Primary Health Care: Making the Alma-Ata a reality

What is primary health care? 

According to the Alma- Ata declaration - it is the first point of contact in the health system and it is universal health care that is based on methods and technology that makes basic health care accessible to all individuals and families in a community. It is 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, primary health care is an approach to health beyond the traditional health care system. It forms a part of the country’s health system as it is the focus in development of the community. Thus, primary healthcare and public health strategies are the foundation of universal health systems.

 What are the principles of primary health care?

The principles of Primary Health Care lay the foundation when it comes to promoting health care and developing strategies involving other sectors of state.

There are five principles of primary health care namely:

1.Universal coverage of the population, with care provided to need

2. Services should be promotive, preventative, curative and rehabilitative

3. Services should be effective, culturally acceptable and manageable

4. Communities should be involved in the development of services to promote self-reliance and reduce dependency

5. Approaches to health should relate to other sectors of development

I.     "... 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..."    

        According to the primary health care definition everyone should have access to equal health resources regardless of their background. It ensures that each clinic and hospital globally, "Universal coverage... ", has all the necessary resources to promote good health by making sure that these resources are within reach of all communities.

  II.     "... individuals and families in the community through their full participation..."     

            

      Principle 2 encourages the provision of services that are promotive, preventive, curative and rehabilitative, such as:

1. The provision of education to community members concerning specific health problems.

2. Ensuring that all citizens have access to clean, safe water and nutritious food on a regular basis to ensure good health.

3. The immunization of people against major diseases and viruses.

4. The access of free health care services to those unable to afford it.

5. The delivery, access and/or provision of essential medication (drugs) such as    ARVs or TB medication, especially to rural communities or those in need.

 These services are among the few that either allow people to promote their own health, prevent the spread of diseases, curate community members or help rehabilitate those affected. These also help to make sure that health care is 

accessible to all. 

     

III.  "...Primary health care is essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals..." 

 

This part of the definition emphasises the importance of

how services and resources should be effective, culturally

acceptable, and manageable by communities. This

principle is also referred to as Appropriate technology   

( David Sanders et al, 2018). Finance plays an important role

in efficient and effective health care services. Primary health

care ensures that the "health for all" right is obtained, by

encouraging  hospitals and medical practices to reduce

unnecessary costs in order to re-invest in the patients,

as well as investing in appropriate  technology. It is also vital

to understand and be up to date with the current change in

people's culture.(HowMed, 2015))

IV.     "...It is the first level of contact of individuals, the family and the community ...and constitutes the first element of a continuing health care process..."  

Communities should responsibility and be actively involved in the provision of services that they deem necessary. Applying the value and the principle of self reliance and achieving it in community development practices, empowers individuals and communities and enhances their dignity.

V.     "...It forms an integral part of the country’s health system of which it is the nucleus, and of the overall social and economic development of the country...."

The health care needs of individuals and communities goes further than what just health care services (eg, housing, food and clean water) can provide. To promote and achieve good

health, effort from all sectors of society and state are required, such as transport, labour, and industry and this is also known as intersectional collaboration. 

The principles of Primary Health Care are the best way to organise health services and ensure that all individuals have access to health care. The international health

partnership of the countries helps to put the principles into practice. Therefore the primary health care principles help make the Alma-Ata a reality.

References:

David Sanders, Natalie Gordon, Jocelyn de Jongh, Frans Kotze, June Jeggels, Dorothy Boshoff, Rina Swart, Rati Mpofu, Uta Lehman, Neil Myburgh, Firdouza Waggie, (2000) 'Session 5:Origins and main features of Primary Health Care', in David Sanders, Natalie Gordon, Jocelyn de Jongh, Frans Kotze, June Jeggels, Dorothy Boshoff, Rina Swart, Rati Mpofu, Uta Lehman, Neil Myburgh, Firdouza Waggie, (ed.) Primary Health Care. University of the Western Cape: University of the Western Cape, pp. 35-38.

howMed. 2018. Primary Health Care-Introduction,principles and elements. [Online] Available at: http://howmed.net/community-medicine/primary-health-care-introduction-principals-and-elements/. [Accessed 26 April 2018