Declaration of Alma-Ata

Sustainable Development Goals

Duterte Health Agenda
Learning Objectives
At the end of the discussion, the students should be
able to:
a. briefly discuss the Declaration of Alma-Ata by
the World Health Organization
b. enumerate the Sustainable Development Goals
(SDG) of 2030
c. discuss the targets of each of the 17 SDGs
d. discuss the Duterte Health Agenda
 Declaration of Alma-Ata

Tertiary
Health Care

Secondary Health Care

Primary Health Care

COMMUNITIES

Fig 1. Primary Health Care within the Context of the Health Care Delivery System
 Section VII
Primary Health Care
1. Reflects and evolves from the economic conditions, socio-cultural
and political characteristics of the country, and its communities,
and is based on the application of the relevant results of social,
biomedical and health services research and public health
expenditures

2. Address the main health problems in the community, providing

promotive, preventive, curative and rehabilitative services
accordingly
3. Includes at least – education about prevailing health problems and
the methods of preventing and controlling them; promotion of food
supply and proper nutrition; an adequate supply of safe water and
basic sanitation; maternal and child health care, including family
planning; immunization against major infectious diseases;
prevention and control of locally endemic diseases; appropriate
treatment of common diseases and injuries; and provision of
essential drugs.

4. Involves in addition to the health sector, all related sectors and

aspects of national and community development in particular,
agriculture, animal husbandry, food industry, education housing,
public works, communication and other sectors; and demands the
coordinated efforts of all those sectors
5. Requires and promotes maximum community and individual
self-reliance and participation in the planning, organization,
operation and control of primary health care, making fullest
use of local, national and other available resources; and to this
end develops through appropriate education the ability of
communities to participate

