MIDTERMS - PRIMARY HEALTHCARE APPROACH NCM 104

VI. PRIMARY HEALTH CARE

APPROACH  HISTORY OF PRIMARY HEALTH CARE

WHAT IS PRIMARY HEALTHCARE? Alma Ata Declaration on Primary Health Care (1978)

The WHO defines Primary Health Care an essential  Health is a basic fundamental right.
health care made universally acceptable to  There exists global burden of health inequalities
individuals and families in the community by means among populations.
acceptable to them through their full participation  Economic and social development is of basic
and at a cost that the community and country and importance for the full attainment of health for
afford at every stage of development. all.
 Governments have a responsibility for the health
Alma Ata Declaration
of their people
The Declaration of Alma-Ata was adopted at the
Letter of Instruction (LOI) 949
International Conference on Primary Health Care
(PHC), Almaty (formerly Alma-Ata), Kazakhstan  Adoption of the PHC strategy by the Philippines
(formerly Kazakh Soviet Socialist Republic), 6-12  “Health in the Hands of the People by 2020”.
September 1978
Primary Health Care (PHC) in the Philippines
Primary Health Care
May 1977. 
Essential health care based on practical, scientifically
sound and socially acceptable methods and The 30th World Health Assembly adopted resolution
technology made universally accessible to individuals which decided that the main social target of
and families in the community through their full governments and of WHO should be the attainment
participation and at a cost that the community and by all the people of the world by the year 2000 a level
country can afford to maintain at every stage of their of health that will permit them to lead a socially and
development in the spirit of self-reliance and self- economically productive life.
determination. (Alma Ata Declaration)
September 6-12, 1978. 
Goal
International Conference in PHC was held in this year
The ultimate goal of primary health care is better at Alma Ata, USSR (Russia)
health for all.
October 19, 1979. 
Key elements
The President of the Philippines (Ferdinand Marcos)
 Reducing exclusion and social disparities in health issued Letter of Instruction (LOI) 949 which mandated
(universal coverage) the then Ministry of Health to adopt PHC as an
 Organizing health services around people’s needs approach towards design, development, and
and expectations (health service reforms) implementation of programs which focus health
 Integrating health into all sectors (public policy development at the community level.
reforms)
 Pursuing collaborative models of policy dialogue
(leadership reforms) RATIONALE
 Increasing stakeholder participation
MIDTERMS - PRIMARY HEALTHCARE APPROACH NCM 104

1. Adopting primary health care has the following -Attaining health for all Filipinos will require
rationales: expanding participation in health and health-related
2. Magnitude of Health Problems programs whether as service provider or beneficiary.
3. Inadequate and unequal distribution of health Empowerment to parents, families and communities
resources to make decisions of their health is the desired
4. Increasing cost of medical care outcome.
5. Isolation of health care activities from other
-Advocacy must be directed to national and local
development activities
policy making to elicit support and commitment to
major health concerns through legislations,
OBJECTIVES
1) Improvement in the level of health care of the budgetary and logistical considerations.
community  2. Promoting and supporting community managed
2) Favorable population growth structure health care
3) Reduction in the prevalence of preventable,
communicable and other disease. -The health in the hands of the people brings the
4) Reduction in morbidity and mortality rates government closest to the people. It necessitates a
especially among infants and children. process of capacity building of communities and
5) Extension of essential health services with organization to plan, implement and evaluate health
priority given to the underserved sectors. programs at their levels.
6) Improvement in basic sanitation
3. Increasing efficiency in health sector
7) Development of the capability of the community
aimed at self- reliance.  -Using appropriate technology will make services
8) Maximizing the contribution of the other sectors and resources required for their delivery,
for the social and economic development of the effective, affordable, accessible and culturally
community. acceptable.
 -The development of human resources must
TYPES OF PHC WORKERS
correspond to the actual needs of the nation and
1. Barangay Health Worker or Village Health Worker the policies it upholds such as PHC.
o The Department of Health (DOH) continue to
2. Intermediate level Primary Health Worker
support and assist both public and private
FOUR PILLARS institutions particularly in faculty development,
enhancement of relevant curricula and
1. Active Community Participation development of standard teaching materials.

