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Primary Health Care

3 min read

References:

  1. Community and Public Health Nursing, 2nd Philippine Edition, ISBN 978-981-48-6503-6, by Earl Francis R. Sumile (pp. 191-204)

Primary care is the provision of interventions to cure specific conditions of individuals at the level of the community. It is the first level of healthcare delivery in which a generalist like a physician or a nurse renders medical and nursing services for individuals and population groups. It is often the first point of contact of patients in the healthcare system. Primary Health Care, in contrast, is an over-all approach to providing people access to basic healthcare and ultimately improve health of communities. It operates on three dimensions: a goal, a strategy, and a philosophy.

  1. Goal: all people are provided access to basic health services, based on the declaration of health as a human right.
  2. Strategy: it promotes collaboration among all sectors in society, valuing partnerships between public and private organizations.
  3. Philosophy: it guides public health practitioners to rally communities to assume responsibility for the health.

PHC operates on the traditional cornerstones or pillars of active community participation, inter- and intra-sectoral linkages, the use of appropriate technology, and available support systems. They follow the core values of social justice, equity, respect for human dignity and rights, solidarity, and self-reliance in providing essential health services:

  1. Health education, the primary role of public health nursing
  2. Immunization
  3. Essential Medicines/Drugs
  4. Mother and Child Health Services (MNCHN)
  5. Endemic Disease Control and Management
  6. Nutrition
  7. Treatment of Simple Conditions
  8. Sanitation and Access to Safe Water Supply

Elements of Primary Health Care

We’ve listed the three dimensions, four cornerstones, five core values, and eight health services from PHC. These are all considered in the three elements of PHC:

  1. Primary Care and Essential Public Health Functions as the core of integrated services
  2. Multisectoral Policy and Action: public health is a multidisciplinary science that revolves around prevention disease, prolonging life, and promoting health and efficiency of populations through collective efforts of all stakeholders.
  3. Empowered People and Communities: this envisions health in the hands of the people, putting emphasis on health as a responsibility besides as a right. Health education and literacy can give people a sense of initiative, instilling a self-reliance in health.

Determinants of Success

Four critical factors to “Health for all, by all” as outlined by The Astana Declaration (WHO, 2018a) include:

  1. Knowledge and Capacity Building: information is an essential element of self-sufficiency. Active participation in planning and developing health programs and services aid in building capacity, fostering a people-centered healthcare system. Community organizing (e.g. COPAR) can also identify potential leaders as active partners of health agencies and professionals in promoting health and preventing disease.
  2. Human Resources for Health: various skills and disciplines are required in community health. Manpower is the most important resource in healthcare delivery. This includes nurses, midwives, physicians, among other health professionals.
ManpowerPopulation Served
RHU/HC Physician20,000
Public Health Nurse10,000
Public Health Midwife5,000
Public Health Dentist50,000
RHU20,000
BHS5,000
  1. Financing: access to essential health services ultimately advance the well-being of the population, but it entails cost and thus requires funding. In 2018, the DOH reported that more than half of all health expenditures remain funded out-of-pocket (OOP); directly from the person receiving care. Sin taxes (R.A. 10351, R.A. 10963) are partially used for healthcare funding.
  2. Technology: the provision of the highest possible level of wellness requires the access to available services and technology. Health professionals must employ and equip their practice with technologies to contribute to the goals of PHC. The WHO defines appropriate health technology as effective, safe, affordable, sustainable, and acceptable.

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