On the World Health Organization’s Neglect of the Role of Medical Doctors in Its Conception and Practice of Primary Health Care

2019 ◽  
Vol 49 (3) ◽  
pp. 642-657
Author(s):  
Socrates Litsios
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Soviet Union ◽  
World Health ◽  
Director General ◽  
Medical Doctors ◽  
Primary Health ◽  
The Soviet Union ◽  
Year 2000

Primary health care (PHC) emerged in the early 1970s as WHO’s response to the failure of its basic health services approach. The Soviet Union succeeded in getting WHO’s governing bodies to agree to hold an international conference on PHC, a conference that was held in Alma-Ata, the capital of the Soviet Republic of Kazakhstan, in September 1978. In 1975, Dr. Halfdan Mahler, WHO’s charismatic director-general, introduced the goal of “health for all” (HFA) by the year 2000. Alma-Ata declared PHC as the key for achieving HFA. Although WHO had promoted the involvement of medical schools in community health, Mahler’s antimedical establishment rhetoric contributed to WHO ignoring the potential role that medical doctors could play in PHC and HFA.

scholarly journals The origins of Ethiopia's primary health care expansion: The politics of state building and health system strengthening

2020 ◽  
Author(s):  
Kevin Croke
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Developmental State ◽  
Sub Saharan Africa ◽  
Health System Strengthening ◽  
World Health ◽  
Director General ◽  
Central Feature ◽  
Primary Health ◽  
Health Programmes

Abstract Ethiopia’s expansion of primary health care over the past 15 years has been hailed as a model in sub-Saharan Africa. A leader closely associated with the programme, Tedros Adhanom Gebreyesus, is now Director-General of the World Health Organization, and the global movement for expansion of primary health care often cites Ethiopia as a model. Starting in 2004, over 30 000 Health Extension Workers were trained and deployed in Ethiopia and over 2500 health centres and 15 000 village-level health posts were constructed. Ethiopia’s reforms are widely attributed to strong leadership and ‘political will’, but underlying factors that enabled adoption of these policies and implementation at scale are rarely analysed. This article uses a political economy lens to identify factors that enabled Ethiopia to surmount the challenges that have caused the failure of similar primary health programmes in other developing countries. The decision to focus on primary health care was rooted in the ruling party’s political strategy of prioritizing rural interests, which had enabled them to govern territory successfully as an insurgency. This wartime rural governance strategy included a primary healthcare programme, providing a model for the later national programme. After taking power, the ruling party created a centralized coalition of regional parties and prioritized extending state and party structures into rural areas. After a party split in 2001, Prime Minister Meles Zenawi consolidated power and implemented a ‘developmental state’ strategy. In the health sector, this included appointment of a series of dynamic Ministers of Health and the mobilization of significant resources for primary health care from donors. The ruling party’s ideology also emphasized mass participation in development activities, which became a central feature of health programmes. Attempts to translate this model to different circumstances should consider the distinctive features of the Ethiopian case, including both the benefits and costs of these strategies.

Promoting Primary Health Care in Contiguous Urban and Rural Populations: Nigeria

1987 ◽  
Vol 7 (4) ◽  
pp. 353-366 ◽  
Author(s):  
Ehigie Ebomoyi ◽  
Joshua D. Adeniyi
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Urban Communities ◽  
World Health ◽  
Rural Populations ◽  
Primary Health ◽  
Rural And Urban ◽  
Health Community ◽  
The World ◽  
Year 2000

The World Health Organization's goal of “Health for All by Year 2000” through Primary Health Care (PHC) is commendable, but can only be attained with the involvement and collaboration of the non-health sectors as well as the health community. Thirteen rural and urban communities in Nigeria were assessed to develop social, health and primary health care profiles. A model for introducing PCH applicable to these communities was prepared.

