Selective primary health care as conceived in the walshwarren article proposed a selective attack on the most severe public health problems. Intimidation, coercion, and resistance in the final. After the year 1978 alma ata conference, the rockefeller foundation held a conference in 1979 at its bellagio conference center in italy to address several concerns. Primary health care requires a change in socioeconomic status, distribution of resources, a focus on health system development, and emphasis on basic health services. What is the difference between comprehensive and selective. In the aftermath of the alma ata conference, three types of primary health care phc, have been identified. Strategies for control of disease in the developing world. Background since the whos alma ata declaration on primary health care phc there has been debate about the advisability of adopting comprehensive or selective phc.
It is clear that comprehensiveness here is used to refer to a larger range of health care interventions compared with a more restrictive selective approach. In selective primary health care, julia walsh and kenneth warren present a logical approach to health planning based on costeffectiveness techniques. Considered too idealistic and expensive, it was replaced with a diseasefocused, selective model. The inclusionof water supply and sanitation programs as a component of primary health care phc has been questioned on the basis of calculations of the costs of these programs per infant death averted. Pdf the origins of primary health care and selective.
I have analyzed these organizations political context, their leaders, the methodologies and technologies associated with the primary health care perspective, and the debates on the meaning of primary health care. These questions are paramount in the minds of health planners as they pursue national. These debates led to the development of an alternative, more restricted approach, known as selective primary health care. Proponents of the latter argue that a more selective approach will enable. However, there is little understanding of the origins of the term. It was thought that this narrow and focused attack would. The primary health care movement is seen to have been scuttled by. Harvard medical school and peter bent brigham hospital. The declaration, named for the host city, almaty, kazakhstan formerly known as almaata, outlined the organizations stance towards health care made available for all people in the world 1 2. Selective primary health care revisited john briscoe, phd abstract. Here, the idea of selective primary health care was introduced as a strategy to complement comprehensive phc. The setting for integrated primary care and behavioral health can vary from a private.
Distinguishing between primary health care and selective primary health care. Pai convenes the primary health care strategy group, a coalition of civil society health advocates from around the world dedicated to improving global and domestic financing and policy for strong primary. Selective primary health care an interim strategy for. Primary health care requires a change in socioeconomic status. The model is designed to improve care for a number of populations. The origins of primary health care and selective primary health care. With these priorities in mind a program of selective primary health care is compared with other approaches and suggested as the most costeffective form of medical intervention in the least. Their paper is a timely example of the risks of using.
Chapters 10 discusses community based health services and team approach in the health service. Chapter 9 is about primary health care and the definition, historical development, concepts and philosophies of primary health care. Selective primary health care selective primary health care. Health care phc was comprehensive, viewing health services as part of a new inter. Even less is known of the transition to another version of primary health care, best known as selective primary health care. Poverty effects of public health reforms in turkey. By horizontal delivery, services are delivered through public financed health systems and are. Review of african political economy meredeth turshen. Chapter 9 is about primary health care and the definition, historical development, concepts and.
Alma alta, primary health care, and selective primary. Pdf the origins of primary health care and selective primary. In other contexts, primary health care has been understood as a set of priority health interventions for lowincome populations also called selective primary health care. Primary health care phc is essential health care made universally accessible to individuals and acceptable to them, through full participation and at a cost the community and country can afford. Regardless of social and economic status every individual in the nation must have access to good health care. Health services curative and preventive can be provided using two modes of delivery. The primary health care movement is seen to have been scuttled by many prominent supporters.
Here, the idea of selective primary health care was introduced as a strategy to. Primary health care introduction, principles and elements. Others have understood primary health care as an essential component of human development, focusing on the economic, social and political aspects. The selective approach to primary health care model provides a justification for policy makers to continue with established norms. The inclusion of water supply and sanitation programs as a component of primary health care phc has been questioned on the basis of calculations of the costs of these programs per infant death averted. In the aftermath of the alma ata conference, three types of primary.