6. Should be sustained by integrated, functional and mutually

supportive referral system leading to the progressive
improvement of comprehensive health care for all, and giving
priority to those in need
7. Relies at the local and referral levels of health
workers, including physicians, nurses, midwives,
auxiliaries and community workers as
applicable, as well as traditional practitioners as
needed; who are suitably trained, socially and
technically, to work as a health team and to
respond to the expressed health needs of the
community.
 The proposal aims to reduce by half at the
end of 2030 the number of people living in
poverty in all its dimensions both from
developed and developing countries which
includes child poverty, poverty among elderly,
among minor groups and to particular aspects of
poverty such as homelessness, food poverty and
fuel poverty.
 Hunger that leads to malnutrition is common among
developing countries and minor cases are seen in
developed countries. However, the SDG addresses the
problem because it has not been eliminated along with
problems with stunting and wasting. Obesity on the other
hand is also becoming a dilemma as overconsumption is
also a form of malnutrition. However, with hunger as the
major contributor to malnutrition, it is encouraged that
countries must make agriculture sustainable for the
consumption of its constituents.
1. Reduce maternal mortality
2. Reduce child and neonatal mortality
3. End epidemics of HIV, TB, malaria, and combat hepatitis, water-
borne diseases and other communicable diseases
4. Reduce mortality due to NCD and improve mental health
5. Strengthen prevention and treatment of substance abuse (narcotics,
alcohol)
6. Reduce mortality due to road traffic injuries
7. Promote universal access to sexual and reproductive healthcare
services
8. Achieve universal health coverage
9. Reduce deaths and illness due to pollution and contamination
 This goal focuses on the access of primary
and secondary education among the developing
countries as it has been a recognized problem for
its importance in employment purposes among
youths and adults. Opportunities should be given
to integrate a well-capable individual that will be
able to empower his or herself into the
management and life of educational institutions
at all levels.
 Equality between genders is deemed
necessary across all countries. While most men
are recognized as more capable of job
opportunities, the role of women in the society
should also be taken into consideration as there
should be empowerment of their rights. The
society must be able to accept and acknowledge
other gender and should ensure of their equality.
 Water accessibility and availability to most developed countries is not a
problem. The goal then lies with the access of countries to sustainable water
due to continuous depletion of natural resources wherein waste coming from
each and every individual becomes a posing problem as it affects the fresh
water and sanitation services. The goal therefore focuses on the improvement
and management of water as services should be deemed taking up lesser
energy. Protection through reforestation of water-related ecosystem is a
challenge both for developing and developed countries. The objective therefore
is to protect and restore water-related ecosystems through sustainable
development plans.
 Securing universal access to energy by 2030 is the focus of
this goal and is clearly directed to developing countries’
energy needs. It aims to give access to energy among all
nations. Although most developed countries already
achieved this goal, the challenge lies in sustaining renewable
energy at affordable prices. According to the SDG
Universality Report, “The development of renewable energy,
the phasing out of fossil fuels, and the promotion of energy
efficiency should be the key feature of developed countries’
sustainable development strategies”.
 The GDP per capita of developed countries have already
achieved high levels, its effort is now focused on achieving
sustainable patters of production and consumption and in
shifting their objective towards growing wellbeing. With this,
labor should also be translated into jobs as nations are
challenged to open job opportunities and employment in its
equality and rights because it is believed that this is the key
foundation to the countries’ sustenance of GDP.
 Coping up with the world’s technologies should always be
undertaken by each and every country as innovations makes
more productivity for the country. This includes
industrialization or providing product or labor for the creation
of something valuable. With the upgrading of infrastructure
and retrofit industries to make a country sustainable by 2030.
But also includes innovations that are of less cost with high
efficiency, high productivity, clean and environmentally sound
technologies and industrial processes that have relevance to
undertake over the next generation.
 Treatment among, across and within nations should be equal
from all perspectives. From social responsibilities to economic
responsibilities such as distribution of goods and services
among countries. This is necessary to maintain and
progressively achieve equality which urges countries to adopt
policies that are universally applicable for achieving and
sustain income growth of the bottom 40% of the population at
a rate higher than the national average. Other than that,
countries should also work towards development of new
policies or guidelines to achieve continuous progress and
adapt with the growing demands of its constituents.
Inclusive and sustainable urbanization is the goal of both
developed and developing countries with regard to
sustainability, safety and resilience. This could be
achieved by 2030 through improvements in planning
policies, establishment of quantified targets,
improvements in the sustainability of housing and other
building amongst others. In addition, air pollution and
waste management should also be taken into
consideration in the planning and prioritization.
Although there is noticeable control in the consumption
of energy, it is still a problem in most developed
countries as some still cannot control excessive
consumption of non-renewable energy. This is then the
challenge for the countries to switch from consumption
of non-renewable to renewable energy. Although most
industries have already done, much progress is expected
for the next 15 years.
 Climate change has always been hard to combat
especially with the current growing population,
congestion, consumption of goods and production of
waste. It is therefore, the top priority of each and every
country to make tougher targets, control, management
and compliance among its individuals. Although some
progress has been done to preserve the natural resources,
the results do not remarkably sustain the environment.
 The goal promotes and educates all individuals to take
measure in the conservation of marine resources. It
should be put in place by 2020. This means that there
should be an end to illegal fishing or any destructive
fishing practices. It should preserve not only the marine
but also the coastal ecosystems as there have been recent
problems on ocean acidification.
 This goal along with the previous goal want to sustain
terrestrial ecosystems as there has been constant
depletion of land biodiversity. To do that, there should be
reforestation. It should strengthen law and policies. More
effort exerted to take urgent and significant action to
reduce degradation of the natural habitat of land
animals. Countries should protect land, soil, forests,
biodiversity and ecosystems both within their country
and outside.
 All countries need to review the adequacy of their
institutions and judicial processes for the achievement of
sustainable target set at the end of 2030 at all levels as an
identified key priority. The top targets for this goal is to
reduce violence, reduce illicit financial and arms flows,
and ensuring responsive, inclusive, participatory and
representative decision-making at all levels.
 These SDGs are set to be done by all countries in
collaboration with one another. It is a partnership that
involves all participants for the attainment of a
sustainable development. The implementation will
strengthen through constant feedbacks, monitoring and
evaluation done by each country which will somehow
determine the benefits and risks encountered. This can
then be tailor-fitted to sustain the development of
countries.
 All for Health
towards
Health for All

