Criticisms of Primary Health Care and The Alma Ata Declaration
Though many countries were keen on the idea of primary health care -health for all- after the Alma Ata conference took place, it became a difficult task. The declaration itself was criticized for being too “idealistic”, and “having an unrealistic time table” as stated by Marcos Cueto in his article “The ORIGINS of Primary Health Care and Selective Health Care”. Primary Health Care was too broad and goals set up at the conference seemed insignificantly far, “Health for All by 2000” was agreeably unattainable. In 1979, just a year later, the Rockefeller Foundation held a small conference named the “Health and Population in Development” in Italy. This meeting, in connection to the previous one at Alma Ata, was to put the health of the people in regards to its population as population control and family planning played a big roll in health care. This conference was based on a paper published by Julia A. Walsh and Kenneth S. Warren “Selective primary health care: An interim strategy for disease control in developing countries.” The article proposed that until we can achieve primary health care for all, the most effective way to provide health care for a population is to select the diseases to target that creates the greatest mortality and morbidity in a population. They assess the diseases to control based on the following four factors: prevalence, morbidity, mortality and feasibility of control (cost-effectiveness). ] Thus upbringing a more specific approach - Selective Primary Health Care. Primary Health Care was introduced in Africa after 1978. The primary health care 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.
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