Alma Ata Declaration
In 1978, the Alma Ata Declaration said that health is a human right. Health is defined as a state of complete physical, mental, and social wellbeing. The Declaration said that communities should follow the rules of primary health care to improve everyone’s health (WHO 2008). Primary health care is based on the idea of social justice. Community health focuses on giving people the tools they need to make informed health decisions (Green 2004).
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The goal of this essay is to talk about what the Alma-Ata Declaration says about primary health care and how ideas about it have changed over time. Also, the WHO report, Primary Health Care?, will be used to talk about how important primary health care is today. Now more than ever, we need to pay attention to the health of Australian Indigenous children in the Western part of Melbourne.
In the Alma-Ata declaration, primary health care is defined as health care that is based on practical, evidence-based, and socially acceptable methods and is available to everyone in a community. The principles are an important part of the health system. At the first level, they provide health care with an overall focus on the socioeconomic development of communities and countries (Awofeso 2004).
As soon as the Alma-Ata conference was over, primary health care was criticized. Politicians didn’t like the idea that communities would be in charge of planning and carrying out health care services. So, political commitment was not kept, and it wasn’t backed up with the reforms that were needed (Hall & Taylor 2003).
There were no rules in place at government agencies to make sure that everyone, especially poor and disadvantaged people, had equal access to services. Also, experts and politicians turned down the idea of primary health care, which would have let communities plan and run their own health services (McMurray & Param 2008).
Around the world, resources for public health were taken away from primary health care to help deal with emergencies with a lot of deaths. This included the comeback of tuberculosis, the spread of malaria, and the start of HIV/AIDS (WHO 2008).
World events like an oil crisis, a global recession, and the introduction of structural adjustment programs by development banks changed the way primary health care was set up. spending money on health and social services (WHO 2008).
Because there wasn’t enough money and training for health care workers, there weren’t enough services for communities, and people chose to skip the first level of services. Primary health care services were limited in coverage and quality because they were hard to get to, had few resources, and had old or broken equipment (Hall & Taylor 2003).
The reach and impact of primary health care services were limited because they were hard to get to, had few resources, and used old or broken equipment. Due to understaffed centers and poor service, primary health care workers lost motivation and quit.
In some countries, primary health care still doesn’t get enough money and support because health organizations don’t have enough structure and money to invest. This leads to poor coverage and quality of services (Hall & Taylor 2003).
The goal of health for all by the year 2000 would not be reached, the World Health Organization (WHO) said in a 1994 review of changes in health development since Alma-Ata (WHO 2008).
The ideas behind primary health care can’t be thrown out, but they need to be adapted and used in different ways in the real world (Macdonald 2004). In a case study called “Good Health at Low Cost,” published by the Rockefeller Foundation, it was found that countries like China, Costa Rica, and Sri Lanka were able to create affordable and effective health systems by putting a lot of emphasis on overall social welfare developments, even though their economies and political systems were different (McPake 2008).
In 2008, the Commission on Social Determinants of Health released a report that said all government policies should pay close attention to everyone’s health because differences in health outcomes are signs that policies aren’t working. The report also says that primary health care should be used as a model for health systems that address the social, economic, and political factors that lead to poor health (WHO 2008).
The World Health Organization (WHO) Report, Primary Health Care-Now More Than Ever (2008), says that policymakers need to know more about primary health care to make health systems that are fair, inclusive, and equitable for everyone. Also, it shows the need for comprehensive policies that make sure the health system as a whole works well.
In the report, the idea of primary health care as a set of values and principles to guide the growth of health systems is looked at again. But it talks about what we’ve learned from the past and Alma-Ata, as well as what challenges we might face in the future, with a focus on closing unacceptable gaps in health systems (WHO 2008).
WHO sees four key changes that need to be made for primary health care to be accepted. These changes reflect a convergence between primary health care values, equity, solidarity, social justice, and community expectations of a globalized society, with the principles forming the core of the health system and focusing on community and country socio-economic development (WHO 2008).
People-centered health systems that make sure people’s needs are met, socially relevant services, and the ability to adapt to a world that is always changing are all part of service delivery reforms. Universal coverage reforms aim to make sure that everyone has equal access to health care and social health protection. Leadership reforms to make health authorities more reliable by promoting and protecting the health of communities through participation and negotiation-based leadership, which is needed because modern health systems are so complicated (WHO 2008).
In many countries, the management of national resources to support reforms in primary health care needs a lot of social and political attention and action. International cooperation and acceptance of primary health care reforms can help health systems change quickly to make sure they are fair, efficient, and cost-effective (WHO 2008). Also, primary health care reforms need to be backed up by programs that make sure people from low-income backgrounds or with disabilities have equal access to health services. In Australia, these people are from Indigenous communities.
