Naga College Foundation, Inc.

College of Health Sciences

Lesson 3
 At the end of the lesson, the students
should be able to:
• explain the elements and principles of
Primary Health Care;
• describe the status and processes of
the Philippine Health Care System; and
• discuss the processes involved in
health management.

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 2
The Declaration of Alma-Ata states that primary health care is essential health
care based on scientifically sound and socially acceptable methods, universally
accessible to individuals
Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 3
• Primary health care (PHC) is essential
health care made universally accessible
and acceptable to individuals through
full participation and at a cost the
community and country can afford.
• It is an approach to health beyond the
traditional health care system that
focuses on health equity-producing
social policy.
• Primary healthcare (PHC) has basic
essential elements and objectives that
help to attain better health services for
all.
Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 4
 It refers to an organized
plan of health services
(Miller-Keane, 1987)

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 5
It is the rendering of health care
services to the people (Williams-
Tungpalan, 1981)

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 6
 This is the network of
health facilities and
personnel which
carries out the task of
rendering health care
to the people (Williams-
Tungpalan, 1981)

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 7
It is a complex set of organizations
interacting to provide an array of
health services in the Philippines
(Dizon, 1977).

There is a strong involvement of the

private sector comprising 50% of the
health system, but regulatory
functions of the government have
yet to be fully maximized.

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 8
The ultimate goal of
primary health care
is
.

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 10
Education concerning prevailing health problems and the
methods of identifying, preventing, and controlling them Essential drugs arrangement

Nutritional food supplement, an adequate

Locally endemic disease prevention and control
supply of safe and basic nutrition

Expanded program of immunization against Treatment of communicable and non-communicable

major infectious diseases disease and promotion of mental health

Maternal and child health care, including family Safe water and sanitation
planning

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 11
Expended options of immunizations

Reproductive health needs

Provision of essential technologies for health

Health promotion

Prevention and control of non-communicable diseases

Food safety and provision of selected food supplements

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 12
A health system based on primary health care will:
1. build on the Alma-Ata principles of equity, universal access,
community participation, and intersectoral approaches;
2. take account of broader population health issues, reflecting and
reinforcing public health functions;
3. create the conditions for effective provision of services to poor and
excluded groups;
4. organize integrated and seamless care, linking prevention, acute
care, and chronic care across all components of the health system;
and
5. continuously evaluate and strive to improve performance.
Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 13
 1. Improvement in the level of health care of the
Behind these elements community
lies a series of basic
objectives that should be 2. Favorable population growth structure
formulated in national 3. Reduction in the prevalence of preventable,
policies in order to launch communicable, and other diseases
and sustain primary health 4. Reduction in morbidity and mortality rates, especially
care (PHC) as part of a among infants and children
comprehensive health 5. Extension of essential health services with priority given
system and coordination to the underserved sectors
with other sectors. 6. Improvement in basic sanitation

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 14
 7. Development of the capability of the community aimed
Behind these elements at self-reliance
lies a series of basic 8. Maximizing the contribution of the other sectors for the
objectives that should be social and economic development of the community
formulated in national 9. Equitable distribution of health care
policies in order to launch
and sustain primary health 10. Community participation
care (PHC) as part of a
comprehensive health 11. Multi-sectional approach
system and coordination
with other sectors. 12. Use of appropriate technology

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 15
Health Care Managers usually carry out the following functions in the process of
management:

Managers are usually required to

set a direction and determine what
needs to be accomplished.
It means setting priorities and
determining performance targets.

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 16
Health Care Managers usually carry out the following functions in the process of
management:

This refers to the management

function on designing the
organization or the specific
division, unit, or service for which
the manager is responsible.
Further, it means designating
reporting relationships and
intentional patterns of interaction.

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 17
Health Care Managers usually carry out the following functions in the process of
management:

This function refers to acquiring

and retaining human resources.
It also refers to developing and
maintaining the workforce through
various strategies and tactics.

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 18
Health Care Managers usually carry out the following functions in the process of
management:

This function refers to monitoring

staff activities and performance
and taking the appropriate actions
for corrective action to increase
performance.

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 19
Health Care Managers usually carry out the following functions in the process of
management:

Its focus is to initiate action in the

organization through effective
leadership and motivation of, and
communication with, subordinates.

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 20
Authority, Responsibility, and Accountability

is a manager's
formal and legitimate right to
make decisions, issue orders,
and allocate resources to
achieve organizationally
desired outcomes.

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 21
Authority, Responsibility, and Accountability

means an
employee's duty to perform
assigned task or activities.

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 22
Authority, Responsibility, and Accountability

means
that those with authority and
responsibility must report and
justify task outcomes to those
above them in the chain of
command.

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 23
Types of Authority (and Responsibility)
Line authority managers Functional authority Staff authority is granted to
have the formal power to staff specialists in their
direct and control is where managers areas of expertise.
immediate subordinates. have formal power It is not a real authority in
The superior issues orders over a specific subset the sense that a staff
and is responsible for the of activities. manager does not order or
result; the subordinate instruct but simply advises,
obeys and is responsible recommends, and counsels
only for executing the order in the staff specialists' area
according to instructions. of expertise.

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 24
 Centralization, Decentralization, and Formalization
Centralization is the Decentralization is Formalization is the
location of decision- the location of written documentation
making authority decision-making used to direct and
near top authority near lower control employees
organizational levels. organizational levels.

