IHS - Basic Principles of Primary Health Care (PHC) & Universal Health Care (UHC)

Health

A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.

Primary Health Care (PHC) Definition

• Essential health care based on practical, scientifically sound, and socially acceptable methods.

• Made universally accessible through community participation.

• Affordable at stages of development (self-reliance and self-determination).

• First level healthcare, emphasizing prevention & accessibility.

Alma-Ata Declaration (1978)

• Recognized PHC as the key to achieving Health for All.

• Conference organized by WHO & UNICEF.

• Defined PHC as comprehensive and interrelated to physical, mental, and social well-being.

Four Levels of Health Care System

1. Primary - First contact (Barangay Health Stations, Rural Health Units)

2. Secondary - Specialized care (Provincial/Direct Hospitals)

3. Tertiary - Advanced/specialized care (Medical Centers, Specialty Hospitals)

4. Quaternary - Highly specialized (Research/Teaching Hospitals)

Roles & Benefits of Primary Health Care (PHC)

• Provides continuous and comprehensive care.

• Helps patients access social welfare & public health services.

• Supports underprivileged populations.

Elements of PHC (Alma-Ata Declaration)

1. Health Education

2. Proper Nutrition

3. Safe Water & Sanitation

4. Maternal & Child Health (Family Planning)

5. Immunization

6. Prevention & Control of Endemic Diseases

7. Appropriate Treatment of Diseases & Injuries

8. Mental Health Promotion

9. Provision of Essential Drugs

Universal Health Care (UHC) Definition

• Ensures that all citizens have access to quality healthcare services without financial hardship/burden.

• Health is right, not a privilege.

Universal Health Care Act (RA 11223)

• Signed into law on February 20, 2019 by President Rodrigo Duterte.

• Automatically enrolls all Filipinos in the National health Insurance Program (NHIP).

• Strengthens the healthcare system by improving service delivery and financing.

Key Features of Universal Health Care (UHC) Act

• Automatic PhilHealth coverage for all Filipinos.

• Health Care Provider Networks (HCPN) - Public & private providers offering coordinated health services.

• Public Health Units (PHU) - Established in all hospitals to support public health programs.

Health Care Provider Networks (HCPN)

Public & private providers offering coordinated health services.

Public Health Units (PHU)

• Hospital unit supporting public health programs.

• Established in all hospitals to support public health programs.

Building Blocks of UHC (WHO, 2010)

1. Health Financing - Protects the poor and vulnerable sectors.

2. Service Delivery - Ensures equitable access to quality health services.

3. Policy, Standards & Regulation - Guarantees medicine & technology safety.

4. Governance for Health - Ensures efficiency and accountability.

5. Human Resources for Health - Sufficient & competent health workforce.

6. Health Information Systems - Uses data for better healthcare management.

Health Financing

Protects the poor and vulnerable sectors.

Service Delivery

Ensures equitable access to quality health services.

Policy, Standards & Regulation

Guarantees medicine & technology safety.

Governance for Health

Ensures efficiency and accountability.

Human Resources for Health

Sufficient & competent health workforce.

Health Information Systems

Uses data for better healthcare management.

Results of UHC Policy Implementation

• 92% PhilHealth coverage achieved.

• Health facilities upgraded & constructed.

• 23,800 health professionals deployed.

• Distribution of critical medical supplies & vaccines.

Return Service Agreement (RSA)

• Scholars of government-funded health programs must work in public health for at least 3 years within 1 year of graduation/licensure.

• Scholarship recipients must serve in public health facilities.

• Priority placement in Geographically Isolated and Disadvantaged Areas (GIDAs).

Health Technology Assessment (HTA)

• Evaluates the effectiveness, safety, and cost-efficiency of medical technologies.

• Ensures scientific, transparent, and evidence-based decision-making.

Financing of UHC

• Population-based Services - Fully financed by the government (DOH & LGUs).

• Individual-based Services - Covered by PhilHealth, private insurance, and HMOs.

• Prepayment Mechanisms - reduce out-of-pocket expenses.

Population-based Services

Fully financed by the government (DOH & LGUs).

Individual-based Services

Covered by PhilHealth, private insurance, and HMOs.

Prepayment Mechanisms

Reduce out-of-pocket expenses.

Methods of Healthcare Payment

1. Fee-for-Service - Patients pay per service.

2. Capitation - Fixed payment per person.

3. Case Payment - Payment based on diagnosis.

4. Global Budget - Set budget for hospitals.

5. Per Diem - Daily rate for hospital stays.

6. Prospective Payment - Pre-determined payments based on expected costs.

Fee-for-Service

Patients pay per service.

Capitation

Fixed payment per person.

Case Payment

Payment based on diagnosis.

Global Budget

Set budget for hospitals.

Per Diem

Daily rate for hospital stays.

Prospective Payment

Pre-determined payments based on expected costs.

Regulation & Quality Control

• License to Operate (LTO) & Accreditation - Issued to hospitals & facilities, valid for 3 years.

• National Price Reference Index (DPRI) - Ensures fair pricing of drugs & medical supplies.

• Mandatory provision of fairly priced generics - Ensures medicine affordability.

License to Operate (LTO) & Accreditation

Issued to hospitals & facilities, valid for 3 years.

National Price Reference Index (DPRI)

Ensures fair pricing of drugs & medical supplies.

Mandatory Provision of Fairly Priced Generics

Ensures medicine affordability.

Equity in UHC

• Health services distributed based on medical need, not financial capability.

• Addresses health disparities through priority programs for vulnerable populations.