THE DUTERTE HEALTH AGENDA

“ Lahat para sa Kalusugan

tungo sa Kalusugan para sa Lahat”
 Values
• Filipinos able to access services with least financial, cultural and
geographical barriers
• Preference for the underserved
• Filipinos able to demand quality and compassionate services at par
with global clinical and non-clinical standards
• Filipinos able to continuously get the most health from resources
allocated (cost-effective)
• Filipinos able to make informed choices with respect to their
health/care and participate in holding the government accountable
to the people
 Vision
Financial Protection
- Filipinos protected from health-related impoverishment
Better Health Status
- Filipinos attain best possible health outcomes with less
disparity
Responsiveness
- Filipinos feel respected and valued in all of their interaction
with the health system
What services to
Strategy
guarantee or
prioritize? How to best
deliver the
Access
Protectfunctional
from
services?
Attain & Sustain
TRIPLE
SERVICEBURDEN
DELIVERY OF DISEASE
NETWORKS
UNIVERSAL HEALTH INSURANCE

How to equitably and efficiently finance the service?

 Triple Burden of Disease
a. SERVICES THAT ADDRESS THE TRIPLE BURDEN OF
DISEASE
o Communicable
o Non-communicable, including malnutrition
o Diseases of rapid urbanization and industrialization (e.g. Injuries,
mental health (including suicide prevention) and alcohol /drug use)
 Triple Burden of Disease
b. SERVICES THAT CORRESPOND TO THE FULL
SPECTRUM OF CARE FOR ALL LIFE STAGES (minimal
exclusions)
o Promotive, preventive, curative, rehabilitative, palliative
oEmphasis on role of health promotion and primary care
(annual health check)
 Triple Burden of Disease
c. INTERVENTIONS THAT MODIFY BUILT
ENVIRONMENT AND MOBILIZE COMMUNITIES
o Trigger behavioral shift towards healthy lifestyle/habits
o Adopt and scale-up community-based interventions
o Create strategic partnerships to promote healthy homes,
workplaces, schools and transport
 Service Delivery Network
a. NETWORKS AS CONTRACTED UNITS OF PHILHEALTH,
ACCOUNTABLE FOR ENSURING:
o Appropriate, ethical and at par with clinical and non-clinical standards
oPhysical access
oSeamless continuum of services
oPatient/client-friendly and culturally-sensitive services
 Service Delivery Network
b. NETWORKS ENHANCED BY RELIABLE DATA & REGULAR
FEEDBACK
oMandate online submission/data sharing and reporting to disease
registries
oObtain accurate feedback: e.g. ghost patients, surprise field visits
oStreamline monitoring and evaluation systems and create dedicated
performance unit
 Service Delivery Network
c. NETWORKS RESILIENT IN TIMES OF DISASTER
oStrengthen preparedness initiatives
 Universal Health Insurance
a. PHILHEALTH AS GATEWAY TO FINANCIAL ACCESS TO
SERVICES and PROTECTION FROM CATASTROPHIC
SPENDING
b. PHILHEALTH AS MEANS TO SUSTAINABLY FINANCE
GOODS AND SERVICES
 Governance
BUILD CAPACITY AND ESTABLISH
ACCOUNTABILITY IN FULFILLMENT OF
INDIVIDUAL & SECTORAL MANDATES
• Strengthen DOH as a policy and regulatory agency and PhilHealth as the national
government purchaser
• Leverage support for and hold LGUs accountable in their role as as service providers
and local stewards of health

