PRIMARY

HEALTH CARE
JONA PHIE D. MONTERO, RN,RM

J. MONTERO. 2017. SKSU NURSING

I. Concept of Health

1986.
A state of complete physical,
mental and social well-being and
not merely the absence of disease
or infirmity

J. MONTERO. 2017. SKSU NURSING

CONCEPT OF HEALTH AND ILLNESS

J. MONTERO. 2017. SKSU NURSING

CONCEPT OF HEALTH AND ILLNESS

J. MONTERO. 2017. SKSU NURSING

 ACTIVITY 1. think.pair.share

• WHAT IS YOUR DEFINITION OF HEALTH? 1/4

J. MONTERO. 2017. SKSU NURSING

CONCEPT OF HEALTH AND ILLNESS

WELLNESS
State of WELL-BEING

J. MONTERO. 2017. SKSU NURSING

 Seven
components of
WELLNESS
J. MONTERO. 2017. SKSU NURSING
 CONCEPT OF HEALTH AND ILLNESS

ILLNESS
Highly PERSONAL STATE
Physical, emotional, intellectual, social, developmental or spiritual
functioning is thought to be diminished.

J. MONTERO. 2017. SKSU NURSING

 Models of Health and Illness
A. SMITH’s MODEL OF HEALTH
1.Clinical Model
2.Role Performance Model
3.Adaptive Model
4.Eudemonistic Model

J. MONTERO. 2017. SKSU NURSING

CLINICAL MODEL
*Not being sick*

J. MONTERO. 2017. SKSU NURSING

 ROLE PERFORMANCE MODEL
*ability to fulfill societal roles*

J. MONTERO. 2017. SKSU NURSING

 ADAPTIVE MODEL
*disease is a failure in adaptation*

J. MONTERO. 2017. SKSU NURSING

 EUDEMONISTIC MODEL
*Emphasizes interactions between
physical, social, psychological and
spiritual aspects of life and
environment*
J. MONTERO. 2017. SKSU NURSING
ECOLOGIC MODEL
*use in predicting illness*

J. MONTERO. 2017. SKSU NURSING

HEALTH -ILLNESS CONTINUUM
* Measure perceived level of wellness*

J. MONTERO. 2017. SKSU NURSING

DUNN’S HIGH LEVEL
WELLNESS GRID

*Interaction of
environment with
illness-wellness
continuum

J. MONTERO. 2017. SKSU NURSING

 LEVELS OF PREVENTION
1.PRIMARY
2.SECONDARY
3.TERTIARY

J. MONTERO. 2017. SKSU NURSING

 PRIMARY PREVENTION
*HEALTH PROMOTION AND DISEASE PREVENTION*

J. MONTERO. 2017. SKSU NURSING

 PRIMARY PREVENTION
HEALTH PROMOTION DISEASE PREVENTION
( PRIMORDIAL PREVENTION)
Patient WELL PATIENTS AT RISK PATIENTS
Goal  WELLNESS  PROTECT AND PRESERVE LIFE
 PROMOTE HEALTH LIFESTYLE
 ELIMINATE HEALTH RISK FACTORS
Example • PROPER NUTRITION • VACCINATION
• EXERCISES • IMMUNIZATION
• HEALTH EDUCATION ACTIVITIES • PROPHYLAXIS
• STRESS REDUCTION

J. MONTERO. 2017. SKSU NURSING

SECONDARY PREVENTION
*diagnosis and treatment*

J. MONTERO. 2017. SKSU NURSING

 SECONDARY PREVENTION
DIAGNOSIS PROMPT TREATMENT
(EARLY DETECTION)
Patient ASYMPTOMATIC SYMPTOMATIC
Example  REGULAR DENTAL EXAM  FIRST AID
 CHECK-UP  SURGERY
 SCREENING/LABORATORY TESTS  ACUTE CARE
 OPERATION TIMBANG  EMERGENCY CARE
 CASE FINDING
 PHYSICAL ASSESSMENT

