CHAPTER 9- PRIMARY HEALTH CARE
Primary Health Care- brining health to people
 Health is in the hands of people
 Self-reliance is the major goal
Primary Care- interventions to cure specific
disease at the level of community
 First level healthcare delivery
 “Preventive medicine”
 Health is through nurse, midwife, MD
Dimension of PHC
philosophy: guides
practitioner to stimulate
community to be
responsible in their own
health
Strategy: collaboration of
all sectors to all
Goal: Access of healthcare
to all
Pillars of PHC:
 Active community participation
 Inter-and intra sectoral linkages
 Use of appropriate technology
 Support system made available
Healthcare system characteristics:
A- accessible
 30 minutes away or 5km from the
house
A- affordable
 Avail of technology of private & public
sector must be within the budget, to
maximize the budget and benefit
more people
A- available
 Available to all people
A- acceptable
 Within the lens of culture
 Culturally congruent care (Madeleine
Leininger)
A- appropriate
 Based on peoples needs, effective and
safe
DETERMINANTS OF SUCCESS OF PHC
1. Knowledge and capacity building
 Health education and activities so
people acquire knowledge and skills
to manage their own health
2. Human resources for health
 Deployment of health practitioners in
underserved areas
 Doctors to the barrios program
(DTTB) program
o assignment of doctors for 2
yrs.
 In no doctor place for
2yrs
 4th – 6th class place
 Nurse deployment program
o 6 months assignment in RHU
o And 6 months in hospital
service
 RH midwife program
 DOH pre-service scholarship program
o Full scholarship
o Return of service 2 yrs. per
year of scholarship
 1 RHU/RHU PHYSICIAN- 20,000
 1 PHN- 10, 000
 1 RM- 5,000
 BHS- 5,000
 BHW- PER 20 HOUSEHOLDS
 DENTIST- 50,000
Financing
 RA 10351- excise taxes for tobacco
and alcohol
  RA 10963- TRAIN LAW, increased tax COMPACK- complete treatment pack
for tobacco and alcohol and sugar
 Losartan
beverages
 Amlodipine
Technology  Metformin
 Simvastatin
 Application of skills in form of
medicines, vaccines, devices and Traditional and alternative health care
system
Western medicine- scientific drugs
Appropriate health technology
Eastern medicine- traditional
Methods, procedure, techniques that are
RA 8423- use of traditional and
 Scientifically valid complementary medicine (T and CM)
 Adapted to local needs
1. Acupressure- pressure points without
 Acceptable
puncturing
 Maintainable
2. Acupuncture- use of special needles
o NS1 dengue kit
3. Reflexology- pressure of body’s reflex
o Rapid tests
points
SASAE 4. Massage- rubbing, stroking
5. Aromatherapy- use of sense of smell
 Safe- no harm 6. Chiropractic- pain syndromes, pelvis,
 Acceptable- culturally congruent spine
 Sustainable- can be maintained, 7. Nutritional therapy
supplied to all 8. Pranic healing- balancing energy
 Affordable 9. Herbal medicine/phytomedicine- use
 Effective- achieves its intended of plant derivatives
benefit or purpose
decoction Boiling for 20 mins
ESSENTIAL DRUGS/MEDICINES poultice Application to the
site
 Provision of medicines to treat
infusion Soak in hot water
endemic cases or simple problems like
10-15 mins
fever, diarrhea, headache
tincture Mix in alcohol
1. life saving

2. can be used by all

RA 6675- Generics Act of 1998

 Ensure adequate supply and

distribution, use and acceptance of
drugs and medicines identified by
their generic names

EO 49- PHILIPINE NATIONAL DRUG

FORMULATORY

RA 7581- PRICE ACT

RA 9502- Cheaper medicine act

 Chapter 10 1. criteria for selection

Community engagement GIDA- geographically inaccessible

disadvantaged areas
 People participation
 Social movement that aims to  Population of 100 or more families
transform current realities affecting  Marginalized or in need
people’s health  Peace and order is safe
 People are willing
Forms of community engagement
2. ocular visit
CODE IS COPAR
3. initiating contact
Community Community
Organizing Development ENTRY AND INTEGRATION

entry

 Meeting with local leaders

Community Community  Agreement with them
based Empowerment  Commences when local leader
Participatory introduce the organizer to the people
Action
Research Integration

 For organizer to deeper understand

COMMUNITY ORGANIZING
the people
 Active community participation-  For people to know organizer
critical to achieve goals of PHC  Establishment of trust
 People should work together o home visits
 Outsider cannot take the perspective o community immersion- more
of those who actually experienced it ideal

Essence of community organizing SOCIAL INVESTIGATION

FACES  collection of information

o Surveys
 Focus of community organizing is self-
o Interviews
reliance
o Community diagnosis- process
 Aim of CO is community development
of analyzing interpreting data
 Concept of CO is teamwork
to identify needs and
 Element of CO is people participation
problems of people
 Strategies of CO is teaching, training,
and transfer of technology SOCIAL MOBILIZATION

3 broad phases of CO  Organizational phase

 Point where active participation
SOCIAL PREPARATION
occurs
 Partnership with people
IDENTIFYING POTENTIAL LEADERS
 Identifying needs and problems of
community 1. Resident
2. Good moral
SITE SELECTION
3. Willing to work
 4. Not holding leadership role Change agent- influence them in making
5. Influential and respected by people decision for their future

CORE GROUP FORMATION Enabler- education and training

 Executive committee or council COMMUNITY DEVELOPMENT

 Election of key roles
 Process- people participation in
ORGANIZATION BUILDING identifying solution to problems
 Outcome- enjoy health and QOL thru
steps
their own efforts
1. Community assembly
4 characteristics
2. Vision, mission, and goals
3. Formulation of plan of action a) Process for change
4. Sub-committee assignment b) Program of activities
 Everyone should attend c) An outcome
d) An ideology of action
Structure of CO
Tips for success CO
EXECUTIVE COMMITTEE
 Get to know them genuinely
 Respect them
HELLP  Value life and dignity
 Avoid judging them
 Health  Work with them
 Education  Help them gain self-reliance
 Livelihood  Open communication
 Liturgy  Be flexible and appreciate them
 Peace and order  Be consistent and honest
 Be fair
EVALUATION AND PHASE OUT
 Believe in goodness, show enthusiasm
Done when they become independent, self- in them
help, and leadership is achieved  Invest in people
 Manage expectations
1. Increased people participation
 Maintain professional relationship
2. Creation of multiple core groups
 Teamwork and collaborate with them
3. Functional org with well-defined
policies and activities

CAPACITY BUILDING

 Education and training activities

 Happens throughout the phase
o SWOT ANALYSIS
o SALT

Community organizer

FACE

Facilitator- bridge linkages and sectors

Advocate- voice of unheard