The political context of primary health care.

Abstract

Primary Health Care (PHC) is an investment in the future because it does more than cure sickness it invests in the community and prevents a great deal of sickness. The World Health Organization (WHO) has been working to implement effective PHC through out the world. The Alma-Ata declaration in 1978 was a significant point in the history of PHC because it allowed all involved parties to closely examine the context in which PHC operates. The main principle of PHC is equity. Accessibility and confidence in quality are what the people of a community need for PHC to work. Prevention is another necessary feature of PHC because investing in the quality of life for the people in a community will reduce their need for medical treatments. Because PHC involves quality of life the issues of social life economic life and environmental quality are all brought together. This intersectoral action has made PHC a political issue as well as a medical one. Community participation has proven to be the deciding factor in the success or failure of any particular PHC program. In areas where the community looks favorably upon its PHC system the system will flourish. But in communities where there is distrust or apathy the system will die. The lessons of the past have shown several important issues that directly impact PHC. There has not been 1 replicable model for PHC delivery which means that PHC is context dependent. Unlike disease eradication programs which can be implemented anywhere PHC must adapt to the local needs of the community. The end must remain the same but means must be flexible. PHC is a process that needs to develop over time in concert with the changes in the community. PHC must also be based on a high level of quality service and commitment both from the health care providers and the community itself. PHC must be built with dialogue and information or else the process will fail. The health care providers and the members of the community must communicate with each other in constructive ways. It is very important that health care providers do not exclude the lay person because this will lead to failure.