PHA-Exch> "Health for all need not be a dream buried in the past"

[Claudio Schuftan]

From: Vern Weitzel <vern.weitzel at gmail.com>
crossposted from: "[health-vn discussion group]" <health-vn at cairo.anu.edu.au
>

From: Neil Pakenham-Walsh, UK <neil.pakenham-walsh at ghi-net.org>

This week's issue of The Lancet marks the 30th anniversary of the Alma-Ata
Declaration. "Health for all need not be a dream buried in the past", says
the front cover.

The entire contents are available free of charge (free registration
required) at:
http://www.thelancet.com/journals/lancet/full?issue_key=S0140-6736(08)X6039-8


Here are some extracts:

Margaret Chan (Director-General, WHO): "30 years ago, the Declaration of
Alma-Ata articulated primary health care as a set of guiding values for
health development, a set of principles for the organisation of health
services, and a range of approaches for addressing priority health needs
and the fundamental determinants of health. The ambition, which launched
the health for all movement, was bold...."

In a review titled 'Alma-Ata 30 years on: revolutionary, relevant, and
time to revitalise', a highly distinguished international team of authors
(Joy Lawn, Jon Rohde, Susan Rifkin, Miriam Were, Vinod K Paul, Mickey
Chopra) say: "Health for all and primary health care are as relevant and
more possible today than 30 years ago. What is needed is consistent
commitment to the principle of health for all, and consistent policy and
action that is not fragmented. This is especially important for those
underserved communities, present in every country, that have seen the
least progress in the last 30 years. We believe that revitalisation of the
tenets of the Alma-Ata Declaration is necessary to meet the MDGs in 2015
and beyond. Like the first primary health-care revolution, this will take
champions - as Mahler said at the 2008 World Health Assembly "unless we
all become partisans in renewed local and global battles for...equity...we
shall indeed betray the future of our children and grandchildren."

There are also two original research papers of particular relevance to
HIFA2015:

1. Atif Rahman et al. Cognitive behaviour therapy-based intervention by
community health workers for mothers with depression and their infants in
rural Pakistan: a cluster-randomised controlled trial. Lancet
2008;372:902-909

Commenting on the above, Vikram Patel and Betty Kirkwood say: "Atif Rahman
and colleagues show that a cognitive behavioural intervention, suitably
modified for this setting and delivered by community health workers with 3
days of training along with intensive monthly group supervision, had an
impressive effect on improving recovery rates of mothers who had
depression, and that this effect was sustained for 1-year of follow-up."

2. Luis Huicho et al. How much does quality of child care vary between
health workers with differing durations of training? An observational
multicountry study. Lancet 2008;372:910-916

In their commentary, Barbara McPake and Kwadwo Mensah say: "[The authors]
compared results across four countries and found that health workers with
a shorter duration of training performed at least as well and sometimes
substantially better than those with a longer duration of training in
assessing, classifying, and managing episodes of routine childhood
illness, and in counselling the children's carers."
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