ENSURE EFFICIENCY, TRANSPARENCY &

PREDICTABILITY AND INTEGRITY OF
GOVERNMENT TRANSACTIONS
• Reduce red tape and limit turnaround time of transactions to 3 days
• Make transactions client-friendly, professional and transparent
• Establish mechanisms to ensure integrity is upheld in all transactions
 Health Financing
GENERATE MORE REVENUES FOR HEALTH

• Ensure progressiveness of premium rates for the formal sector

• Improve collection efficiency
• Raise premium rate (by 2018)

PURCHASE HEALTH SERVICES EFFICIENTLY

• Set price ceilings to reduce unpredictability of out-of-pocket payments
• Reform provider payment mechanism to reflect true cost
 Service Delivery
DEFINE HEALTH ENTITLEMENTS AND STANDARDS OF CARE
• Establish transparent priority setting process to ensure equitable and fair expansion of
health insurance benefits
• Prioritize mental health, smoking cessation, and drug rehabilitation entitlements
• Incorporate patient’s rights/rights-based approach in entitlements
• Require only “unique health ID” when accessing entitlements

ESTABLISH FUNCTIONAL PRIMARY-CARE FOCUSED

SERVICE DELIVERY NETWORKS
• Define scope of services and map existing service capabilities
• Develop health facility/hospital investment plan
• Position DOH hospitals within SDNs (teaching/training, equity center)
 Health Care Workforce
RECONFIGURE FRONTLINE HUMAN RESOURCE COMPLEMENT BASED
ON COMPETENCY RATHER THAN PROFESSION
• Modify curriculum to make it more responsive to the needs
• Match medical schools work with geographic areas (return service program for graduates)

ESTABLISH SUSTAINABLE RECRUITMENT AND RETENTION OF TALENTED

PROFESSIONALS
• Consolidate financing towards fair compensation (salary, PhilHealth reimbursements, other
incentives)
• Actively promote opportunities for post-graduate training
• Reorient deployment programs to balance contribution
with career development
 Medicines, Devices
& Other Technology

ENSURE ACCESS TO LOW-COST QUALITY ESSENTIAL MEDICINES and

DIAGNOSTICS
• Publish prices of drugs and diagnostics
• Establish price negotiation board and mechanisms for bulk purchasing
• Explore options for supply chain management (outsourcing)

USE HEALTH TECHNOLOGY ASSESSMENT(HTA) TO SYSTEMATICALLY

DETERMINE DRUGS AND DIAGNOSTICS THAT WILL BE PAID BY DOH
and PHIC
• Establish body and institutionalize process to conduct HTA to guide coverage decisions
 Health Information and
Information Systems

STRENGTHEN SECTOR’S CAPACITY FOR HEALTH PROMOTION

• Establish external health promotion body

UPHOLD CITIZEN’S RIGHTS TO INFORMATION AND PATIENT’S RIGHTS

• Make health data, processes, and prices transparent & accessible

STRENGTHEN DATA GOVERNANCE FOR NATIONAL DECISION MAKING

• Streamline data and report requirements across facilities
• Harmonize health information systems and databases
• Require submission of data as part of licensing and contracting
• Establish mechanisms to obtain regular feedback from all stakeholders
Battlecry:

Mahal Ko ang Pilipinas, simply

because it is the Land of my Birth
Duterte Marching Order
 Hire anyone you think can help basta wag lang
corrupt
 No queuing, kawawa ang Pilipino
 Change is coming
 All appointees undergo
screening process. No kaibigan,
kamag-anak.
 No junket travels
References:
• A, J., & L, S. (2013, April 23). Overview of Public Health Administration. Retrieved
September 9, 2016, from http://samples.jbpub.com/9781449688332/Chapter1.pdf
• Alma Ata Declaration. (1978). Retrieved from
http://www.powershow.com/view/4a9bd-MGZlO/ALMA_ATA_DECLARATION_p
owerpoint_ppt_presentation
• Department of Health (2016). Duterte Health Agenda
• United Nations (2015). Sustainable Development Goals Retrieved August 06, 2016,
from https://sustainabledevelopment.un.org/sdgs
• United Nations. (2015, October 21). General Assembly. Retrieved from
http://www.un.org/ga/search/view_doc.asp?symbol=A/RES/70/1&Lang=E
• World Health Organization (1978). Declaration of Alma Ata. Retrieved September
09, 2016, from
http://www.euro.who.int/__data/assets/pdf_file/0009/113877/E93944.pdf
PRIMARY HEALTH CARE
The WHO defines PHC as:

