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Alma Ata after 40 years: Primary Health Care and Health for All—from consensus to complexity
Forty years ago, the 134 national government members of the WHO signed the Alma Ata Declaration. The Declaration made Primary Health Care (PHC) the official health policy of all members countries. Emerging from the conference was the consensus that health was a human right based on the principles of equity and community participation. Alma Ata broadened the perception of health beyond doctors and hospitals to social determinants and social justice. In the following years implementing this policy confronted many challenges. These included: (1) whether PHC should focus on vertical disease programmes where interventions had the most possibility of success or on comprehensive programmes that addressed social, economic and political factors that influenced health improvements; (2) whether primary care and PHC are interchangeable approaches to health improvements; (3) how equity and community participation for health improvements would be institutionalised; and (4) how financing for PHC would be possible. Experiences in implementation over the last 40 years provide evidence of how these challenges have been met and what succeeded and what had failed. Lessons from these experiences include the need to understand PHC as a process rather than a blueprint, to understand the process must consider context, culture, politics, economics and social concerns, and therefore, to recognise the process is complex. PHC needs to be examined within evaluation frameworks that address complexity. Recent developments in monitoring and evaluation have begun to respond to this need. They include realist evaluation and implementation research.
BASE
Rapid rural appraisal: Its use and value for health planners and managers
In: Public administration: an international quarterly, Band 74, Heft 3, S. 509-526
ISSN: 0033-3298
Reviews and Information Section
In: Community development journal, Band 20, Heft 3, S. 238-239
ISSN: 1468-2656
The Chinese Model for Science and Technology: its Relevance for Other Developing Countries
In: Development and change, Band 6, Heft 1, S. 23-40
ISSN: 1467-7660
Serve the People: Observations on Medicine in the People's Republic of China. By Victor W. and Ruth Sidel. [New York: Josiah Macy, 1973. 317 pp. $10.00.]
In: The China quarterly, Band 60, S. 818-820
ISSN: 1468-2648
China's Developmental Experience. Edited by Michel Oksenberg. [New York: Praeger, 1973. 227 pp. $8.50.]
In: The China quarterly, Band 57, S. 180-182
ISSN: 1468-2648
Health Services in China
In: IDS bulletin: transforming development knowledge, Band 4, Heft 2-3, S. 32-38
ISSN: 1759-5436
The Organization and Support of Scientific Research and Development in Mainland China. By Y. L. Wu and Robert B. Sheeks. [New York: Praeger, 1970. 618 pp. $17·50. London: Pall Mall Press, 1970. £7·25.]
In: The China quarterly, Band 45, S. 176-178
ISSN: 1468-2648
Health strategy and development planning: lessons from the People's Republic of China [focuses on the relationship and need for integrating health and economic policies]
In: The journal of development studies: JDS, Band 9, S. 213-232
ISSN: 0022-0388
Health strategy and development planning: Lessons from the people's republic of China
In: The journal of development studies, Band 9, Heft 2, S. 213-232
ISSN: 1743-9140
Health sector reforms in Kenya: an examination of district level planning
The paper examines health sector reforms in Kenya at the district level based on the Government of Kenya's Health Policy Framework of 1994. The authors present the context of and historical perspective to health sector reforms in Kenya and discuss the major reform policies including decentralization to the district level. The authors then review intended policy outcomes, investigating assumptions on which the implementation and effectiveness of the reform agenda at the local level are based. The authors argue that emphasis on outcomes rather than process has not supported sustainable reforms or achieved the government's goal of improving health and ensuring equity for the citizens of the country.
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Book reviews
In: Asian affairs, Band 21, Heft 3, S. 336-382
ISSN: 1477-1500
Book reviews
In: Asian affairs, Band 19, Heft 2, S. 193-241
ISSN: 1477-1500