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    Primary Health Care

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    Bea Samonte
    The document outlines the rationale and principles of primary health care. It discusses how primary health care aims to provide equitable and affordable basic health services through community participation and inter-sectoral collaboration. The key aspects covered include the Alma Ata Declaration which established primary health care, its minimum essential elements like maternal/child health and immunization, and its goals of improving population health and promoting self-reliance. Barriers to primary health care implementation include inadequate resources, isolation from development activities, and issues with community/health worker participation and adoption of appropriate technologies.

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    Primary Health Care

    Uploaded by

    Bea Samonte
    102 views4 pages
    The document outlines the rationale and principles of primary health care. It discusses how primary health care aims to provide equitable and affordable basic health services through community participation and inter-sectoral collaboration. The key aspects covered include the Alma Ata Declaration which established primary health care, its minimum essential elements like maternal/child health and immunization, and its goals of improving population health and promoting self-reliance. Barriers to primary health care implementation include inadequate resources, isolation from development activities, and issues with community/health worker participation and adoption of appropriate technologies.

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    Family Med

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    The document outlines the rationale and principles of primary health care. It discusses how primary health care aims to provide equitable and affordable basic health services through community participation and inter-sectoral collaboration. The key aspects covered include the Alma Ata Declaration which established primary health care, its minimum essential elements like maternal/child health and immunization, and its goals of improving population health and promoting self-reliance. Barriers to primary health care implementation include inadequate resources, isolation from development activities, and issues with community/health worker participation and adoption of appropriate technologies.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    102 views4 pages

    Primary Health Care

    Uploaded by

    Bea Samonte
    The document outlines the rationale and principles of primary health care. It discusses how primary health care aims to provide equitable and affordable basic health services through community participation and inter-sectoral collaboration. The key aspects covered include the Alma Ata Declaration which established primary health care, its minimum essential elements like maternal/child health and immunization, and its goals of improving population health and promoting self-reliance. Barriers to primary health care implementation include inadequate resources, isolation from development activities, and issues with community/health worker participation and adoption of appropriate technologies.

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    of 4

    `

    FAMILY & COMMUNITY MED


    1.1A PRIMARY HEALTH CARE

    CORE OBJECTIVES
    Explain the rationale of Primary Health Care
    Review the provisions of the Alma Ata Declaration
    Define Primary Health Care
    Explain the Elements, Goals and Principles of Primary Health
    Care
    RATIONALE FOR PRIMARY HEALTH CARE
    MAGNITUDE OF HEALTH PROBLEMS
    High IMR
    Still high incidence of communicable diseases
    Poor environmental sanitation
    Rapid population growth, ignorance, poverty

    INADEQUATE & UNEQUAL DISTRIBUTION OF HEALTH RESOURCES

    Problems on accessibility of HCS

    Inadequate HCS

    Underutilized HCS

    More health facilities in the urban areas

    Uneven distribution of qualified health personnel

    Health care providers working abroad (brain-drain)

    INCREASING COST OF MEDICAL CARE


    Escalating cost of medicines
    Parallel drug importation
    Allocation of national budget is most spent on curative services
    as opposed to public health preventive services
    Increase in health expenditure has not brought commensurate
    results to improved health care
    ISOLATION OF HEALTH CARE SERVICES FROM OTHER
    DEVELOPMENTAL ACTIVITIES
    Lack of coordination with agriculture, education, public works
    ..etc.
    Health sector alone cannot achieve the Health for all Goal
    Primary causes of ill-health and misery are socio-economic
    (poverty, lack of education, social isolation)
    Must expand the responsibilities of the health sector
    THE ALMA ATA DECLARATION
    1978, Alma Ata, USSR
    Defines Primary Health Care

