Determinants of Resiliency in Primary Health Care Delivery in the Philippines

The Philippines  adopted  the  Primary  Health  Care (PHC)  Strategy  following  the  1979  Alma  Ata  Declaration. The country already had a long  history of  PHC and  community health  programs  as  part  of  rural  development  programs  and  reforms  in  restructuring  the  health  care  delivery  system.  The Local  Government  Code  of  1991[1]   devolved  the  health  sector  to  the  Local  Government  Units (LGUs) while  the  Traditional and  Alternative Medicine  Act (TAMA)  of  1997 [2] provided  for  the  “….  delivery  of  health care  services  to  the  Filipino  people  through  the  development  of  traditional  and  alternative  health  care  services  and  its  integration  into  the  national  health  care  delivery  system”. In  2013, the  Department  of  Health,  Philippine  Health  Insurance  Corporation  and  Department  of  Science  and  Technology  started  the  implementation  of  the  Philippine  eHealth  Strategic Framework  and  Program which  set  the  direction  for  the  adoption  of  eHealth  solutions  to  health  care  service  standards  and  services including  that  for  natural  and  man-made  disasters. These legislative and program initiatives  on  health  influenced  the  PHC  implementation  in  the  Philippines  hence  the  need  to  review  the  status  of  PHC  in  the  country[3].   The eight essential elements  of  PHC  effectively  integrates  the  health  and  social  development  aspects  of  the  health  system: (a) safe  water  and  sanitation; (b) food  and  nutrition; (c) maternal  and  child  health; (d) immunization; (e) curative  care; (f) essential  drugs;  (g) health  education; (h) traditional  medicine; and (i) community  development.  In spite of  the integrating  PHC  framework  and  elements, the  physical,  social  and  environmental  vulnerabilities  of  the  country  as  a  whole  has  led  to  disruptions  in  health  systems  development. The Philippines, which was hit by at least 274 typhoons and other natural disasters between 1995 and 2015, making it one of the five countries worldwide that were struck by the most  weather-related calamities during the 20-year period, according to the Geneva-based United Nations Office for Disaster Risk Reduction (UNISDR).[4] These disruptive  events  brought  about  by  natural  and  man-made  disasters  have also  disrupted  health  service  delivery  mechanisms  and  health  programs  implementation.  The national and local  health  systems  have  adjusted  to  these  events  and  in  the  process  adopted  resilience  and  recovery  measures  to  ensure  the  continuity  of   services.  These  current  challenges  to  the  health  system  require  an  analysis  of  the  determinants  of  operational  continuity  in  the  delivery  of  essential  primary  health  care  service.  Subsequently, using  strategies  to  ensure  that  the  structures  and  processes of  these  determinants  need  to  be  identified,  described  and  forwarded  as  recommendations.

The expected  output  is  a  health  system  research  study  and  policy  recommendations to  address  the   following  policy  questions:

1. What  are  the  key  determinants  of  operational  continuity  in  the  delivery  of  essential  primary  health  care  services  in  times  of  disruptive  events?
2. What  are  the  strategies  to  ensure  that  structures  and  processes  of  these  determinants  are  in  place  such  that  primary  health  care  systems  will  remain  operational  when  exposed  to  disruptive  events  such  as  disasters and  disease  outbreaks?

[1]Republic Act 7160 known  as  AN ACT PROVIDING FOR A LOCAL GOVERNMENT CODE OF 1991             
[2]Republic  Act 8423  known  as  the  “Traditional  Medicine  and  Alternative  Medicine  Act  of  1997”.
[3]World  Health Organization (2011) Philippine  Country  Consultations  on  Draft  Strategy  for  Primary  Health  Care  and  Health Systems  Strengthening,  Final  Report

Project Director: 

Dennis Batangan

Project No.: 


Funding Agency: 

Philippine Council for Health Research and Development

Year Completed: 

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