PRIMARY HEALTH CARE
ESSENTIAL HEALTH SERVICES
• The Declaration of Alma-Ata was
adopted at the International Conference on
Primary Health Care, Almaty (formerly
Alma-Ata), presently in Kazakhstan,
September 6-12, 1978.
• It expressed the need for urgent action by
all governments, all health and
development workers, and the world
community to protect and promote the
health of all the people of the world.
• It was the first international declaration
underlining the importance of primary
health care.
The primary health care approach since then are
accepted by member countries of WHO as the
key to achieving the goal of "Health for All"
PHC
• made universally accessible to individuals
and families in the community through their
full participation and at a cost that the
community and the country can afford to
maintain at every stage of their
development in the spirit of self-
determination"
Letter Of Instruction 949
In the Philippines, primary health care was
implemented, which was signed by former
President Marcos on October 19, 1979.
MISSION
• To strengthen the health care system by
increasing opportunities and supporting
the conditions wherein people will
manage their own health care
GOAL
• Health for All
• SELF-RELIANCE
• ability to stand on their own self-
sufficiency
• In accordance with the goal
of the Department of Health
which is,
• Framework
• People’s empowerment and
partnership is the key strategy to
achieve the goal “Health for all
Filipinos and Health in the hands of
the people by the year 2020”.
GENERAL PRINCIPLES AND STRATEGIES
• HEALTH AND DEVELOPMENT ARE
INTERRELATED
• ESSENTIAL HEALTH SERVICES MUST
BE ACCESSIBLE, AVAILABLE,
ACCEPTABLE AND AFFORDABLE.
• GENUINE PEOPLE’S PARTICIPATION
IS ESSENTIAL – Community Participation
• SELF-RELIANCE
• SOCIAL MOBILIZATION
• DECENTRALIZATION
• PROVISION OF QUALITY, BASIC AND
HEALTH AND DEVELOPMENT ARE
INTERRELATED
• Convergence (meeting) of health,
food, nutrition, water, sanitation,
and population services.
• Integration of PHC into national,
regional, provincial, municipal and
barangay development plans.
• Convergence (meeting) of health, food,
nutrition, water, sanitation, and
population services.
• Integration of PHC into national, regional,
provincial, municipal and barangay
development plans.
ESSENTIAL HEALTH SERVICES MUST BE
ACCESSIBLE, AVAILABLE
• Health services delivered where the
people are
• Use of indigenous volunteer health
worker as a health provider with a
ratio of one community health
worker per 10-20 households
• Use of traditional medicines with
essential drugs
GENUINE PEOPLE’S PARTICIPATION IS
ESSENTIAL
• Awareness building and consciousness
rising on health- related issues.
• Planning, implementations, monitoring
and evaluation done through small group
meeting (10-20 household cluster)
• Selection of community health workers
by the community.
• Formation of health committees.
• Establishment of community health
organization at the parish or municipal
level.
• Mass health campaigns and mobilization
to combat health problems
SELF-RELIANCE
• Use of local resources
• Training of community in leadership and
management skills
• Incorporation of income generating
projects, cooperatives and small scale
industries.
SOCIAL MOBILIZATION
• Establishment of an effective health
referral system
• Multi-sectoral and interdisciplinary
linkage
• Information, education, communication
support using multi-media
 • Collaboration between government Intersectional Linkages
and non-government organizations

DECENTRALIZATION Primary Health Care forms an integral part of the

• Devolution (RA 7160)
• Transfer of power from the national
government to local government
unit
• Reallocation of budgetary
resources
• Reorientation of health
professionals on Primary Health
Care
health system and the over all social and
economic development of the community. As
such, it is necessary to unify health efforts within
the health organization it self and with other
sectors concerned. It implies the integration of
health plans with the plan for the total community
development.
• Sectors most closely related to
health includes those concerned
with:

• Advocacy for political will and • Agricultural

support from the national leadership • Education
down to the barangay level.
• Public works
PROVISION OF QUALITY, BASIC AND • Local government
ESSENTIAL HEALTH SERVICES • Social welfare
• Population control
• Training design and curriculum based on
• Private sectors
community needs and priorities
• Attitude, knowledge and skills developed
are on promotive, preventive, curative Intersectoral Linkage
and rehabilitative health care
• In the health sector, the acceptance or
• Regular monitoring and periodic primary health care necessitates the
evaluation of community health worker restructuring of the health system to
performance by the community and broaden health coverage and make health
health staff. service available to all. There is now
widely accepted pyramidal organization
MAJOR ELEMENTS that provides level of services starting with
primary health and progressing to
specialty care. Primary care is the hub of
. Use of Appropriate Technology the health system.
• This emphasizes equity and justice, that
health is a basic right of every individual
and not just to those who can afford to
pay their own health care
• Criteria in determining use of appropriate
technology
• Effectiveness and safety
• Complexity – simple and easy to apply
• Cost
• Scope of technology – effective,
appropriate
• Acceptability
• Feasibility – compatible with the local
setting

Multi-Sectoral Approach to Health

 • 3. Tertiary Level of health Care • Organizing community health action
Facilities • Mobilizing local resources
• These are highly technological and • Providing essential health services
sophisticated services offered by
medical centers and large hospitals. • Evaluating the results of health
These are specialized national actions
hospital.
• Health services offered: for clients
afflicted with diseases which
seriously threaten their health and
which requires highly technical and
specialized knowledge, facilities
and personnel to treat effectively.

PRIMARY HEALTH WORKER

• Village/Grassroots
• Train community health workers,
health auxiliary volunteers, TBA
• 1st contact of the community (initial
link)
• Work in liaison with local health
service worker
• Provide elementary, curative
preventive health care measures
• Intermediate level
• General Medical Practitioners, PHN,
Midwifes
• 1st source of professional health
care
• Attend to health problems beyond
the competencies of the village
workers
• Provides support to the front line
health workers in term of
supervision, training, referral
services and supplies through
linkages with other sectors
• Health Personnel of first line hospitals
• Physicians with specialty area, nurses and
dentists
• Establish close contact with the
village and intermediate level health
workers to promote the continuity of
care from hospital to community to
home.
• Provide back-up health services for
cases requiring hospital or
diagnostic facilities not available in
health care
3. Community participation
• Defining their health and health
related needs and problems
• Identifying realistic solution
UHC
The recently passed Universal Health Care
(UHC) Law in the Philippines puts PHC center
stage through reforms aimed to improve health
system performance. While the vision is
laudable, making it happen is challenging. This
article offers early learnings from the
implementation of the UHC Law drawn from
Think Well Philippines’ program of technical
assistance and policy research to support the
Department of Health (DOH) and the Philippine
Health Insurance Corporation (PhilHealth)¹. We
identified key opportunities and challenges
created by the UHC Law against the three main
pillars of strengthening PHC [1]. The UHC vision
will have to be progressively realized through
paradigm shifts, communication interventions,
and a clear and strategic roll out plan.
Philippine Health Sector Reform: The UHC
Law
Health sector reform in the Philippines has been
accelerated by the passage of Republic Act
11223, more commonly known as the UHC Law
. This landmark piece of legislation seeks to
revitalize health care through a whole-of-system,
whole-of-government, whole-of-society, people-
centered approach. It recognizes that health
systems are naturally complex, dynamic, and
adaptive. The legislation acknowledges that
improving health system performance requires
sustainable, wholesale changes. The pillars of
PHC underpin the entire UHC reform.