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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

By
Shannon Barkley ,
Luke N. Allen ,
Lynsey Brown ,
Kaara Calma ,
Farihah Malik ,
Lundi-Anne Omam ,
Suraya Dalil  and
Edward Kelley
Edited by
Sameen Siddiqi ,
Awad Mataria ,
Katherine D. Rouleau  and
Meesha Iqbal
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 ‘Pragmatic’ reductivism and geopolitical transitions in ensuing decades saw original goals superseded by selective PHC.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 careMultisectoral policy and actionEmpowered people and communitiesIntegrated health servicesHealth system strengtheningUniversal health coverageHealth-related sustainable development goals
Type
Chapter
Information
Making Health Systems Work in Low and Middle Income Countries
Textbook for Public Health Practitioners
 , pp. 20 - 33
Publisher: Cambridge University Press
Print publication year: 2022

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