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 25
Staffing
This refers to the assignment of
individuals to responsible positions
identified in a management plan.
It determines the competencies required
for a position through:
• identifying key result areas KRAs per
major activities in the plan; and
• determining qualifications and
competencies required to perform the
activities and achieve the KRAs.
Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 26
Staffing
It also includes assigning or recruiting staff that
qualifies for the responsibilities.
For existing programs and services, this
involves:
• reviewing and adjusting the competency
requirements for each major activity with
corresponding KRAs; and
• matching competency requirements vis-à-vis
the responsible person already assigned to
the activity.
Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 27
According to Dizon (1977), the
Philippine health care
system is "a complex set of organizations
interacting to provide an array of health
services."
It has progressed due to challenges
encountered over time.

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 28
 The Department of Health shall be
responsible for the following:
1. formulation and development of
national health policies, guidelines,
standards, and manual of operations
for health services and programs;
2. issuance of rules and regulations,
licenses, and accreditations;
3. promulgation of national health
standards, goals, priorities, and
indicators;
4. development of special health
programs and projects; and
5. advocacy for legislation on health
policies and programs.
Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 29
 The primary function of the
Department of Health is the
promotion, protection,
preservation, or restoration of
the health of the people through
the provision and delivery of
health services and through the
regulation and encouragement
of providers of health goods and
services (E.O. No. 119, Sec. 3).
Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 30
 Health as a right: Health for All
Filipinos by the year 2000 and
Health in the Hands of the
People by the year 2020.

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 31
 The mission of DOH, in partnership
with the people, is to ensure equity,
quality, and access to health care:
• by making services available;
• by arousing community
awareness;
• by mobilizing resources; and
• by promoting the means to better
health.

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 32
Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 33
This includes:
(1) rural health units, their sub-centers, chest clinics, malaria eradication units,
and schistosomiasis control units operated by the DOH:
(2) puericulture centers operated by League of Puericulture Centers; tuberculosis
clinics and hospitals of the Philippine Tuberculosis Society;
(3) private clinics, clinics operated by the Philippine
Medical Association; clinics operated by large industrial
firms for their employees;
(4) community hospitals and health centers operated by
the Philippine Medical Care Commission and other health
facilities operated by voluntary religious and civic groups
(Williams-Tungpalan, 1981).
Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 34
These are the smaller, non-
departmentalized hospitals, including
emergency and regional hospitals in
which services to patients with
symptomatic stages of the disease,
which require moderately specialized
knowledge and technical resources
for adequate treatment is offered.

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 35
These are medical centers and large hospitals that offer highly
technological and sophisticated services.
These are the specialized national hospitals.
The services rendered at this level are
for clients afflicted with diseases that
seriously threaten their health and
which require highly technical and
specialized knowledge, facilities, and
personnel for effective treatment
(Williams-Tungpalan, 1981).
Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 36
Go to a health care facility near you and identify the its level
category.
Explain why.

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 37
• available health manpower resources
• local health needs and problems
• political and financial feasibility

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 38
 Village or • They are the first contacts of the community
Grassroot and initial links of health care.
Health Workers
Intermediate
• They simple curative and preventive health
Level Health care measures promoting healthy
Workers environment.
First Line • They also in activities geared towards the
Hospital improvement of the socio-economic level of
Personnel the community like food production program.
• These include community health workers,
volunteers, and/or traditional birth attendants

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 39
 Village or • These workers represent the first source of
Grassroot
Health Workers professional health care.
Intermediate • They attend to health problems beyond the
Level Health
Workers competence of village workers.
First Line • They provide support to front-line health
Hospital
Personnel workers in terms of supervision, training,
supplies, and services.
• These workers may include medical
practitioners, nurses, and midwives.
Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 40
 Village or
Grassroot
• They provide backup health services for cases
Health Workers that require hospitalization.
Intermediate
Level Health
• They establish close contact with intermediate
Workers level health workers or village health workers.
First Line
Hospital
• This set of workers includes physicians with
Personnel specialty, nurses, dentist, pharmacists, and
other health professionals.

Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 41
 • Global stewardship is emerging from intensified
exchanges between countries, often in
recognition of shared threats, challenges or
opportunities from growing solidarity; and from
the global commitment to eliminate poverty
exemplified in the Millennium Development
Goals (MDGs).
• The Philippine Health Care System underwent
continuous changes through the years in which
to provide quality healthcare for all remains its
main goal.
Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 42
 • The growing reality that many individuals
present with complex symptoms and multiple
illnesses challenges service delivery to develop
more integrated and comprehensive case
management.
• A complex web of interrelated factors is at work,
involving gradual but long-term increases in
income and population, climate change,
challenges to food security, and social tensions,
all with definite, but largely unpredictable,
implications for health in the years ahead.
Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 43
 • The support for a renewal of PHC stems from
the growing realization among health
policymakers that it can provide a stronger
sense of direction and unity in the current
context of fragmentation of health systems
and an alternative to the assorted quick fixes
currently touted as cures for the health
sector's ills.
• Present-day health systems are a patchwork
of components, many of which may be far
removed from the goals set out 30 years ago.
Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 44
 • These same health systems are converging.
Driven by the demographic, financial, and social
pressures of modernization, they increasingly
share the aims of improved health equity,
people-centered care, and a better protection of
the health of their populations.
• The increasing weight of some of the key values
underlying these expectations-equity, solidarity,
the centrality of people and their wish to have a
say in what affects them and their health-is a
long-term trend.
Health Information System for MLS Instructor: Aileen Mae Esmele-Ceas, RMT, MAEd-Sci, LPT 45