251:
38:
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healthcare training. They stressed rural rather than urban healthcare, and preventive rather than curative services. They also provided a combination of western and traditional medicines. The
Barefoot Doctors had close community ties, were relatively low-cost, and perhaps most importantly they encouraged self-reliance through advocating prevention and hygiene practices. The program experienced a massive expansion of rural medical services in China, with the number of Barefoot Doctors increasing dramatically between the early 1960s and the
276:
by Julia Walsh and
Kenneth S. Warren entitled "Selective Primary Health Care, an Interim Strategy for Disease Control in Developing Countries". This new framework advocated a more economically feasible approach to PHC by only targeting specific areas of health and choosing the most effective treatment plan in terms of cost and effectiveness. One of the foremost examples of SPHC is "GOBI" (growth monitoring, oral rehydration, breastfeeding, and immunization), focusing on combating the main diseases in developing nations.
448:
morbidity, mortality and feasibility of control (cost-effectiveness) - were subsequently proposed. The best known model was the
Selective PHC approach (described above). Selective PHC favoured short-term goals and targeted health investment, but it did not address the social causes of disease. As such, the SPHC approach has been criticized as not following Alma Ata's core principle of everyone's entitlement to healthcare and health system development.
87:, elaborates on the goals of PHC as defined by three major categories, "empowering people and communities, multisectoral policy and action; and primary care and essential public health functions as the core of integrated health services." Based on these definitions, PHC cannot only help an individual after being diagnosed with a disease or disorder, but can actively contribute to preventing such issues by understanding the individual as a whole.
125:
1729:
83:-producing social policy. PHC includes all areas that play a role in health, such as access to health services, environment and lifestyle. Thus, primary healthcare and public health measures, taken together, may be considered as the cornerstones of universal health systems. The World Health Organization, or
417:
Considering that 360 million people across the world live with disabling hearing loss, including 32 million children and nearly 180 million older adults, and that chronic ear diseases, such as chronic suppurative otitis media, can lead to hearing loss and may cause life-threatening complications, the
399:
conditions at local clinics, and organizing the referral of more complicated mental health problems to more appropriate levels of mental health care. The
Ministerial Conference, which took place in Alma Ata, made the decision that measures should be taken to support mental health in regard to primary
434:
The "Barefoot
Doctors" of China were an important inspiration for PHC because they illustrated the effectiveness of having a healthcare professional at the community level with community ties. Barefoot Doctors were a diverse array of village health workers who lived in rural areas and received basic
408:
in particular are one of the leading causes of death with individuals already suffering from severe mental health disorders. General health services such as PHC is one approach to integrating an improved access to such health services that could help treat already existing mental health disorders as
266:
The primary health care approach has seen significant gains in health where applied even when adverse economic and political conditions prevail. The Alma-Ata declaration proposed PHC (Primary Health Care) goals but faced global criticism for being vague, costly, and unattainable. This led to diverse
224:
Multi-sectional approach – recognition that health cannot be improved by intervention within just the formal health sector; other sectors are equally important in promoting the health and self-reliance of communities. These sectors include, at least: agriculture (e.g. food security); education;
275:
After the year 1978 Alma Ata
Conference, the Rockefeller Foundation held a conference in 1979 at its Bellagio conference center in Italy to address several concerns. Here, the idea of Selective Primary Health Care was introduced as a strategy to complement comprehensive PHC. It was based on a paper
241:
In sum, PHC recognizes that healthcare is not a short-lived intervention, but an ongoing process of improving people's lives and alleviating the underlying socioeconomic conditions that contribute to poor health. The principles link health, development, and advocating political interventions rather
350:
and child mortality. Health care planning is used to see which diseases require most attention and, subsequently, which intervention can be most effectively applied as part of primary care in a least-cost method. The targets and effects of selective PHC are specific and measurable. The approach
66:
accessible to all individuals and families in a community. PHC initiatives allow for the full participation of community members in implementation and decision making. Services are provided at a cost that the community and the country can afford at every stage of their development in the spirit of
447:
Although many countries were keen on the idea of primary healthcare after the Alma Ata conference, the
Declaration itself was criticized for being too “idealistic” and “having an unrealistic time table”. More specific approaches to prevent and control diseases - based on evidence of prevalence,
190:
Community participation – in order to make the fullest use of local, national and other available resources. Community participation was considered sustainable due to its grass roots nature and emphasis on self-sufficiency, as opposed to targeted (or vertical) approaches dependent on
451:
In Africa, the PHC system has been extended into isolated rural areas through construction of health posts and centers that offer basic maternal-child health, immunization, nutrition, first aid, and referral services. Implementation of PHC is said to be affected after the introduction of
418:
seventieth World Health
Assembly on May 31, 2017 signed the resolution WHA70.13 (Agenda item 15.8) urging member states to integrate strategies for ear and hearing care within the framework of their primary health care systems, under the umbrella of universal health coverage.
