scholarly journals Visualising Primary Health Care: World Health Organization Representations of Community Health Workers, 1970–89

2018 ◽  
Vol 62 (4) ◽  
pp. 401-424 ◽  
Author(s):  
Alexander Medcalf ◽  
João Nunes
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
World Health Organization ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
World Health ◽  
Primary Health ◽  
The World ◽  
Health Organization

For the World Health Organization (WHO), the 1978 Alma-Ata Declaration marked a move away from the disease-specific and technologically-focused programmes of the 1950s and 1960s towards a reimagined strategy to provide ‘Health for All by the Year 2000’. This new approach was centred on primary health care, a vision based on acceptable methods and appropriate technologies, devised in collaboration with communities and dependent on their full participation. Since 1948, the WHO had used mass communications strategies to publicise its initiatives and shape public attitudes, and the policy shift in the 1970s required a new visual strategy. In this context, community health workers (CHWs) played a central role as key visual identifiers of Health for All. This article examines a period of picturing and public information work on the part of the WHO regarding CHWs. It sets out to understand how the visual politics of the WHO changed to accommodate PHC as a new priority programme from the 1970s onwards. The argument tracks attempts to define CHWs and examines the techniques employed by the WHO during the 1970s and early 1980s to promote the concept to different audiences around the world. It then moves to explore how the process was evaluated, as well as the difficulties in procuring fresh imagery. Finally, the article traces these representations through the 1980s, when community approaches came under sustained pressure from external and internal factors and imagery took on the supplementary role of defending the concept.

An Overview of Primary Health Care

1976 ◽  
Vol 6 (2) ◽  
pp. 309-314 ◽  
Author(s):  
John Fry
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
World Health Organization ◽  
Critical Analysis ◽  
World Health ◽  
Training And Education ◽  
Primary Health ◽  
The World ◽  
Health Organization

Primary health care has become a focus of interest from the World Health Organization down. The hopes that more emphasis on primary care will lead to less expensive and better care will not be realized unless a more critical analysis of its problems is undertaken and some of its defects and deficiencies put right. Its roles must be better defined and the work shared within a team; training and education must be more related to its needs; and much sharper research is required to decide what is useful and what is useless.

scholarly journals Iniquidades sociais e intersetorialidade: desafio à atenção primária à saúde

2018 ◽  
Vol 12 (6) ◽  
pp. 1705
Author(s):  
Regina Célia Fiorati ◽  
Larissa Barros de Souza ◽  
Fernanda Carla De Assis Cândido ◽  
Luana Nunes de Freitas Silva ◽  
Larissa Chacon Finzeto ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
World Health Organization ◽  
World Health ◽  
Capital Social ◽  
Eligibility Criteria ◽  
Primary Health ◽  
Revisión Sistemática ◽  
The World ◽  
Health Organization

RESUMOObjetivo: investigar ações intersetoriais voltadas ao enfrentamento das iniquidades sociais, em nível de Atenção Primária à Saúde, desenvolvidas com vistas à redução das desigualdades em saúde no Brasil. Método: revisão sistemática com busca nas Bases de dados LILACS e MEDLINE. Utilizaram-se, como critérios de elegibilidade, pesquisas desenvolvidas no Brasil, de 2005 a 2015, em português, inglês ou espanhol, com, pelo menos, um descritor em título ou resumo. Para a análise dos dados, utilizaram-se os referenciais teóricos, as variáveis ação intersetorial governamental e ação intersetorial com participação social e o Guia de Diretrizes PRISMA. Resultados: 40% dos estudos trataram sobre ações intersetoriais de nível governamental envolvendo iniciativas do governo federal; 20%, de ações intersetoriais locais envolvendo a sociedade civil; 40%, dos dois tipos; 40%, baseados no referencial da Organização Mundial da Saúde; 20%, no referencial do Capital Social; 20%, nos referenciais da Organização Mundial da Saúde e Curso da Vida e 20%, nos referenciais da Organização Mundial da Saúde e do Capital Social. Conclusão: políticas intersetoriais, em conjunto com a sociedade, aumentam as possibilidades de concretização de equidade social no Brasil. Descritores: Atenção Primária à Saúde; Iniquidade Social; Determinantes Sociais da Saúde; Ação Intersetorial; Políticas Públicas; Equidade em Saúde.ABSTRACT Objective: to investigate intersectoral actions aimed at confronting social inequities, in the level of Primary Health Care, developed with a view to reducing health inequalities in Brazil. Method: systematic review with search in LILACS and MEDLINE databases. As eligibility criteria, research developed in Brazil, from 2005 to 2015, in Portuguese, English or Spanish, with at least one title or summary descriptor was used. For the data analysis, the theoretical references, the variables governmental intersectorial action and intersectorial action with social participation and the PRISMA Guidelines Guide were used. Results: 40% of the studies dealt with intersectorial actions of governmental level involving initiatives of the federal government; 20%, of local intersectoral actions involving civil society; 40% of the two types; 40%, based on the World Health Organization's benchmark; 20%, in the reference of the Capital Stock; 20% in the World Health Organization and Lifetime referral guidelines and 20% in the World Health Organization and Social Capital benchmarks. Conclusion: intersectorial policies, together with society, increase the possibilities of achieving social equity in Brazil. Descriptors: Primary Health Care; Social Inequity; Social Determinants of Health; Intersectoral Action; Public Policies; Health Equity.RESUMEN Objetivo: investigar acciones intersectoriales dirigidas al enfrentamiento de las inequidades sociales, a nivel de Atención Primaria a la Salud, desarrolladas con vistas a la reducción de las desigualdades en salud en Brasil. Método: revisión sistemática con búsqueda en las Bases de datos LILACS y MEDLINE. Fueron utilizados, como criterio de elegibilidad, de investigación desarrollado en Brasil, desde 2005 hasta 2015, en portugués, inglés o español, con, al menos, un descriptor en el título o en el resumen. Para el análisis de los datos se utilizaron los referenciales teóricos, las variables acción intersectorial gubernamental y acción intersectorial con participación social y el Guía de Directrices PRISMA. Resultados: 40% de los estudios trataron sobre acciones intersectoriales de nivel gubernamental involucrando iniciativas del gobierno federal; 20%,  de acciones intersectoriales locales involucrando a la sociedad civil; el 40% de los dos tipos; El 40%, basado en el referencial de la Organización Mundial de la Salud; el 20%, en el referencial del Capital Social; y el 20%, en los referenciales de la Organización Mundial de la Salud y el Curso de la Vida y el 20%, en los referentes de la Organización Mundial de la Salud y del Capital Social. Conclusión: políticas intersectoriales, en conjunto con la sociedad, aumentan las posibilidades de concreción de equidad social en Brasil. Descriptores: Atención Primaria a la Salud; Iniquidad Social; Determinantes Sociales de la Salud; Acción Intersectorial; Políticas Públicas; Equidad em Salud.

