Primary Health Care - Approaches

Approaches

The primary health care approach has seen significant gains in health were applied even when adverse economic and political conditions prevail.

Although the declaration made at the Alma-Ata conference deemed to be convincing and plausible in specifying goals to PHC and achieving more effective strategies, the Alma-Ata Declaration generated numerous criticisms and reactions worldwide. Many argued it was not possible because the mission and provision of aid was unattainable in terms of cost. It also censured that the declaration did not have clear targets, as it was too idealistic and broad in the provision of global health for all. As a result, primary health care approaches have evolved in different contexts to account for disparities in resources and local priority health problems. This is called the Selective Primary Health Care (PHC), an alternative approach to the principle PHC.

The Selective PHC approach is a form of health care consisting of four techniques known as GOBI (growth monitoring, oral rehydration techniques, breast feeding, and immunization). It specifically focuses on severe public health problems in certain local geographical areas in the developing countries where few diseases are responsible for large rates of death and disabilities. Thus, health care planning is employed to see which diseases deserve most attention and subsequently major possibilities of intervention that can be effectively applied. . It is built on the belief that providing comprehensive primary health care is not feasible given limited resources in many of the developing countries. Areas where diseases caused the largest burden of illness are important and seen as first priority to eliminate or help reduce absolute poverty in a least-cost effective method due to diminishing resources. The targets and effects of Selective PHC are specific, measurable, concise and easy to observe as it focuses on areas that are believed to be paramount based one of many criterion known as GOBI-FFF.

When comparing different primary health care, selective is seemed to be the most cost effective as it's the most cost-effective form of medical intervention. SPHC did benefit some people due to its selective targets however, it is deemed to focus on specific medical interventions instead of addressing larger socio-political development processes. Also, in Comprehensive Primary Health Care's perspective, SPHC isn't known to be a long term solution and leaves nothing of lasting value. In addition, primary health care is not available to all people, targeting the diseases affecting the largest proportion of the population can improve the health of many more individuals in less developed areas. Indication of cost-effectiveness can be measured by changes in mortality or averted deaths. Although it targets major diseases in developing countries but SPHC cannot fulfill the ideals of Alma Ata. In addition, the SPHC focus on priority diseases are limited to children and women as "breeders".