108:. The Alma-Ata Conference mobilized a "Primary Health Care movement" of professionals and institutions, governments and civil society organizations, researchers and grassroots organizations that undertook to tackle the "politically, socially and economically unacceptable"
225:
communication (e.g. concerning prevailing health problems and the methods of preventing and controlling them); housing; public works (e.g. ensuring an adequate supply of safe water and basic sanitation); rural development; industry; community organizations (including
220:
storage. Less appropriate examples of medical technology could include, in many settings, body scanners or heart-lung machines, which benefit only a small minority concentrated in urban areas. They are generally not accessible to the poor, but draw a large share of
400:
health care. However, there was no such documentation of this event in the Alma Ata
Declaration. These discrepancies caused an inability for proper funding and although was worthy of being a part of the declaration, changing it would call for another conference.
363:. In particular, in the future the majority of older people will be living in developing countries that are often the least prepared to confront the challenges of rapidly ageing societies, including high risk of having at least one chronic
250:
878:
Walsh, Julia A., and
Kenneth S. Warren. 1980. Selective primary health care:An interim strategy for disease control in developing countries. Social Science & Medicine. Part C: Medical Economics 14 (2):145-163
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Individuals with severe mental health disorders are found to live much shorter lives than those without, anywhere from ten to twenty-five-year reduction in life expectancy when compared to those without.
187:
and other services to meet the main health problems in a community must be provided equally to all individuals irrespective of their gender, age, caste, color, urban/rural location and social class.
359:
Given global demographic trends, with the numbers of people age 60 and over expected to double by 2025, PHC approaches have taken into account the need for countries to address the consequences of
216: – medical technology should be provided that is accessible, affordable, feasible and culturally acceptable to the community. Examples of appropriate technology include refrigerators for cold
421:
A World Report on Hearing (WRH) was published in response to the resolution (WHA70.13), to provide guidance for Member States to integrate ear and hearing care into their national health plans.
58:
Primary health care enables health systems to support a person’s health needs – from health promotion to disease prevention, treatment, rehabilitation, palliative care and more. It is essential
176:
that should be formulated in national policies in order to launch and sustain PHC as part of a comprehensive health system and in coordination with other sectors:
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55:) is a whole-of-society approach to effectively organise and strengthen national health systems to bring services for health and wellbeing closer to communities.
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GOBI is a strategy of UNICEF consisting of (and an acronym for) four low-cost, high impact, knowledge mediated measures introduced as key to halving
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These strategies focus on severe population health problems in certain developing countries, where a few diseases are responsible for high rates of
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Some jurisdictions apply PHC principles in planning and managing their healthcare services for the detection, diagnosis and treatment of common
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Growth monitoring: the monitoring of how much infants grow within a period, with the goal to understand needs for better early nutrition.
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PHC approaches, including SPHC (Selective Primary Health Care), accommodating resource disparities and local health priorities
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This ideal model of healthcare was adopted in the declaration of the International Conference on Primary Health Care held in
1029:
Pfeiffer, J (2003). "International NGOs and primary health care in Mozambique: the need for a new model of collaboration".
