WHO's 2008 Report and UNICEF call for return to primary health care
The World Health Report 2008 titled Primary Health Care - now more than ever calls for a return to primary health care as a more holistic approach to health to overcome current inequities and inefficiencies in global health.
14 October 2008, Almaty, Kazakhstan - The World Health Report 2008 titled Primary Health Care - now more than ever calls for a return to primary health care as a more holistic approach to health to overcome current inequities and inefficiencies in global health.
"We are, in effect, encouraging countries to go back to basics. Viewed against the current trends, the primary health care looks more and more like a smart strategy to get health development back on track," said Dr Margaret Chan, WHO Director General, in launching the Report. When countries at the same level of economic development are compared, the Report found those where health care is organized around the tenets of primary health care produce a higher level of health outcomes for the same investment.
The World Health Report 2008 cites striking inequities in maternal and child health. Of the estimated 136 million women who will give birth this year, around 58 million will receive no medical assistance whatsoever during childbirth and the postpartum period, endangering their lives and that of their children. Also, vast differences are found in health outcomes within countries and sometimes within individual cities. In Nairobi, for example, the under-five mortality rate is below 15 per 1000 in the high-income area, but the rate is 254 per 1000 in a slum in the same city.
The report explains that primary health care brings balance back to health care and puts families and communities at the hub of the health system. The approach aims to tackle inequalities in health by moving towards universal coverage and ensuring more effective and efficient health care.
Speaking at a press conference in Alma Ata, the WHO Director General Dr Margaret Chan said: "Never before has our world possessed such a sophisticated catalogue of tools and technologies for curing disease and prolonging life. Yet, each year, nearly 10 million young children and pregnant women have their lives cut short by largely preventable causes."
Joining Dr Chan, UNICEF Executive Director Ann Veneman said that maternal and newborn survival is a key barometer of health system effectiveness. "High maternal, infant and under-five mortality often indicates lack of access to basic services such as clean water and sanitation, immunizations and proper nutrition," said Veneman. In order to address these ills and inequities, she added "primary health care must be scaled up especially for women and children who are so often the poorest and most vulnerable.".
Huge differences exist in what people have to pay for health care as well, according to the Report. For 5.6 billion people in low- and middle-income countries, more than half of all health care expenditure is through out-of-pocket payments. Annual government expenditure on health varies from as little as US$20 per person to well over US$6 000. The Report notes that conditions of inequitable access, impoverishing costs, and erosion of trust in health care constitute a threat to social stability.
The World Health Report 2008 Primary Health Care - now more than ever commemorates the 30th anniversary of the Alma Ata International Conference on Primary Health Care held in 1978. The event was the first to put health equity on the international political agenda. However, inequalities in health outcomes and access to care are so much greater now than they were 30 years ago hence affirming the ever-heightened relevance for the primary health care approach across health systems in countries.
Health systems will not naturally gravitate towards greater fairness and efficiency and deliberate policy decisions would be needed by countries, said the official launch release.