2. Intra and Inter-sectoral linkages Advancing essential national health research

3. Use of appropriate technology - Essential National Health Research (ENHR) is an

integrated strategy for organizing and managing
4. Support mechanism made available
research using intersectoral, multi-disciplinary and
MAJOR STRATEGIES scientific approach to health programming
and delivery.
1. Elevating health to a comprehensive and
sustained national effort Essential Health Services

Education for all

MIDTERMS - PRIMARY HEALTHCARE APPROACH NCM 104

Locally endemic disease control Intersectoral linkages

Expanded program for immunization -Between the health sector and other sectors in
society.
Maternal and child health
COMMUNITY PARTICIPATION
Essential drugs provision
 An educational and empowering process.
Nutrition
 People identify the problems and the needs.
Treatment of communicable and
noncommunicable diseases  People assume responsibilities to plan,
manage, control, and assess the collective
Safe water and good waste disposal actions that are necessary.
KEY PRINCIPLES OF PHC EQUITABLE DISTRIBUTION OF HEALTH RESOURCES
 Accessibility, affordability, acceptability, and  Doctors to the Barrios (DTTB) Program
availability
 Registered Nurses Health Enhancement and
 Support mechanisms Local Service (RN HEALS)
 Multisectoral approach Appropriate Technology Criteria
 Community participation  Safety
 Equitable distribution of health resources  Effectiveness
 Affordability
 Appropriate technology  Simplicity
 Acceptability
THE 4 AS OF PHC
 Feasibility and reliability
 Accessibility  Ecological effects
 Potential to contribute to individual and
 Affordability community development

 Acceptability Senate Bill No. 1673UNIVERSAL HEALTH

COVERAGE ACT OF 2018
 Availability
 Filed on January 31, 2018 by Angara, Juan
Support Mechanisms
Edgardo "Sonny" M.
People
AN ACT PROVIDING FOR A UNIVERSAL
Government HEALTH COVERAGE FOR FILIPINOS AND
APPROPRIATING FUNDS THEREFOR
Private sector
 Scope
Multisectoral Approach
National
Intrasectoral linkages
Legislative status
-Within the health sector
MIDTERMS - PRIMARY HEALTHCARE APPROACH NCM 104

 Pending in the Committee (2/5/2018) Institute of Traditional and Alternative Health

Care (PHITAHC).
 Health is a resource for life, not the object of
living; it is a positive concept emphasizing social  The PHITAC is mandated to encourage scientific
and personal resources, as well as physical research on and develop traditional and
capacities (World Health Organization, 1986). alternative health-care systems, develop and
coordinate skills-training courses for various
 The new view of health demands a funding and forms of traditional and alternative health-care
resource revolution from an illness focus to a modalities, formulate standards, guidelines and
balanced resource allocation for wellness. This codes of ethical practice appropriate for the
resource shift is not likely to occur without practice of traditional and alternative health care,
controversy and confusion because of the as well as in the manufacture, quality control and
persistent belief that health is the absence of marketing of different traditional and alternative
disease or illness. There is growing awareness of health-care materials, natural and organic
the many determinants of health, most of which products, for approval and adoption by the
are entirely outside of the current health sector. appropriate government agencies; formulate
 All communities have highly variable and unique policies for the protection of indigenous and
natural health resources and technology from
strengths and health needs. Good Health unwarranted exploitation, for approval and
adoption by the appropriate government
therefore, is manifested by the progressive
agencies; formulate policies to strengthen the
improvements in the living conditions and quality
role of traditional and alternative health-care
of life enjoyed by the community residents.
delivery system; and promote traditional and
TRADITIONAL AND ALTERNATIVE HEALTH alternative health care in international and
national conventions.
CARE
Traditional and Alternative Health Care
 The Philippines being a tropical country is blessed
with more a thousand plants that have medicinal Traditional and Alternative Medicine Act of 1997
use, more so, the cultural diversity also produced (R.A. 8423)
numerous alternative healthcare modalities that
have been  proven to be effective in addressing Created the Philippine Institute of Traditional and
several health problems. Alternative Health Care

