HIS 101 Compiled Notes 3 Prepared by: Joey Bal Rodillado, RMT

Primary Health Care Delivery System

Health Information Systems
Lesson Three

Definition of Primary Health Care

Declaration of Alma-Ata states that primary health care is
(WHO-WPRO, 2018):
Essential health care based on scientifically sound
and socially acceptable methods.
Universally accessible to individuals and families
with their full participation at a cost that the
community and country can afford in a spirit of self-
reliance and self-determination.
Primary health care (PHC) is essential health care made
universally accessible to individuals and acceptable to
them, through full participation and at a cost
the community and country can afford.
An approach to health beyond the traditional health care
system that focuses on health equity-producing social
policy.
Primary health care (PHC) has basic essential elements and
objectives that help to attain better health services for
all.

Health Care System

Refers to an organized plan of health services (Miller-
Keane, 1987)

Health Care Delivery

Rendering of health care services to the people (Williams-
Tungpalan, 1981)

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Source: Nuevo, Jose Jurel, et al. Health Information System for Medical Laboratory Science 1 st ed. C & E Publishing, Inc.
HIS 101 Compiled Notes 3 Prepared by: Joey Bal Rodillado, RMT

Health Care Delivery System

Refers to the network of health facilities and personnel
which carries out the task of rendering health care to the
people (Williams-Tungpalan, 1981)

Philippine Health Care System

Complex set of organizations interacting to provide an
array of health services (Dizon, 1977)
The Philippine health care system has rapidly evolved with
many challenges through time
Health service delivery was devolved to the Local
Government Units (LGUs) in 1991, and for many reasons, it
has not completely surmounted the fragmentation issue
Health human resource struggles with the problems of
underemployment, scarcity and skewed distribution
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

Essential Elements of Primary Health Care

Ultimate goal of primary health care is better health for
all
WHO has identified five key elements in achieving this
goal:
1. Universal coverage to reduce exclusion and social
disparities in health;
2. Service delivery organized around people's needs and
expectations;
3. Public policy that integrates health into all sectors;
4. Leadership that enhances collaborative models of
policy dialogue; and
5. Increased stakeholder participation

Eight Elements of Primary Health Care

1. Education concerning prevailing health problems and

the methods of identifying, preventing, and
controlling them.
2. Locally endemic disease prevention and control.

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Source: Nuevo, Jose Jurel, et al. Health Information System for Medical Laboratory Science 1 st ed. C & E Publishing, Inc.
HIS 101 Compiled Notes 3 Prepared by: Joey Bal Rodillado, RMT

3. Expanded program of immunization against major

infectious diseases.
4. Maternal and child health care including family
planning.
5. Essential drugs arrangement.
6. Nutritional food supplement, an adequate supply of
safe and basic nutrition.
7. Treatment of communicable and non-communicable disease
and promotion of mental health.
8. Safe water and sanitation.

Other Elements of PHC

Expanded options of immunizations
Reproduction 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

Principles of Primary Health Care

An important conceptual shift towards the model of health
systems based on primary health care should always be
emphasized
In a systems perspective, the potential conflict between
primary health care as a discrete level of care and as an
overall approach to responsive, equitable health service
provision can be reconciled
This shift emphasizes that primary health care is
integrated into a larger whole, and its principles will
inform and guide the functioning of the overall system
Health systems based on primary health care will:
Build on the Alma Ata principles of equity, universal
access, community participation, and inter-sectoral
approaches
Take account of broader population health issues,
reflecting and reinforcing public health functions
Create the conditions for effective provision of
services to poor and excluded groups

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Source: Nuevo, Jose Jurel, et al. Health Information System for Medical Laboratory Science 1 st ed. C & E Publishing, Inc.
HIS 101 Compiled Notes 3 Prepared by: Joey Bal Rodillado, RMT

Organize integrated and seamless care, linking

prevention, acute care and chronic care across all
components of the health system
Continuously evaluate and strive to improve
performance

Thirteen Principles of Primary Health Care

1. Series of basic objectives should be formulated in national
policies in order to launch and sustain primary health care
as part of a comprehensive health system and coordination
with other sectors
2. Improvement in the level of health care of the community
3. Favorable population growth structure
4. Reduction in the prevalence of preventable, communicable
and other disease
5. Reduction in morbidity and mortality rates especially among
infants and children
6. Extension of essential health services with priority given
to the undeserved sectors
7. Improvement in basic sanitation
8. Development of the capability of the community aimed at
self-reliance
9. Maximizing the contribution of the other sectors for the
social and economic development of the community
10. Equitable distribution of health care
a. Primary care and other services to meet the main
health problems in a community must be provided
equally to all individuals irrespective of their
gender, age, and caste, urban/rural and social class
11. Community participation
a. Comprehensive healthcare relies on adequate number and
distribution of trained physicians, nurses, allied
health professions, community health workers and
others working as a health team and supported at the
local and referral levels
12. Multi-sectional approach recognition that health
cannot
be improved by intervention within just the formal health
sector
a. Other sectors are equally important in promoting
health and self-reliance of communities

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Source: Nuevo, Jose Jurel, et al. Health Information System for Medical Laboratory Science 1 st ed. C & E Publishing, Inc.
HIS 101 Compiled Notes 3 Prepared by: Joey Bal Rodillado, RMT

13. Use of appropriate technology

a. Medical technology should be provided that accessible,
affordable, feasible and culturally acceptable to the
community

