More Information on Primary Health Care
Primary health care was placed at the center of the international health agenda in 1978 through the Declaration of Alma-Ata which was adopted at an International Conference on Primary Health Care (PHC). The Declaration of Alma-Ata states that “Primary health care is essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination. It forms an integral part both of the country’s health system, of which it is the central function and main focus, and of the overall social and economic development of the community. It is the first level of contact of individuals, the family and the community with the national health system bringing health care as close as possible to where people live and work, and constitutes the first element of a continuing health process”.
The ambitious goal of “Health for All by the Year 2000” was set. The fact that “Health for All” was not fully achieved does not discredit those goals and principles. Insufficient attention to a health systems approach was a root cause of many of the bottlenecks that hampered the achievement of the goals of Alma-Ata. However, the financial limitations placed on public health systems in the two decades after Alma-Ata may have precluded successful results no matter what strategies were adopted.
Thirty years after Alma-Ata, there is renewed dialogue about the role of Primary Health Care in the international health agenda. The Division of Health Sector Development in the WHO Regional Office for the Western Pacific will participate fully in that dialogue at international, regional and national levels. This will include analytic work to document experience and best practice, as well as participation in policy dialogues on the most feasible ways to achieve the goals of PHC through strengthened health systems.
A frequent misconception has been that PHC is separate from the rest of the health care system, an idea that is clearly at odds with the definition of PHC agreed at Alma-Ata. A balanced health care system is needed, one that deals with both the primary or first contact with the health care system and the “continuing health process”. As important as the international health policy dialogue is, the responsibility for the type of health service available in a country belongs with individual nations. The Division in the Region will provide technical assistance as requested by Member States in tailoring their interventions in health systems strengthening (HSS) so that may achieve better health outcomes based on the principles of Alma-Ata.