Health Systems Based on Primary Health Care

doi:10.1017/9781009211086.003

Chapter 2 - Health Systems Based on Primary Health Care

from Section 1 - Analyzing Health Systems: Concepts, Components, Performance

Published online by Cambridge University Press: 08 December 2022

Suraya Dalil and

Edited by

Katherine D. Rouleau and

Meesha Iqbal

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Sameen Siddiqi: Affiliation:
Aga Khan University
Awad Mataria: Affiliation:
World Health Organization, Egypt
Katherine D. Rouleau: Affiliation:
University of Toronto
Meesha Iqbal: Affiliation:
UTHealth School of Public Health, Houston

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Summary

This chapter sets out the history, evolution of primary health care (PHC) and discusses its application to contemporary health systems. PHC is a whole-of-society approach to health that aims to maximize the level and distribution of health and well-being through three components: primary care and essential public health functions as the core of integrated health services; multisectoral policy and action; and empowered people and communities. The concept of PHC emerged in the 1960s but was formally codified in the 1978 Alma Ata Declaration. ‘Pragmatic’ reductivism and geopolitical transitions in ensuing decades saw original goals superseded by selective PHC. The World Health Report 2008 – Primary Health Care: Now More Than Ever renewed focus on PHC in the prevailing context of hospital-centrism, commercialization and fragmentation. Mounting evidence on effectiveness, equity and efficiency has made it clear that PHC is the path to achieve universal health coverage and the other health related Sustainable Development Goals. In 2018, governments renewed their commitment to strengthen primary health care in the Declaration of Astana.The WHO and UNICEF Operational Framework for PHC provides guidance for governments to translate these commitments into action.

Keywords

Primary health care Multisectoral policy and action Empowered people and communities Integrated health services Health system strengthening Universal health coverage Health-related sustainable development goals

Information

Type: Chapter
Information: Making Health Systems Work in Low and Middle Income Countries
Textbook for Public Health Practitioners
, pp. 20 - 33

DOI: https://doi.org/10.1017/9781009211086.003 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2022

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References

World Health Organization, United Nations Children’s Fund (UNICEF). A vision for primary health care in the 21st century: towards universal health coverage and the Sustainable Development Goals. 2018. https://apps.who.int/iris/handle/10665/328065 (accessed June 18, 2021).Google Scholar

Guzys, D.. Community and primary health care. In Guzys, D., Brown, R., Halcomb, E., et al., eds., An Introduction to Community and Primary Health Care. Victoria, Cambridge University Press, 2017, pp. 3–19.CrossRef Google Scholar

World Health Organization. Declaration of Alma-Ata. 1978. https://cdn.who.int/media/docs/default-source/documents/almaata-declaration-en.pdf?sfvrsn=7b3c2167_2 (accessed June 12, 2021).Google Scholar

Kluge, H., Kelley, E., Theodorakis, P. N., et al. Forty years on from Alma Ata: present and future of primary health care research. Prim Health Care Res Dev 2018; 19(5): 421–423.CrossRef Google Scholar PubMed

Kruk, M. E., Porignon, D., Rockers, P. C., et al. The contribution of primary care to health and health systems in low- and middle-income countries: a critical review of major primary care initiatives. Soc Sci Med 2010; 70(6): 904–911.Google Scholar

Starfield, B., Shi, L., Macinko, J.. Contribution of primary care to health systems and health. Milbank Q 2005; 83(3): 457–502.CrossRef Google Scholar PubMed

World Health Organization. Primary health care and health emergencies. 2018. www.who.int/docs/default-source/primary-health-care-conference/emergencies.pdf?sfvrsn=687d4d8d_2 (accessed June 11, 2021).Google Scholar

World Health Organization, United Nations Children’s Fund (UNICEF). Declaration of Astana. 2018. www.who.int/docs/default-source/primary-health/declaration/gcphc-declaration.pdf (accessed June 15, 2021).Google Scholar

World Health Organization, United Nations Children’s Fund (UNICEF). Operational Framework for Primary Health Care: Transforming Vision into Action. Geneva, World Health Organization, 2020. https://apps.who.int/iris/handle/10665/337641 (accessed June 16, 2021).Google Scholar

