Editorial. Primary health care in the twenty-first century

This paper builds upon and extends the definition of primary health care in the 1978 Declaration of Alma-Ata. The definition proposes a stronger role for community-based delivery of services and community mobilization, participation and empowerment. It calls for a stronger integration with vertical, disease-specific programs. And, finally, it calls for a strong role for certain curative services (including basic and essential surgery) that many today would not consider as part of primary health care. There is growing evidence that communities can and should play a stronger role than has traditionally been the case, that community-level workers who are properly trained and supported can provide effective services outside of health facilities, and that primary health centers staffed with non-specialist physicians and even non-physician clinicians can perform many of the lower-level inpatient services now performed at first-level referral hospitals. An approach to primary health care that is appropriate to the local context and that merges local epidemiological priorities with the communities' perceived priorities will make it possible to engage communities as partners. Currently, essential and basic health care services are available to only one-half of the world’s population. The full development of primary health care as envisioned here will accelerate progress in achieving Health for All as envisioned at the International Conference on Primary Health Care in 1978.

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Guest Editorial

Australian Journal of Primary Health ◽

10.1071/py00029 ◽

2000 ◽

Vol 6 (4) ◽

pp. 7

Author(s):

Mavis Smith

Keyword(s):

Health Care ◽

Primary Health Care ◽

Guest Editorial ◽

Care Service ◽

Health Care Service ◽

First Century ◽

Policy Makers ◽

The United Kingdom ◽

Primary Health ◽

Service Models

The Second International Primary Health Care 2000 Conference drew together leading policy makers and experienced practitioners from Canada, the United Kingdom, South Africa, New Zealand and all States of Australia to explore primary health care service models and programs emerging in response to the economic and social pressures of the twenty-first century.

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Skin diseases in children in rural Kenya: long-term results of a dermatology project within the primary health care system

British Journal of Dermatology ◽

10.1046/j.1365-2133.2001.03962.x ◽

2001 ◽

Vol 144 (1) ◽

pp. 118 ◽

Cited By ~ 6

Author(s):

W. Schmeller

Keyword(s):

Health Care ◽

Primary Health Care ◽

Health Care System ◽

Skin Diseases ◽

Long Term Results ◽

Primary Health Care System ◽

Primary Health ◽

Rural Kenya ◽

Care System

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Non-Fatal Deliberate Self-Harm in Three Remote Indigenous Communities in Far North Queensland, Australia

Crisis ◽

10.1027/0227-5910/a000589 ◽

2019 ◽

Vol 40 (6) ◽

pp. 422-428 ◽

Cited By ~ 1

Author(s):

Chris Rouen ◽

Alan R. Clough ◽

Caryn West

Keyword(s):

Health Care ◽

Primary Health Care ◽

Care Center ◽

Indigenous Communities ◽

Indigenous Australians ◽

Deliberate Self Harm ◽

Health Care Center ◽

Far North ◽

Primary Health ◽

Self Harm

Abstract. Background: Indigenous Australians experience a suicide rate over twice that of the general population. With nonfatal deliberate self-harm (DSH) being the single most important risk factor for suicide, characterizing the incidence and repetition of DSH in this population is essential. Aims: To investigate the incidence and repetition of DSH in three remote Indigenous communities in Far North Queensland, Australia. Method: DSH presentation data at a primary health-care center in each community were analyzed over a 6-year period from January 1, 2006 to December 31, 2011. Results: A DSH presentation rate of 1,638 per 100,000 population was found within the communities. Rates were higher in age groups 15–24 and 25–34, varied between communities, and were not significantly different between genders; 60% of DSH repetitions occurred within 6 months of an earlier episode. Of the 227 DSH presentations, 32% involved hanging. Limitations: This study was based on a subset of a larger dataset not specifically designed for DSH data collection and assesses the subset of the communities that presented to the primary health-care centers. Conclusion: A dedicated DSH monitoring study is required to provide a better understanding of DSH in these communities and to inform early intervention strategies.

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