Dr.
Jessica
▪ The International Conference on Primary Health Care was held
from 6-12 September 1978 at Alma-Ata, USSR.
▪ It was a historic landmark as it heralded a new era in health.
▪ The Conference adopted various recommendations and the
Declaration of Alma-Ata.
▪ The Declaration spelt out health in the social and economic contexts
and declared that primary health care was the key to attaining the
target of health for all by the year 2000 in a spirit of social justice.
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1. The conference strongly reaffirms that health is a fundamental
human right and that the attainment of the highest possible level of
health is a most important worldwide social goal.
2. The inequality in health is politically, socially, and economically
unacceptable.
3. Economic and social development is of basic importance to the
fullest attainment of health for all. The promotion and protection of
the health of the people is essential to sustained economic and social
development and contribute to a better quality of life.
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4. The people have the right and duty to participate individually and
collectively in the planning and implementation of their health care.
5. Main social target should be HFA 2000. PHC is the key to attaining
this target.
6. Definition of Primary Health Care is mentioned.
7. Primary health care:
a) reflects and evolves from the sociocultural and political characteristics and
economic conditions;
b) addresses the main health problems in the community, providing promotive,
preventive, curative and rehabilitative services accordingly;
c) includes at least: 8 elements;
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d) involves all related sectors and aspects of national and community
development;
e) requires and promotes maximum community and individual self-reliance and
participation in the planning, organization, operation and control of primary
health care, making fullest use of local, national and other available resources;
f) should be sustained by integrated, functional and mutually supportive referral
systems, leading to the progressive improvement of comprehensive health
care for all, and giving priority to those most in need;
g) relies, at local and referral levels, on health workers, including physicians,
nurses, midwives, auxiliaries and community workers, as well as traditional
practitioners as needed, suitably trained socially and technically to work as a
health team and to respond to the expressed health needs of the community.
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8. Formulation of national policies, strategies and plans of action to
launch and sustain PHC as part of a comprehensive national health
system and in coordination with other sectors.
9. International cooperation in a spirit of partnership.
10. Attainment of HFA200 through a fuller and better use of the world's
resources.
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❖ 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.
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Education concerning
prevailing health Prevention and Immunization against Maternal and Child
problems and control of locally the major infectious Health care including
methods of preventing endemic diseases diseases (EPI) family planning
and controlling them.
Promotion of food Appropriate treatment An adequate supply of
Provision of essential
supply and proper of common diseases safe water and basic
drugs
nutrition and injuries sanitation
Mental Health has
recently been adopted
Primary Dental Care Primary Eye care
as one element of
PHC
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EQUITY
COMPREHENSIVE
APPROPRIATE TECHNOLOGY
COMMUNITY INVOLVEMENT
MULTISECTORAL APPROACH TO HEALTH
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▪ Universal coverage with need-based care.
▪ Everybody should have access to PHC, whether rich or
poor, near or far, developed on underdeveloped.
▪ If there exists a problem of resources, the most in need
should be given priority.
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▪ Promotive, preventive curative and rehabilitative service.
▪ Comprehensive health care approach.
▪ Preventive and promotive services should be given priority, but
communities may have less interest in them unless accompanied by
curative services.
▪ All services might lead to a level of health which can maintain the
functionality and dignity of life.
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▪ that is scientifically sound, effective, culturally acceptable, affordable
and manageable services, in response to local needs.
▪ ACCEPTABILITY: all service should be planned based upon the
local problems and conditions within the limited resources of the
community.
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Self-reliance and self-dependence:
▪ Community should be actively involved starting from the problem
identification phase up to the evaluation phase, so as to create a
sense of ownership and commitment to the PHC services and no
longer dependent to the service providers.
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▪ Health could not be achieved by the activities of health sector alone.
▪ Multisectoral causation of health should be intervened by various
sectors; such as education for literacy, economic development for
income supplementation, basic sanitation for safe drinking water and
sanitary surroundings, transports and communication for easy
accessibility, etc.
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