Weiyuan, C.. China’s village doctors take great strides. Bull World Health Organ 2008; 86(12): 914–915.Google Scholar

Bryant, J. H., Richmond, J. B.. Alma-Ata and primary health care: an evolving story. In Heggenhougen, H. K., ed., International Encyclopedia of Public Health. Boston, MA, Elsevier, 2008, pp. 152–174.CrossRef Google Scholar

Bryant, J.. Health and the Developing World. New York, Cornell University Press, 1969.Google Scholar

McKeown, T.. The Modern Rise of Population. New York, Academic Press, 1976.Google Scholar

Newell, K. W.. World Health Organization. Health by the people. 1975. https://apps.who.int/iris/handle/10665/40514 (accessed June 15, 2021).Google Scholar

Taylor, C. E., ed. Doctors for the Villages: Study of Rural Internships in Seven Indian Medical Colleges. New York, Asia Publishing House, 1976.Google Scholar

Rifkin, S. B.. Alma Ata after 40 years: primary health care and health for all – from consensus to complexity. BMJ Glob Health 2018; 3(Suppl. 3): e001188.Google Scholar

Cueto, M.. The origins of primary health care and selective primary health care. Am J Public Health 2004; 94(11): 1864–1874.CrossRef Google Scholar PubMed

World Health Assembly. Thirty-second World Health Assembly, Geneva, 7–25 May 1979: resolutions and decisions. 1979. https://apps.who.int/iris/handle/10665/153658 (accessed June 18, 2021).Google Scholar

Hone, T., Macinko, J., Millett, C.. Revisiting Alma-Ata: what is the role of primary health care in achieving the Sustainable Development Goals? Lancet 2018; 392(10156): 1461–1472.Google Scholar

Rohde, J., Cousens, S., Chopra, M., et al. 30 years after Alma-Ata: has primary health care worked in countries? Lancet 2008; 372(9642): 950–961.CrossRef Google Scholar PubMed

Walsh, J. A., Warren, K. S.. Selective primary health care: an interim strategy for disease control in developing countries. N Engl J Med 1979; 301(18): 967–974.Google Scholar

World Health Organization. The World Health Report 2008: Primary Health Care (Now More Than Ever). Geneva, World Health Organization, 2008. https://apps.who.int/iris/handle/10665/43949 (accessed June 18, 2021).Google Scholar

World Health Organization. The World Health Report 2010: Health Systems Financing – the Path to Universal Coverage. Geneva, World Health Organization, 2010. https://apps.who.int/iris/handle/10665/44371 (accessed June 19, 2021).Google Scholar

United Nations Department of Economic and Social Affairs. Goal 3: ensure healthy lives and promote well-being for all at all ages. 2016. https://sdgs.un.org/goals/goal3 (accessed June 18, 2021).Google Scholar

World Health Organization. Progressing primary health care: a series of country studies. 2018. www.who.int/publications-detail-redirect/WHO-HIS-SDS-2018.17 (accessed June 18, 2021).Google Scholar

Edelman, A., Marten, R., Montenegro, H., et al. Modified scoping review of the enablers and barriers to implementing primary health care in the COVID-19 context. Health Policy Plan 2021; 36(7): 1163–1186.Google Scholar

Jungo, K. T., Anker, D., Wildisen, L.. Astana declaration: a new pathway for primary health care. Int J Public Health 2020; 65(5): 511–512.Google Scholar

Valentijn, P. P., Schepman, S. M., Opheij, W., et al. Understanding integrated care: a comprehensive conceptual framework based on the integrative functions of primary care. Int J Integr Care 2013; 13: e010.CrossRef Google Scholar PubMed

Brown, L. J., Oliver-Baxter, J.. Six elements of integrated primary healthcare. Aust Fam Physician 2016; 45(3): 149–152.Google Scholar