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development – comprehensive healthcare relies on an adequate number and distribution of trained physicians, nurses,
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This article is about an approach to providing universal health care. For the sector of the health care system, see
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White F. Primary health care and public health: foundations of universal health systems. Med Princ Pract 2015
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and disease prevention intervention at the community level as well as disease management strategies within
342:: for example, iron and folic acid fortification/supplementation to prevent deficiencies in pregnant women.
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Adopted at the International Conference on Primary Health Care, Alma-Ata, USSR, 6–12 September 1978.
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that is based on scientifically sound and socially acceptable methods and technology. This makes
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well as prevent other disorders that could arise simultaneously as the pre-existing condition.
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1150:"The Christian Medical Commission and the Development of WHO's Primary Health Care Approach"
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Socrates Litsios (2002). "The Long and Difficult Road to Alma-Ata: A Personal Reflection".
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in all countries. There were many factors that inspired PHC; a prominent example is the
27:"Essential" health care key to securing universality by emphasizing community and equity
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had been used by UNICEF since its inception in 1946), leading to the acronym GOBI-FFF.
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749:"International Conference on Primary Health Care, Alma-Ata: twenty-fifth anniversary"
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909:, Chapter 5: Choosing Interventions to Reduce Specific Risks. Geneva, WHO Press.
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1006:"Meeting Report on Excess Mortality in Persons with Severe Mental Disorders"
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Screening in Primary Health Care: Setting Priorities With Limited Resources
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Behind these elements lies a series of basic principles identified in the
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pursuing collaborative models of policy dialogue (leadership reforms); and
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Medical consultations for pregnant women and mothers of young children in
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Three additional measures were introduced to the strategy later (though
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684:"The ORIGINS of Primary Health Care and SELECTIVE Primary Health Care"
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aims to prevent most health and nutrition problems before they begin:
1405:
1080:
The World Health Report 2008: Primary Health Care, Now More Than Ever
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133:
72:
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The ultimate goal of primary healthcare is the attainment of better
205:
and others working as a health team and supported at the local and
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around people's needs and expectations (service delivery reforms);
123:
36:
988:
Department of Health, Provincial Government of the Western Cape.
379:. According to WHO, dealing with this increasing burden requires
183:
distribution of health care – according to this principle,
140:(WHO), has identified five key elements to achieving this goal:
1250:
1246:
800:
Bulletin of the World Health Organization (December 2008).
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777:
Bulletin of the World Health Organization (October 2008).
1211:
WHO European Observatory on Health Systems and Policies
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in Manado, Indonesia, during Pacific Partnership 2012.
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1540:
1504:
1448:
1393:
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1096:. TĂĽbingen: German Institute for Medical Missions.
1068:WHO (1978). "Alma Ata 1978: Primary Health Care".
128:A primary health care worker in Saudi Arabia, 2008
779:"Consensus during the Cold War: back to Alma-Ata"
306:: to combat dehydration associated with diarrhea.
136:services for all. It is for this reason that the
991:Mental Health Primary Health Care (PHC) Services
242:than passive acceptance of economic conditions.
572:. Baltimore: Johns Hopkins. pp. 227–229.
1262:
8:
802:"China's village doctors take great strides"
1024:
1022:
942:. World Health Organization. Geneva. 2021.
921:Older people and Primary Health Care (PHC).
1269:
1255:
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970:: CS1 maint: location missing publisher (
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851:. World Health Organization. p. 14.
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611:"Politics, primary healthcare and health"
1113:International Journal of Health Services
71:. In other words, PHC is an approach to
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506:Primary Health Care and Resource Centre
148:in health (universal coverage reforms);
1192:Geographies of Health: an Introduction
963:
591:
589:
1614:Artificial intelligence in healthcare
191:international development assistance.
168:increasing stakeholder participation.
158:integrating health into all sectors (
98:"), and became a core concept of the
7:
824:"Health topics: Primary health care"
94:, Kazakhstan in 1978 (known as the "
845:Braveman, Paula; E. Tarimo (1994).
1689:reform debate in the United States
1148:Socrates Litsios (November 1994).
