• reducing exclusion and social disparities in health (universal coverage reforms);
• organizing health services around people’s needs and expectations (service delivery reforms);
• integrating health into all sectors (public policy reforms);
• pursuing collaborative models of policy dialogue (leadership reforms); and
• increasing stakeholder participation.

Brief History of PHC

• 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.

Definitions

1. WHO

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 and afford at every stage of development.

2. Alma Ata

Eight essential ELEMENTS based on the Alma Ata on PHC:An essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally, accessible to individuals and families in the community by means of acceptable to them, through their full participation and at a cost that community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination.

1. Health Education
2. Treatment of Locally Endemic Diseases
3. Expanded Program on Immunization
4. Maternal and Child Health
5. Provision of Essential Drugs
6. Nutrition
7. Treatment of communicable and non-communicable diseases
8. Safe water and good waste disposal

Major Strategies of PHC

1. Elevating Health to a comprehensive and sustained national effort
2. Promoting and Supporting Community-Managed Health Care
3. Increasing efficiencies in the Health Sector
4. Advancing essential national health research

Types of PHC workers

1. Barangay Health Worker or Village Health Worker
2. Intermediate level Primary Health Worker

4 Pillars of PHC

1. Active Community Participation
2. Intra and Inter-sectoral linkages
3. Use of appropriate technology
4. Support mechanism made available

Image source: 1

Primary Health Care: History, Elements, Strategies, & Pillars Original source at: Nurseslabs

Primary Level of Care

• Devolved to cities and municipalities
• Usually the first contact between the community members and other levels of health facility.
• Center physicians, public health nurse, rural health midwives, brgy. Health workers, traditional healers.

Secondary Level of Care

• Given by physicians with basic health training.
• Usually given in health facilities either private owned or government operated.
• Infirmaries, municipal, district hospital, out-patient departments.
• Rendered by specialists in health facilities.

Tertiary Level of Care

• Referral system for the secondary care facilities.
• Provided complicated cases and intensive care.
• Medical centers, regional and provincial hospitals and specialized hospitals.

Levels of Health Care Referral System Original source at: Nurseslabs