World Health Organization. Integrating health services. Brief, technical series on primary health care. 2018. https://apps.who.int/iris/bitstream/handle/10665/326459/WHO-HIS-SDS-2018.50-eng.pdf (accessed June 18, 2021).Google Scholar

World Health Organization. Framework on integrated, people-centred health services: report by the secretariat. 2016. https://apps.who.int/gb/ebwha/pdf_files/WHA69/A69_39-en.pdf (accessed June 13, 2021).Google Scholar

Ngo Bibaa, L. O.. Primary health care beyond COVID-19: dealing with the pandemic in Cameroon. BJGP Open 2020; 4(4): bjgpopen20X101113.Google Scholar

Rechel, B.. How to enhance the integration of primary care and public health? Approaches, facilitating factors and policy options. 2020. https://apps.who.int/iris/handle/10665/330491 (accessed June 15, 2021).Google Scholar

Barkley, S., Starfield, B., Shi, L., et al. The contribution of primary care to health systems and health. In Kidd, M., Heath, I., Howe, A., eds., Family Medicine: The Classic Papers. Boca Raton, FL, CRC Press, 2016, pp. 191–239.Google Scholar

World Health Organization. Primary health care: closing the gap between public health and primary care through integration. 2018. www.who.int/publications/i/item/primary-health-care-closing-the-gap-between-public-health-and-primary-care-through-integration (accessed June 18, 2021).Google Scholar

Freund, T., Everett, C., Griffiths, P., et al. Skill mix, roles and remuneration in the primary care workforce: who are the healthcare professionals in the primary care teams across the world? Int J Nurs Stud 2015; 52(3): 727–743.Google Scholar

World Health Organization. Rio Political Declaration on Social Determinants of Health. 2011. https://cdn.who.int/media/docs/default-source/documents/social-determinants-of-health/rio_political_declaration.pdf?sfvrsn=6842ca9f_5&download=true (accessed June 18, 2021).Google Scholar

Salunke, S., Lal, D. K.. Multisectoral approach for promoting public health. Indian J Public Health 2017; 61(3): 163–168.CrossRef Google Scholar PubMed

Lin, S. C., Chen, I. J., Yu, W. R., et al. Effect of a community-based participatory health literacy program on health behaviors and health empowerment among community-dwelling older adults: a quasi-experimental study. Geriatr Nurs 2019; 40(5): 494–501.Google Scholar

World Health Organization. The Ottawa Charter for Health Promotion. 1986. www.euro.who.int/__data/assets/pdf_file/0004/129532/Ottawa_Charter.pdf (accessed June 18, 2021).Google Scholar

UNAIDS. Invest in advocacy: community participation in accountability is key to ending the AIDS epidemic. 2016. www.unaids.org/sites/default/files/media_asset/JC2830_invest_in_advocacy_en.pdf (accessed June 18, 2021).Google Scholar

Rohrer, K., Rajan, D., Population consultation on needs and expectations. In Schmets, G., Rajan, D., Kadandale, S., eds., Strategizing National Health in the 21st Century: A Handbook. Geneva, World Health Organization, 2016, pp. 35–102.Google Scholar

Cyril, S., Smith, B. J., Possamai-Inesedy, A., et al. Exploring the role of community engagement in improving the health of disadvantaged populations: a systematic review. Glob Health Action 2015; 8: 29842.Google Scholar

Reeve, C., Humphreys, J., Wakerman, J., et al. Strengthening primary health care: achieving health gains in a remote region of Australia. Med J Aust 2015; 202(9): 483–487.Google Scholar

Smylie, J., Kirst, M., McShane, K., et al. Understanding the role of Indigenous community participation in Indigenous prenatal and infant-toddler health promotion programs in Canada: a realist review. Soc Sci Med 2016; 150: 128–143.Google Scholar

Torri, M. C.. Multicultural social policy and community participation in health: new opportunities and challenges for indigenous people. Int J Health Plann Manage 2012; 27(1): e18–e40.Google Scholar

Williams, M. V., Baker, D. W., Honig, E. G., et al. Inadequate literacy is a barrier to asthma knowledge and self-care. Chest 1998; 114(4): 1008–1015.Google Scholar

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