In 1978, a conference was held in Kazakhstan. Individuals from 134 different countries attended this conference and the Alma-Ata Declaration was agreed upon and signed. The Alma-Ata Declaration stated that Primary Health Care was the key feature in promoting health care around the world, from first world countries through to third world countries.
“Primary health care is 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. 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 and constitutes the first element of a continuing health care process.” This was accepted as the definition of Primary Health Care according to the Alma-Ata Declaration.
Five key principles were named in order to achieve the definition of Primary Health Care. These principles act as the pillars that ensure the aforementioned definition is accomplished.
The first principle is “equitable distribution” of health services. The ultimate goal of primary health care is better health for all, which entails reducing exclusion and social disparities amongst the general population. Primary health care should be provided equally to everyone, irrespective of their gender, age, ethnicity or location. It should be accessible to individuals that are in need of care but cannot afford it. Health services are often found only in towns which may be inaccessible to individuals or families in a developing country or rural area. In order to achieve universal health coverage, it is essential that the community has access to quality healthcare services and has access to safe, effective, quality and affordable medicines and vaccines.
The second principle is the “focus on prevention”. Health services should aim at promoting health in communities. This will enable individuals to have the necessary knowledge in order to increase control over their health. Preventative measures should be taken in order to save lives and costs for the community, as well as government institutions. This can be achieved by informing the community about vaccines that could prevent life-threatening diseases and thereby allowing them access at an affordable cost. Antiretroviral drugs can decrease the mortality rate of individuals. Promoting sex education can prevent unwanted pregnancies and sexually transmitted diseases. As Desiderius Erasmus once said, “Prevention is better than cure.”
The third principle is “appropriate technology”. Appropriate technology should be simple, effective, cheap, as well as environmentally sound and sustainable. This technology should be manageable by health practitioners as well as the community. Examples of appropriate technology include: Thermometers that are widely available for individuals to use for themselves or for their children, thus decreasing the risk of febrile convulsion. Glucose kits should be easily accessible to individuals suffering from hyperglycemia or hypoglycemia. In cases of individuals with hypertension or hypotension, blood pressure monitors should be available in order to monitor their condition. Appropriate technology also means that life has become easier in terms of communication as communities are able to get hold of health care services telephonically or by email.
The fourth principle is “community involvement”. Community participation and contribution has been recognised as an essential component of achieving primary health care. Community participation is a cost-effective way of extending the health care system. Communities that invest labour, time, money or materials in health-promoting activities are more committed to the use and maintenance of supplies that they produce. If communities are willing to get involved, it will be easier for health care services to lend their expertise as they will have help with the maintenance of clinics in the community. Communities that are able to promote their own health and help in the planning, maintenance and execution of health services are essential to the aspect of primary health care.
The fifth principle is a “Multisectoral approach”. This refers to the partnership of various sectors across the nation. If multiple sectors are engaged, associates are able to pull knowledge and proficiency from one another, therefore profiting from their varied assets and working together towards producing better health outcomes for the community. A few sectors that need to be involved are housing, agriculture, education and industry. Together, they are able to work on achieving the objectives of primary health care.
In conclusion, the principles aim to ensure that the definition of primary health care is adhered to and ultimately achieved. Primary health care links strongly to the community and is essential in dealing with the many determinants of health.
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