    Essential health care based on practical, scientific


    ally sound, socially acceptable methods and
    technology made universally acceptable to
    individuals and families in the community through
    their full participation and at a cost that the
    community and the country can afford to maintain at
    every stage of the their development the spirit of selfdetermination..
    PRIMARY HEALTH CARE DEFINED
    WHO Declaration
    Defines Primary Health Care

    Essential health care based on practical, scientific


    ally sound, socially acceptable methods and
    technology made universally acceptable to
    individuals and families in the community through
    their full participation and at a cost that the
    community and the country can afford to maintain at
    every stage of the their development the self-reliance
    and self- determination..
    Primary health care is an approach, NOT a program

    PRIMARY HEALTH CARE APPROACH


    Is based on :

    Social equity (Equitable distribution)

    Nation-wide coverage

    Self-reliance

    Inter-sectoral collaboration

    People (community) participation

    8 MINIMUM ESSENTIAL ELEMENTS OF PRIMARY HEALTH CARE


    1. Education concerning the prevailing health problems and
    methods to prevent and control them
    2. Promotion of food supply & proper nutrition
    3. The provision of safe water and basic sanitation
    4. Maternal and child health care including family planning
    5. Immunization against the major infectious diseases
    6. Prevention and control of locally endemic diseases
    7.
    Appropriate treatment of common diseases and injuries
    8. Provision of essential drugs

    1.
    2.
    3.
    4.
    5.
    6.
    7.
    8.

    MILLENIUM DEVELOPMENTAL GOALS 2015


    Eradicate extreme poverty and hunger
    Achieve primary universal primary education
    Promote gender equality and empower women
    Reduce child mortality
    Improve the maternal health
    Combat HIV/AIDS, malaria, TB and other diseases
    Ensure environmental sustainability
    Develop a global partnership for development
    THE 2 PROLONGED GOAL OF PHC
    SOCIAL GOAL
    PHC will improve the quality of life and the extension of
    maximum health benefits to all particularly to the underserved
    population
    DEVELOPMENTAL GOAL
    Because it views the community as moving progressively
    towards socio-economic prosperity with the ultimate goal of
    self-reliance
    GOALS OF PRIMARY HEALTH CARE
    Health for all by year 2000
    Health in the hands of the people by the year 2020
    THE PHILOSOPHY OF PRIMARY HEALTH CARE
    IS BASED ON THE VALUES THAT HEALTH IS
    A fundamental right of every citizen
    An individual collective responsibility
    An equal opportunity
    Is part and essential element of the socio-economic
    development of any country

    GENERAL OBJECTIVES OF PRIMARY HEALTH CARE


    Mobilize communities to make them participate fully in their
    own health
    2. Promote good health practice and maintain optimum quality of
    life
    3. To promote equal access to essential health services through
    community participation in basic health care
    1.

    MAJOR THEMES OF THE STRATEGIES IN PHC


    Health For All (HFA) implies equity
    Aim is to give people a positive sense of health
    Page 1 of 4

    FCM III

    1.1A PRIMARY HEALTH CARE

    HFA will be achieved by people themselves


    HFA requires coordinated action of all sectors concerned
    The focus of health care system is to bring basic services close
    to where people live & work
    Health problems transcends national frontiers & requires
    international cooperation (UN, WHO, WB, UNICEF)

    "Health is a means and end to development"


    INTER-RELATIONSHIP OF HEALTH & DEVELOPMENT

    COMPONENTS OF PRIMARY HEALTH CARE


    Preventive health care
    Promotive health care
    Curative health care
    Rehabilitative health care
    APPROACHES TO HEALTH CARE

    PILLARS OF PRIMARY HEALTH CARE fr WHO


    Political will & commitment
    Community participation
    Inter-sectoral cooperation
    Appropriate technology/systems support

    PILLARS OF PRIMARY HEALTH CARE fr DOH


    Community participation
    Inter/intra-sectoral cooperation
    Appropriate technology
    Systems support
    COMMUNITY PARTICIPATION