J. MONTERO. 2017. SKSU NURSING

 TERTIARY PREVENTION
*rehabilitation, health restoration, palliative care*

J. MONTERO. 2017. SKSU NURSING

 TERTIARY PREVENTION
REHABILITATION PALLIATIVE CARE
Patient LATE SICK, CHRONICALLY ILL
Example  PHYSICAL THERAPY  HOSPICE CARE
 SPPECH THERAPY  END OF LIFE CARE
 SELF MONITORING

J. MONTERO. 2017. SKSU NURSING

• https://www.med.uottawa.ca/sim/data/Prevention_e.htm

J. MONTERO. 2017. SKSU NURSING

 II. HEALTH as MULTIFACTORAL PHENOMENON

MODERN CONCEPT OF HEALTH

OPTIMUM LEVEL OF
FUNCITONING (OLOF)
of individuals, families and
communities is being influenced by
several factors in the ecosystem.

J. MONTERO. 2017. SKSU NURSING

 FACTORS AFFECTING OLOF
1. Behavioral
2. Heredity
3. Environment
4. Socio-economic
5. Health care delivery system
6. Political
Factors in the
BEHAVIORAL
ecosystem
POLITICS HEREDITY

OLOF
HEALTH CARE
DELIVERY ENVIRONMENT
SYSTEM

SOCIO-
ECONOMIC

J. MONTERO. 2017. SKSU NURSING

Factors in the BEHAVIORAL
*attitudes

ecosystem
POLITICS
*power
HEREDITY
*genes
*authority
*race
*safety and security
*family history
*opperession

HEALTH CARE
OLOF
ENVIRONMENT
DELIVERY SYSTEM
*sanitation
*programs
*vegetation
*health facility SOCIO-
ECONOMIC
*education
*employment
*housing

J. MONTERO. 2017. SKSU NURSING

III. THE PHILIPPINE HEALTH CARE DELIVERY SYSTEM

J. MONTERO. 2017. SKSU NURSING

National Health
Situation

J. MONTERO. 2017. SKSU NURSING

National Health
Situation

MMR
J. MONTERO. 2017. SKSU NURSING
National Health
Situation

Uptake to medical services

J. MONTERO. 2017. SKSU NURSING

National Health Situation

J. MONTERO. 2017. SKSU NURSING

 Philippine Health Care Delivery System
Health Care Delivery System – the totality of all policies, facilities
equipments, products, human resources and services which address the
health needs, problems and concerns of the people. It is large,
complex, multi-level and multi-disciplinary consisting of
• The public sector
• The private sector

J. MONTERO. 2017. SKSU NURSING

 Public sector
• Executive Order 102 – identifies DOH as the national authority
on health
providing technical and other resource assistance to concerned
groups;
• mandates DOH to perform the roles related to leadership in
health, enabler and capacity builder and administrator of
specific services
• RA 7160 (Local Government Code)
for the delivery of basic services an
government including
health services and facilities making
partners in the attainment of local
responsive and local government s
 Roles and Functions of the DOH
1. Leadership in Health
• Serve as national policy and regulatory institution from which LGUs, NGOs
and other members of the health sector involved in social welfare and
development will anchor their health thrusts and directions
• Provide leadership in the formulation, monitoring and evaluation of national
health policies, plans and programs
• Serve as advocate in the adoption of health policies, plans and programs to
address national and local concerns.
2. Enabler and Capacity-builder
• Innovate new strategies in health to improve effectiveness of health
programs, initiate public discussion on health issues and undertaking and
disseminate policy research outputs to ensure informed public participation
in policy decision-making
• Exercise oversight functions and monitoring and evaluation of national
health plans, programs and policies
• Ensure the highest achievable standards of quality health care, health
promotion and protection
3. Administrator of Specific Services
• Manage selected national health facilities and hospitals that shall
serve as national referral centers, referrals for local health systems
• Administer direct services for emergent health concerns that require
new complicated technologies necessary for public welfare; administer
special components of specific programs in as much as it will benefit
and affect large segments of the population
• Administer health emergency response services including referral and
networking system for trauma, injuries, catastrophic events, epidemic
and other widespread public danger
Vision A global leader for attaining health outcomes, competitive and responsive health system and
equitable health care financing.
Mission Guarantee equitable, sustainable and quality health for all
Filipinos especially the poor and shall lead the quest for
excellence in health

