The concept of primary health care emerged during the final
decades of the Cold War (the late 1960 and early 1970s). By then, the so- called vertical health approach used in malaria eradication by US agencies and WHO since the late 1950s were being criticized, thus new proposals for health and development appeared. John Bryant, in his book ―Health and Developing world‖, question the introduction of hospital- based health care system to developing countries and lack of emphasis on prevention. SIR. ACKAH Mar 11, 2024 2 According to him, more than half of the world population were not having access to health care at, and the rest who have access too, the receive does not solve the problems. Kenneth W. Newell, a WHO staff member from 1967, who had a survey on the experiences of medical auxiliaries in developing countries. In health by people, he argued that ‘a strict health sectorial approach is ineffective. In addition, the 1974 Canadian Lalond Report [named after the minister of health] deemphasized the importance attributed to the quantity of medical instructions and proposed for determinant of health; biology, health services, environment, and lifestyles. SIR. ACKAH Mar 11, 2024 3 Other influential studies outside the public health domain also challenged the assumption that, health resulted from the transference of technology or more doctors and other services. Thomas McKeown (a British historian) argued that the overall health of the people was less related to medical advances than to standards of living and nutrition. Ivan Illichsdical Nemesis contended that medicine was not only irrelevant but even detrimental, because medical doctors deprived health from the public. SIR. ACKAH Mar 11, 2024 4 Missionaries’ experiences also brought primary health care into play. A specialized organization of the World Council of Churches (Christian Medical Commission) and the Lutheran World Federation, was created in the late 1960s by medical missionaries working in developing countries. This new organization stressed on the training of village workers at the grassroots level, equipped them with essential drugs and simple methods of treatments. In 1970, a journal contact was created, which used the term primary health care, probably for the first time. SIR. ACKAH Mar 11, 2024 5 Another important inspiration for primary health care was the global popularity that the massive expansion of rural medical services in communist China experienced, especially the ‗‘barefoot doctors‘‘. This visibility conceded with China’s entrance into the United Nations [UN] system [include the WHO]. The ‘barefoot doctors whose numbers increased dramatically in the early 1960s were a diverse array of village health workers who lived in the community they served, stressed rural rather than urban health care and preventive rather than curative services, and combined Western and traditional medicines. SIR. ACKAH Mar 11, 2024 6 Primary health care was also favored by a new political context characterized by the emergence of decolonized African nations and the spread of national, anti-imperialist, and leftist movements in many less-developed nations. These changes led to new proposals on development made by some industrialized countries. SIR. ACKAH Mar 11, 2024 7 In summary, the concept of Primary Health Care [PHC] emerged during the 1970s when ideas about health care began to change generally and specifically in relation to the third or developing world. These new Ideas about health care emerge from many sources. Examples of these sources include; SIR. ACKAH Mar 11, 2024 8 Changing theories about the relationship between health and development; Concerns about population growth; Question about the relevance of implementing a western-type medical service in a developing country; SIR. ACKAH Mar 11, 2024 9 The remarkable progress that was being made in improving health in countries like China; The achievements of many skill, mostly community-based health care initiatives in developing countries And the work of the Christian Medical Commission of the World Council of Churches, whose church–related medical programs in the developing World emphasized, amongst other things, the importance of the community engagement and the training of auxiliary health workers. SIR. ACKAH Mar 11, 2024 10 ALMA-ATA The landmark event for primary health was the International Conference on Primary Health Care that took place at Alma-Ata from September 6 to 12, 1978 and involved over 3000 delegates from 134 governments and 67 multilaterals / NGOs. Alma-Ata was the capital of the Soviet Republic of Kazakhstan, located in the Asiatic region of the Soviet Union. When the conference took place, primary health care was to some degree already sold to many participants. From 1976 to 1978, the WHO and UNICEF organized a series of regional meetings to discuss alternative approaches. The conferences main document, the Declaration of Alma-Ata, which was already known by many participants, was approved by acclamation. SIR. ACKAH Mar 11, 2024 11 Within the same conference in 1978 at Alma –Ata [USSR] all the government of 134 countries made these declaration: The conference confirmed that health, which is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity, is a fundamental human right and the attainment of the highest possible level of health is a most important. world- wide social goal whose realization requires the action of many other social and economic sectors in addition to the health sector. SIR. ACKAH Mar 11, 2024 12 The existing gross inequality in the health status of the people particularly between developed and developing countries as well as within countries is politically, socially and economically unacceptable and is therefore of common concern to all countries. The international objective of health for all by the year 2000 as the economic and social developments, based on a new international economic order is of basic importance to the fullest attainment of health for all. SIR. ACKAH Mar 11, 2024 13 The people have the right and duty to participate individually and collectively in planning and implementation of their own health care. Governments have a responsibility for the health of their people which can be fulfilled by the provision of adequate health and social measures. All government should formulate national policies, strategies and plans of action to launch and sustain primary health care . SIR. ACKAH Mar 11, 2024 14 All countries should co-operate in a spirit of partnership and service to ensure primary health care [PHC] for all people. An acceptable level of health for all the people by the year 2000 can be attained through a further and better use of the world resources. SIR. ACKAH Mar 11, 2024 15 Objectives of the Conference To promote the concept of primary health care in all countries. To exchange information and experience on the development of primary health within the framework of comprehensives national health system and services To evaluate the present health and health care situation throughout the world as it relates to and can be improved by primary health care. SIR. ACKAH Mar 11, 2024 16 To define the principles of primary health care as well as the operational means of overcoming practical problems in the development of primary health care. To define the role of governments, national and international organizations in technical cooperation and support for the development of primary health care To formulate recommendations for the development of primary health care. WHO defined the concept primary health care as a strategy to reach the goal of health for all by the year 2000. SIR. ACKAH Mar 11, 2024 17 Definition Of ‘’Health for All [HFA] HFA is defined as the attainment by all peoples of the world by a particular date[ kept at that time as the year 2000] of a level of health that will permit them to lead a socially and economically productive life. It does not imply that by that date, everybody in the world will have the most state of the art health care but that by date everybody in the world will attain a level of health so as to enable him or her to lead physically , mentally, socially and economically fulfilling life and contribute fully, depending on his/ her capabilities , towards the socio-economic development of the community and nation. SIR. ACKAH Mar 11, 2024 18 The global strategy for health for all by the year 2000 [HFA200] set the following guiding targets to be achieved by the year 2000; Life expectancy at birth above 60 years Infants mortality rate below 50 per 1000 live births Under -5 mortality rate below 70 per live births .
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Health for All means that health is to be brought within the reach of everyone in a given community. It implies the removal of obstacles to health that is to say elimination of Malnutrition Ignorance Disease Contaminated water supply Unhygienic environment etc SIR. ACKAH Mar 11, 2024 20