 The country’s diverse yet rich culture and Traditional medicine

heritage gave birth to many of the current
Sum total of knowledge, skills, and practice on health
traditional and alternative health care practices.
care, not necessarily explicable in the context of
At the time when western medicine had not
modern, scientific philosophical framework, but
reached the country yet, the answer to many of
recognized by the people to help maintain and
the diseases and health problems were the herbs
improve their health towards the wholeness of their
and plants in their surroundings.
being, the community and society, and their
 With these facts, the Philippine government interrelations based on culture, history, heritage, and
enacted a law, which incorporates traditional and consciousness.
alternative medicine in the national health care
Alternative health care modalities
system, thus the establishment of the Philippine
MIDTERMS - PRIMARY HEALTHCARE APPROACH NCM 104

Other forms of nonallopathic, occasionally, Alternative Health Care Modalities

nonindigenous or imported healing methods, though
not necessarily practiced for centuries nor handed Acupressure
down from one generation to another. A method of healing and health promotion that uses
the application of pressure on acupuncture points
without puncturing the skin

Acupuncture

A method of healing using special needles to

puncture and stimulate specific anatomical points on
the body

Aromatherapy

The art and science of the sense of smell whereby

 Medicinal Plant Preparations essential aromatic oils are combined and then
Decoction applied to the body in some form of treatment

Boil the recommended part of the plant material in Chiropractic

water. A discipline of the healing arts concerned with the
Infusion pathogenesis, diagnosis, therapy, and prophylaxis of
functional disturbances, pathomechanical states,
Plant material is soaked in hot water. pain, syndromes, and neurophysiological effects
related to the static dynamics of the locomotor
Poultice
system, especially of the spine and pelvis
Directly apply recommended plant material on the
Herbal medicine/Phytomedicine
part affected.
Finished, labeled, medicinal product that contain as
Tincture
active ingredients aerial or underground parts of the
Mix the plant material in alcohol plant or other materials or combination thereof,
either in the crude state or as plant preparations.
10 medicinal plants endorsed by DOH
Nutritional Therapy

The use of food as medicine and to improve health

by enhancing the nutritional value of food
components that reduces the risk of a disease. It is
synonymous with nutritional healing.

Pranic healing

A holistic approach of healing that follows the

principle of balancing energy

Reflexology
MIDTERMS - PRIMARY HEALTHCARE APPROACH NCM 104

The application of therapeutic pressure on the body’s

reflex points to enhance the body’s natural healing
mechanisms and balance body functions. It is based
on the principle that internal glands and organs can
be influenced by properly applying pressure to the
corresponding reflex area on the body.

Massage

A method wherein the superficial soft parts of the

body are rubbed, stroked, kneaded, or tapped for
remedial, aesthetic, hygienic, or limited therapeutic
purposes.

Massage Techniques

1. Effleurage (Stroking) 

— Main uses are at the beginning or end of a

massage or as connecting or linking movements.

2. Petrissage

— Deeper strokes applied by the fingers, thumb or

heels of a hand. Kneading, picking up, wringing and
rolling are all forms of petrissage.

3. Tapotement

— Used for stimulating and toning an area. Forms of

this technique include cupping and hacking, among
others.

4. Frictions

— Applied on the surface tissue, these are rubbing

movements on the skin.

5. Vibrations

— Generally used to relieve fatigue and pain, these

movements can help cure a certain area, creating a
natural sedative.

 Combining these massage techniques is how

different massage modalities were created,
with each providing their own therapeutic
value.