Session 3:

Alma-Ata Declaration
 Learning Tasks

 Define Alma-Ata declaration

 Mention themes leading to Alma Ata
 List objectives of Alma Ata declaration
 Explain components of Alma Ata declaration
Definition of Alma Ata Declaration
 Alma Ata declaration is the International Declaration on
Primary Health Care expressing the need for urgent action by
all governments, all health and development workers, and the
world community to protect and promote the health of all the
people of the world.
 Themes Leading to Alma Ata Declaration

 Changing theories of health and development: shift away from

GNP as measure of development towards recognition of the
need of social development
 Concerns about poverty and population control
 Increasing reliance upon alternative approaches to medical
care model
 Success of CHWs and associated emphasis on community
participation
• Revival of interest in public health; tackling causes of ill
health rather than symptoms
 Objectives of Alma-Ata Declaration
 The objectives were:
i. To promote the concept of primary health care in all countries;
ii. To exchange experience and information on the development of primary health
care within the framework of comprehensive national health systems and
services;
iii. To evaluate the present health and health care situation throughout the world as it
relates to, and can be improved by, primary health care;
iv. To define the principles of primary health care as well as the operational means
of overcoming practical problems in the development of primary health care;
v. To define the role of governments, national, and international organizations in
technical cooperation and support for the development of primary health care;
vi. To formulate recommendations for the development of primary health care.
 Components of Alma-Ata Declaration
•The following are components of the Alma Ata declaration:
 Current World Health Situation:
o The Conference declared that the health status of hundreds of people in the world
today is unacceptable, particularly in developing countries. More than half the
population of the world does not have the benefit of proper health care.
o In view of the magnitude of health problems and the inadequate and inequitable
distribution of health resources between and within countries, and believing that
health is a fundamental human right and worldwide social goal.
o The Conference called for a new approach to health and health care, to close the
gap between the “haves” and “have-nots”, achieve more equitable distribution of
health resources, and attain a level of health for all the citizens of the world that
will permit them to lead a socially and economically productive life.
•
 Primary Health Care Approach
o The Conference considered primary health care to be essential care
based on practical, scientifically sound and socially acceptable
methods and technology made universally accessible to individuals
and families in the community through their full participation and at
a cost that the community and country can afford to maintain at
every stage of their development in the spirit of self-reliance and self
determination.
o It is the first level of contact of individuals, the family, and the
community with the national health system, bringing health care as
close as possible to where people live and work, and constitutes the
first element of a continuing health care process.
o The Conference reaffirmed that governments have a responsibility for the
health of their peoples which can be fulfilled only by adequate and equitably
distributed health and social measures.
o Each country must interpret and adapt particular, detailed aspects of primary
health care within the country’s own social, political, and developmental
context. All persons have the right and duty to participate individually and
collectively in the planning and implementation of their health care,
o On the basis of experience in a number of countries, the Conference affirmed
that the primary health care approach is essential to achieving an acceptable
level of health throughout the world in the foreseeable future as an integral
part of social development in the spilt of social justice. Thus the goal of
health for all by the year 2000 would be attained.
•
 Primary Health Care and Development

o The Conference considered the close interrelationship and interdependence of

health and social and economic development with health.
o Hence, activities of the health sector must be coordinated at national, intermediate,
and community or local levels with sectors, including education, agriculture,
animal husbandry, household water, housing, public works, communications, and
industry.
o Health activities should be undertaken concurrently with measures such as those
for the improvement of nutrition, particularly of children and mothers; increase in
production and employment, and a more equitable distribution of personal income;
anti-poverty measures; and protection and improvement of the environment
o The Conference;
 Emphasized the importance of full and organized community participation
 Self-reliance.
 Community participation in the recognition and solution of their health problems
 Affirmed the need for a balanced distribution of all available resources.
 Technical and Operational Aspects
o The varied experience of countries dealing with diverse health
problems in rural and urban areas was discussed.
o Aspects of providing promotive, preventive, curative,
rehabilitative, and emergency care appropriate to meet the main
health problems in the community, with special attention to
vulnerable groups, and be responsive to the needs and
capacities of the people.
o All levels of the national health system have to support primary
health care through appropriate training, super-vision, referral,
and logistic support.
o Primary health care requires the development, adaptation, and application
of appropriate health technology that the people can use and afford,
including an adequate supply of low-cost, good quality essential drugs,
vaccines, biologicals, and other supplies and equipment, as well as
functionally efficient supportive health care facilities, such as health centres
and hospitals.
o The agreed translation of the principles of primary health care into action
would require the priority allocation of budgetary resources to primary
health care, better distribution and use of existing resources
o Research with full involvement of populations in support of primary health
care, especially health services research and the systematic application of
knowledge in innovative ways, should be carried out
•
 National Strategies and International Support

o The Conference believed that, in adopting the Declaration of Alma-

Ata, governments have made a historic collective expression of
political will in the spirit of social equity aimed at improving health
for all their peoples.
o Each nation should now make a strong and continuing commitment
to primary health care at all levels of government and society.
o National strategies are required to;
 Translate policies into action
 Make health care available equitably to the entire population.
 Take into account socioeconomic factors and policies, available
resources, and the particular health problems and needs of the
population,
o The Conference emphasized that the strategies should be
formulated and applied with the fullest possible participation
of communities and all levels and sectors of government.
o It further recognized that the improvement of health
substantially contributes to increased productivity and
wellbeing of the individual and the community.
• Countries can learn and benefit from each other’s experience
and urged all countries to cooperate among themselves in the
promotion of primary health care through the sharing of
information, experience, and expertise
o International organizations, multilateral and bilateral agencies,
nongovernmental organizations, and other partners should actively
promote the national development of primary health care and give
technical and financial support with full respect for the principles of
national self-reliance and self determination and maximum
utilization of locally available resources.
o The Conference noted that any progress towards disarmament and
the attainment of universal peace would release resources that could
be used to accelerate socioeconomic development including primary
health care, and also benefit populations suffering from the effects of
armed conflict.
•
 Evaluation

 What are the objectives of Alma Ata

declaration?
 What was the world situation before
declaration?
 List themes which led to Alma Ata declaration