1094:The Quest for Health and Wholeness
25:
1716:(Category Health care by country)
1154:American Journal of Public Health
1728:
1727:
649:Public Health Agency of Canada.
1754:Types of health care facilities
1425:Academic health science centre
518:Primary Health Care (magazine)
1:
1662:Health information management
1647:health information technology
1385:Health information management
1043:10.1016/s0277-9536(02)00068-0
1031:Social Science & Medicine
271:Selective Primary Health Care
1637:Translational bioinformatics
1092:McGilvray, James C. (1981).
615:J Epidemiol Community Health
512:Primary Health Organisations
496:Millennium Development Goals
456:programs by the World Bank.
425:Background and controversies
296:in 1983. The measures are:
1667:Consumer health informatics
1219:, World Health Organization
1125:10.2190/RP8C-L5UB-4RAF-NRH2
918:World Health Organization.
903:World Health Organization.
826:. World Health Organization
609:Starfield, Barbara (2011).
595:World Health Organization.
491:Alliance for Healthy Cities
1780:
890:UNICEF's GOBI-FFF Programs
651:About Primary Health Care.
570:A History of Global Health
29:
1723:
1657:Public health informatics
1570:Electronic health records
1440:Supervised injection site
1380:Allied health professions
1284:
1239:Resources in your library
1013:World Health Organization
806:World Health Organization
783:World Health Organization
756:Report by the Secretariat
568:Packard, Randall (2016).
548:World Health Organization
199:allied health professions
138:World Health Organization
100:World Health Organization
906:World Health Report 2005
628:10.1136/jech.2009.102780
597:Declaration of Alma-Ata.
365:non-communicable disease
355:PHC and population aging
304:Oral rehydration therapy
203:community health workers
1605:Medical image computing
1555:Artificial intelligence
1205:Declaration of Alma-Ata
1166:10.2105/AJPH.94.11.1884
939:World report on hearing
700:10.2105/ajph.94.11.1864
406:Cardiovascular diseases
235:voluntary organizations
144:reducing exclusion and
75:beyond the traditional
1642:Translational medicine
1015:. 18–20 November 2015.
995:Accessed 16 June 2011.
924:Accessed 16 June 2011.
894:Accessed 16 June 2011.
682:Marcos, Cueto (2004).
653:Accessed 12 July 2011.
413:PHC and hearing health
263:
214:appropriate technology
195:Health human resources
129:
45:
1631:Computational biology
1532:Universal precautions
1217:Universal Health Care
1190:Gatrell, A.C. (2002)
974:) CS1 maint: others (
887:Rehydration Project.
812:on December 12, 2008.
544:"Primary health care"
454:structural adjustment
391:PHC and mental health
253:
127:
64:universal health care
40:
1625:Behavior informatics
1194:, Oxford: Blackwell.
1087:on October 14, 2008.
467:Emergency healthcare
375:and conditions like
340:Food supplementation
322:food supplementation
174:Alma Ata Declaration
120:Goals and principles
96:Alma Ata Declaration
1609:imaging informatics
1517:Cultural competence
1230:Primary health care
501:Primary care ethics
437:Cultural Revolution
385:health care systems
110:health inequalities
49:Primary health care
1595:Health informatics
1370:Healthcare science
747:Secretariat, WHO.
688:Am J Public Health
264:
254:The hospital ship
146:social disparities
130:
77:health care system
69:self-determination
67:self-reliance and
46:
18:Primary healthcare
1764:Social inequality
1741:
1740:
1505:Skills / training
1429:Teaching hospital
1225:Library resources
1160:(11): 1884–1893.
949:978-92-4-002048-1
736:10.1159/000370197
694:(11): 1864–1874.
361:population ageing
280:GOBI and GOBI-FFF
231:local governments
16:(Redirected from
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1731:
1730:
1619:Neuroinformatics
1560:Connected health
1271:
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1083:. Archived from
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808:. Archived from
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789:on July 9, 2012.
785:. Archived from
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430:Barefoot Doctors
381:health promotion
335:Female education
114:Barefoot Doctors
79:that focuses on
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1401:Assisted living
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