Executive Summary

The Declaration of Alma-Ata, adopted at the International Conference on Primary Health Care in September 1978, establishes health as a fundamental human right and a critical global social goal. The document identifies the gross inequality in health status between developed and developing nations as unacceptable and proposes "Primary Health Care" (PHC) as the primary vehicle for achieving an acceptable level of health for all by the year 2000. Central to the declaration is the shift from a purely medical model to a holistic approach that integrates social and economic development. Key takeaways include:

1. Health Definition: Health is defined as a state of complete physical, mental, and social well-being, requiring intersectoral action beyond the healthcare industry.
2. Primary Health Care (PHC): PHC is the essential function of a national health system, emphasizing universal accessibility, community participation, and scientifically sound methods.
3. Intersectoral Responsibility: Health is inextricably linked to economic development, requiring coordinated efforts from sectors such as agriculture, education, and housing.
4. Global Resource Reallocation: The declaration calls for a diversion of resources from military spending toward social development and primary health care.

Fundamental Principles of Health and Development

• The declaration grounds its framework in the assertion that health is a "fundamental human right." This classification mandates that the attainment of the highest possible level of health be a worldwide social priority.
• The Holistic Definition of Health Health is explicitly defined not merely as the absence of disease or infirmity, but as a "state of complete physical, mental and social wellbeing." Because of this broad definition, the realization of health is not the sole responsibility of the medical sector but requires the active participation of numerous social and economic sectors.
• Economic and Social Interdependence The document identifies a symbiotic relationship between health and development:
• Sustained Development: The promotion and protection of health are essential for social and economic progress.
• Peace and Stability: Improving health contributes to a better quality of life and world peace.
• New International Economic Order: Economic development based on this new order is considered vital for closing the health gap between developed and developing countries.

The Strategic Role of Primary Health Care (PHC)

The Declaration identifies Primary Health Care as the central function and main focus of a country's health system. It is described as the "first level of contact" for individuals and families, bringing care as close as possible to where people live and work.

Characteristics of Primary Health Care

1. To be effective, PHC must adhere to the following standards:
2. Scientific and Social Validity: It must be based on practical, scientifically sound, and socially acceptable methods and technology.
3. Universal Accessibility: It must be accessible to all individuals and families in the community.
4. Affordability: The cost must be maintainable by the community and country at every stage of development, fostering self-reliance and self-determination.
5. Community Participation: People have both a right and a duty to participate individually and collectively in the planning and implementation of their health care.

Essential Components and Requirements of PHC

The declaration outlines a comprehensive list of activities that constitute the minimum requirements for Primary Health Care. Core Services of Primary Health Care Category Essential Elements

1. Education Instruction on prevailing health problems and methods for prevention and control.
2. Nutrition & Water Promotion of food supply and proper nutrition; adequate safe water and basic sanitation.
3. Maternal & Child Health Comprehensive care including family planning.
4. Disease Prevention
5. Immunization against major infectious diseases;
6. prevention/control of locally endemic diseases.
7. Treatment Appropriate treatment of common diseases and injuries;
8. provision of essential drugs.

Operational Requirements

1. Intersectoral Coordination: PHC involves agriculture, animal husbandry, food, industry, education, housing, public works, and communications.
2. Health Workforce: Teams should include physicians, nurses, midwives, auxiliaries, community workers, and traditional practitioners, all suitably trained to respond to the community’s expressed health needs.
3. Referral Systems: PHC must be sustained by integrated and mutually supportive referral systems to ensure comprehensive care for those most in need.

Governmental and International Obligations

The Declaration places the responsibility for the health of the people directly on governments. The main social target for governments and the international community was the attainment of a level of health by the year 2000 that would permit all people to lead socially and economically productive lives. National Policy and Political Will

1. Governments are urged to: Formulate national policies, strategies, and plans of action to launch PHC.
2. Mobilize domestic resources and exercise the political will necessary to sustain health systems.
3. Integrate PHC into comprehensive national health systems in coordination with other development sectors.
4. International Cooperation and Resource Reallocation

The document emphasizes that the health of one country's population benefits all other countries. It calls for:

1. Partnership: A spirit of technical cooperation and partnership between WHO, UNICEF, and other international organizations.
2. Disarmament for Health: A significant portion of the world's resources is currently spent on armaments and military conflicts. The declaration argues that a policy of "independence, peace, détente and disarmament" would release resources that should be devoted to social and economic development, specifically primary health care.
3. Support for Developing Nations: Increased technical and financial support should be channeled to developing countries to implement the spirit and content of the Declaration.