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A helicopter sits in the background as two medical nurses treat a patient outside the entrance to the tent of a nomadic family, Kazakhstan, USSR, 1978. Credit: WHO, 1978.
Source publication
In September 1978, the WHO convened a momentous International Conference on Primary Health Care in Alma-Ata, capital of the Soviet republic of Kazakhstan. This unprecedented gathering signalled a break with WHO’s long-standing technically oriented disease eradication campaigns. Instead, Alma-Ata emphasised a community-based, social justice-oriented...
Context in source publication
Context 1
... Further highlighting technical installations over social dimensions was a special exhibit of medical equipment produced by socialist countries. During the midconference weekend days (September 9 and 10), over 500 participants went on dozens of excursions (see figure 2) to Samarkand, Bukhara, Chimkent, Karaganda, Frunze and the Tashkent region. Others travelled along 70 different routes through the Alma-Ata region, visiting xlii Kazakhstanskaia Pravda, 7 September 1978, 1. more than 100 medical and public health facilities. ...
Citations
... This conference was held in September 1978 in collaboration between the World Health Organization (WHO) and the United Nation's Children Fund (UNICEF) on 6-12. The main formulation of the 1978 Alma Ata Declaration adopted by the countries participating in the Conference was the statement that Primary Health Services is the main strategy for achieving health for all, as a form of embodiment of human rights [5]. ...
... In order to provide a basis for understanding primary health, a definition of PHC was established at the National Forum on Health in 1997. 1,2 Primary Health Care is understood to be "the care provided at the first level of contact with the health care system, the point at which health services are mobilized and coordinated to promote health, prevent illness, care for common illness, and manage health problems". 3,4 PHC is the area of the health care system most suited to offering primary prevention and health promotion activities as it is easily accessible, provides continuity of care, and is used by a large proportion of the population. ...
Background:
Primary Health Care (PHC) facilities are critical in preventing, detecting, and managing sickness and injury, thereby lowering morbidity and mortality. This is easily accomplished through health education, which is one of the most effective disease prevention methods.
Objective:
The goal of this study is to evaluate the implementation of the health education technique in PHC facilities in the Kavango East Region.
Materials and methods:
A quantitative method was used in conjunction with a descriptive cross-sectional design to evaluate the implementation of health education in PHC facilities in the Kavango East Region.
Results:
The outcomes show that 76% of patients who visit health facilities did not receive health education about their condition, and those who did receive health education know six times more about how to prevent the conditions they are suffering from than those who did not. The study also found that 49.14% of patients got information that was irrelevant to their conditions. These results indicate a statistically significant relationship (2.32 OR 0.93 at 95% CI) between patients who did not receive health education and frequent visits to the PHC facility with the same complaints.
Conclusion:
There is a lack of health education implementation in PHC facilities, with patients not getting or being provided with relevant health education to empower them to take care of their own health. The emphasis of PHC centers is on curative services rather than preventative and rehabilitation services. PHC facilities must improve health education as a critical approach to health promotion and disease prevention. This will allow patients to take appropriate preventive measures, resulting in fewer trips to PHC facilities.
... At the same time, the Semashko model also considered prevention, which was called 'dispensarisation' and included massive screening and check-ups for specific diseases. From health financing point of view, health care was free for the patients, but very expensive for the Government of the USSR (Birn and Krementsov, 2018). Therefore, after collapse of the USSR, the Soviet Republics were unable to maintain this model which resulted in a crisis for the newly independent ex-Soviet states in the delivery of health care (Balabanova et al., 2012). ...
... In the reviewed literature, 41 identified documents discuss this component of the health system. PHC in the most CIS countries is disease-centric and does not include a patient-centred approaches (Birn and Krementsov, 2018;Beran et al., 2019). Prevention-centric approaches are missing in PHC in all CIS countries . ...
Aim:
The aim of this study is to review the literature in Commonwealth of Independent States (CIS) countries with regard to their response to non-communicable diseases (NCDs) and the implementation of the World Health Organization (WHO) Package of Essential Non-communicable (PEN) disease interventions for primary health care.
Background:
NCDs are estimated to account from 62% to 92% of total deaths in CIS countries. Current management of NCDs in CIS countries is focused on specialists and hospital care versus primary health care (PHC) as recommended by the WHO.
Methods:
This paper uses a scoping review of published and grey literature focusing on diabetes and hypertension in CIS countries. These two conditions are chosen as they represent a large burden in CIS countries and are included in the responses proposed by the WHO PEN.
Findings:
A total of 96 documents were identified and analysed with the results presented using the WHO Health System Building Blocks. Most of the publications identified focused on the service delivery (41) and human resources (20) components, while few addressed information and research (17), and only one publication was related to medical products. As for their disease of focus, most studies focused on hypertension (14) and much less on diabetes (3). The most studies came from Russia (18), followed by Ukraine (21) and then Kazakhstan (12). Only two countries Moldova and Kyrgyzstan have piloted the WHO PEN. Overall, the studies identified highlight the importance of the PHC system to better control and manage NCDs in CIS countries. However, these present only strategies versus concrete interventions. One of the main challenges is that NCD care at PHC in CIS countries continues to be predominantly provided by specialists in addition to focusing on treatment versus preventative services.