• “Essential health care made universally,

accessible to individuals & families in the
community by means of acceptable to
them, through their full participation & at
a cost that community and country can
afford to maintain at every stage of their
development in the spirit of self-reliance &
self-determinations”
History of PHC:

• May 1977- The 30th World Health Assembly

adopted resolution WHA 3043, which decided
that the main social target of the government &
WHO should be the attainment of a level of health
that would lead people to a socially &
economically productive life by year 2000.
 “Health for all by year 2000”
• September 6-12, 1978: First International
Conference in PHC was held at Alma Ata, USSR
(Russia) on PHC
 PHC is the key to attain of “Health for All” goal
• October 19, 1979: LOI 949. Legal Basis of PHC in
the Philippines.
-Issued by Pres. F. Marcos, which mandated the
Ministry of Health to adopt PHC as approach towards
design, development, and implementation of
programs which focus health development at the
community level.
• September 11, 1981: Launching of PHC by
Sec. Azurin in the Philippines.
• 1990: Health in the hands of the people by
year 2020.
• AO No. 11 of 1993: Installed PHC as a
course strategy in program thrusts of the
government at national and local community
leaders to enable their people in active
participation for better health and self-
reliance
The Alma Ata Conference on PHC made the
following declarations:
• Health is a basic fundamental right.
• There exists global burden of health inequalities
among populations.
• Economic and social development is of basic
importance for the full attainment of health for
all.
• Governments have a responsibility for the health
of their people.
Why adopt PHC?
• Magnitude of health problems
• Inadequate and unequal distribution of health
resources
• Increasing cost of medical care
4 Pillars or Cornerstone:
> Active community participation
> Intra & inter-sectoral linkages
> Use of appropriate technology
> Support mechanism made available
ESSENTIAL HEALTH SERVICES OF PHC:
Education for Health
Locally Endemic Disease Control
Expanded Program on Immunization
Maternal and Child Health and Family Planning
Envi’l Sanitation and Promotion of Safe Water Supply
Nutrition and Promotion of Adequate Food Supply
Treatment of CD and Common Illness
Supply of Essential Drugs
  
1. Education for Health
• This is one of the potent methodologies
for information dissemination. It
promotes the partnership of both the
family members and health workers in
the promotion of health as well as
prevention of illness.
2. Locally Endemic Disease Control
• The control of endemic disease
focuses on the prevention of its
occurrence to reduce morbidity rate.
• Example: Malaria control and
Schistosomiasis control
3. Expanded Program on Immunization
• This program exists to control the
occurrence of preventable illnesses
especially of children below 6 years old.
Immunizations on poliomyelitis, measles,
tetanus, diphtheria and other preventable
disease are given for free by the
government and ongoing program of the
DOH.
4. Maternal and Child Health
and family planning
• The mother and child are the most
delicate members of the community. So
the protection of the mother and child to
illness and other risks would ensure good
health for the community. The goal of
family planning includes spacing of
children and responsible parenthood.
5. Environmental Sanitation and
Promotion of Safe Water Supply

• Environmental Sanitation is defined as the

study of all factors in the man’s environment,
which exercise or may exercise deleterious effect
on his well-being and survival.
• Water is a basic need for life and one factor in
man’s environment. Water is necessary for the
maintenance of healthy lifestyle. Safe Water and
Sanitation is necessary for basic promotion of
health.
6. Nutrition and Promotion of
Adequate Food Supply

