PRIMARY HEALTH CARE APPROACH PHC focuses responsibility for health on the

individual, his family and the community.

WHO defines PHC as essential health
care made universally accessible to individuals - Includes full participation and active
and families in the community by means involvement of the community towards
acceptable to them through their full self-reliant people, capable of achieving
participation at a cost that the community and an acceptable level of health and
country can afford at every stage of wellbeing.
development. - It also recognizes the interrelationship
between health and the overall political,
PHC was declared during the First International
socio-cultural and economic
Conference on PHC held in Alma Ata, USST on
development of society.
September 6-12, 1978 by WHO
ELEMENTS/COMPONENTS OF PHC
1. Environmental sanitation
The Goal was adopted in the Philippines through
2. Control of communicable disease
letter of instruction 949 signed by President
3. Immunization against major infectious
Marcos on October19, 1979 and has an
diseases
underlying theme of “Health in the Hands of the
4. Health education
People by 2020.”
5. Maternal and Child Health and Family
Planning
6. Adequate Food and proper nutrition
DOH 7. Provision of medical care and
A global leader for attaining better emergency treatment
health outcomes, competitive and responsive 8. Treatment of locally endemic diseases
health care system, and equitable health 9. Provision of essential drugs
financing.
Vision: Health for all in the Philippines STRATEGIES OF PHC:
Mission: To guarantee equitable, sustainable 1. Reorientation and reorganization of the
and quality health for all Filipinos, especially the national health care system with the
poor, and to lead the quest for excellence in establishment of functional support
health. system mechanism in support of the
mandate of devolution under the Local
Government Code of 1991.
CONCEPT OF PHC 2. Effective preparation and enabling
process for health action at all levels.
- Characterized by partnership and
3. Mobilization of the people to know their
empowerment of the people (core
communities and identifying their basic
strategy)
health needs with the end in view of
- 4 A’s of essential health services that are
providing appropriate solutions
community based: accessible,
(including legal measures) leading to
acceptable, available, affordable and
self-reliance and self-determination.
sustainable for both the community and
4. Development and utilization of
government.
appropriate technology focusing on
local indigenous resources available in
and acceptable to the community.
 5. Organization of the communities arising
from their expressed needs which they
have decided to address and that this is
continually evolving in pursuit of their
own development.
6. Increase opportunities for community
participation in local level planning,
management, monitoring and evaluation
within the context of regional and
national objectives.
7. Development of intrasectoral linkages
with other government and private
agencies so that programs of the health
sector is closely linked with those of
other socio-economic sectors at the 3 LEVEL OF HEALTH CARE SERVICES
national, intermediate and community AND THE TWO-WAY REFERRAL
levels. SYSTEM
8. Emphasizing partnership so that the
health workers and the community Refer to PHN in the Philippines (by Cuevas et
leaders/members view each other as al)
partners rather than merely providers
- A referral is a set of activities
and receiver of health respectively.
undertaken by a health care provider on
facility in response to its inability to
provide the necessary health
The FRAMEWORK for meeting the goal of intervention for a patient.
Primary Health Care (PHC) is Organizational
strategy, which calls for active and continuing
partnership among the communities, private and
government agencies in health development.
- May be:
o Internal – occurring within the
4 Cornerstones/ Pillars of PHC facility from one personnel to
another.
1. Active community Participation o External – movement from one
2. Intra and Inter – Sectoral linkages
health facility to another; maybe
3. Use if Appropriate Technology vertical (higher level of health
4. Support mechanism made available
facility) or horizontal (different
catchment).
 Intrasectoral Linkages
- In the health sector, the acceptance of
PHC necessitates the restructuring of the
health system f broaden health coverage
and make services available to all.
There is now a widely accepted pyramidal
organization that provides levels of services
3 LEVELS OF HEALTH CARE starting with primary health and progressing to
EXTERNAL HEALTH REFERRAL specialty care. Primary health care is the
SYSTEM hub/center of the health system.
- Primary Level of Care
o Develoved to the cities and
municipalities and is the first Intersectoral Linkages
contact between the community - PHC forms an integral part of the health
people and the different levels system and the overall social economic
of health facility. development of the community. As
- Secondary Level of Care such, it is necessary to unify health
o Rendered by physicians with efforts within the health organization
basic health training in district itself and with other sectors concerned.
provincial and city hospitals; It implies the integration of health plans
capable of basic surgical with the plan for the total community
procedures and simple development.
laboratory examinations; serve
as the referral center of primary Intersectoral Linkages: sectors most closely
health facilities. related health includes those concerned with:
- Tertiary Level of Care
- Agricultural
o Rendered by specialists in
- Education
medical centers, regional - Public Works
hospitals, and specialized - Social Welfare
hospitals like the Lung center of - Population control
the Philippines served as the - Local government
referral center of secondary - Private sectors
health facilities.
TWO LEVELS OF PRIMARY HEALTH B. 2nd International Conference
CARE WORKERS - Held in Adelade, South
Australia in 1988 focused on
1. Village or Grassroot health workers
health public policy.
- Refers to trained community
health workers, BHW, health 4 Priority areas were identified:
auxiliary volunteer or a
1. Supporting the health of women
traditional birth attendant or
2. Improving food security
healer.
3. Safety and nutrition
2. Intermediate level health workers
4. Reducing tobacco and alcohol
- General medical practitioners or
use and creating supportive
their assistants. Public Health
environments for health.
Nurse, rural sanitary inspectors
and midwives may compose
these groups.
C. 3rd International Conference
HEALTH PROMOTION AND CONCEPTS - Held in Sundsvall, Sweden in
1991 which centered on
(NURSING PRACTICE IN THE
sustainable development and
COMMUNITY) by MAGLAYA 5th edition p.32
equity in creating supportive
A. 1st International Conference environments for health at the
- Almost 10 years after the community level with people as
declaration of PHC was signed, the driving force development.
the Otawa Charter of Health
Promotion came out of the First
International Conference on D. 4th International Conference
health Promotion in November - The Jakarta declaration on
1986. Leading Health promotion into
- The Charter defines health the 21st century which is the
promotion as “the process of output of the 4th international
enabling people to increase conference on health promotion
control over, and to improve, held in 1997.
their health”.
- It identified 5 priority action Identified 5 priorities for action:
areas: 1. Promoting social responsibility for
1. Building health health
public policy 2. Increasing community capacity and
2. Creating empowering the individual
supportive 3. Expanding and consolidating
environments partnerships for health
3. Strengthening 4. Increasing investments for health
community action development
4. Developing 5. Securing and infrastructure for health
personal skills promotion
5. Reorienting
health services
 E. 5th Global Conference on Health
Promotion (2000) June 5-9, Mexico City
- Examined the contributions by
health promotion in improving
the health and quality of life of
people living in difficult
circumstances.
- It called for the strengthening of
the science and art of health
promotion and strengthening
political skills for health
promotion.

F. 6th International Conference

- The Bangkok Charter of health
promotion in Globalized World
which was adopted in this
conference in 2005 focuses on
the need to address the
determinants of health through
health promotion.
Determinants of health:
1. Income and social status
2. Education
3. Physical environment
4. Employment and working conditions
5. Social support networks
6. Culture
7. Genetics
8. Personal behavior and coping skills
9. Health services
10. Gender