Research Article - Journal of Public Health Policy and Planning (2019) Volume 3, Issue 3

Primary health care evidence and its contribution to health outcomes in selected municipalities and cities in Philippines

about health. It mobilized a ?Primary Health Care (PHC) Movement? of professionals and institutions, governments and civil society organizations, researchers and grassroots organizations that undertook to tackle the politically, socially and economically unacceptable health inequalities in all countries (The World Health Report, 2008). Evidence shows that, across the income spectrum, countries with high-performing primary health care systems deliver better health-outcomes at lower cost, with greater equity and better responsiveness to the need of the populations. However, there is considerable variation in health outcomes between and within countries at similar income level and there is no complete understanding of what makes primary health care system work. More than 30 years after the adoption of PHC in the Philippines, the health status of the country has improved but not as much as in other Southern-Asian countries. It is essential to determine the full extent by which PHC was implemented and how it helped achieve improved health outcomes. Aim: The purpose of this study is to evaluate the evidence of primary health care (PHC) in selected municipalities and cities in the Philippines. Furthermore, it aims to determine the association between PHC indicators and the selected health outcomes such as life expectancy, infant mortality rate (IMR), under 5 mortality rate, maternal mortality rate and TB prevalence. Method: The ecological study design and the case study method were used in the study. Secondary data analysis of the existing data from the primary study, ?Reconfiguring Primary Health Care within the Context of Universal Health Care? was done, where the municipality was used as the unit of analysis. Data from 16 municipalities and one city were analyzed. These municipalities were from the Cordillera Administrative Region (CAR), Regions IV-B, VI, and XII. Scatterplot diagram was used to describe the association of the PHC indices and the selected outcomes. Data were further analyzed using Spearman?s rho and Chi square test. Results: There is evidence of PHC in all field sites. However, its existence in the areas included in the study is of varying degrees. Generally, the health outcomes of the selected municipalities when compared to national targets are noted to be good. Infant mortality, under 5 mortality, and TB prevalence of most of the municipalities are below national target. Maternal mortality rate when compared to national average is low, which is desirable. However, life expectancy of most municipalities is below the national target. The presence of any of the PHC indices, whether complete or inadequate tend to be associated with good health outcomes. There is an inverse negative association between the health outcome and the PHC indices using the scatterplot diagram. Spearman rho coefficient scores reveal significant associations among PHC indicators such as comprehensiveness rs=0.683, p<0.05 and continuity of care rs=0.702, p<0.05 with life expectancy. For TB prevalence, comprehensiveness was also found to be significantly associated rs=0.535, p<0.05. Using Chi square test, results reveal significant associations between continuity of care and life expectancy ?2(2,N=16)=12.44, p<0.05, first contact and IMR ?2(1,N=17)=3.864,p<0.05, first contact and MMR ?2(1,N=17)=3.864, p<0.05, comprehensiveness and TB prevalence ?2(1,N=17)=4.286, p<0.05, and cost effectiveness and TB prevalence ?2(1, N=17)=11.875, p<0.05. Conclusion and recommendations: Primary Health Care, whether implemented completely or not remains to be a viable means of improving the health outcomes. However, although associations were found to exist between some PHC indices and the health outcomes, further evidence is needed to confirm the same findings at an individual level. There is a need to focus and work on specific indicators that denote PHC and at the same time are found to be associated with healthoutcomes, for PHC to genuinely serve its purpose of ?raising the level of health in populations?. Author(s): Joycelyn A Filoteo*, Esther O Dela Cruz, Rebecca A Guarino

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