ABSTRACT
At the time of the 40th anniversary of the Alma-Ata Declaration, the World Health Organization member states signed the Declaration of Astana. From Health For All to Universal Health Coverage, primary health care is consistantly identified as the key to achieving human health, and preventive services are critical and central component of primary health care. China has provided valuable experience for primary health care to countries around the world. However, with significant socioeconomic changes and rapid population aging, the contexts of primary health care and prevention services in China has undergone tremendous changes. Chronic diseases have become major burden of disease. System development and institution building, health service delivery system development, and the entire society of the country with large population are encountering new and serious challenges. On the basis of reviewing the development of preventive medical services in China for 40 years, Authors analyzes strengths and weaknesses of preventive services in China and looks forward to the challenges and opportunities in the coming decades, from perspective of primary, secondary and tertiary prevention strategies, and proposes suggestions for future development.
ABSTRACT
RESUMEN Al conmemorarse 40 años de la Conferencia Internacional de Atención Primaria de Salud de 1978 en Alma Ata (Kazajistán, ex URSS), la vigencia de sus principios fundamentales se mantiene, siendo importante recordarlos como un referente para el futuro mediato, y proyectarlos a la salud para todos, pendiente de construir con todos.
ABSTRACT As we commemorate 40 years of the International Conference of Primary Health Care celebrated in Alma-Ata (Kazakhstan, ex-USSR) in 1978, the currency of its fundamental principles holds strong, and it is important to remember them as a referent for the near future, and to project them to every individual's health, to be built by all.
Subject(s)
History, 20th Century , Primary Health Care , Global Health , Comprehensive Health Care , Congresses as Topic , Alma Ata Declaration , International Cooperation , Time Factors , Kazakhstan , Congresses as Topic/history , GoalsABSTRACT
Alma Ata is still in force in those experiences of comprehensive health care from all and for all that some countries have managed to implement, especially in the rural areas with populations affected by exclusion and poverty. Peru has several of them that find their roots in experiences previous to the 1978 Conference. It is interesting to confirm that many of these were initially dedicated to the care of pregnant women and newborns, and then they have translated their lessons learned to the care of the whole population.
Alma Ata sigue vigente en aquellas experiencias de Cuidado Integral de la Salud por todos y para todos que algunos países han logrado implementar, sobre todo en zonas rurales con poblaciones afectadas por la exclusión y la pobreza. El Perú detenta varias de ellas, que incluso encuentran sus raíces en experiencias previas a la Conferencia de 1978. Es interesante confirmar que muchas de estas se abocaron primero a la atención de las gestantes y recién nacidos, y luego han trasladado sus lecciones aprendidas al cuidado de toda la población.
ABSTRACT
The historical account of the International Conference on Primary Health Care of Alma-Ata (Soviet Union) WHO/UNICEF, the most important international health policy event in the early 70's that marked a milestone in public health in the world, is presented. It was attended by 134 countries, 67 international organizations and many non-governmental organizations. Unfortunately, China was the big absentee. At the end of the historical account, the Declaration of Alma-Ata 1978 is presented.
Se presenta el relato histórico de la Conferencia Internacional sobre Atención Primaria de la Salud de Alma-Ata (URSS) OMS/UNICEF, el evento de política de salud internacional más importante en la década de los 70 que marcó un hito en la salud pública del mundo. Contó con la presencia de 134 países, 67 organismos internacionales y muchas organizaciones no gubernamentales. Lamentablemente, China fue el gran ausente. Al final del relato histórico, se presenta la Declaración de Alma-Ata 1978.
ABSTRACT
Nearly 34 years ago, in 1978 in the face of a looming crisis in the health of the world’s populations and rising health inequality, 134 countries came together to sign the historic Alma Ata Declaration where the idea of primary health care as the chosen path to “Health for All” was formulated. However even before the declaration and more so since, countries have diverse interpretations of Universalism, each setting it in the context of its own health care model. These have ranged from the minimalist to the more comprehensive welfare state. Today, as health statistics reveal, the crisis has deepened, not only in the developing world but also in the developed world. It is important to debate the nature of the crisis and understand current policy initiatives and their ideological legitimations. The paper attempts to trace, clarify and account for the shifts in international discourse on universal health care (UHC). It argues that the idea of UHC is still with us, but there have occurred substantial shifts in discourse and meaning, shaped by changing international and national contexts and social forces impinging on health systems. The current concept of universal health coverage has only a notional allusion to universality of Alma Ata and disregards its fundamental principles. It concludes that the shifts are detrimental and its value in promoting health for all is likely to be severely limited.
