Healthcare Management

By Kieran Walshe; Judith Smith | Go to book overview

7: Managing in primary care

Judith Smith


Introduction and overview

The defining moment in contemporary history of primary healthcare is generally considered to have been the declaration, at a World Health Organisation conference in 1978, of what primary healthcare should provide to people within communities and nations. This declaration, known as Alma Ata after the name of the town in the Russian Federation where the conference took place, sets out the following statements about the nature of primary healthcare:

[Primary healthcare] forms an integral part of both the country's
health system of which it is the central function and the main focus
of the overall social and economic development of the community.
(WHO 1978: Section VI)

Primary health care addresses the main health problems, providing
preventive, curative, and rehabilitative services accordingly but
will include at least: promotion of proper nutrition and an adequate
supply of safe water; basic sanitation; maternal and child care, includ-
ing family planning; immunization against the major infectious dis-
eases; education concerning basic health problems and the methods
of preventing and controlling them; and appropriate treatment of
common diseases and injuries. (WHO 1978: Section VII)

These definitions are striking in their holistic assessment of primary healthcare as being what Tarimo (1997) has termed an 'approach to health development', namely all those elements of care and community development that together enable people to lead healthy and meaningful lives. A view of primary healthcare as an approach to health development holds that it is central and foremost within a healthcare system, comprising all those activities and conditions that go towards ensuring the public health. 'Primary' therefore implies that this area of care is fundamental, essential and closest to people's everyday lives and experiences. The Alma Ata declaration goes on to call for countries of the world to address the

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