Health Care Ten years after Alma Ata

1988 ◽  
Vol 28 (267) ◽  
pp. 519-530
Author(s):  
Andrei K. Kisselev ◽  
Yuri E. Korneyev
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
World Health ◽  
Social Goal ◽  
Human Right ◽  
World Health Assembly ◽  
Primary Health ◽  
The World ◽  
Socially Relevant ◽  
Year 2000

In 1977 the Thirtieth World Health Assembly decided that the main social goal of governments and WHO should be “the attainment by all citizens of the world by the year 2000 of a level of health that will permit them to lead a socially and economically productive life”.The International Conference on Primary Health Care (PHC), meeting in Alma Ata, USSR, in 1978, asserted that health is a human right and that health care should be accessible, affordable and socially relevant.

scholarly journals Advanced Practice Nursing and the Expansion of the Role of Nurses in Primary Health Care in the Americas

2021 ◽  
Vol 7 ◽  
pp. 237796082110194
Author(s):  
Luís Carlos Lopes-Júnior
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Educational Background ◽  
Advanced Practice Nursing ◽  
World Health ◽  
Noncommunicable Diseases ◽  
Advanced Practice ◽  
Primary Health ◽  
Health Organization

Nurses have an educational background particularly suited to the growing challenges of the 21st century, characterized by an accelerated demographic transition, accompanied by a scenario of triple disease burden: 1) the unsurpassed agenda for infectious diseases; 2) the increase in deaths attributable to external causes; and 3) the predominance of chronic noncommunicable diseases. Advanced Practice Nurses (APN) already have regulations well-established in many countries such as Australia, Belgium, Canada, the USA, Finland, France, Ireland, Japan, Poland, the United Kingdom, and the Czech Republic, among others. This paper aimed to point out and to reflect on Advanced Practice Nursing and the expansion of the role of nurses in Primary Health Care (PHC) in the Americas. In the same year the Nursing Now Campaign was launched, Pan American Health Organization (PAHO) and World Health Organization (WHO) prepared the document Expanding the Role of Nurses in PHC which calls on governments and nurses from countries in the Americas to implement APN training for PHC and Nurses from Central and South America who already have specialization programs, residency, academic master's and doctoral degrees. Expansion is intended to provide greater coverage and assistance to users of the health system, take advantage of nurses' intellectual capacity, and retain good professionals in the profession. This is a crucial moment for nursing worldwide. However, it is imperative to ensure the voice and impact of nursing continues to reverberate long after the end of 2021. In this paper, a debate on the strengths and challenges for the expansion of the APN role in PHC in the Americas is discribed.

scholarly journals Health for All by the Year 2000: Can Pakistan Meet the Target?

1987 ◽  
Vol 26 (4) ◽  
pp. 473-484
Author(s):  
S. Akbar Zaidi
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Great Majority ◽  
World Health ◽  
Underdeveloped Countries ◽  
Primary Health ◽  
The World ◽  
Care Approach ◽  
Health Organization ◽  
Year 2000

Since the late 1970s, the "Primary Health Care" (PHC) approach in order to deliver "Health for All by the Year 2000" (HFA/2000), has been in vogue in all the underdeveloped countries (UOCs) of the world. Nearly all the developed and underdeveloped countries endorsed the proposals set out by the World Health Organization (WHO) at its Conference in Alma Ata in 1978 (WHO 1978). The signing of the Alma Ata Charter supposedly signalled the beginning of a new era which would deal with the problems of health and disease of the great majority of the individuals of planet Earth. Pakistan was also one of the signatories of the Alma Ata Charter and has since the signing, been in the forefront of the movement. Pakistan has become a spokesman for the PHC and HF A/2000 approaches at nearly all international seminars and conferences, and those who rule and can implement policies within the country, have continued giving both the policies active oral support. The Primary Health Care approach is, at least on paper, a fairly radical approach which sets out to deal with much more than the simple problems of the health of the poor of the world. It encompasses a very wide canvas, and issues, which apparently are not related directly to health care, also fall under its terms of reference. It is the purpose of this paper to see whether Pakistan can reach the goals of Health for All by the Year 2000, using the Primary Health Care approach, a goal to which it has committed itself totally.

scholarly journals The role of Astana primary health care declaration for development of primary health care at postsoviet countryes

2019 ◽  
Vol 23 (3) ◽  
pp. 13-18
Author(s):  
Nurlan N. Brimkulov ◽  
Damilya S. Nugmanova
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Rural Areas ◽  
World Health ◽  
Negative Consequences ◽  
Health Care Reforms ◽  
System A ◽  
Primary Health ◽  
Health Organization

The article presents the goals, principles and results of the implementation of the Almaty Declaration of the World Health Organization (WHO) on primary health care (PHC) of 1978; the background and main provisions of the Astana Declaration of WHO on PHC 2018. The article presents the stages of PHC development in the USSR, which was characterized by the widespread introduction of narrow specialists at the primary level of health care, which subsequently had certain negative consequences. In a number of post-Soviet countries, the principles of General medical practice (family medicine) were implemented in health care reform, but some provisions of the Alma-Ata Declaration were introduced with distortions. This has led to a lack of effective functioning of the PHC system, a shortage of General practitioners, especially in rural areas. The implementation of the main principles of the new Astana Declaration will be important for the effective implementation of health care reforms in all post-Soviet countries.

