Primary Health Care

1. COMMUNITY HEALTH NURSING
By: Rommel Luis C. Israel III

2. W.H.O. DEFINITION OF CHN
It is the Special field of nursing that
combines the skills of nursing and
public health
a) for the promotion of health,
b) the improvement of the
conditions in the social and
physical environment,
c) rehabilitation of illness and
disability

3. FREEMAN DEFINITION OF CHN
It is a service rendered by a
professional nurse…in places of
work
a) for the promotion of health,
b) prevention of illness,
c) care of the sick at home and
rehabilitation

4. JACOBSON DEFINITION OF CHN
It is a learned practice discipline with
the ultimate goal of contributing, and
in collaboration with others, to the
promoton of the client’s optimum
level of functioning through teaching
and delivery of care.

5. CHN
PHILOSOPHY
• It is based on the worth and
dignity of man
GOAL
• The ultimate goal of community
health services is to raise the
level of health of the citizenry

6. CHN CONCEPTS
• The primary focus is on health
promotion.
• CH Nursing is extended to benefit
not only the individual but the
whole family and the community
• CH Nurses are generalists in terms
of their practice through life’s
continuum

7. CHN CONCEPTS
• Contact with clients may continue
over a long period of time.
• Knowledge from biological and
social sciences, ecology, clinical
nursing, and CH organizations be
utilized.
• Dynamic process of APIE is
implicit in the practice.

8. CHN OBJECTIVES
• To participate in the development
of an over-all health plan for the
community and in its
implementation and evaluation.
• To provide quality nursing services
to the individuals, families and
communities, utilizing as basis
the standards set for CH nursing
practice.

9. CHN OBJECTIVES
•To coordinate nursing services
with various members of the
health team, community
leaders, GOs and NGOs in
achieving the aims of public
health services within the
community.

10. CHN OBJECTIVES
• To participate in/and or conduct researches
relevant to community health and CH nursing
services and disseminate their results for
improvement of health care
• To provide CH Nursing Personnel with
opportunities for continuing education and
professional growth through staff development

11. CHN
• CH Nursing is based on the needs
of the client.
• CH Nurse must understand fully
the objectives and policies of the
agency she represents.
• Family is the unit of service.
• CH Nursing must be available to
all.

12. CHN
• The primary responsibility is
health education.
• CH Nurse works as a member of
the health care team.
• Periodic evaluation of CH Nursing
services must be done.
• Professional growth is a personal
responsibility.

13. CHN
• Utilize available community
health resources.
• Utilize existing groups in the
community.
• Accurate recording and reporting.
• There must be provision for
educative supervision.

14. PHC
PHC IN THE PHILIPPINES
• Practiced even before 1978 when
the WHO declared PHC in Alma
Ata
• What is PHC in the Philippines
now? How is it? Where are the
accomplishments?

15. PHC: Definition
• It is the key in achieving an acceptable level
of health through-out the world in the
foreseeable future as part of social
development and in the spirit of social
justice
- PHC Report of the International
Conferences on PHC, Alma Ata, USSR,
Geneva (WHO: September 1978)

16. WHO (1978) ON PHC
• PHC is people-oriented
• Its success rests on people
• It identified 4 pillars (where actions
for health for all must be based):
1. Political and societal commitment
and determination to move towards
health for all as the main social
target for the coming decades.

17. WHO (1978) ON PHC
2. Community participation – the active
involvement of people and the mobilization
of social forces for health development
3. Intersectional cooperation between the
health section and other development
sectors such as education, communication,
industry, public works, transportation, and
housing

18. WHO (1978) ON PHC
4. System support to ensure
that essential health care and
scientifically sound
affordable health technology
are available to all people.

19. WHO (1978): OBJECTIVES OF
PHC
1. To enable the people to seek
better health at home, in
school, in fields, and in
factories;
2. To enable the people to prevent
injury and diseases, instead of
relying on doctors to repair
damages that can be avoided;

20. WHO (1978): OBJECTIVES OF
PHC
3. To enable the people to exercise
the right and responsibility in
shaping the environment and
bringing about conditions that
make it possible and easier to live
a healthy life
4. To enable the people and exercise
control in managing health and
related systems and to ensure
that

21. WHO (1978): OBJECTIVES OF
PHC
… the basic pre-requirements for
health and access to health
care are available to all people.
LET US EVALUATE OUR OWN
ADOPTED COMMUNITIES:
“As members of the health
team, were we able to meet
these objectives?”

22. PRINCIPLES OF PHC
1. Accessibility, availability, and
acceptability of health
services;
2. Provision of quality basic and
essential health services;
3. Community Participation
4. Self-Reliance

23. PRINCIPLES OF PHC
5. Recognition of
interrelationship between
health and development
6. Social Mobilization
7. Decentralization

24. ACCESSIBILITY, AVAILABILITY,
ACCEPTABILITY OF HEALTH SERVICES
• Health services must be delivered where the
people are
• Use of indigenous/resident volunteer workers as
health care providers with a ratio of one
community health worker per 10-20 household
• Use of traditional (herbal) medicine together
with the essential drugs

25. PROVISION OF QUALITY BASIC AND
ESSENTIAL HEALTH SERVICES
• Training design and curriculum based on
community needs and priorities, task analysis
of CHWs are competency based
• AKS developed are on promotive, preventive,
curative, and rehabilitative health care
• Regular monitoring and periodic evaluation of
CHW performances by the community and
health staff

26. COMMUNITY PARTICIPATION
• Awareness building and consciousness raising
on health and health-related issues
• Planning, implementation, monitoring and
evaluation done through small group meetings
(10-12 household cluster)
• Selection of CHWs by the community
• Community building and community organizing

27. COMMUNITY PARTICIPATION
• Formation of health committees
• Establishment of a community Health Worker
Organization at the parish municipality level
• Mass health campaign and mobilization to
combat health problems.

28. SELF-RELIANCE
• Community generates support (Cash, Kind,
Labor) for the health program
• Use of local resources (human, financial,
material)
• Training of community in leadership and
management skills
• Incorporation of income-generating projects,
cooperatives, small scale industries

29. RECOGNITION OF INTERRELATIONSHIP
BETWEEN HEALTH AND DEVELOPMENT
• Convergence of health, food,
nutrition/water, sanitation, and population
services
• Integration of PHC into national, regional,
provincial, municipal, barangay
development plans
• Coordination of activities with economic
planning, education, agriculture, industry,
housing, public works, communication, and
social services

30. SOCIAL MOBILIZATION
• Establishment of an effective health referral
• Multisectoral and interdisciplinary linkages
• Information, education, and communication
support using multi-media
• Collaboration between GOs and NGOs

31. DECENTRALIZATION
• Re-allocation of budgetary
resources
• Re-orientation of health
professionals on PHC
• Advocacy for political will and
support from the national
leadership down to the barangay
level

32. ESSENTIAL ELEMENTS OF PHC
1. Education on the prevailing
health problems and the
methods of preventing and
controlling diseases;
2. Prevention and control of local
endemic diseases;
3. Promotion of food supply and
proper nutrition;

33. ESSENTIAL ELEMENTS OF PHC
4. Adequate and safe supply of
water and basic sanitation;
5. Maternal-child health
including family planning;
6. Immunization against
infectious diseases

34. ESSENTIAL ELEMENTS OF PHC
7. Appropriate treatment of
common diseases and
injuries;
8. Provisions of essential drugs
and herbal medicines