 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
John H. Bryant, MD, Senior Faculty Associate, Johns Hopkins School of Public Health, Emeritus Professor, Aga Khan University, P.O. Box 177, Moscow, VT 05662, 802-253-5143, jbryant.moscow@worldnet.att.net
The 20th anniversary of the 1978 Alma Ata conference underscored three findings on the original PHC concept: 1) the original insights were strikingly accurate; 2) some issues had been inadequately appreciated, such as government capacity limitations; and, 3) some problems were unpredictable, e.g. HIV/AIDS. WHO is now reviewing perceptions of PHC in its six regions, including the fact that a number of NGO groups believe that WHO has not given PHC sufficient attention. Overall, there is a sense of dramatic changes in epidemiology and in the context for health policy. One resultant perspective sees PHC in a new paradigm. This includes giving primacy to social justice, human rights and equity; and working with multi-sectoral and multi-level parameters. The present paper insists that a further factor be taken into account, namely social determinants of health. Some social determinants call on PHC paradoxically to reach beyond health care to other factors that affect health. Some aspects of PHC would remain absolutely essential -- being community-based and linked through referrals to higher levels of health care. The new call is for interactions with other sectors and for coping with socio-economic disparities that become social determinants of ill health, in the interest of social justice, human rights and equity. The paper discusses the profound implications of such changes for the education, training, and work roles and responsibilities of health workers in developing countries. Participants can expect new understandings of PHC and new perspectives on health workforce problems and policies in developing countries.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.