MODULE 1: INTRO TO HEALTH CARE How Did It Start?

SYSTEM
WHO-UNICEF held international conference in
Terminologies 1978 at Alma-Ata (USSR), the governments of
134 countries and many voluntary agencies
Health - According to WHO, a state of complete called for a revolutionary approach to health
care.
physical, mental, and social wellbeing and not
merely the absence of disease or infirmity The Alma-Ata Conference called for acceptance
of the WHO goal for Health for All (HFA) by the
Primary Health Care - About caring for people, year 2000 and proclaimed primary health care
rather than simply treating specific diseases or as a way in achieving Health for All
conditions.
- essential health care made universally The Alma-Ata Conference defined Primary
Health Care as follows:
acceptable to individuals and families in the
community Primary health care is a state of complete
- by means acceptable to them through active physical, mental, and social wellbeing and not
participation and at a cost that the community merely the absence of disease or infirmity and a
and the country can afford at every stage of fundamental human right and that the
development attainment of the highest possible level of health
is a most important worldwide social goal whose
realization requires the action of many other
According to WHO PHC is a whole-of-society
approach to effectively organize and strengthen social and economic sectors in addition to the
health sector.
national health systems to bring services for
health and wellbeing closer to communities.
Alma Ata Declaration main goal is Health For
Morbidity - Refers to having a disease or a All, Universal Health Coverage: Everyone,
Everywhere.
symptom of disease, or to the amount of
disease within a population
The Universal Health Care (UHC) Act (RA
Mortality - death rate, or the number of deaths 11223)
enacted in 2019 to provide all Filipinos with
in a certain group of people in a certain period
of time. access to quality health care. The act aims to
protect Filipinos from financial hardship and
World Health Organization - Primary roles are ensure equitable access to health services.
to direct international health within the UN’s
 Automatically enrolls all Filipino citizens
system and lead partners in global health
in the National Health Insurance
responses
Program
Department of Health - responsible  Establishes a framework for health
services, including primary care,
for ensuring access to basic public health
insurance, and pharmaceuticals
services to all Filipinos through the provision of
 Mandates health technology assessment
quality health care and regulation of providers of
(HTA) to help develop policies and
health goods and services.
programs
 Sets aside a portion of surplus revenues
for infrastructure development

Objectives of Primary Health Care

1. Improvement in the level of health care of - To apply the standards of accountability
the community in professional practice.

- To develop community satisfaction with - To establish, within available resources,

the primary health care system and to primary health care teams and networks.
provide reasonable and timely
10. Reduction in the prevalence of preventable,
2. Favorable population growth structure communicable, and other disease.

- To increase the programs and services - To support and encourage the

that affect the healthy growth and implementation of provincial public health
development of children and youth. policies and direction.

3. Reduction in the prevalence of preventable, - To support and advocate for healthy public
communicable, and other disease. policy within all sectors and levels of
government
- To support and encourage the
implementation of provincial public health 4 MAIN PILLARS OF PHC
policies and direction. - for reinforcement for the delivery of safe health
care
- To support and advocate for healthy
public policy within all sectors and levels of 1. EQUITABLE DISTRIBUTION
government.
- Health services must be shared equally
4. Reduction in morbidity and mortality rates by all people irrespective of their ability to
especially among infants and children. pay.

