MODULE 1 – PRIMARY HEALTH CARE AND FAMILY
NCM 104 - CHN (Lecture)
PRIMARY HEALTH CARE AND FAMILY
Primary Health Care (PHC)
 Primary Health Care is essential health care
made universally accessible to individuals and
families in the community by means acceptable
to them, through their full participation and at a
cost that the community and country can afford
at every stage of development.
 PHC was adopted in the Philippines through LOI
949 signed by President Marcos on October 19,
1979 and has an underlying theme of “Health in
the hands of the People by 2020”
Goals:
 The ultimate goal of primary health care is better
HEALTH FOR ALL. WHO has identified five key
elements to achieving that goal:
o reducing exclusion and social disparities in
health (universal coverage reforms);
o organizing health services around people's
needs and expectations (service delivery
reforms);
o integrating health into all sectors (public
policy reforms);
o pursuing collaborative models of policy
dialogue (leadership reforms); and
o increasing stakeholder participation.
Elements:
1. Environmental sanitation (adequate supply of
water and good waste disposal)
2. Control of Communicable Diseases
3. Immunization
4. Health education
5. Maternal and Child Health and Family Planning
6. Adequate Food and Proper Nutrition
7. Provision of Medical Care and Emergency
Treatment
8. Treatment of Locally Endemic Diseases
9. Provision of Essential Drugs
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OBJECTIVES OF PRIMARY HEALTH CARE
To enable the people seek better health at home,
in schools, in fields, and in factories.
To enable the people to prevent injury and
diseases, instead of relying on doctors to repair
damages that can be avoided.
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.
To enable the people to exercise control in
managing health and related systems to ensure
that the basic pre-requirements for health and
access to health care are available to all people.
PRINCIPLES AND STRATEGIS
Principles:
1. Accessibility, Availability and Acceptability of
Health Services
Strategies:
 Health services must be delivered where the
people are.
 Use the indigenous/resident volunteer workers
as health care providers with a ratio of one
community health worker per 10-20 household.
 Use of traditional medicine together with the
essential drugs.
2. Provision of Quality Basic and Essential
Health Services
Strategies:
 Training design and curriculum based on
community needs and priorities, task analysis of
community health workers (CHW) are
competency based.
 Attitudes, knowledge and skills developed are on
promotive,
preventive,
curative,
and
rehabilitative health care.
 Regular monitoring and periodic evaluation of
CHW performances by the community and
health staff.
3. Community participation
Strategies:
 Awareness building and consciousness raising
on health and health-related issues.
 Planning, implementation, monitoring, and
evaluation done through small group meetings
(10-12 household clusters).
 Selection of community health workers by the
community.
 Community building and community organizing.
 Formulation of health committees
 Establishment of a community health worker
organization at the parish municipality level
 Mass health campaign and mobilization to
combat health problems
4. Self-reliance
Strategies:
 Community generates support (cash, kind, labor)
for the health program.
 Use of local resource (human, financial,
material).
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
Training of community in leadership and
management.
 Incorporation of income generating projects,
cooperatives, and small-scale industries.
5. Recognition of interrelationship between
health and development
Strategies:
 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.
6. Social mobilization
Strategies:
 Establishment of an effective health referral.
 Multisectoral and interdisciplinary linkages.
 Information, education, and communication
support using multi-media.
 Collaboration between government and nongovernment organizations.
7. Decentralization
Strategies:
 Re-allocation of budgetary sources.
 Re-orientation of health professionals on primary
health care.
 Advocacy for political will and support from the
national leadership down to the barangay level.
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THE FAMILY
Family is the basic unit of society.
Group of people related by blood, marriage, or
adoption living together (U.S. Census Bureau,
2005)
Two or more people who live in the same
household, share a common emotional bond,
and perform certain interrelated social task
(Allender and Spradley, 2004).
Types of Family:
1. Traditional or Nuclear
 Single-income families
 Dual-income families
2. Non-traditional
 Dyad Family
 Dyad (from the Greek: δυάς dyás, "pair") is a
group of two people, the smallest possible
social group. As an adjective, "dyadic"
describes their interaction.