ABSTRACT
O 30º aniversário da certificação oficial da Organização Mundial da Saúde (OMS) da erradicação da varíola foi marcado por uma série de eventos que saudaram a dramática história do triunfo tecnológico e organizacional contra este antigo flagelo. Todavia, as comemorações também servem como momentos para uma reflexão crítica. Este artigo questiona os aplausos excessivos para a erradicação da varíola como o único e absoluto sucesso na história da saúde pública. Examina como e por que a erradicação da varíola e a abordagem da atenção básica de saúde orientada para a justiça social (de acordo com a Declaração de Alma-Ata) se tornaram paradigmas concorrentes. Sintetiza críticas sobre as deficiências da erradicação e busca desvelar alguns dos mitos que envolvem a campanha de erradicação global como uma prioridade e necessidade da saúde pública, e como uma vitória da cooperação da Guerra Fria. O artigo finaliza com reflexões sobre a integração de aspectos técnicos e sociopolíticos da saúde no contexto do Estado de bem-estar social como forma de atingir um amplo e duradouro sucesso para a saúde pública global.
The 30th anniversary of the World Health Organization's (WHO) official certification of smallpox eradication was marked by a slew of events hailing the campaign's dramatic tale of technological and organizational triumph against an ancient scourge. Yet commemorations also serve as moments of critical reflection. This article questions the acclaim showered upon smallpox eradication as the single greatest public health success in history. It examines how and why smallpox eradication and WHO's concurrent social justice-oriented primary health care approach (following from the Declaration of Alma-Ata) became competing paradigms. It synthesizes critiques of eradication's shortcomings and debunks some of the myths surrounding the global eradication campaign as a public health priority and necessity, and as a Cold War victory of cooperation. The article concludes with thoughts on integrating technical and social-political aspects of health within the context of welfare states as the means to achieving widespread and enduring global public health success.
Subject(s)
Humans , Smallpox/prevention & control , Global Health , World Health OrganizationABSTRACT
La Atención Primaria de Salud (APS) sigue representado el mayor esfuerzo internacional de los países por alcanzar la salud mundial. Los planteamientos y las necesidades que se deben asumir continúan vigentes 30 años después de la Conferencia Internacional de Alma-Ata de 1978. La lucha por la Salud para Todos y las estrategias para lograrlo son largas y difíciles. No parte de Alma-Ata, como se lee en la mayoría de los textos, pero lo más sorprendente es que muchas personas pioneras de la APS están olvidadas en los documentos de APS más citados. Las nuevas generaciones de profesionales y trabajadores de la salud no conocen a personajes como Henry Sigerist, Salvador Allende, Gustavo Molina, Sidney Kark, Franco Basaglia, César Uribe Piedrahíta, Héctor Abad o Santiago Rengifo. Recuperar a las personas que lucharon tiene enorme importancia para la salud pública colombiana hoy.
Primary Health Care (PHC) still represents the biggest international effort by countries to reach health worldwide; the approach and needs to be assumed are still valid 30 years after the International Conference of Alma-Ata 1978. The struggle to achieve Health for All and its strategies are long and convoluted. It does not start in Alma Ata as it appears in most of the texts, but most stunning is that most pioneers of PHC are ignored in the most cited PHC documents. The new generations of health professionals and workers do not know about people such as Henry Sigerist, Salvador Allende, Gustavo Molina, Sidney Kark, Franco Basaglia, Cesar Uribe Piedrahita, Hector Abad or Santiago Rengifo. Retrieving the names of people who fought is very important today for the Colombian public health.
Subject(s)
Primary Health Care , Public HealthABSTRACT
La extensión de coberturas mediante la estrategia de atención primaria a la salud se ha convertido, a diez años de Alma Ata, en uno de los temas centrales de discusión dentro de la salud pública en los países en vías de desarrollo rrollo, La producción documental al respecto ha sido no sólo extraordinariamente profusa, sino también contradictora. Por ello, el presente articulo pretende hacer un breve alto en el camino y dar una visión global del asun to, útil para los responsables de servicios de salud en nuestro país. También da cuenta de algunos puntos importantes en la discusión de la atención primaria, como su definición, sus componentes estratégicos, sus contenidos de sus posibilldades de evaluación, as( como de dos cuestiones particularmente polémiau: ¿se trata de una atención de segunda? y el enfoque de la llamada atención primarill selectiva, ¿realmente supone un bajo costo y una alta efectividad?
Subject(s)
Primary Health Care , MexicoABSTRACT
En este trabajo se sostiene que la atención primaria a la salud requiere de una modificación total del modelo profesional vigente, el cual, de una práctica expectante y por demanda, deberá pasar a una práctica anticipatoria y programada. El autor considera que la práctica anticipatoria podrá darse en el momento en que cambie la estrategia de los servicios de salud, de tal manera que la prioridad sea identificar a los sujetos que corren riesgos específicos. Se describen también los instrumentos necesarios para este tipo de estrategia y se hacen consideraciones sobre la axiolog ia de la atención primaria a la salud