5. Extension of essential health services with To ensure equity:

priority given to the underserved sectors.  The population to be served must be known
 The vulnerable groups are to be identified &
6. Extension of essential health services with reached
priority given to the underserved sectors.  The health services have to be dispersed
into:
7. Improvement in Basic Sanitation  The farthest remote rural areas
 The deepest parts of the underserved urban
8. Development of the capability of the population
community aimed at self-reliance.
Lastly, the accessibility has to be improved by:
- To support the provision of  Increasing the number of health facilities
comprehensive, integrated, and evidence-  Improving transport conditions
based primary health care services.
 Organizing outreach services, thus
substituting one when the other is not
9. Maximizing the contribution of the other
available.
sectors for the social and economic
development of the community.
2. COMMUNITY PARTICIPATION
- To boost participation of the community
with government and community and
- A process in which community people are
community sectors to improve the health of
engaged and participated in making
their community.
decisions about their own health
  Accessibility
- Involves participation of the community  Accountability
people from identifying the health needs of  Assessability
the community, planning, organizing,  Availability
decision-making and implementation of  Affordability
health programs  Adequacy
 Appropriateness of health services
3. INTERSECTORAL COORDINATION
- There is an increased realization of the Strategies:
fact that the components of PHC cannot be - Health services must be delivered where
provided by the health sector alone. the people are.
- Ensures different sectors to collaborate - Use indigenous resident volunteer workers
and function interdependently to meet the as health care providers.
health care needs of the people - Use of traditional (herbal) medicine together
with essential drugs
4. APPROPRIATE TECHNOLOGY
3 C’s
"Technology that is scientifically sound,
 Completeness - refers to adequate
adaptable to local needs and acceptable to
attention to all aspects of a medical
those who apply it and to whom it is applied and
problem, including prevention, early
that can be maintained by people themselves in
detection, diagnosis, treatment, follow up
keeping with the principle of self- reliance with
measures, and rehabilitation.
the resources the community and country can
 Comprehensiveness - provision of services
afford.’’
for all or majority types of health problems
Using cheaper, scientifically valid and  Continuity - ensures that the management
acceptable equipment and techniques of a patient’s care over time be coordinated
among providers.
Where do we need health technologies?
2. People are the Center, object and subject
 Diagnostic maneuvers
of development
 Therapeutic maneuvers
- The success of any undertaking that aims at
 Disease prevention serving the people is dependent on people’s
 Disease control participation at all levels of decision-making;
 Health promotion planning, implementing, monitoring and
evaluating. Any undertaking must also be
PRINCIPLES OF PHC base on the people’s needs and problems
1. 8A’sand3C’s (PCF, 1990)
2. People are the Center, object and subject of
development Barriers of Community Involvement
3. Community participation  Lack of motivation
4. Self-reliance  Attitude
5. Partnership between the community and the  Resistance to change
health agencies in the provision of quality of  Dependence on the part of community
life people
6. Recognition of interrelationships between  Lack of managerial skills
the health and development
7. Social mobilization 3. Community participation
8. Decentralization - Heart and soul of PHC

1. 8 A’s Strategies:
 Acceptability
- Awareness-building and consciousness - Integration of PHC into national, regional,
raising on health and health-related issues provincial, municipal, barangay
- Planning, implementation, monitoring and development plans
evaluation - Coordination of activities
- Selection of community health workers
- Community building and community 7. Social mobilization
organizing
- Formation of health committees Strategies:
- Establishment of a community health - Establishment of an effective health referral
worker organization at the parish or system
municipality level - Multisectoral and interdisciplinary linkages
- Mass health campaign and mobilization - Information, education and communication
- Collaboration between government and non-
4. Self-reliance government organizations

Strategies: 8. Decentralization
- Community generates support
- Use of local resources Strategies:
- Training of community in leadership and - Re-allocation of budgetary resources
management skills - Re-orientation of health professionals on
- Incorporation of income-generating primary health care
projects, coops - Advocacy for political will and support

5. Partnership between the community and ELEMENTS OF PRIMARY HEALTH

the health agencies in the provision of CARE
quality of life 1. Education for health
2. Locally endemic disease control
Strategies: 3. Expanded program in immunization
- Training design and curriculum based in 4. Maternal and child health and family
community needs and priorities planning
- Attitudes, knowledge, and skills are 5. Environmental sanitation and promotion
developed of safe water supply
- Regular monitoring and periodic 6. Nutrition and promotion of adequate food
evaluation supply
7. Treatment of communicable diseases
6. Recognition of interrelationships and common illness
between the health and development 8. Supply of essential drugs
Health - good health, is manifested by the
CHALLENGES IN IMPLEMENTATION
progressive improvements in the living
conditions and quality of life enjoyed by the OF PHC
community residents 1. Poor staffing and shortage of health
Developments - quest for an improved quality of personnel
life for all. It is measured by the ability of people 2. Inadequate technology and equipment
to satisfy their basic needs 3. Poor condition of
infrastructure/infrastructure gap,
Strategies: especially in the rural areas
- Convergence of health, food, 4. Concentrated focus on curative health
nutrition/water, sanitation and population services rather than preventive and
services promotive health care
5. services
6. Challenging geographic distribution
7. Poor quality of health care services
8. Lack of financial support in the health
care programs
9. Lack of community participation
10. Poor distribution of health workers
concentrated in the urban areas