The History of Primary Health Care

Introduction to the history of primary healthcare.

The history of primary healthcare.
From the small efforts of various groups to promote accessible and affordable health to all, the first significant step in the history of primary healthcare was the World Health Organization (WHO)’s “Health for all by the year 2000” initiative of 1977 which promoted UHC.
Although it was deemed impossible, atleast it led to the Alma Ata declaration in 1978 where various leaders established primary healthcare as the most practical and effective was of achieving the goal “Health for all by year 2000”.
30 years down the line, in 2008, the World Health Organisation launched the “Primary healthcare: now more than ever” report which highlighted several reforms necessary to make primary healthcare effective.
Then in 2018 was the Astana Declaration which traced the progress of primary healthcare since the Alma Ata declaration and established ways of strengthening primary healthcare to achieve universal health coverage.
At the present time, as we also create and contribute to the history of primary healthcare, in 2023 AfroPHC will be launching the “Policy Framework for primary healthcare in Africa” which outline the goals to be met by Africa to achieve effective PHC for UHC in Africa.

Health for all by the year 2000

“Health for all by the year 2000” was a global health initiative launched by the World Health Organization (WHO) in 1977.
The initiative had three main objectives:
1. To achieve a level of health that would permit all individuals to lead a socially and economically productive life.
2. To reduce the gap in health status between developed and developing countries.
3. To provide essential health care to all individuals and families in the community.

Unfortunately, the goal of “Health for all by the year 2000” was not achieved but it did help in raising awareness of the need for accessible and affordable health for all, and this led to the establishment of primary healthcare in the 1978’s Alma Ata declaration.

The Alma Ata Declaration of 1978

The Alma-Ata Declaration is a health policy document that was adopted at the International Conference on Primary Health Care held in Alma-Ata, Kazakhstan in 1978.
The Declaration has had a profound impact on global health policy and practice. It has been a driving force behind the development of primary healthcare as a central component of health systems around the world.
It defined primary healthcare as “essential health care based on practical, scientifically sound, and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination.”
And it also emphasized the importance of community participation, health promotion, and disease prevention in addition to curative services. It recognized the need for a comprehensive approach to healthcare that addressed not just physical health, but also mental, social, and spiritual well-being.

WHO’S “Primary Health Care: Now More Than Ever” Report of 2008

The report “Primary Health Care: Now More Than Ever” was published in 2008 by the World Health Organization (WHO). The report emphasized the importance of primary health care as the foundation of any effective health system and called for a renewed global commitment to primary health care as a means of achieving better health for all.
It highlighted four key reforms necessary to strengthen primary healthcare:
1. Strengthening health systems: The report called for a comprehensive approach to strengthening health systems, including investments in health infrastructure, health workforce education and training, and health information systems.
2. Improving access to primary health care: The report emphasized the need to improve access to primary health care services, particularly for underserved populations, through strategies such as expanding health coverage and reducing financial barriers to care.
3. Enhancing the quality of primary health care: The report called for efforts to improve the quality of primary health care services through initiatives such as strengthening health workforce capacity, promoting evidence-based practice, and implementing quality assurance systems.
4. Fostering community participation and empowerment: The report highlighted the importance of engaging communities in primary health care planning and decision-making to promote health equity and social justice.
Overall, the report called for a coordinated and sustained effort to strengthen primary health care systems worldwide, with a focus on addressing the health needs of the most vulnerable populations.

The Astana Declaration of 2018

The Astana Declaration is a global commitment to achieving universal health coverage (UHC) through primary health care (PHC). The declaration was adopted at the Global Conference on Primary Health Care in Astana, Kazakhstan in 2018, which marked the 40th anniversary of the historic Alma-Ata Declaration of 1978.
The Astana Declaration reaffirms the principles of the Alma-Ata Declaration, which recognized primary health care as the key to achieving health for all. The Astana Declaration goes further by emphasizing the need for a renewed commitment to primary health care as the foundation of health systems, and as a means of achieving universal health coverage.
The Astana Declaration calls for a series of actions to strengthen primary health care systems, including:
1. Investing in primary health care as the cornerstone of health systems
2. Strengthening health systems through increased funding and resources
3. Ensuring access to essential health services for all, including through community-based approaches
4. Empowering individuals and communities to participate in their own health and health care
5. Strengthening health workforce education and training to ensure a skilled and motivated health workforce
6. Strengthening health information systems to improve decision-making and accountability
7. Strengthening partnerships and cooperation between different sectors and actors to achieve shared health goals.