Goal Health Sector Reform Agenda (HSRA)

Support mechanisms will be through sound organizational
development, strong policies, systems and procedures,
capable human resources and adequate financial
resources
Rationale:
- Slowing down in the reduction of IMR and the MMR
- Persistence of large variations in health status across
populations
- High burden from infectious disease, rising burden from
chronic and degenerative diseases
- Unattended emerging health risks from environment
and work-related factors
- Burden of disease is heaviest on the poor
 Context in developing the community health plan: Global Health
Situation

Global Health Situation The Sustainable development goals

Global health is characterized by:
– Shifts in demographic and epidemiological
trends in diseases including the emergence
and re-emergence of diseases and in the
prevalence of risk and protective factors
– New technologies in health care ,
communication and information
– Existing and emerging environmental
hazards associated with globalization
– Health reforms
 Levels of Health Care Facility

• Basic primary health care team: physician, nurses and

midwives
• Two levels of primary health care workers:
– village or barangay health workers (trained community health
workers, health auxiliary volunteer or TBA) and
– intermediate level health workers (general medical practitioners
or their assistants, PHN, RSI and RM)
 Level of Type of Service Facility where service is Type of health worker
health care rendered rendering the service

Primary Health promotion, preventive care,
level continuing care for common health
problems, attention to psychological
and social care, referrals
BHS, health centers/RHU, Health center physicians,
community hospitals, PHN, RHM, V/BHWs,
puericulture centers traditional healers and
other auxiliary health
workers

Secondary Surgery and medical services, Privately-owned or Physicians and other

level diagnosis and treatment government run provincial health professionals with
and city hospitals; basic health training to
emergency district render appropriate health
hospitals services

Tertiary Advanced, specialized, diagnostic, Regional and national Specialists

level therapeutic and rehabilitative care medical centers and
training hospitals
 Levels of Health Care Facility
Tertiary Regional and national
Specialists Advanced, medical centers and training
specialized, hospitals
diagnostic,
therapeutic and
Physicians and other health rehabilitative care Privately-owned or
professionals with basic Secondary government run provincial
health training to render and city hospitals;
Surgery and medical services,
appropriate health services diagnosis and treatment emergency district hospitals
Primary
Health promotion, preventive care, continuing care for
common health problems, attention to psychological and
social care, referrals
Health center physicians, PHN, RHM, BHS, health centers/RHU,
V/BHWs, traditional healers and other community hospitals, birthing clinic
auxiliary health workers

J. MONTERO. 2017. SKSU NURSING

IV. The Philippine Health Care Delivery System

J. MONTERO. 2017. SKSU NURSING

 Duterte Health Agenda- All for health towards
health for all
• New folder\320908042-Duterte-Health-Agenda-v-7-14-16.pdf

J. MONTERO. 2017. SKSU NURSING

 Assignment
• Share a news item about recent undertakings of DOH that you
think will impact on the health situation in the Philippines
• Discuss the potential effects of these undertakings on the local
health situation

J. MONTERO. 2017. SKSU NURSING

•QUIZ ¼

J. MONTERO. 2017. SKSU NURSING

PRIMARY
HEALTH
CARE

J. MONTERO. 2017. SKSU NURSING

 • Declared in Alma Ata, USSR on September 6
PRIMARY HEALTH CARE 12, 1978

J. MONTERO. 2017. SKSU NURSING

PHC in the Philippines
• LOI 949
• October 19, 1979
• Goal:

HEALTH IN THE HANDS

OF PEOPLE BY 2020

J. MONTERO. 2017. SKSU NURSING

Definition : PHC
An "essential health care" that is based on
"scientifically sound and socially acceptable methods
and technology, which make universal health care
accessible to all individuals and families in a community. It is
through their full participation and at a cost that the
community and the country can afford to maintain at every
stage of their development in the spirit ofself-reliance
and self-determination“
- World Health Organization. Declaration of Alma-Ata. Adopted at the International Conference on Primary Health Care, Alma-Ata,
USSR, 6–12 September 1978.