• One basic need of the family is food. And if food

is properly prepared then one may be assured
healthy family. There are many food resources
found in the communities but because of faulty
preparation and lack of knowledge regarding
proper food planning, malnutrition is one of the
problems that we have in the country.
7. Treatment of Communicable
Diseases and Common Illness
• The diseases spread through direct contact
pose a great risk to those who can be infected.
Tuberculosis is one of the communicable
diseases continuously occupies the top ten
causes of death. Most communicable diseases
are also preventable. The Government
focuses on the prevention, control and
treatment of these illnesses.
8. Supply of Essential Drugs
• This focuses on the information campaign on the
utilization and acquisition of drugs. 
• In response to this campaign, the GENERIC ACT of
the Philippines is enacted.
• It includes the following drugs: Cotrimoxazole,
Paracetamol, Amoxycillin, Oresol, Nifedioine,
Rifampicin, INH (isoniazid) and Pyrazinamide,
Ethambutol, Streptomycin, Albendazole,Quinine
 Primary Health Care Principles and Strategies
Principles Strategies

1. Accessibility, a. Health services delivered where

Affordability, the people are
Availability, and b. Use of indigenous/resident
Acceptability of volunteer health worker as health
Health Services care provider with a ratio of one
community health worker per 10-
20 household
c. Use of traditional (herbal) with
essential drugs
ACCESSIBILITY physical distance of a health
facility or the travel time required for people to get
the needed or desired health services.
 in order for these facilities to be accessible, they
must be within 30 minutes from the communities.

AFFORDABILITY not only in the consideration of

the individual or family’s capacity to pay for basic
health services.
 particularly for public health services, it is also a
matter of whether the community or government
can afford these services.
ACCEPTABILITY  the health care offered is in
consonance with the prevailing culture and
traditions of the population.

AVAILABILITY a question of whether the basic

health services required by the people are offered in
the health care facilities or is provided on a regular
and organized manner.
Primary Health Care Principles and Strategies
Principles Strategies
2. Provision of quality, a. Training design and curriculum based on
basic and essential community needs and priorities, task analysis
health services of community health workers (CHW) and
competency based.
b. Attitudes, knowledge and skills developed are
on promotive, preventive, curative and
rehabilitative health care;
c. Regular monitoring and periodic evaluation
of CHW
d. Performance by the community and health
staff
Primary Health Care Principles and Strategies
Principles Strategies
3. Community a. Awareness-building and consciousness-
Participation raising on health and health-related issues
b. Planning, implementation, monitoring and
evaluation done through small group
meetings (10-20 households cluster)
c. Selection of CHW by the community;
d. Community building and community
organizing;
e. Formation of health committees;
f. Establishment of a CHW organization at
parish/municipal level
g. Mass health campaigns and mobilization to
combat health problems
Primary Health Care Principles and Strategies
Principles Strategies
4. Self-reliance a. Community generating support (cash, in
kind, labor) for the health program
b. Use of local resources (human, financial,
material)
c. Training of community in leadership and
management skills
d. Incorporation of income generating
projects, cooperatives, small scale
industries
Primary Health Care Principles and Strategies
Principles Strategies
5. Recognition of the a. Convergence of health, food, nutrition, water
inter-relationship sanitation and population services
between health and b. Integration of PHC into national, regional,
development provincial, municipal and barangay
development plans
c. Coordination of activities with economic
planning, education, agriculture, industry,
housing, public works, communication and
social services
Primary Health Care Principles and Strategies
Principles Strategies
6. Social mobilization a. Establishment of an effective health referral
system
b. Multisectoral and interdisciplinary linkages
c. Information, education, and communication
support using multimedia
d. Collaboration between government and
government organizations
Primary Health Care Principles and Strategies
Principles Strategies
7. Decentralization a. Reallocation of budgetary
resources
b. Reorientation of health
professionals regarding PHC
c. Advocacy for political will and
support from the national
leadership down to the barangay
level
PHC workers
In general, the PHC team may consist of:
> Physician
> Nurses
> Midwives
> nurse auxiliaries
> Locally trained community health workers
> Traditional birth attendants and healers
 Three Levels of PHC Workers
1.Village or Grassroot Health Workers
 first contacts of the community and initial
links of health care
provide simple curative and preventive health
care measures promoting healthy environment
trained community health workers, volunteers
or traditional birth attendants or healer
2. Intermediate level health workers
 represent the first source of professional health
care
attends to health problems beyond the
competence of village workers
provide support to the front-line health workers
in terms of supervision, training, supplies, and
services
General Medical practitioners, PH nurses
3. First Line Hospital Personnel
 provide back up health services for cases that
require hospitalization or diagnostic facilities not
available in the health center
 establish close contacts with intermediate level
health workers or village health workers to
promote community of care from hospital to
community and home
 Physicians with specialty, nurses, dentist,
pharmacists, other health professionals who are
working in primary hospitals.
Levels of Health Care Facilities
• Primary Level
• Secondary Level
• Tertiary Level
Primary Level

