (target: 9 mos. to 8 years old)
 2. Support Mechanism

There are 3 major entities:

- people
- government
- private sectors
o (NGOs, Socio-civic and FaithGroups)

3. Multi-Sectoral Approach
- Intrasectoral (two-way referral system):
o communication, cooperation and collaboration within the health sectors
- Intersectoral linkages:
o between the health sector and other sectors like education, agriculture and local
government officials
4. Community Participation
- A process in which people identify the problems and needs and assumes responsibilities
themselves to plan, manage, control and assess the collective actions that are proved necessary.
- Health is achieved through self-reliance and selfdetermination, and that individuals, families and
communities are not considered as recipients of care but active participants in achieving their health
goals.

5. Equitable distribution of health resources

- Doctors and nurses flock in the urban areas
- To reverse this trend, DOH spearheaded two programs to ensure equitable distribution of
manpower to rural areas
a. Doctor to the Barrio (DTTB) Program - the deployment of doctors to
municipalities
- deployed to unserved, economically depressed 5th or 6th class municipalities for 2
years

b. Registered Nurses Health Enhancement and Local Service (RN HEALS)

- training and program for unemployed nurse
- deployed to unserved, economically depressed municipalities for 1 year
 6. Appropriate technology
Technology is applied science; appropriate technology means technology that is suitable to the
community using it
Health technology includes:
- Tools
- Drugs
- Methods
- Procedures and techniques
- People’s technology
Indigenous technology

Criteria for Appropriate Health Technology

 Safe (positive outcomes outweighs the negative unintended effects; ex. Pertussis vaccine
not for children more than 7 years old)
 Effectiveness (ex. Medicinal herbs approved by DOH)
 Affordability (cost-effective)
 Simplicity (readily available simple materials that requires simple process in its use)
 Acceptability (culture as important consideration)
 Feasibility and Reliability (must be easy to apply regardless of setting; ex. X-ray vs
sputum)
 Ecological Effects (phasing out of mercury in all Philippine Healthcare Facilities)
 Potential to contribute to individual and community development

Traditional and Alternative Health Care

TAMA- RA 8423 or Traditional and Alternative Medicine Act of 1997 by Secretary of Health Juan
Flavier.
- created the Philippine Institute of Traditional and Alternative Health Care: tasked to promote
and advocate the use of traditional and alternative health care modalities through scientific research and
product development.

Traditional Medicine
sum total of knowledge, skills and practice on healthcare not necessarily explicable in the context of
modern, scientific philosophical framework, but recognized by the people to help maintain and improve
their health toward the wholeness of their being, the community and society, and their interrelations
based on culture, history, heritage and consciousness.
Medicinal Plant Preparation:
a. Decoction- boiling the plant material in water for 20 mins.
b. Infusion- plant material is soaked in hot water for 10-15 mins.
c. Poultrice- directly apply plant material on the affected part, usually in bruises, wounds,
and rashes
d. Tincture- mix the plant material in alcohol
Reminders in the use of Herbal Medicine:
a. Decoction loose potency after some time. Dispose of decoctions after one day. To keep
fresh during the day, keep lukewarm in a flask or thermos
b. Leaves, fruits, flowers or nuts must be mature before harvesting. Less medicinal
substances are found in young parts
c. Stop giving the herbal medication in case untoward reaction such as allergy occurs
d. If signs and symptoms are not relieved after 2
or 3 doses of herbal medication, consult a doctor
e. Avoid the use of insecticides as they may leave poison on plants
f. In the preparation of herbal medicines, use a
clay pot and remove cover while boiling at low heat
g. Use only the part of the plant being
advocated
h. Use only one kind of herbal plant for each type of symptoms and sickness
i. Use only half the dosage prescribed for fresh
parts like leaves when using dried parts

Alternative Health Care Modalities practiced

1. Acupressure- application of pressure on acupuncture points without puncturing the skin
2. Acupuncture- special needles to puncture and stimulate specific anatomical points on the body
3. Aromatherapy- sense of smell whereby essential aromatic oils are combined and then applied to
the body in some forms of treatment
4. Chiropractic- concerned with the pathogenesis, diagnosis, therapy, and prophylaxis of functional
disturbances, pathomechanical states, pain syndromes, and neurophysiological effects related to the
static and dynamics of the locomotor system, especially of the spine and pelvis
5. Herbal medicine/ Phytomedicine- finished, labeled, medicinal products that contain as active
ingredients aerial or underground parts of the plant or other materials or combination thereof, either in
the crude state or as plant preparations
6. Massage- a method wherein the superficial soft parts of the body are rubbed, stroked, kneaded,
or tapped for remedial, aesthetic, hygienic, or limited therapeutic purposes
7. Nutritional Therapy/ Nutritional Healing- The use of food as medicine and to improve health by
enhancing the nutritional value of food components that reduces the risk of disease.
8. Pranic healing- principle of balancing energy
9. Reflexology- application of pressure on the body’s reflex points to enhance the body’s natural
healing mechanism and balance body functions
 Medicinal Plants Use/Indication Preparation
1. Lagundi Asthma, cough and colds, fever, dysentery, Decoction
pain
Wash affected site with
Skin diseases (scabies, ulcer, eczema), wounds decoction
2. Yerba Buena Headache, stomach ache Decoction
Cough and colds Infusion
Rheumatism, arthritis Massage sap
3. Sambong Anti-edema/ anti- urolithiasis Decoction
4. Tsaang Gubat Diarrhea Decoction
Stomach ache
5. Niyog-Niyogan Anti-helminthic Seeds are used
6. Bayabas Washing wounds Decoction
Diarrhea, gargle, toothache
7. Akapulko Anti-fungal Poultice
8. Ulasimang bato/ Pansit Lowers blood uric acid (rheumatism and gout) Decoction
pansitan
Eaten raw
9. Bawang Hypertension, lowers blood cholesterol Eaten raw/ fried
Toothache Apply on part
10. Ampalaya Diabetes mellitus (mild non-insulin Decoction
dependent)
Steamed