Primary health care, often abbreviated as "PHC", has been defined as
"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 the country can
afford to maintain at every stage of their development in the spirit of
self-reliance and self-determination". In other words, PHC is an
approach to health beyond the traditional health care system that
focuses on health equity-producing social policy. PHC includes all areas
that play a role in health, such as access to health services,
environment and lifestyle.
This ideal model of health care was
adopted in the declaration of the International Conference on Primary
Health Care held in Alma Ata, Kazakhstan in 1978 (known as the "Alma Ata
Declaration"), and became a core concept of the World Health
Organization's goal of Health for all.[5] The Alma-Ata Conference
mobilized a "Primary Health Care 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. There were many factors that inspired PHC; a prominent
example is the Barefoot doctors of China.
The ultimate goal of
primary health care is better health for all. The WHO has identified
five key elements to achieving that goal:[8] reducing exclusion and
social disparities in health (universal coverage reforms);
organizing health services around people's needs and expectations
(service delivery reforms); integrating health into all sectors
(public policy reforms); pursuing collaborative models of policy
dialogue (leadership reforms); and increasing stakeholder
participation.
Behind these elements lies a series of basic
principles identified in the Alma Ata Declaration that should be
formulated in national policies in order to launch and sustain PHC as
part of a comprehensive health system and in coordination with other
sectors:[1] Equitable distribution of health care -- according this
principle, primary care and other services to meet the main health
problems in a community must be provided equally to all individuals
irrespective of their gender, age, caste, color, urban/rural location
and social class. Community participation -- in order to make the
fullest use of local, national and other available resources. Community
participation was considered sustainable due to its grass roots nature
and emphasis on self-sufficiency, as opposed to targeted (or vertical)
approaches dependent on international development assistance.[4]
Health workforce development -- comprehensive health care relies on
adequate numbers and distribution of trained physicians, nurses, allied
health professions, community health workers and others working as a
health team and supported at the local and referral levels. Use of
appropriate technology -- medical technology should be provided that is
accessible, affordable, feasible and culturally acceptable to the
community. Examples of appropriate technology include refrigerators for
vaccine cold storage. Less appropriate could include, in many settings,
body scanners or heart-lung machines, which benefit only a small
minority concentrated in urban areas, are generally not accessible to
the poor, but draw a large share of resources.[4] Multi-sectional
approach -- recognition that health cannot be improved by intervention
within just the formal health sector; other sectors are equally
important in promoting the health and self-reliance of communities.
These sectors include, at least: agriculture (e.g. food security);
education; communication (e.g. concerning prevailing health problems and
the methods of preventing and controlling them); housing; public works
(e.g. ensuring an adequate supply of safe water and basic sanitation);
rural development; industry; community organizations (including
Panchayats or local governments, voluntary organizations, etc.).
In
sum, PHC recognizes that health care is not a short-lived intervention,
but an ongoing process of improving people's lives and alleviating the
underlying socioeconomic conditions that contribute to poor health. The
principles link health and development, advocating political
interventions, rather than passive acceptance of economic conditions.
http://en.wikipedia.org/wiki/Primary_...
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