PHA-Exchange> PHC Revitalization

[Claudio]

From: "mohammad ali barzgar" <m_barzgar at hotmail.com>

> Dear Friends,
>
> Greeting from Iran.I wish to admire and congratulate PHM for the
contineous
> challenge since December 2000 for revitalization of PHC/HFA based on
> Alma-Ata Decleration in 1978,which finaly the Worrld Health Organization
> considered to strengthen health services system INCLUDING PHC.While as PHM
> authorities commented in Geneva it was a positive move but not enough.
>
> I would like to mention that again WHO is considering PHC as a programme
> within the health services system. To my point of view instead saying
health
> services system including PHC,it must be mentioned Strengthening Health
> Services System Based On PHC,and not including PHC(It means PHC like any
> other vertical programme is a part of health services system).
>
> While PHC of Alma-Ata has been looked at two diferrent ways:
>
> 1)PHC as level of care which was defined as the first contact point of a
> person with the health services system, if  the problem was beyond the
> capacity of the Primary level the person be refferred to higher levels of
> the system.
>
> 2)PHC as an approach which Primary Health Care was defined as a
> comprehensive approach of Promotive,Preventive,Curative and Rehabilitative
> health care.And such an approach should be exercised at all levels of
health
> services system i.e.Primary,Secondary and Tertiary level of health care
> delivery System.Or inother word PHC like a new blood with approach of
> promotive ,preventive ,curative and rehabilitative should be circulated at
> all levels of health services system.It means Health Services system Based
> on PHC as was envisaged by Alma-Ata.Or PHC should be the
functions(spirite)
> of the whole system,and not a part of it which be mentioned including
> PHC.That is why I belive that the phrase of INCLUDING PHC should be
changed
> to BASED ON PHC.
> Otherwise PHC is considered a vertical programme and not an approach.
>
> Or if we look at the  components of PHC i.e.Health
> Education,Nutrrition,MCH&FP,Water Supply and Sanitation,Control of
Epidemic
> and Endemic Diseases,treatment of common diseases and injuries,Provision
of
> Essential Drugs and Mental Health Services,It covers all the activities of
> the Ministry of Health and even some other ministries like Ministry of
> water.That is why Intersectorial  Collaboration and People Involvement has
> been considered as two Pillars of PHC,because PHC is talking about the
> Health and determinants of the health of the people and not health
services
> only.
>
> Also I fully agree with the PHM points of views that WHO kept silence
about
> the inequity and social justice,Poverty ,unjust economic order due to
> Globalization,and dangerous policy of Multilateral/International Financial
> institutions(WORLD BANK&IMF),WTO,and Drug and Medical Instrument
> Companies.While Philosophy Of PHC is Equity and Social Justice and it's
goal
> is Health For All/HFA, but it's priority is the poorest of the poor.
>
> Lastly I want to conclude that if WHO want to achieve HFA should be
> Re-organised into a health servises Infrastructure based on PHC and advise
> and support  the Ministry of Health of  all the member States to do the
> same,and implement all its programmes including HIV/AIDS in an integrated
> approach of PHC based on the country needs and priorities within such
> Infrastructure.At the same time should learn how should work with other
> sectors like Agriculture,Education,Health manpower
development,Sports,etc..
> for covering the determinants of health.Of course such a WHO  will be a
good
> example of an integrated approach of health care delivery based on
PHC.Time
> being WHO with its fragmented General Programme Of Work,with piece meal
> allocation for several vertical programmes could not be an appropriate
> Directing and Coordinating Technical Agency at Global level and carry out
> its mandate i.e.the highest attaiment of health for all the people of the
> world.Thanks and Kindest regards.Dr.M.A.BArzgar,PHM,IRAN.
>
> Ps:this comment is made based on my experience in Iran since 1971 as one
of
> the initiator of PHC in Iran,and in several countries of EMRO/Region.Also
I
> have written a General  Programme of Work of WHO in 1992 which due to
> prevailing anti PHC policy that time was not taken seriously.If Dr.Lee as
> progressive DG/WHO would like to recieve it I will be pleased to submit to
> him.