Primary Health Care in War and Disaster and the NorAid System

1997 ◽  
Vol 12 (3) ◽  
pp. 10-15 ◽  
Author(s):  
Rannveig Bremer Fjaer
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
World Health ◽  
Vulnerable Groups ◽  
Maternal Complications ◽  
Basic Health ◽  
Primary Health ◽  
Health Organization ◽  
Year 2000

AbstractWhen the infrastructure in a community is destroyed by manmade or natural disaster, even the simplest health services may be difficult to maintain. By the Alma Ata declaration, the World Health Organization (WHO) proclaimed, “Health for all by the year 2000.” The program is designed to cover the basic health needs as defined by the Primary Health Care (PHC) system. Therefore, a most important issue in a disaster, is to support, maintain, and rebuild the PHC system, to secure the population's basic health services.Relevant and rapid aid is of great importance in disaster. The physical and psychological strain caused by disaster will increase the need for medical care compared to that during normal times. Child mortality and maternal complications will rise, Many of the 12 million children, who die every year, die as a result of war, refugee conditions, and/or other types of disaster.The NorAid system is equipment composed to provide PHC, with special emphasis on vulnerable groups e.g., women and children. Provided the medical skills are available, it also may function as a hospital. The system already has been used in many countries, and has been found to be relevant, practical, and relatively cheap compared to the benefits achieved.

scholarly journals Analysis of General Practitioners’ Attitudes and Beliefs about Psychological Intervention and the Medicine–Psychology Relationship in Primary Care: Toward a New Comprehensive Approach to Primary Health Care

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 613
Author(s):  
Attà Negri ◽  
Claudia Zamin ◽  
Giulia Parisi ◽  
Anna Paladino ◽  
Giovanbattista Andreoli
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
General Practitioners ◽  
Psychological Intervention ◽  
World Health ◽  
Attitudes And Beliefs ◽  
Primary Health ◽  
Comprehensive Primary Health Care

The biopsychosocial paradigm is a model of care that has been proposed in order to improve the effectiveness of health care by promoting collaboration between different professions and disciplines. However, its application still faces several issues. A quantitative–qualitative survey was conducted on a sample of general practitioners (GPs) from Milan, Italy, to investigate their attitudes and beliefs regarding the role of the psychologist, the approach adopted to manage psychological diseases, and their experiences of collaboration with psychologists. The results show a partial view of the psychologist’s profession that limits the potential of integration between medicine and psychology in primary care. GPs recognized that many patients (66%) would often benefit from psychological intervention, but only in a few cases (9%) were these patients regularly referred to a psychologist. Furthermore, the referral represents an almost exclusive form of collaboration present in the opinions of GPs. Only 8% of GPs would consider the joint and integrated work of the psychologist and doctor useful within the primary health care setting. This vision of the role of psychologists among GPs represents a constraint in implementing a comprehensive primary health care approach, as advocated by the World Health Organization.

scholarly journals Primary health care for all: lessons from its failure to achieve its goal and COVID-19

2021 ◽  
Vol 40 (1) ◽  
pp. 1
Author(s):  
Erlangga Yusuf
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Soviet Union ◽  
Former Soviet Union ◽  
Well Being ◽  
World Health ◽  
Primary Health ◽  
Access To Health ◽  
Development Goals ◽  
Health Organization

<p align="left">According to the World Health Organization (WHO), primary health care (PHC) can be defined as a whole-of-society approach to health and well-being, centered on the needs and preferences of individuals, families and communities. In the last five years, several major events occurred that emphasize the importance of and the need for PHC. First, the publication of the United Nations Sustainable Development Goals (SDGs) in 2015. One of the SDGs is to achieve universal health care (UHC). UHC means that all people can get access to health service without it resulting in financial hardship, and  the WHO believes that PHC is fundamental to achieving UHC.<sup><span> </span></sup>Second, a new international declaration on PHC has been released in Astana, Kazakhstan, in 2018.<span style="font-size: 8.33333px;"> </span>This is a new declaration and global commitment on PHC, four decennia after the first declaration on PHC in Alma-Ata, in the former Soviet Union</p>

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