• The “first” level of contact between the individual and

the health system.
• Serves as the foundation of health care based upon
which progressive levels of care are restructured.
• RHUs, their sub-centers, chest clinics, malaria
eradication units, and schistosomiasis control units,
puericulture centers, TB clinics and hospitals
*Provide basic curative, preventive, heath care
measures
*First aid
Secondary Level
• The 1st referral level
• Consists of a smaller , non-departmentalized
hospitals including emergency and regional
hospitals.
• Services are offered to patients with symptomatic
staged of disease, which require moderately
specialized knowledge and technical resources for
adequate treatment.
Tertiary Level
• Are highly technological and sophisticated
services offered by medical centers and large
hospitals
• These are the specialized national hospitals.
• Services rendered at this level are for clients
afflicted with diseases which seriously threaten
their health and which require highly technical
and specialized knowledge, facilities, and
personnel to treat effectively.
• Provide training programs
The Basic Requirements for Sound PHC (the 8 A’s and
the 3 C’s)

• Appropriateness • Assessability
• Availability • Accountability
• Adequacy
• Completeness
• Accessibility
• Acceptability
• Comprehensiveness
• Affordability • Continuity
Appropriateness
• Whether the service is needed at all in relation to
essential human needs, priorities and policies.
The service has to be properly selected and
carried out by trained personnel in the proper
way.
Adequacy

• The service proportionate to requirement.

• Sufficient volume of care to meet the need and
demand of a community
Affordability

• The cost should be within the means and

resources of the individual and the
country.
Accessibility

• Reachable, convenient services

• Geographic, economic, cultural
accessibility
Acceptability

• Acceptability of care depends on a variety of

factors, including satisfactory communication
between health care providers and the patients,
whether the patients trust this care, and whether
the patients believe in the confidentiality and
privacy of information shared with the
providers.
Availability

• Availability of medical care means that

care can be obtained whenever people
need it.
Assessability

• Assessebility means that medical care

can be readily evaluated.
Accountability

• Accountability implies the feasibility of

regular review of financial records by
certified public accountants.
Completeness

• Completeness of care requires adequate

attention to all aspects of a medical
problem, including prevention, early
detection, diagnosis, treatment, follow up
measures, and rehabilitation.
Comprehensiveness

• Comprehensiveness of care means that

care is provided for all types of health
problems.
Continuity

• Continuity of care requires that the

management of a patient’s care over time
be coordinated among providers.
 TRADITIONAL AND ALTERNATIVE
HEALTH CARE