    LEVELS OF PEOPLE'S PARTICIPATION IN PRIMARY HEALTH CARE

    Hospital, clinic- based

    Community oriented

    Community based

    Community managed

    CLINICAL MEDICINE VERSUS COMMUNITY HEALTH PROGRAMS


    CLINICAL MEDICINE
    COMMUNITY
    HEALTH
    PROGRAMS
    OBJECTIVE
    Cure patient of
    Improve health status
    disease
    of the community
    INFORMATION
    Clinical history,
    Population data,
    REQUIRED
    physical examination
    health problems,
    and labs
    disease patterns,
    availability of health
    services
    DIAGNOSIS
    Differential diagnosis
    Community diagnosis
    and probable
    and priorities for
    diagnosis
    action
    ACTION PLAN
    Treatment and
    Community health
    rehabilitation
    programs
    EVALUATION
    Follow-up and
    Evaluation of changes
    assessment
    in health status
    TASKS REQUIRING EPIDEMIOLOGICAL & PLANNING SKILLS
    District population Define population groups assess health and
    disease problems Collect health data produce health information
    assess district health status decide on priority health problems
    choose alternative interventions implement programs- increase
    access and coverage evaluate effectiveness Improvements in health
    status
    TRADITIONAL VS PRIMARY HEALTH CARE
    DIMENSION
    TRADITIONAL
    PRIMARY HEALTH
    CARE
    Goal
    Absence of disease
    Development and
    preventive health care
    Focus of care
    The sick
    The well and early
    sick
    Settings for services
    Urban based in
    Rural based and
    hospitals
    satellite clinics
    Clinics and homes
    Community health
    Accessible only to a
    centers, health posts
    few
    are accessible to all
    People
    Passive recipients of
    Active participation in
    health care
    health development
    Structure
    Health is isolated from
    Health is an integral
    other sectors
    part of the socioeconomic
    development system
    Process
    Decision- making from
    Decision-making from
    top-down
    bottom-up
    Technology
    Curative services
    Promotive &

    Page 2 of 4

    FCM III
    based on modern
    medicine/sophisticated
    technology
    Doctor dominated

    Outcome

    Reliance on health
    professionals

    1.1A PRIMARY HEALTH CARE


    preventive services
    blending traditional
    medicine with modern
    medicine
    Acceptance of
    indigenous
    practitioners
    Appropriate
    technology for
    frontline care
    Local self-reliance ,
    socially and
    economically
    productive
    Self-help

    INTRASECTORAL LINKAGE

    FIVE BASIC PRINCIPLES OF PHC


    1. EQUITABLE DISTRIBUTION
    Health services must be

    Equally accessible

    Not neglecting rural and isolated peri-urban dwellers

    A 2 WAY HEALTH REFERRAL SCHEME

    2. FOCUS ON PREVENTION
    Preventive services
    Promotive services
    Less on curative and rehabilitative
    3. MULTI-SECTORAL APPROACH

    4. COMMUNITY PARTICIPATION
    People must want to be healthy to keep healthy
    COMMUMNITY INVOLVEMENT
    Must share the responsibility and participate in:
    1. Defining the health and health related needs and problems
    2. Identifying realistic solutions
    3. Organizing and mobilizing its resources for health activities
    4. Evaluating the results of health actions
    Both inter and intra-sectoral approach, requires:
    1.) Understanding of the various factors influencing the health of the
    community
    2.) Realization by all professional and technical professional of the
    contribution of each on the delivery o health care
    3.) Establishing a mechanism for joint planning, implementation and
    evaluation of community health programs
    4.) Sharing of resources of the community to attain a common goal

    INTERSECTORAL LINKAGE
    Agriculture
    Education
    Public works
    Local governments
    Social welfare
    Population control
    Private Sectors

