(Writer’s note: This article attempts to examine the realization of the Primary Health Care program in the Philippines. It also seeks to know the current status of this health program, which was presented during the First International Conference on Primary Health Care in Alma Ata, USSR 36 years ago.)
PRIMARY Health Care has been defined during the First International Conference on Primary Health Care as the “essential health care made universally accessible to individuals and families in the community by means acceptable to them, through their full participation and at cost that the community can afford at every stage of development”.
Furthermore, it is, “a practical approach to making health benefits within the reach of all people” and “an approach to health development, which is carried out through a set of activities and whose ultimate aim is the continuous improvement and maintenance of health status.”
From the time of its creation, it has the following objectives:
· Improvement in the level of health care of the community;
· Favorable population growth structure;
· Reduction in the prevalence of preventable, communicable and other disease;
· Reduction in morbidity and mortality rates especially among infants and children;
· Extension of essential health services with priority given to the underserved sectors;
· Improvement in Basic Sanitation;
· Development of the capability of the community aimed at self- reliance; and
· Maximizing the contribution of the other sectors for the social and economic development of the community.
Lastly, it has the following components within the health program:
· Education for health;
· Locally endemic disease control;
· Expanded program on immunization;
· Maternal and child health and family planning;
· Environmental sanitation and promotion of safe water supply;
· Nutrition and promotion of adequate food supply;
· Treatment of communicable diseases and common illnesses; and
· Supply of essential drugs
Primary Health Care does have an ambitious vision. Unfortunately, there really exists a disparity between the set goals and the actual outcome based on surveyed statistics that depicts the state of Filipinos’ health and are summarized as follows:
· One in 16 girls aged 15 to 19 are already young mothers;
· 26 percent of women aged 15 to 24 years have already begun bearing children;
· Married women lack knowledge and information on family planning;
· Only 2 in every 5 women receive counselling on contraceptives;
· Infants and children are more likely to die if they are born from mothers who are too young, too old, or if they are of high birth order;
· Improving access to maternal health plays a key role in increasing Filipino children’s well-being and survival;
· Nearly half of Filipino children do not consume fruits and vegetables;
· 39 percent of children aged 1 to 2 years have not received iron drops or syrup during the past six months preceding 2003.
· 67 percent of mothers with children under five years cannot afford health care
· 60 percent of Filipinos cited lack of money for medical treatment as their main health problem
· 27 percent mentioned that access to health care is impeded due to distance of health facility from home
· The Philippines is ranked as 8th among the 22 countries with the highest tuberculosis burden
· In the year 2000, TB killed 25, 000 Filipinos many of them in the prime of their life
Currently, the Philippine government has designed a good number of health programs to address the health problems and align the country to the goals of Alma Ata for the past 36 years.
However, statistics tell us otherwise. In fact, our country has high unmet needs. For instance, when infectious diseases prevailed among the top causes of morbidity and mortality in our country, one plausible explanation may be inequity to health care.
Medical sociologists and public health experts would agree that infectious diseases can be used as an index or measure of poverty.
It can be due to the fact that with access to proper medical care, communicable diseases are highly preventable.
But prevention comes with a price: vaccines, health promotion tools and materials and health dissemination are all costly.
Overall, the government needs to realize the value of investing on health-related programs that emphasize the promotive and preventive measures of health rather than focusing on the curative and rehabilitative health care.
Then what is the measure of success or failure of the Primary health care?
I believe this is a matter of question that is left unanswered. And this query shall extend the next few decades in the Philippines unless the government does something sustainable in achieving health for all by 2020.
After all, it has been 36 long years and yet our country is still at the mercy of communicable diseases that is caused by inequity to health due to poverty.
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.