RA 8423 or the TRADITIONAL & ALTERNATIVE

MEDICINE ACT OF 1997  this created the
Philippine Institute of Traditional and Alternative
Health Care, which is tasked to promote and
advocate the use of traditional and alternative
health care modalities through scientific research
and product development.
RA 8423 defined TRADITIONAL MEDICINE as…
• “the sum total of knowledge, skills, and practice
on the health care, not necessarily explicable in
the context of modern, scientific, philosophical
framework, but recognized by the people to help
maintain and improve their health towards the
wholeness of their being, the community and the
society, and their interrelations based on culture,
history, heritage, and consciousness”
ALTERNATIVE HEALTH CARE
• Other forms of nonallopathic, occasionally
nonindigenous or imported healing
methods, though not necessarily practiced
for centuries nor handed down from one
generation to another.
 10 Medicinal Plants endorsed by the DOH
MEDICINAL USE/INDICATION PREPARATION
PLANTS
Lagundi Asthma, cough and colds, fever, Decoction
dysentery, pain, skin diseases Wash infected site
(scabies, ulcer, eczema), wounds with decoction
Yerba buena Headache, stomachache, cough Decoction
and colds, rheumatism, arthritis Infusion
Massage sap
Sambong antiedema/antiurolithiasis Decoction
Tsaang gubat Diarrhea, stomachache Decoction
Niyog-niyogan antihelminthic Seeds are used
Bayabas Washing wounds, diarrhea, gargle, Decoction
toothache
Akapulko antifungal Poultice

Ulasimang bato/ Lowers BUA (rheumatism and Decoction, eaten

pansit-pansitan gout) raw
Bawang Hypertension, lowers blood Eaten raw/fried
cholesterol
toothache Apply on part
Ampalaya DM (mild non-insulin dependent) Decoction,
Steamed
 Lagundi Sambong Tsaang gubat

Yerba buena Niyog-niyogan Ulasimang bato

Akapulko Ampalaya

Bawang

Bayabas
ALTERNATIVE HEALTHCARE MODALITIES
1. Acupressure  a method of healing and health
promotion that uses the application of pressure
on acupuncture points without puncturing the
skin.
2. Acupuncture a method of healing using
special needles to puncture and stimulate
specific anatomical points on the body
3. Aromatherapy  the art & science of the sense
of smell whereby essential aromatic oils are
combined and then applied to the body in some
form of treatment
4. Chiropractic  a discipline of the healing arts
concerned with the pathogenesis,
diagnosis, therapy, and prophylaxis of
functional disturbances, pathomechanical
states, pain syndromes, and
neurophysiological effects related to the
static and dynamics of locomotor system,
especially of the
spine and pelvis
5. Herbal medicine / phytomedicine
6. Massage  a method wherein the superficial
soft parts of the body are rubbed, stroked,
kneaded, or tapped for remedial, aesthetic,
hygienic, or limited therapeutic purposes
7. Nutritional therapy  the use of food as
medicine and to improve health by
enhancing the nutritional value of food
components that reduces the risk of a
disease. It is synonymous with nutritional
healing
8. Pranic healing  a holistic approach that
follows the principle of balancing energy
9. Reflexology  the application of therapeutic
pressure on the body’s reflex points to
enhance the body’s natural healing
mechanisms and balance body functions.
 it is based on the principle that internal
glands and organs can be influenced by
properly applying pressure to the
corresponding reflex are on the body
 PHC VS PRIMARY CARE
POINT OF
PRIMARY HEALTH CARE PRIMARY CARE
COMPARISON
Focus client Family and community Individual
Focus of care Promotive and preventive through Curative, provided by
community participation health professionals
Decision-making Community-centered/consultative- Health worker driven
process participative
Outcome Self-reliance/ self-help Reliance on health
professionals to
restore/regain health

Setting for services Rural-based satellite clinics, Mostly urban-based

community health centers, health hospitals, clinics
posts that are accessible to all

Goal Development and preventive care Absence of disease

 a n k Y o u
T h