Walley 2008 Making PHC reality

Title Primary Health Care: Making Alma-Ata a Reality
Format Publication
Authors Walley, J., Lawn, J.E., Tinker, A., deFrancisco, A., Chopra, M., Rudan, I., Ghutta, Z.A., Black, R.E., Lancet Alma-Ata Working Group
Journal Name (if applicable) Lancet
Date Published 2008
Open Access Y/N No
Hard copy PDF Available Y/N Yes
Link http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(08)61409-9/abstract
Abstract The principles agreed at Alma-Ata 30 years ago apply just as much now as they did then. “Health for all” by the year 2000 was not achieved, and the Millennium Development Goals (MDGs) for 2015 will not be met in most low-income countries without substantial acceleration of primary health care. Factors have included insuffi cient political prioritisation of health, structural adjustment policies, poor governance, population growth, inadequate health systems, and scarce research and assessment on primary health care. We propose the following priorities for revitalising primary health care. Health-service infrastructure, including human resources and essential drugs, needs strengthening, and user fees should be removed for primary health-care services to improve use. A continuum of care for maternal, newborn, and child health services, including family planning, is needed. Evidence-based, integrated packages of community and primary curative and preventive care should be adapted to country contexts, assessed, and scaled up. Community participation and community health workers linked to strengthened primary-care facilities and fi rst-referral services are needed. Furthermore, intersectoral action linking health and development is necessary, including that for better water, sanitation, nutrition, food security, and HIV control. Chronic diseases, mental health, and child development should be addressed. Progress should be measured and accountability assured. We prioritise research questions and suggest actions and measures for stakeholders both locally and globally, which are required to revitalise primary health care.