Experiences with primary health care in Zambia [antikvár]

Preface The International Conference on Primary Health Care held in Alma-Ata in 1978 was a landmark in the history of international health. Never before or since has the commitment of the world community to health development and equity in health been so clearly articulated. But the transformation of intentions to practice had to be left to individual countries which alone could translate the Declaration of Alma-Ata into better health for their peoples. The assessment of progress and impact must therefore be based on the experiences of individual countries or communities. This book describes the experience of one country in trying to implement primary health care. That country is Zambia, which was officially designated as a least developed country in 1991 after two decades of serious economic decline. WHO is publishing this book as part of its efforts to stimulate more thought, discussion and action on the complex issue of how to make primary health care work. In choosing Zambia, WHO is demonstrating its concern to see much greater global interest and support for countries and peoples in greatest need. The contributors to the book have all had personal involvement in implementation of the primary health care approach in Zambia at various times since the Alma-Ata Conference. Whether based in the Ministry of Health at national level, in the University of Zambia or working in district projects supported by nongovernmental organizations, their respective experiences and insights combine to provide a unique account of the complex process of establishing a health system based on primary health care. Much time has been devoted to international debate on whether primary health care has been a success or a failure. It seems to us that this is a futile exercise which reflects a serious lack of understanding of the fact that health development will always depend on a number of fundamental factors, and particularly on economic development. The principles of primary health care are guidelines whose application will increase a country's ability to achieve health for all, but only within the parameters of its own economic realities. Thus, in the case of Zambia, the spiralling decline which set in during the early 1970s has been a major obstacle. Nevertheless, WHO remains convinced that the principles of primary health care, beginning with equity, are the only means of achieving a