LAST September of 1978, representatives from over 134 countries, 67 international organizations and different health care organizations gathered together for the First International Conference on Primary Health Care in Alma Ata, USSR.

It was convened by the World Health Organization (WHO) and the United Nation’s Children Fund to discuss about different matters on health.

It was themed, “Health for All by the year 2000.”

“Health for All was a response of the world’s countries to the great inequalities and health status among different people,” states Dr. David Tejada, former Health Minister of Peru.

For Dr. Mirta Roses, former director of Pan American Health Organizations: ““I think everybody got into a matter had a clear idea of what they wanted to achieve.”

“They were sharing great concerns for the disparities and unacceptable inequalities between the rich and the poor,” she adds.

By 1970s, a number of developing countries had been experimenting new ways of addressing health with a limited resource that was later known as “Primary Health Care,” which was a way of seeing health as much more than just treating disease.

As a matter of fact, Primary Health Care was adopted in the Philippines through ‘Letter of Instruction 949’ signed by the then President Ferdinand Marcos on October 19, 1979 with the underlying theme of “Health in the Hands of the People by 2020.”

“Health means healthy living conditions, preventing specific risks and preventing specific diseases and curing and rehabilitating people; but, doing all these in an integral way,” maintains Dr. Tejada.

“The concept of ‘Health for All’ was a social call to action,” he adds.

Meanwhile, Dr. Roses supports: “People had a lot of enthusiasm and building on the experiences of hundreds of thousands of communities, villages and health workers and political leaders to push for a new economic order that would be fairer and based on social justice.”

According to Hilda Solis, a United Nations representative, “Health for all means everyone has access and all the rights that go along that provide humanitarian assistance to everyone regardless of race, ethnic and socioeconomic backgrounds.”

In sum, Primary Health Care was an ambitious goal of providing access to health and calls for the breakdown of health care inequalities between the rich and the poor.

Furthermore, it was a SMART (Specific, Measurable, Attainable, Realistic, Time-bound) goal: Health is achieved by the people by 2020.

But what do current statistics tells us?

According to 2008 National Demographic and Health Survey (NDHS):

1. Fertility levels have a steady decline in the Philippines to three children per woman.

2. Unplanned pregnancy is one in every three births in the Philippines.

3. On average, eight out of 10 currently married Filipino women know of a family planning method.

4. Nine in 10 Filipino mothers receive some antenatal care, but only 44 percent of births occur in health facilities.

5. One in every 30 children dies in the Philippines before reaching his or her 5th birthday.

6. Forty-seven per 1,000 children born of mothers with only elementary education die before the 5th birthday.

7. Eighty-eight percent of children born in the Philippines are breastfed.

8. Although 94 percent of Filipino women have heard of AIDS, only 53 percent know two major methods of prevention which are condom use and monogamous sexual relations.

On the other hand, the Department of Health shares the following data:

1. The top seven causes of mortality in the Philippines are: disease of heart; disease of vascular system; malignant neoplasms; pneumonia; accidents; tuberculosis; and chronic lower respiratory diseases.

2. The top eight causes of morbidity in the Philippines are: Acute Respiratory Infection; Pneumonia; Bronchitis; Hypertension; Acute Watery Diarrhea; Influenza; Urinary Tract Infection; and TB respiratory.

Examining these figures tell us that majority of the diseases that afflict our country is infectious in nature.

Infectious diseases are highly preventable. Ideally, this should have been addressed by the Primary Health Care program.

Where did we go wrong?

(To be continued on June 20, 2014)

Sources: Department of Health Statistical Data; 2008 National Demographic and Health Survey; Public Health Nursing in the Philippines; and Pan American Health Organization of WHO.

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