... Such health care system was demonstrated to the delegates of the Alma-Ata conference and presented as the highest achievement of the Soviet "model" of PHC. Unfortunately, the Soviet leadership viewed the conference more as a significant ideological or political event, but in fact later showed a lack of understanding and rejection of the basic principles of primary health care and family medicine [23]. ...
In light of the COVID-19 pandemic, the article provides a literature review on the development of the concept of universal health coverage (UHC), starting with the Alma-Ata Declaration on PHC of 1978, including the Astana Declaration of 2018 and the UN Political Declaration on UHC of 2019. The development of primary health care in the CIS countries followed different scenarios, often deviating from the principles of the Alma-Ata Declaration. In Kyrgyzstan, when reforming health care, the basic principles of PHC and family medicine were also implemented with distortions, which played a negative role in the context of the pandemic. The COVID-19 pandemic has tested the strength of health systems around the world, highlighting the urgent need to achieve universal health coverage, which is only possible with strong primary health care.
... "The Lancet (2009)" defined health as the body's capacity to adapt to new challenges. After the Alma-Ata Declaration was signed in 1978, the slogan "Health for All" became a signature motto (Birn and Krementsov, 2018). Thus, one of the Millennium Development Goals (MDGs) was developed to increase people's health. ...
This study aims to estimate determinants of MM in selected districts of Punjab. Data have been extracted from 196 families from three respective districts. Education, safe water availability, sanitation, health infrastructure, immunization card, family size, residence, household income, and ANC visits are taken as independent variables. Education, family size, poor and middle-income class variables had a positive and significant effect on the MM in DG Khan. This study revealed that education, safe water, and income show positive and significant impact on MM in Chakwal district. While, sanitation variable, area of residence and health infrastructure shown negative and significant impact health. The study found that education, household income and family size had a positive and significant effect on the MM in Sialkot. While, Safe water availability, sanitation, health infrastructure and immunization card have negative and insignificant effect on female health. Government should give more strength to integrated reproductive and newborn child health (IRMNCH) program.
... Even so, and despite the exclusions and stratification characteristic of much of the Third World and parts of the First (especially the USA), efforts at creating publicly-financed and operated healthcare systems made undeniable gains until the 1970s. Marking the apex of these struggles at the international level, and their turning point (with dashed hopes), was the International Conference on Primary Health Care held in Alma-Ata, Kazakhstan (former USSR), in 1978 and the movement surrounding it [26]. The effort to move from disease control to the broader right to health, from top-down to community-based approaches to health-all in the context of a New International Economic Order, upending existing power asymmetries between First World and Third, between capital and labor, etc.-might have become revolutionary indeed. ...
The presumed global consensus on achieving Universal Health Coverage (UHC) masks crucial issues regarding the principles and politics of what constitutes “universality” and what matters, past and present, in the struggle for health (care) justice. This article focuses on three dimensions of the problematic: 1) we unpack the rhetoric of UHC in terms of each of its three components: universal, health, and coverage; 2) paying special attention to Latin America, we revisit the neoliberal coup d’état against past and contemporary struggles for health justice, and we consider how the current neoliberal phase of capitalism has sought to arrest these struggles, co-opt their language, and narrow their vision; and 3) we re-imagine the contemporary challenges/dilemmas concerning health justice, transcending the false technocratic consensus around UHC and re-infusing the profoundly political nature of this struggle. In sum, as with the universe writ large, a range of matters matter: socio-political contexts at national and international levels, agenda-setting power, the battle over language, real policy effects, conceptual narratives, and people’s struggles for justice.
In a world of growing health inequity and ecological injustice, how do we revitalize medicine and public health to tackle new problems? This groundbreaking collection draws together case studies of social medicine in the Global South, radically shifting our understanding of social science in healthcare. Looking beyond a narrative originating in nineteenth-century Europe, a team of expert contributors explores a far broader set of roots and branches, with nodes in Sub-Saharan Africa, South America, Oceania, the Middle East, and Asia. This plural approach reframes and decolonizes the study of social medicine, highlighting connections to social justice and health equity, social science and state formation, bottom-up community initiatives, grassroots movements, and an array of revolutionary sensibilities. As a truly global history, this book offers a more usable past to imagine a new politics of social medicine for medical professionals and healthcare workers worldwide. This title is also available as open access on Cambridge Core.
In a world of growing health inequity and ecological injustice, how do we revitalize medicine and public health to tackle new problems? This groundbreaking collection draws together case studies of social medicine in the Global South, radically shifting our understanding of social science in healthcare. Looking beyond a narrative originating in nineteenth-century Europe, a team of expert contributors explores a far broader set of roots and branches, with nodes in Sub-Saharan Africa, South America, Oceania, the Middle East, and Asia. This plural approach reframes and decolonizes the study of social medicine, highlighting connections to social justice and health equity, social science and state formation, bottom-up community initiatives, grassroots movements, and an array of revolutionary sensibilities. As a truly global history, this book offers a more usable past to imagine a new politics of social medicine for medical professionals and healthcare workers worldwide. This title is also available as open access on Cambridge Core.