AfroPHC’s Policy Framework for PHC and UHC in Africa

This week we have been looking at the history of primary healthcare.
At the present time, as we also create and contribute to the history of primary healthcare, in 2023 AfroPHC will be launching the “Building PHC Teams for UHC in Africa” which underscores the crucial role of the PHC workforce within a team based approach. It also outlines the key actions that need to be met by Africa to achieve effective PHC for UHC in Africa.
This policy framework was funded by Primary Health Care Performance Initiative (PHCPI) and echoes the voices of frontline primary healthcare workers and leaders across, Africa, collated through a series of virtual policy workshops and group discussions. The final workshop was held in October 2022 in Johannesburg, South Africa where a cohort of about 30 multicountry multiprofessional delegates met in person to finalise the policy framework.
In summary, the policy calls to Africa to pay heed to the call of its health professionals, to seize opportunities to overcome African challenges, to embrace the World Health Organisation’s Report of 2008 and Astana Declaration of 2018 by prioritizing integrated, resilient, person-centred and high quality PHC within UHC, re-organising UHC around PHC service delivery, integrating public health with primary care, and bringing private PHC providers into a regulated PHC system for UHC in Africa.

Video Competition

AfroPHC has been developing a primary healthcare policy framework that is being launched on the 14th of March 2023. The framework consists of 31 main points/goals plus an opening and closing. Now, we are hosting a competition to create videos for each of the 33 points.

This competition is for healthcare students and professionals in Africa. Participation will be in groups and to participate, the group leader has to register below and download the video scripts document. This document has 33 scenes, one for each of the 33 points in the policy framework. In the scripts document, the policy framework points are in given in peach background. And this document can be downloaded here: https://drive.google.com/file/d/1tcbBgmYaFECY3v3UPXveiBGssCnKue39/view?usp=drivesdk

The participants are to shoot 5 videos for any 5 scenes directed in the scripts document. Each video should be atleast 15 seconds and atmost 30 seconds long (15-30 seconds long). The participants are to shoot the videos as directed in the scripts. They are free to make slight changes, the number of the main cast in the introduction and closing scenes can be reduced to 5. If participants feel like they can do one or more of the scenes in a better way than the one directed, they should email their suggested script(s) to innocential@innocentialdiaries.xyz for approval first before shooting. Such scripts will not be shared with other participants.

The participants are expected to collaborate with their healthcare centers for the video shooting and the equipment required. The scripts documents lists the extra requirements that might not be available in a healthcare center. Anyone can play any role given in the scripts document. However, identity clothing is required for each specified role. For example, a student nurse can act as a doctor in the play provided he dresses as a doctor in that play. The videos are to be simple and there’s no need for professional equipment or editing.

Technical requirements include:

  • Minimum resolution of the video of at least 720p.
  • The videos should have an aspect ratio of horizontal 4:3.
  • A maximum file size of 300MB, while utilizing commonly used video-codecs (e.g. H.264) and formats (.mov or .mp4).
  • Audio with a minimum bitrate of 128kbps.
  • Do not add text or watermarks or logos on the videos.
  • Only the calls should be cited in the videos. The words spoken in the videos should only be the calls recited.
  • The videos should not be significantly inclined torwards one gender.
  • Name the video files according to the scene titles given.

After shooting the 5 videos, the participants must put them in a Google drive folder and email the link to innocential@innocentialdiaries.xyz. Make sure this email has been granted access to the folder. These 5 videos should be submitted before the deadline, 12 February 2023, 2359hrs GMT+2. We will then shortlist two teams, and these two teams would have to shoot the videos for the remaining 28 scenes (to make a total of 33 videos, one video for each of the scenes given). They are to submit these videos as described above before the deadline, 28 February 2023, 2359hrs GMT+2.

The winners will be announced within a week, on this page and on our social accounts. There will be 2 winners. The 1st place will be awarded $500US. The second place will be awarded $250US. The ranking will be done by a set of judges and it will be based on creativity, quality and excellence. The winning participants will be required to grant AfroPHC the copyrights and ownership of their video content before being awarded the cash prizes.

For questions and updates, kindly join our Competition Whatsapp group: https://chat.whatsapp.com/FB9mee2zrWxF5D2OgjGupF. We will be happy to provide any information necessary.

Best of luck!