Open access research what is the difference between. Comprehensive versus selective primary health care. Pdf comprehensive versus selective primary health care. By educating the public on the prevention and control of health problems, and encouraging participation, the world health organization works to keep disease from spreading on a personal level 1 2.
Selective approach to primary health care model one health. Horizontal and vertical delivery of health services. Primary health care is a new approach to health care, which integrates at the community level all the factors required for improving the health status of the population. As an alternative to phc, selective primary health care would institute health care directed at preventing or treating the few diseases that are responsible for the greatest mortality. Alma alta, primary health care, and selective primary health.
Conference health and population in development in 1979 at bellagio, italy. The idea of selective primary health care was first explored in depth in an article by j. Essential elements of effective integrated primary care and. It was thought that this narrow and focused attack would maximize health improvements in developing countries. Their paper is a timely example of the risks of using simple technical criteria to plan solutions to complex public health problems. The setting for integrated primary care and behavioral health can vary from a private practice primary care clinic to a publically funded safety net provider. Selective primary health care and new health interventions shortly after its appearance phc was criticized for being too broad, idealist and having an unrealistic timetable. In this section you will learn about the elements or functions of phc box 1. However, all of these teams include the integration of primary care and behavioral health professionals. Primary health care was declared the model for global health policy at a. Functional ability and quality of life in critical illness survivors with intensive care unit acquired weakness. Essential elements of effective integrated primary care. Ma 021 is and the rockefeller foundation, 13 avenue of the americas.
Rockefeller foundation, new york, ny we determined the major causes of third world morbidity and mortalitythe diarrheas and respira. Primary health care requires a change in socioeconomic s. In response to the vagueness of primary health care and the conference of alma ata, an alternative movement began to gain momentum. Mar 07, 2020 primary health care phc is essential health care made universally accessible to individuals and acceptable to them, through full participation and at a cost the community and country can afford. Intimidation, coercion, and resistance in the final stages of the south asian smallpox eradication campaign, 19731975. This movement, termed selective primary health care sphc, emphasized the costeffectiveness of vertical programs with measurable results. After 40 years, global health is returning to the vision of the alma ata declaration in 1978, when the world looked different geopolitically, the soviet union hosted a landmark international. The origins of primary health care and selective primary health care article pdf available in american journal of public health 9411. A secondary analysis of a randomised controlled trial. The origins of primary health care and selective primary. Rockefeller foundation, the world bank and usaid changes in unicef. Request pdf comprehensive versus selective primary health care. Proponents of the latter argue that a more selective approach will enable interim gains while proponents of a comprehensive approach argue that it is needed to address the underlying causes of ill health and improve health. Public education is the first, and one of the most essential, component of primary health care 2 3.
Primary health care was declared the model for global health policy at a 1978 meeting of health ministers and experts from around the world. Introduction twenty years after the introduction of the concept of primary health care phc the question as to whether selective or comprehensive phc is the better approach. Global health history online course selective primary health care. It is an approach to health beyond the traditional health care system that focuses on health equityproducing social policy. In 1978, the world health organization who adopted the declaration of almaata 1 2. This makes universal health care accessible to all. How is this impact analyzed in terms of health improvements. Primary health care, or phc refers to essential health care that is based on scientifically. What is the impact of technology on improving the life situations of people, especially the poor.
The overall health of the population bore less relationship to medical advances than to. The during the past few decades, the concept of primary health care has had a significant influence on health workers in many lessdeveloped countries. Primary health care position statement 4 services for australian rural and remote allied health august 2009 selective primary health care the concept of selective primary health care sphc emerged in. Selective approach to primary health care model one. Primary health care, or phc refers to essential health care that is based on scientifically sound and socially acceptable methods and technology. The history of the origins of primary health care and selective primary health care analyzed in this article illustrate 2 diverse assumptions in international health in the 20th century. First, there was a recognition that diseases in lessdeveloped nations were socially and economically sustained and needed a political response. For example, sphc identified four factors to guide the selection of target diseases for. I have analyzed these organizations political context, their leaders, the methodologies and technologies associated with the primary health care perspective, and the debates on the meaning of primary health. The analysis of the phased implementation of primary health care is limited.