Aboriginal people accepted the primary health care approach because they saw people and health as a whole (Macdonald 2004). By planning and putting in place home visits by health workers and helping people in their own environment, services for mothers and children have been successful (Flahive 2009). Between 1996 and 2001, the difference in how long an Indigenous Australian child could be expected to live was about 17 years. In 2009, the Australian Bureau of Statistics (ABS) said that Indigenous Australian children’s life expectancy was about 10 years lower than that of non-Indigenous Australian children (ABS 2009) Even though the difference is still big, it is getting smaller.
In 2001, 57% of the Indigenous people living in the western part of Melbourne were under the age of 25. This is one of the highest rates in Victoria (Department of Health and Aging 2005).
The main points of the Aboriginal Services Plan Indigenous disadvantage can be lessened by making big changes in three areas: early childhood development, early school attendance and performance, and a good transition from childhood to adulthood (Department of Health 2008).
Social, cultural, and economic factors affect a child’s health, especially in the first three years. A child’s health, education, development, and growth during this time also affects his or her health and education as an adult (Department of Health 2008).
In 2003-04, the Metropolitan Maternal and Child Health Service had 1666 records for Koorie children (Department of Health 2008).
The Aboriginal Best Start Program is a service run by the Victorian Aboriginal Community Service Association. It focuses on the health, development, learning, and well-being of all Aboriginal children up to age 8. (Department of Health 2008). The program helps communities and local services so that families can get better child and family support. This is done by making sure and promoting that Koorie children get the best possible start in life.
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The Indigenous Child Protection Program in the NorthWest Metropolitan region is a service that aims to raise cultural awareness in the community and strengthen partnerships between Aboriginal service providers. The program has allowed the North West to offer a high level of services that are culturally appropriate and make sure that children in protective care stay in touch with their families and the wider Aboriginal community (Department of Health 2008).
The Aboriginal community-controlled health organization in Fitzroy has a program that aims to improve overall health by increasing knowledge and awareness about mother and child health through health promotion activities and services for families with children up to 8 years old. Aboriginal children are getting more shots because of the program (Department of Health and Aging 2005).
Changes to Australia’s primary health care? Australia’s first national primary health care strategy is based on ten elements for an improved primary health care system to improve and strengthen service delivery in response to current and future health issues. These ten elements are:
In our future primary health care system, all Australians should be able to get services that keep people healthy and help them deal with sickness. These services should be:
Accessible, appropriate clinically and culturally, timely, and affordable,
Patient-centered and encouraging of health literacy, self-management, and the independence of each person
More focused on preventive care, such as helping people live healthier lives. Well-integrated, coordinated, and offering continuity of care, especially for those who
with multiple, long-term, and complicated health problems
Service delivery arrangements should support: Care that is safe, of high quality, and always getting better through relevant research and new ideas;
Taking care of health information better
The ability to respond to local needs and situations in the best way possible by using operational models that are sustainable and effective.
There are a number of things that help the people who work in primary health care. They are: working environments and conditions that attract, support, and keep workers;
High-quality education and training for both new and old employees.
Primary health care is: Affordable, efficient, and good value for money? (Health and Aging Department, 2009)
Four key priorities that came out of the strategy are:
improving access and reducing inequality, better management of chronic conditions, putting more emphasis on prevention, and improving quality, safety, performance, and accountability? (Health and Aging Department, 2009)
Person-centered care, better management of health information, and building a more educated workforce are what make these priority areas work. The strategy also takes into account community support for health status and access to services, more use of multi-disciplinary teams, and accountability for performance, as well as health promotion activities that focus on preventing diseases instead of treating short-term illnesses (Department of Health and Aging 2009).
Countries with dedicated and resourceful primary health care systems show that efficient and affordable health care is possible. Research shows that health outcomes are better overall, there are fewer hospitalizations, and there are fewer health inequalities (Department of Health and Aging 2009).
The first part of improving Australia’s primary health care system is to make sure that all Australians have access to clinical services that are appropriate for their culture, are delivered quickly, and are mostly affordable. Indigenous Australians, for example, have a hard time getting the health care they need. However, if everyone did their part and worked together, these gaps would be closed (Department of Health and Aging 2009).
In order to close the health gap between Indigenous and non-Indigenous Australians, the strategy takes into account the health problems and gaps caused by the fact that Indigenous people have higher rates of disease, disability, and drug abuse. All of Australia’s governments have set aside money to improve the health of Indigenous Australians, especially the health of children, who are the future (Department of Health and Aging 2009).
Indigenous Australians will be able to use mainstream health services through person-centered approaches, which is another way the government plans to get rid of health disparities (Department of Health and Aging 2009).
These focused activities will have a big impact on Indigenous children when it comes to preventing chronic diseases, taking care of chronic illnesses, and making sure they are at the center of care (Department of Health and Aging 2009).