J. MONTERO. 2017. SKSU NURSING

 PRIMARY HEALTH CARE

Healthcare is:
- Acceptable - Accessible - Affordable
- Available - Sustainable - Community Based

Focus- Individual -Family - Community

Full participation and active involvement of the community

SELF RELIANT PEOPLE

J. MONTERO. 2017. SKSU NURSING

FOUR (4) PILLARS OF PHC

J. MONTERO. 2017. SKSU NURSING

 KEY PRINCIPLES
• Accessibility, affordability, acceptability and availability
• Support mechanisms
• Multi sectoral approach
• Community participation
• Equitable distribution of health resources
• Appropriate technology

J. MONTERO. 2017. SKSU NURSING

 COMPONENTS OF PHC
There are 8 elements of primary-health care (PHC).
E– Education concerning prevailing health problems and the methods of identifying, preventing and
controlling them.
L– Locally endemic disease prevention and control.
E– Expanded program of immunization against major infectious diseases.
M– Maternal and child health care including family planning.
E– Essential drugs arrangement.
N– Nutritional food supplement, an adequate supply of safe and basic nutrition.
T– Treatment of communicable and non-communicable disease and promotion of mental health.
S– Safe water and sanitation.

J. MONTERO. 2017. SKSU NURSING

WHAT IS THE DIFFERENCE BETWEEN PRIMARY
HEALTH CARE AND PRIMARY CARE?

J. MONTERO. 2017. SKSU NURSING

 Primary health care vs Primary Care
Point of Comparison Primary Health Care Primary Care
Client Family and community Individual
Care Promotive and preventive through Curative- provided by health
community participation professional
Decision-making Community-centered/consultative Health worker drivesn
and participative
Outcome Self-reliance Reliance to health professional
Setting for services Rural based satellite clinic Urban-based: hospital
Goal Development and preventive care Absence of disease

J. MONTERO. 2017. SKSU NURSING

Traditional and
Alternative Health Care

J. MONTERO. 2017. SKSU NURSING

J. MONTERO. 2017. SKSU NURSING
 RA 8423
• Traditional and Alternative Medicine Act of 1997
- Promote and advocate the use of traditional and alternative
health care modalities through scientific research and product
development

J. MONTERO. 2017. SKSU NURSING

 10 Medicinal Plants endorsed by the DOH

• Bayabas - washing wounds, diarrhea, Gargle,

Toothache
• Yerba Buena - headache, Stomach ache, cough and colds,
rheumatism
• Lagundi - Asthma, cough, colds
• Ampalaya - diabetes mellitus
• Tsaang gubat - diarrhea, stomach ache
• Bawang - hypertension, lowers blood cholesterol
• Sambong - anti-edema, anti urolithiasis
• Akapulko - anti-fungal
• Niyog-niyogan - anti helminthic
• Ulasimang Bato - lowers blood uric acid J. MONTERO. 2017. SKSU NURSING
Acupressure
Application of pressure on acupuncture points without
puncturing the skin

J. MONTERO. 2017. SKSU NURSING

Acupuncture
Uses special needles to puncture and stimulate specific
anatomical points on the body

J. MONTERO. 2017. SKSU NURSING

Aromatherapy
Essential aromatic oils are combined then apply in the body

J. MONTERO. 2017. SKSU NURSING

Chiropractic
Use of Healing arts related to the statics and dynamics of the
locomotor system, especially of spine and pelvis

J. MONTERO. 2017. SKSU NURSING

Massage
Method wherein the superficial soft parts of the body are
rubbed, stroke, kneaded, or tapped for remedial, aesthetic,
hygieninc or limited therapeutic services

J. MONTERO. 2017. SKSU NURSING

Nutritional therapy
Use of food as medicine and to improve health

J. MONTERO. 2017. SKSU NURSING

Pranic Healing
Use of balancing energy

J. MONTERO. 2017. SKSU NURSING

Reflexology
Application of therapeutic pressure on the body’s reflex
points to enhance body’s natural healing mechanism

J. MONTERO. 2017. SKSU NURSING

ACTIVITY:
• DISCUSS PRIMARY HEALTH CARE
– TALK SHOW
– PANEL DISCUSSION
– ROLE PLAY
– RADIO BROADCASTING

J. MONTERO. 2017. SKSU NURSING