As nations seek to strengthen their health
systems, they are increasingly looking to primary health care (PHC) to
provide a clear and comprehensive sense of direction. The World Health
Report 2008 analyses how primary health care reforms, that embody the
principles of universal access, equity and social justice, are an essential
response to the health challenges of a rapidly changing world and the growing
expectations of countries and their citizens for health and health care.
The Report identifies four interlocking
sets of PHC reforms that aim to: achieve universal access and social protection,
so as to improve health equity; re-organize service delivery around people's
needs and expectations; secure healthier communities through better public
policies; and remodel leadership for health around more effective government
and the active participation of key stakeholders.
This Report comes 30 years after the
Alma-Ata Conference of 1978 on primary health care, which agreed to tackle
the "politically, socially and economically unacceptable" health inequalities
in all countries. Much has been accomplished in this regard: if children
were still dying at 1978 rates, there would have been 16.2 million child
deaths globally in 2006 instead of the actual 9.5 million. Yet, progress
in health has been deeply and unacceptably unequal, with many disadvantaged
populations increasingly lagging behind or even losing ground.