The pair of individuals in a dyad can be linked
via romantic interest, family relation, interests,
work, partners in crime, and so on. The
relation can be based on equality, but may be
based on an asymmetrical or hierarchical
relationship (master–servant). A dyad can be
unstable because both persons must
cooperate to make it work. If one of the two
fails to complete their duties, the group would
fall apart. Because of the significance of
marriages in society, their stability is very
important. For this reason, marital dyads are
often enforced through legal, economic, and
religious laws.
 Cohabitational Family
 those individuals who choose to live
together for a variety of reason: relationship,
financial need, changing values
 Extended (Multigenerational) Family
 Single Parent Family
 never married, separated, divorced or
widowed
 Blended Family
 mother or a father bringing their children to
form new family; Stepfamily when two
separate families merge into one
 Communal Family
 two or more groups of families living
together and share facilities in the form of a
society
 Gay or lesbian family
 Foster Family
 Adolescent Family
 Intra-generational Family
3. High Risk Family
1. Families included in the poverty level
2. Families headed by a single teenage parent
3. Families with anticipated stress ( ex. an
infant who is preterm, ill or handicapped)
4. Families with lifestyle problems (ex.
Alcoholism, use of illicit drugs, family
violence)
 Single Adult Living Alone
 Found in 2 groups:
o Young adult who has achieved
independence and enters the work
force
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The elderly left alone due to death of a
spouse
 Adoptive Family
 RA 8552 or Domestic Adoption Act of 1998
 Types of Adoption:
o Agency Adoption – when a licensed
adoption agency finds and develops
adoptive families for children who are
voluntarily or involuntarily committed to
the state.
o International Adoption – also known
as intercountry adoption, is the adoption
of a child from another country.
o Private Adoption – the birth parent, or
parents, voluntarily place their child for
adoption, often choosing the family with
whom they will place their child
o
FAMILY HEALTH TASK
Stage
Stage 1:
Marriage/beginning
Family
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Stage 2:
Early child bearing
family
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Stage 3:
Family with Pre-school
children
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Stage 4:
Family with School-age
children
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Stage 5:
Family with teenagers
and Young- adults/
Adolescent children
Task
Establish a mutually
satisfying marriage
Planning to have / not
have children
Having and adjusting
to infants
Supporting the needs
of all three members
Re-negotiating
marital relationship
Adjusting to cost of
Family life
Adapting to the needs
of pre-school children
to stimulate growth
and development
Adjusting
to
the
activity of growing
children
Promoting
joint
decision s between
children and parents
Encouraging
&
supporting children’s
educational
achievements
Family must broaden
family ties to allow
adolescents
more
freedom and prepare
them for life on their
own
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Partner may view this
stage as the prime of
their lives or as a
period of gradual
decline
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Families are more
apt to suffer from
chronic and disabling
conditions
Can offer a great
deal of support and
advice to young ones
who are just
beginning their
families
Stage 6:
The Family of Middle
years
Stage 7:
Family in Retirement or
Older Age
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FAMILY TASK:
 Physical maintenance
 Socialization of family members
 Allocation of resources
 Maintenance of order
 Division of labor
 Reproduction, recruitment and release of
family members
 Placement of members into the larger society
 Maintenance of motivation and morale
CHARACTERISTIC OF A HEALTHY FAMILY
o Members communicate openly with each
other to express concerns and needs of each
member.
o Healthy families remain flexible in role
assignment.
o Adults in healthy families agree on the basic
principles of parenting
o Healthy families are adaptable and not
overwhelmed by changes that occur in the
home and relationships as a result of
childbearing
LEVELS OF PREVENTION

Three levels of health promotion and disease
prevention
1. Primary Prevention
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 those preventive measures that prevent
the onset of illness or injury before the
disease process begins.
 Examples include immunization and
taking regular exercise.
2. Secondary Prevention
 those preventive measures that lead to
early diagnosis and prompt treatment of
a disease, illness or injury to prevent
more severe problems developing.
Here health educators such as Health
Extension Practitioners can help
individuals acquire the skills of
detecting diseases in their early stages.
 Examples include screening for high
blood pressure and breast selfexamination
3. Tertiary Prevention
 those preventive measures aimed at
rehabilitation
following
significant
illness. At this level health services
workers can work to retrain, re-educate
and rehabilitate people who have
already developed an impairment or
disability
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