Introduction

Primary Health Care (PHC) is an essential health care made universally acceptable 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 and can afford at every stage of development.

Definitions

World Health Organization (WHO)

The WHO defines Primary Health Care an essential health care made universally acceptable 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 and afford at every stage of development.

Rationale

Adopting primary health care has the following rationales:

1. Magnitude of Health Problems

http://www.healthdata.org/philippines

Common Health Issues

Physical Activity and Nutrition
Overweight and Obesity
Tobacco
Substance Abuse
HIV/AIDS
Mental Health

Common Diseases That Might Pose a Health Risk

The majority of people moving to and living in the Philippines enjoy
romantic lives in this paradisiacal archipelago. However, they do also face
the far less romantic risk of catching one of the many infectious diseases
prevalent in Southeast Asia. Major food-borne and water-borne infectious
diseases include bacterial diarrhea, hepatitis A, and typhoid fever.
Mosquito-borne diseases such as dengue fever, malaria, and Japanese
encephalitis pose considerable health threats as well. The water-contact
disease leptospirosis is also a common ailment.

Unsurprisingly, the mosquito-borne diseases are ever-present in endemic

areas of the Philippines, and the risk of infection is high. Other diseases
are also prevalent among large parts of the population. For instance,
tuberculosis still affects many people in the Philippines due to the lack of
accessible healthcare in many parts of the country.

2. Inadequate and unequal distribution of health resources

Inadequate health insurance coverage is one of the largest barriers to health

care access,3 and the unequal distribution of coverage contributes to
disparities in health. Out-of-pocket medical care costs may lead individuals to
delay or forgo needed care (such as doctor visits, dental care, and
medications), and medical debt is common among both insured and
uninsured individuals. Vulnerable populations are particularly at risk for
insufficient health insurance coverage; people with lower incomes are often
uninsured, and minorities account for over half of the uninsured population.

limited availability of health care resources is another barrier that may

reduce access to health services3 and increase the risk of poor health
outcomes.21, 22 For example, physician shortages may mean that patients
experience longer wait times and delayed care. Many health care resources
are more prevalent in communities where residents are well-insured, but the
type of insurance individuals have may matter as well. Medicaid patients, for
instance, experience access issues when living in areas where few physicians
accept Medicaid due to its reduced reimbursement rate.

3. Increasing cost of medical care

Medical costs are poised to continue their relatively flat growth in

2019, but researchers say the steady trend is unsustainable for
consumers.

The expected 6% growth in 2019 aligns with the 5.5% to 7% trend

over the past five years—a welcome change from the double-digit
spikes in the 2000s—but higher costs haven't translated to similar
gains in consumers' health and productivity, said
PricewaterhouseCoopers researchers who studied employer-
sponsored healthcare spending.

Expensive new medical services and drugs and market consolidation

are driving higher costs, said Barbara Gniewek, a health services
principal at PwC.

As health systems consolidate and snap up physician practices,

prices typically rise through facility fees and other fixed costs,
according to the report.

Providers, employers and health plans are offering consumers new

access to care through telehealth, retail and urgent-care clinics. The
long-term goal is to decrease spending, but better access often leads
to higher utilization in the short-term, PwC researchers said.
Health care costs have risen faster than the average annual income.
Health care consumed 4 percent of income in 1960 compared to 6
percent in 2013.

What Caused This Increase?

There were two causes of this massive increase: government policy

and lifestyle changes.

t, the United States relies on company-sponsored private health

insurance. The government created programs like Medicare and
Medicaid to help those without insurance. These programs spurred
demand for health care services. That gave providers the ability to
raise prices. A Princeton University study found that Americans use
the same amount of health care as residents of other nations. They
just pay more for them. For example, U.S. hospital prices are 60
percent higher than those in Europe. Government efforts to reform
health care and cut costs raised them instead.

Second, chronic illnesses, such as diabetes and heart disease, have

increased. They are responsible for 85 percent of health care costs.
Almost half of all Americans have at least one of them. They are
expensive and difficult to treat. As a result, the sickest 5 percent of
the population consume 50 percent of total health care costs. The
healthiest 50 percent only consume 3 percent of the nation's health
care costs. Most of these patients are Medicare patients. The U.S.
medical profession does a heroic job of saving lives. But it comes at
a cost. Medicare spending for patients in the last year of life is six
times greater than the average. Care for these patients costs one-
fourth of the Medicare budget. In their last six months of life, these
patients go to the doctor's office 29 times on average. In their last
month of life, half go to the emergency room. One-third wind up in
the intensive care unit. One fifth undergo surgery.
 Costly Healthcare

Compared to most other Asian countries, the out-of-pocket

spending on healthcare has increased significantly in the Philippines
in recent years. At the same time, public spending has declined.
Patients now pay almost half of their healthcare costs themselves.
Unfortunately, still less than half of the population is covered by
healthcare in the Philippines.

Moreover, healthcare coverage does not guarantee financial

protection or access to high-quality services. This is mostly due to
the fact that the Philippine Health Insurance Corporation (PHIC)
offers only limited benefits. In fact, PHIC’s share of healthcare
expenditure has grown very little since it was established in 1995. As
public insurance plans only cover medical services up to a certain
cost, patients face the remaining expenses.

fURTHER INFO: https://www.thebalance.com/causes-of-rising-

healthcare-costs-4064878

4. Isolation of health care activities from other development

activities

WHY ENGAGE IN LOCALITY DEVELOPMENT? (relate in health care

during reporting)

 Locality development can break down barriers within the

community by encouraging and improving communication
among diverse individuals and groups in the population.
 Locality development can lay a solid foundation for
community support of activism around issues of importance.
 Locality development can bring forth the natural leaders from
within the community. This happens both naturally, as the
result of the locality development process, and through the
encouragement of current leaders.
 Locality development can encourage the community to
identify its own resources and understand its own strengths.
Once people have a clear sense of what they have available
and what they themselves can do, they can use their resources
to their best advantage.
 Locality development can make the community self-sufficient
and able to identify and solve its own problems. The
advantages of being in this position include:
 An increase in the speed with which the community can
respond to problems and mobilize resources.
 Assurance that the problems the community addresses are
those that really concern it.
 Locality development can give voice to everyone, and make
participatory democracy the normal method of community
decision-making. Building an inclusive, participatory
infrastructure ensures that everyone's opinions and needs are
heard, and leads to the establishment of community systems
that involve all sectors.
 Locality development can build a foundation for real
community and equity, leading to a healthy community and
long-term, positive social change. When people work together
as a community, it's much harder to write off particular
groups, or to ignore their needs, and much easier to envision
and work toward a community in which all the necessary
underpinnings of health are available to everyone.
Further info: https://ctb.ku.edu/en/table-of-contents/assessment/promotion-strategies/community-
development/main