PRIMARY HEALTH CARE

PRIMARY HEALTH CARE: Brief History

May 1977. The 30th World Health Assembly
adopted resolution which decided that the main
social target of governments and of WHO should be
the attainment by all the people of the world by the
year 2000 a level of health that will permit them to
lead a socially and economically productive life.

September 6-12, 1978. International

Conference in PHC was held in this
year at Alma Ata, USSR (Russia).

October 19, 1979. The President of the Philippines

(Ferdinand Marcos) issued Letter of Instruction (LOI)
949 which mandated the then Ministry of Health to
adopt PHC as an approach towards design,
development, and implementation of programs which
focus health development at the community level.
RATIONALE FOR ADOPTING PHC

Magnitude of health problems

Isolation of
Inadequate & health care
unequal Increasing costs activities from
distribution of of medical care other
health resources development
activities
 OBJECTIVES OF PHC
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.
 OBJECTIVES OF PHC
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
TYPES OF PRIMARY HEALTH CARE WORKER

Barangay
Health Intermediate
Worker or level Primary
Village Health Health
Worker Worker
 FOUR PILLARS OF PHC

Active community participation

Intra and Support
Use of
inter mechanism
appropriate
sectoral made
technology
linkages available
MAJOR STRATEGIES OF PHC

A. Elevating health to a comprehensive and

sustained national effort
Will require the following:
• Expanding participation in health and health-related programs
• Empowerment to parents, families and communities to make decisions
of their health
• Advocacy must be directed to national and local policy
MAJOR STRATEGIES OF PHC
B. 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.
MAJOR STRATEGIES
C. Increasing efficiency in health sector

 Use of appropriate technology

 The development of human resources must correspond to the actual needs
of the nation and the policies it upholds
 The Department of Health (DOH) continue to support and assist both public
and private institutions particularly in faculty development, enhancement of
relevant curricula and development of standard teaching materials.
MAJOR STRATEGIES
D. 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.
 LEGAL BASIS
• October 19, 1979 – Letter of Instruction (LOI) 949, the legal
basis of PHC was signed by Pres. Ferdinand E. Marcos, which
adopted PHC as an approach towards the design, development
and implementation of programs focusing on health
development at community level.
 DEFINITION

• The WHO defines Primary Health Care an essential health care made
universally acceptable 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.
GOAL OF PHC

five key elements to achieving that goal:

UNIVERSAL SERVICE
PUBLIC POLICY
COVERAGE DELIVERY
REFORMS
REFORMS REFORMS

INCREASING
LEADERSHIP
STAKEHOLDER
REFORMS
PARTICIPATION
ELEMENTS OF PHC

EXPANDED
EDUCATION FOR LOCALLY ENDEMIC
PROGRAM ON
HEALTH DISEASE CONTROL
IMMUNIZATION

ENVIRONMENTAL
MATERNAL AND CHILD HEALTH SANITATION AND
PROMOTION OF SAFE
FAMILY PLANNING WATER SUPPLY

NUTRITION AND PROMOTION OF

ADEQUATE FOOD SUPPLY
TREATMENT OF CD AND SUPPLY OF ESSENTIAL
COMMON ILLNESS DRUGS
PRINCIPLES AND STRATEGIES OF PHC

accessibility availability

1. 4 A’s
Appropriateness of
acceptability health services
PRINCIPLES AND STRATEGIES OF PHC

2. Community participation

3. People are the center, object and subject of

development
BARRIERS OF COMMUNITY INVOLVEMENT

LACK OF
MOTIVATION

ATTITUDE

LACK OF
RESISTANCE TO
DEPENDENCE MANAGERIAL
CHANGE
SKILLS
PRINCIPLES & STRATEGIES OF PHC

4. SELF-RELIANCE 5. DECENTRALIZATION

6. PARTNERSHIP BETWEEN THE

COMMUNITY AND HEALTH
7. SOCIAL
AGENCIES IN THE PROVISION OF MOBILIZATION
QUALITY OF LIFE

8. RECOGNITION OF INTERRELATIONSHIP
BETWEEN THE HEALTH AND DEVELOPMENT