Management of Primary Health Care

Health care managers usually carry out the following
functions in the process of management:
Planning
Managers are required to set a direction and
determine the needs to be accomplished
This means setting priorities and determining
performance targets
Organizing
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
Determining positions, teamwork assignments, and
distribution of authority and responsibility
Management principles in relation to organizing:
Authority, responsibility, and
accountability
Accountability is a manager's formal and
legitimate right to make decisions, issue
orders, and allocate resources to achieve
organizationally desired outcomes
Responsibility means an employee's duty to
perform assigned task or activities
Authority means that those with authority
and responsibility must report and justify
task outcomes to those above them in the
chain of command

Management principles in relation to organizing:

Types of Authority
Line authority

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Source: Nuevo, Jose Jurel, et al. Health Information System for Medical Laboratory Science 1 st ed. C & E Publishing, Inc.
HIS 101 Compiled Notes 3 Prepared by: Joey Bal Rodillado, RMT

Managers have the formal power to

direct and control immediate
subordinates
The superior issues orders and is
responsible for the result
The subordinate obeys and is
responsible only for executing the
order according to instructions
Functional authority
Managers have formal power over a
specific subset of activities
Staff authority
Granted to staff specialists in
their areas of expertise
It is not a real authority in the
sense that a staff manager does
not order or instruct but simply
advises, recommends, and counsels
in the staff specialists' area of
expertise

Centralization – decision-making authority falls

on top organizational levels
Decentralization – decision-making authority
falls on lower organizational levels
Formalization – written documentation used to
direct and control employees
Staffing
Assignment of individuals to responsible
positions identified in a management plan
Determine the competencies required for a
position through:
Identify key result areas (KRA) per major
activities in the plan
Key result areas refer to general areas of
outputs or outcomes for which the
department’s role is responsible
Determine qualifications and competencies
required to perform the activities and
achieve the KRA

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Source: Nuevo, Jose Jurel, et al. Health Information System for Medical Laboratory Science 1 st ed. C & E Publishing, Inc.
HIS 101 Compiled Notes 3 Prepared by: Joey Bal Rodillado, RMT

Assign or recruit staff that qualifies for the

responsibilities
For existing programs and services:
Review and adjust the competency
requirements for each major activity with
corresponding KRA
Match competency requirements vis a vis the
responsible person already assigned to the
activity
Controlling
This function refers to monitoring staff
activities and performance, and taking the
appropriate actions for corrective action to
increase performance
Directing
Its focus is to initiate action in the
organization through effective leadership and
motivation of, and communication with,
subordinates

Philippine Health Care System

Department of Health Mandate

The Department of Health shall be responsible for
the following:
Formulation and development of national health
policies, guidelines, standards and manual of
operations for health services and programs
Issuance of rules and regulations, licenses and
accreditations
Promulgation of national health standards,
goals, priorities and indicators
Development of special health programs and
projects and advocacy for legislation on health
policies and programs

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

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Source: Nuevo, Jose Jurel, et al. Health Information System for Medical Laboratory Science 1 st ed. C & E Publishing, Inc.
HIS 101 Compiled Notes 3 Prepared by: Joey Bal Rodillado, RMT

encouragement of providers of health goods and services

(E.O. No. 119, Sec. 3)

Vision
“Health as a right. Health for All Filipinos by the year
2000 and Health in the Hands of the People by the year
2020.”

Mission
The mission of the DOH, in partnership with the people to
ensure equity, quality and access to health care:
by making services available
by arousing community awareness
by mobilizing resources
by promoting the means to better health

Levels of Health Care Facilities

Primary level
Rural health units and their sub-centers, chest
clinics, malaria eradication units, and
schistosomiasis control units operated by the DOH
Puericulture centers operated by the League of
Puericulture Centers
Tuberculosis clinics and hospital of the Philippine
Tuberculosis Society
Private clinics, clinics operated by the Philippine
Medical Association
Clinics operated by large industrial firms for their
employees
Community hospitals and health centers operated by
the Philippine Medicare Care Commission and other
health facilities operated by voluntary religious
and civic groups
Secondary level
Smaller, non-departmentalized hospitals, including
emergency and regional hospitals in which services
to patients with symptomatic stages of disease,
which require moderately specialized knowledge and

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Source: Nuevo, Jose Jurel, et al. Health Information System for Medical Laboratory Science 1 st ed. C & E Publishing, Inc.
HIS 101 Compiled Notes 3 Prepared by: Joey Bal Rodillado, RMT

technical resources for adequate treatment, are

offered

Tertiary level
Highly technological and sophisticated services
offered by medical centers and large hospitals
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

Factors Affecting Health Workers Among Countries

and Communities
Available health manpower resources
Local health needs and problems
Political and financial feasibility

Three Levels of Primary Health Care Workers

Village or Grassroots’ Health Workers
First contacts of the community and initial links of
health care
Provide simple curative and preventive health care
measures promoting healthy environment
Participate in activities geared towards the
improvement of the socio-economic level of the
community like food production program
Community health worker, volunteers, or traditional
birth attendants

Intermediate Level Health Workers

Represent the first source of professional health
care
Attend to health problems beyond the competence of
village workers
Provide support to front-line health workers in
terms of supervision, training, supplies, and
services
Medical practitioners, nurses and midwives

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Source: Nuevo, Jose Jurel, et al. Health Information System for Medical Laboratory Science 1 st ed. C & E Publishing, Inc.
HIS 101 Compiled Notes 3 Prepared by: Joey Bal Rodillado, RMT

First-Line Hospital Personnel

Provide backup health services for cases that
require hospitalization
Establish close contact with intermediate level
health workers or village health workers.
Physicians with specialty, nurses, dentist,
pharmacists, other health professionals

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Source: Nuevo, Jose Jurel, et al. Health Information System for Medical Laboratory Science 1 st ed. C & E Publishing, Inc.