    SOME MAJOR CONSTAINTS RELATED TO ATTITUDES OF HEALTH


    ADMINISTRATORS, HEALTH WORKERS AND THE COMMUNITY
    ADMINISTRATOR
    HEALTH WORKER
    COMMUNITY
    Lack of political will
    Poor motivation
    Indifference/apathy
    Bureaucratic set-up
    Indifference
    Dependence
    makes him
    impersonal
    Lack of dedication;
    Lack of incentives
    Resistance to change
    poorly motivated
    Belief system
    Political pressures
    Lack of skills in
    Traditional ways
    problem-solving ,
    Values resistant to
    managerial skills in
    change
    the community

    5. APPROPRIATE TECHNOLOGY
    A method or technique which provides a socially and
    environmentally acceptable level of service or quality product at
    the least economic cost
    It is the application of appropriate technology implies the use of
    methods, procedures and techniques, equipment/materials that
    are not only scientifically sound but also suitable to the
    community
    Page 3 of 4

    FCM III
    1.
    2.
    3.
    4.
    5.

    6.

    1.1A PRIMARY HEALTH CARE

    CRITERIA FOR SELECTING THE TECHNOLOGY


    Effective and safe
    Complexity- must be simple and easy to use
    Cost

    Inexpensive, must not be disproportionate


    Acceptability

    e.g. acceptance of BHWs


    Scope of the technology

    related to effectiveness, safety, appropriateness and


    cost

    E.g. DPT vaccine


    Feasibility

    Compatible with local conditions

    E.g. can be used even with out electricity

    EXAMPLES OF APPROPRIATE TECHNOLOGY IN PRIMARY HEALTH


    CARE

    Treatment of dehydration in cases of acute diarrhea with


    glucose containing electrolyte solution (ORS)

    Herbal medicines for common ailments

    Self-financing community projects

    Botika sa Barangay

    Use of indigenous materials

    Home-made cotton pledgets

    STRATEGIES FOR IMPLEMENTATION


    PRINCIPLES
    STRATEGIES
    Accessibility

    Health services
    Availability
    delivered where the
    Acceptability
    people are
    Affordability of health

    Use of resident volunteer


    services
    health workers

    Use of traditional herbal


    meds
    Provision of quality,

    Training, design and


    basic and essential
    curriculum based on
    health services
    community needs and
    priorities, task analysis
    of community health
    workers (CHW and
    competency based

    Attitudes, skills,
    knowledge, developed
    are on promotive,
    preventive curative and
    rehabilitative

    Regular monitoring and


    periodic evaluation of
    BHW performance by
    the community and
    health staff
    Community participation

    Awareness-building and
    consciousness raising
    on health and related
    issues

    Planning, implementing,
    monitoring, and
    evaluation, done through
    small group meetings
    (10-20 household
    cluster)

    Selection of CHW by the


    community

    Community building and


    community organizing

    Formation of health
    committees

    Establishment of a CHW

    Self-reliance

    Recognition of the interrelationships between


    health and development

    Social mobilization

    Decentralization

    organization at the
    parish or municipal level
    Mass health campaigns
    and mobilizations to
    combat health problems
    Community generates
    support (cash, kind,
    labor) for the health
    program
    Use of local resources
    (human financial,
    material)
    Training of community in
    leadership and
    management skills
    Incorporation of income
    generating projects,
    cooperatives, small
    scale industries
    Convergence of health,
    food, nutrition, water,
    sanitation, and
    population services
    Integration of PHC into
    national, regional,
    provincial, municipal,
    and barangay
    development plans
    Coordination of activities
    with economic, planning,
    education agriculture,
    industry, housing, public
    works, communication
    and social services
    Establishment of an
    effective health referral
    system
    Multisectoral and
    interdisciplinary linkages
    Information education,
    communication support
    using multi-media
    Collaboration between
    government and
    governmental
    organizations
    Reallocation of
    budgetary resources
    Re-orientation of health
    professionals re: PHC
    Advocacy for political
    will and support from the
    national leadership down
    to the barangay level

    Page 4 of 4

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