Primary Health Care As An Approach To Health

Primary health care as an approach
to health care delivery

Prepared by: Bradley Bianzon
Primary Health Care
 the essential care made universally accessible to

individuals and families in the community through
their full preparation.
 Essential health care made universally acceptable to individuals and families in the
community
 By means acceptable to them and through their full participation
 At a cost that the community and country can afford at every stage of development
ESSENTIAL HEALTH CARE SERVICES
 GOAL-THEME : Health for all Filipinos and Health in the Hands of the
People by the year 2020
 This is achieved through community and individual self-reliance
 MISSION : To strengthen the health care system wherein people will
manage their own health care
 CONCEPT : partnership and empowerment of the people
 LEGAL BASIS:
• Letter of Instruction 949
• President Ferdinand Marcos
• October 19, 1979
• First International Conference on Primary Health care
• Alma Ata, USSR
• September 6-12, 1978
• Sponsored by the World Health Organization and UNICEF
5 KEY ELEMENTS
 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 stakeholder participation.
8 Essential Health Services
 → E - Education for health

 → L - Locally endemic disease control
 → E - Expanded program for immunization
 → M - Maternal and child health including responsible parenthood
 → E - Essential drugs
 → N - Nutrition
 → T - Treatment of communicable and noncommunicable diseases
 → S - Safe water and sanitation
KEY PRINCIPLES
1. 4 A’s
Accessibility
o distance/travel time required to get to a health care facility/service.
o the home must be w/in 30 min. from the Brgy. health stations
Affordability
o Consideration of the individual, family, community, and government can afford the services
o The out-of-pocket expense determines the affordability of health care.
o In the Philippines, government insurance is covered through philhealth
KEY PRINCIPLES
Acceptability
o Health care services are compatible with the culture and traditions of the population.
Availability
o A question whether the health service is offered in health care facilities or is provided on a regular
and organized manner.
Examples:
o Botika ng Bayan
▪ Ensures the availability and accessibility of affordable essential drugs.
▪ It sells low-priced generic home remedies, OTC and common antibiotics.
o Ligtas sa Tigdas ang Pinas
▪ Mass door-to-door measles immunization
KEY PRINCIPLES
2. SUPPORT MECHANISM
 There are 3 major resources:

 i. People
 ii. Government
 iii. Private Sectors (e.g. NGO, church…)
KEY PRINCIPLES
 3. MULTISECTORAL APPROACH
 Intrasectoral linkages (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.
KEY PRINCIPLES
4. COMMUNITY PARTICIPATION
 A process in which people identify the problems and needs and
assumes responsibilities themselves to plan, manage, and control.
KEY PRINCIPLES
5. EQUITABLEDISTRIBUTION OF HEALTH RESOURCES

 2 DOH programs to ensure equitable distribution:
 Doctor to the Barrio (DTTB) Program
- the deployment of doctors to municipalities that are w/o doctors.
- deployed to unserved, economically depressed 5th or 6th class municipalities for 2 years.
 Registered Nurses Health Enhance
 ment and Local Service (RN HEALS)
- training and program for unemployed nurse
- deployed to unserved, economically depressed municipalities for 1 year.
KEY PRINCIPLES
6. APPROPRIATE TECHNOLOGY
 ▪ Health Technology includes:
- tools
- drugs
- methods
- procedures and technique
- people’s technology
- indigenous technology
KEY PRINCIPLES
 ▪ Criteria for Appropriate health technology

• Safety
• Effectiveness
• Affordability
• Simplicity
• Acceptability
• Feasibility and Reliability
• Ecological effects
• Potential to contribute to individual and community development
ORGANIZATIONAL STRATEGY
• Framework for meeting the goal of primary

health care
• Calls for active and continuing partnership
among the communities, private and
government agencies in health
development
LEVELS OF HEALTH CARE SERVICES
 PRIMARY
• Barangay Health Station
• Private Practitioners
• Community Hospitals
• Rural Health Unit
 SECONDARY
• Emergency/District Hospitals
• Provincial/City Hospitals
 TERTIARY
• Regional Medical Centers and Training Hospitals
• National Medical Centers
• Teaching and Training Hospital
TWO LEVELS OF PHC WORKER
VILLAGE / BARANGAY HEALTH WORKERS (V/BHWs)

 - Trained community health workers
 - Health auxiliary volunteer
 - Traditional birth attendant or healer
INTERMEDIATE LEVEL HEALTH WORKERS

 - General medical practitioner
 - Public health nurse
 - Rural sanitary inspector
 - Midwives
PRIMARY CARE
 Includes health promotion, disease prevention, health maintenance,
counseling, patient education and diagnosis and treatment of acute
and chronic illness in different health settings (American
Association of Family Medicine)
 Refers to the first contact of a person with a professional
 A model of nursing care that emphasizes continuity of care
 Nursing care is directed towards meeting all the patient’s need.
PRIMARY CARE
MEDICINAL PLANT PREPARATION
 1. DECOCTION - boiling the plant material in water for 20 min.

 2. INFUSION - plant material is soaked in hot water for 10 - 15
minutes.
 3. POULTRICE - directly apply plant material on the affected part,
usually in bruises, wounds, and rashes.
 4. TINCTURE - mix the plant material in alcohol.
EPIDEMIOLOGY
 o the study of the DISTRIBUTION and

DETERMINANTS of health-related states or events in
specified populations, and the application of this study to
the prevention and control of health problems
❖ DISTRIBUTION
o refers to the analysis by time, places and classes of people affected.
❖ DETERMINANTS
o include all the biological, chemical, physical, social, cultural, economic, genetic, and
behavioral factors that influence health.
❖ PRACTICAL APPLICATIONS OF EPIDEMIOLOGY

1. Assessment of the health status of the community or community diagnosis
2. Elucidation of the natural history of disease
3. Determination of disease causation
4. Prevention and control of disease
5. Monitoring and evaluation of health interventions
6. Provision of evidence for policy formulation
❖ PREVALENCE PROPORTION (P)
▪ Measures the total number of existing cases of disease at a particular point in time divided
by the number of people at the point in time.
▪ Thus, if the point in time is the time of examination, then the denominator is the number of
people examined.
▪ Prevalence can be calculated by:
• Where F is any number of the base 10 that is used as a multiplier to avoid having decimals
as the final value of the indicator.
• Incidence – measures the number of new cases, episodes, or events occurring over a
specified period, commonly a year within a specified population at risk.

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Primary health care as an approach

to health care delivery

 the essential care made universally accessible to

 1. Reducing exclusion and social disparities in health (universal

 → E - Education for health

 There are 3 major resources:

 Intrasectoral linkages (Two-way referral system)

5. EQUITABLEDISTRIBUTION OF HEALTH RESOURCES

 ▪ Criteria for Appropriate health technology

• Framework for meeting the goal of primary

VILLAGE / BARANGAY HEALTH WORKERS (V/BHWs)

INTERMEDIATE LEVEL HEALTH WORKERS

 1. DECOCTION - boiling the plant material in water for 20 min.

 o the study of the DISTRIBUTION and

❖ PRACTICAL APPLICATIONS OF EPIDEMIOLOGY

▪ Prevalence can be calculated by:

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