Alma Ata

Declaration
and Primary
Health Care

Alma Ata Declaration

Primary Health Care was

declared during the First

International Conference on
Primary Health Care in Alma Ata,
USSR on September 6-12, 1978.
It was sponsored by the World
Health Organization and UNICEF.

Philippines Response
to PHC
PHC recognizes the inter-relationship

between health and the over-all

socio-economic development.
PHC was adapted in the Philippines
through Letter of Instruction 949,
signed by Pres. Ferdinand E. Marcos
on October 19, 1979.
Healthy Population = Economic
Development

Primer on the PHC

1. Goal: Health for All by the Year

2000 (WHO, 1978)and Health in

the Hands of the People by the
Year 2020
2. Mission: To strengthen the health
care system by increasing
opportunities and supporting the
conditions wherein people will
manage their own health care.
3. Central Theme: Partnership and

4. Core Strategy: Full participation

and active involvement of the
community towards the
development of self-reliance
5. Organizational Strategy:
Provides the framework for
meeting the goal of PHC which is
Health for All which calls for
active and continuing partnership
among the communities, private
and government agencies which

LEGAL BASIS OF
PRIMARY HEALTH
CARE

Universal Declaration of Human

Rights, Article 25, Section 1
- Everyone has the right to a standard

of living adequate for the health and

well-being of himself and his family,
including food, clothing, housing, and
medical care and necessary social
services and the right to security in
the event of unemployment, sickness,
disability, old age, widowhood, or lack
of livelihood.

1987 Philippine Constitution,

Article XIII, Section 11
- The State shall adopt an integrated
and comprehensive approach to
health development which shall
endeavor to make essential goods,
health and other social services
available to all the people at
affordable cost. There shall be
priority for the needs of the
underprivileged, sick, elderly,
disabled, women, and children. The

World Health Organization

(1995)

- Governments have a
responsibility for the health
of their people which can be
fulfilled only by the
provision of adequate health
and social measures.

Fundamental Services of
Primary Health Care
1. Adequate and safe supply of

water and basic sanitation

2. Control of communicable disease
3. Immunization
4. Education on prevailing health
problems and prevention of illness
5. Maternal and child health and
family planning care

6. Adequate food and proper

nutrition
7. Provision of medical care
and emergency treatment
8. Treatment of locally endemic
disease
9. Provision of essential drugs
and herbal medicines

Three Major
Aspects of
Primary Health
Care Elements

1. PROMOTIVE ASPECTS
.Education concerning health

problems and the methods of

preventing them
.Promotion of food supply
and proper nutrition
.Adequate supply of safe
water and basic sanitation

2. PREVENTIVE ASPECTS
Maternal Health Care
Child Health Care
Family Planning
Immunization against major
infectious diseases
Prevention and control of
locally endemic diseases

3. CURATIVE ASPECTS
Appropriate treatment
of common diseases and
injuries
Provision of essential
drugs

Cornerstones/Pillars in
PHC
1. Support Mechanism made

available equity
2. Active Community
Participation
3. Intra- and Intersectoral
Linkages
4. Use of Appropriate Technology

Characteristics of PHC
Essential Services

1.Community-based
2.Accessible
3.Acceptable
4.Sustainable
5.Affordable

Obstacle to Primary
Health Care Nursing

1.Role Complexity
2.Special

Responsibilities
3.Role Confusion
4.Lack of Skills Training

HEALTH
PROMOTION

Definition
- Health Promotion is the process of

enabling people to increase control

over, and to improve, their health. To
reach a state of complete physical,
mental and social well-being, an
individual or group must be able to
identify and to realize aspirations, to
satisfy needs, and to change or cope
with the environment

OTTAWA CHARTER
Health is seen as a resource for
everyday life, not the objective of
living. Health is a positive concept
emphasizing social and personal
resources, as well as physical
capacities. Therefore, health
promotion is not just the
responsibility of the health sector, but
goes beyond healthy life-styles to
well-being.
(First International Conference on

Health Promotion occurs through

processes of:
1. Enabling people
2. Advocacy
3. Mediating among sectors
In essence, health promotion action
involves:
.Helping people to develop
personal skills
.Creating supportive environments
.Strengthening communities

 Influencing governments

to enact healthy public

policies
Reorienting and improving
health services

Ottawa Charters Health

Promotion Strategies
1. Build Healthy Public Policy
.Legislation
.Making of health-related laws and

fiscal measures
.Organizational change that is
geared towards more dynamic and
relevant organizational structure
and organizational climate

2. Create a Supportive Environment

.All nations and peoples should adopt

the principle of reciprocal

maintenance where everybody looks
out for everyones welfare; - take care
of each other
work as a global community to conserve
the worlds natural resources
- protect the natural environment so
that future generations may still enjoy
healthy and productive life on this
planet

3. Strengthen Community Action

Empowerment of the communities
through community
development/action
- The process of collective community
efforts directed towards increasing
community control over the
determinants of health, improving
health and becoming empowered to
apply individual and collective skills to
address health priorities and meet
respective health needs

4. Develop personal skills

Personal and social
development can be attained
through:
. Health education
. Enhancing social and life skills
. Prepare people to cope with
the crises and challenges in life

Health Education as
defined by the WHO
Health Education consciously

constructed opportunities for

learning designed to facilitate
changes in behavior towards a
predetermined goal, and
involving some form of
communication designed to
improve health literacy,
knowledge, and life skills

5. Re-orient Health Services

The adoption of healthy options
for a healthy life should be the
focus of attention not only by
individuals and communities but
also the different components
which affect the optimum level of
functioning (OLOF) like social,
political, economic, and the
physical environment.

Core Health Promotion Strategies

1. Health Awareness raising
awareness or consciousness of
health issues
a. Methods health education talks,
group work, mass media, displays
and exhibitions, campaigns
b. Actions encourage people to
seek early detection and treatment

2. Changing Attitudes and

Behaviors changing or modifying

the lifestyle of individuals through
adoption of healthier options and
behaviors
a. Methods group work, skills
training, self-help groups, one-toone instruction, group or individual
therapy, written material advice
b. Actions encourage women of
reproductive age, whether single or
married, to conduct regular BSE and

3. Improving Knowledge providing

information through health education
using different instructional media and
materials
a. Methods demonstration of BSE, one-toone teaching, displays and exhibitions,
written materials and mass media
campaigns, group teaching
b. Actions clients identify what they know
and want to know about breast cancer;
perform return demonstration of BSE

4. Self-empowering
improving self-awareness, selfesteem, and decision-making
5. Societal and
environmental change
changing the physical or social
environment

Roles of Practitioner Involved

in Integrated Health
Promotion Programs
1. Enabler making it possible for people to

have the knowledge, skills and attitude

that will allow them to have direct control
and use of health resources in the
community
2. Advocate support, promote or advance

an idea or cause, speak for or in behalf of

others to help them advance their cause or
concern

 Advocacy is a combination of

individual and social actions

designed to gain political
commitment, policy support,
social acceptance and systems
support for a particular health
program
Action for health - often
requires health workers to speak
out publicly or write on behalf of
others, calling for changes in