Authors’ Commentary: Domestic Violence Against Women, Public Policies and Community Health Workers in Brazilian Primary Health Care

2019 ◽  
Vol 40 (3) ◽  
pp. 237-239
Author(s):  
Marcos Signorelli ◽  
Angela Taft ◽  
Pedro Paulo Gomes Pereira
Keyword(s):  
Health Care ◽  
Domestic Violence ◽  
Primary Health Care ◽  
Community Health ◽  
Community Health Workers ◽  
Health Professionals ◽  
Health Workers ◽  
Family Health ◽  
Further Education ◽  
Primary Health

In this commentary paper, we highlight the key role that community health workers and family health professionals can perform for the identification and care for women experiencing domestic violence in communities. These workers are part of the primary health-care strategy in the Brazilian public health system, who are available in every municipalities and neighborhoods of the country. Based on our ethnographic research, we argue that identification and care of abused women by these workers and professionals follow a pattern which we described and named “the Chinese whispers model.” We also point gaps in training these workers to deal with complex issues, such as domestic violence, arguing for the need of formal qualification for both community health workers and family health professionals by, for example, incorporating such themes into curricula, further education, and continuing professional development.

Health for All and Primary Health Care, 1978–2018: A Historical Perspective on Policies and Programs Over 40 Years

2018 ◽  
Author(s):  
Susan B. Rifkin
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
United Nations ◽  
Good Health ◽  
World Health ◽  
Primary Health ◽  
The World ◽  
Definition Of Health ◽  
Definition Of ◽  
Health Organization

In 1978, at an international conference in Kazakhstan, the World Health Organization (WHO) and the United Nations Children’s Fund put forward a policy proposal entitled “Primary Health Care” (PHC). Adopted by all the World Health Organization member states, the proposal catalyzed ideas and experiences by which governments and people began to change their views about how good health was obtained and sustained. The Declaration of Alma-Ata (as it is known, after the city in which the conference was held) committed member states to take action to achieve the WHO definition of health as “state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Arguing that good health was not merely the result of biomedical advances, health-services provision, and professional care, the declaration stated that health was a human right, that the inequality of health status among the world’s populations was unacceptable, and that people had a right and duty to become involved in the planning and implementation of their own healthcare. It proposed that this policy be supported through collaboration with other government sectors to ensure that health was recognized as a key to development planning. Under the banner call “Health for All by the Year 2000,” WHO and the United Nations Children’s Fund set out to turn their vision for improving health into practice. They confronted a number of critical challenges. These included defining PHC and translating PHC into practice, developing frameworks to translate equity into action, experiencing both the potential and the limitations of community participation in helping to achieve the WHO definition of health, and seeking the necessary financing to support the transformation of health systems. These challenges were taken up by global, national, and nongovernmental organization programs in efforts to balance the PHC vision with the realities of health-service delivery. The implementation of these programs had varying degrees of success and failure. In the future, PHC will need to address to critical concerns, the first of which is how to address the pressing health issues of the early 21st century, including climate change, control of noncommunicable diseases, global health emergencies, and the cost and effectiveness of humanitarian aid in the light of increasing violent disturbances and issues around global governance. The second is how PHC will influence policies emerging from the increasing understanding that health interventions should be implemented in the context of complexity rather than as linear, predictable solutions.

What are the roles of community health workers? Looking back at the philosophies of primary health care

2019 ◽  
Vol 27 (2) ◽  
pp. 117-120
Author(s):  
Marietou Niang
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Community Development ◽  
Health System ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Primary Health ◽  
Looking Back

This commentary discusses the different roles of community health workers (CHWs), their challenges and limitations in a historical perspective of primary health care (PHC). We first try to show that the comprehensive philosophy of PHC promulgated in Alma-Ata proposed the role of CHWs as actors who work in community development. On the other hand, in the 1980s, with the emergence of the selective philosophy of PHC, CHWs’ role was more affiliated with the health system. We conclude our pitch about the balance that can exist between these different roles by suggesting that CHWs can work in continuity with the health system, but they should not be considered as affordable labor. Also, they must be supported in their activities to develop their communities, allowing them to participate effectively in programs and policies that concern them and their community.

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