Scaling up primary health care in the philippines: Lessons from a systematic review of experiences of community-based health programs

Abstract

Background. In view of renewed interest in primary health care (PHC) as a framework for health system development, there is a need to revisit how successful community health programs implemented the PHC approach, and what factors should be considered to scale up its implementaton in order to sustainably atain ideal community health outcomes in the Philippines. Objectve and methodology. Using the 2008 World Health Report PHC reform categories as analytcal framework, this systematc review aimed to glean lessons from experiences in implementng PHC that may help improve the functoning of the current decentralized community-level health system in the country, by analyzing gathered evidence on how primary health care evolved in the country and how community health programs in the Philippines were shaped by the PHC approach. Results. Nineteen (19) artcles were gathered, 15 of which documented service delivery reforms, two (2) on universal coverage reforms, three (3) on leadership reform, and one (1) on public policy. The literature described how successful PHC efforts centered on community partcipaton and empowerment, thus pinpointng how community empowerment stll needs to be included in natonal public health thrusts, amid the current emphasis on performance indicators to evaluate the success of health programs. Conclusion and recommendatons. The studies included in the review emphasize the need for natonal level public health interventons to be targeted to community health and social determinants of health as well as individual health. Metrics for community empowerment should be developed and implemented by government towards sustainable health and development, while ensuring scientfc validity of community health interventons.