Thursday, February 6, 2025

Alma Ata: Revitalising primary health care in achieving SDGs 2030– Notes for Botswana

“ Socio-economic and political factors affecting poverty and inequality underlie the majority of the health problems in middle to low income countries. Primary resources such as land are inadequate for the population and/or unjustly distributed. The overall level of literacy and education is low, infrastructure is under developed. The health facilities and personnel are concentrated in one or two cities instead of in the rural areas where they are most needed. Women carry a considerable burden as bearers of children and carers of families, and continue to experience low social status and poor access to education”, (Pascale Allotey, 2005).

The above statement was made by Pascale Allotey at the United Nations expert group meeting of women in Bangkok , Thailand in November, 2005. Allotey’s statement helped unpack the effectives of Primary Health Care (PHC) in improving sexual and reproductive health of women. However, it has been observed by different scholars that since the Alma Ata Declaration in 1978 real progress in the health of the marginalised in general is equivocal and as a result of that calls have been made to revitalise and reform PHC because  the potential for change promised by it has not been realised and certainly not achieved. PHC is a domain of reform and change, to maintain a cost-effective, equitable and accessible health care system, policy and strategies must address growing health system complexities. The policies and strategies for PHC’s as per the WHO “Best Buys” (Tool kits) include workforce shortages, technological advances, rising rates of chronic disease, increases in co-morbidity and growing multi-morbidities.

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