Monday, July 29, 2019
Alma Ata Declaration
Alma Ata Declaration         In 1978 the Alma Ata Declaration affirmed health as a human right with health being defined as a state of complete physical, mental and social wellbeing. The Declaration proclaimed that communities should adopt the principles of primary health care to achieve better health for all (WHO 2008). The principles of primary health care are based on a social justice approach where community health focuses on empowering individuals enabling them to make informed health decisions (Green 2004).         The aim of this essay is to discuss primary health care in the Alma-Ata Declaration and how attitudes towards primary health care have changed over time. Furthermore, it will discuss the relevance of primary health care today according to the WHO report, Primary Health Care ? Now more than ever, focusing on Australian Indigenous children?s health in the Western region of Melbourne.         In the Alma-Ata declaratio n, primary health care is essentially healthcare based on practical, evidence based and socially acceptable methods that are made accessible to all individuals within a community through full participation. The principles form the integral part of the health system, providing health care at the first level with an overall focus on the communities and countries socio-economic development (Awofeso 2004).         Primary health care was criticised as soon as the Alma-Ata conference concluded, politicians did not accept that communities would be responsible for planning and implementing health care services. As a result, political commitment was not sustained nor was it backed with necessary reforms (Hall & Taylor 2003).         Government agencies lacked any provisions for ensuring equity to accessing services especially for the poorer and disadvantaged communities. Furthermore, experts and politicians refused the principle of primary hea lth care which allowed communities to plan and implement their own health care services (McMurray & Param 2008).         Internationally, resources for public health were diverted from primary health care to aid with the management of high-mortality emergencies. This included the resurgence of tuberculosis, increases in malaria and the emergence of HIV/AIDS (WHO 2008).         World events impacted on the development of primary health care, an oil crisis, a global recession and the introduction of structural adjustment programs by development banks shifted governments? budgets away from health and social services (WHO 2008).         Inadequate funding and training for healthcare professionals resulted in a lack of services for communities with people choosing to by-pass the primary level of services being provided. Inaccessibility, limited resources and poor equipment left primary health care services limited in coverage and quality (Hall & Taylor 2003).         Inaccessibility, limited resources and poor equipment left primary health care services limited in coverage and impact. Due to poor levels of service, primary health care workers lost motivation and resigned as a result of under-staffed centres and inadequate delivery of service.         In some countries primary health care continues to be inadequately supported and resourced due to lack of structure and investment within health organisations leading to poor coverage and quality of services (Hall & Taylor 2003).         In 1994, the World Health Organisation (WHO) review of world changes in health development since Alma-Ata bleakly concluded that the goal of health for all by 2000 would not be met (WHO 2008).
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