TheDeclarationofPRIMARYHEALTHCARE

WorldHealthAssembly
WorldHealthOrganizationandUNICEF
1978,AlmaAta,USSR

TheConferencestronglyaffirmsthathealth,whichisastateofcompletephysical,mentalandsocial
wellbeing,andnotmerelytheabsenceofdiseaseorinfirmity,isafundamentalhumanrightandthat
theattainmentofthehighestpossiblelevelofhealthisamostimportantworldwidesocialgoalwhose
realizationrequirestheactionofmanysocialandeconomicsectorsinadditiontothehealthsector.

I. Theexistinggrossinequalityinthehealthstatusofthepeopleparticularlybetweenthe
developedanddevelopingcountriesaswellaswithinthemispolitically,sociallyand
economicallyunacceptableandis,therefore,ofcommonconcerntoallcountries.

II. Economicandsocialdevelopment,basedona NewInternationalEconomicOrder,isof

basicimportancetothefullestattainmentofhealthforallandtothereductionofthegap
betweenthehealthstatusofthedevelopinganddevelopedcountries.Thepromotionand
protection of the health of the people is essential to sustained economic and social
developmentandcontributestoabetterqualityoflifeandtoworldpeace.

III. Thepeoplehavethe RIGHT and DUTY toparticipateindividuallyandcollectivelyinthe

planningandimplementationoftheirhealthcare.

IV. Governmentshavearesponsibilityforthehealthoftheirpeople,whichcanbefulfilledonly
by the provision of adequate health and social measures. A main social target of
governments,internationalorganizationsandthewholeworldcommunityinthecoming
decadesshouldbetheattainmentbyallpeoplesoftheworldbytheyear2000ofalevelof
healththatwillpermitthemtoleadasociallyandeconomicallyproductivelife. Primary
healthcareisthekeytoattainingthistargetaspartofdevelopmentinthespiritofsocial
justice.

V. Primaryhealthcareisessentialhealthcarebasedonpractical,scientificallysoundand
socially acceptablemethodsandtechnologymadeuniversallyaccessibletoindividuals
and families in the community through their full participation and at a cost that the
communityandcountrycanaffordtomaintainateverystageoftheirdevelopmentinthe
spiritofselfrelianceandselfdetermination.Itformsanintegralpartbothofthecountry's
healthsystem,ofwhichitisthecentralfunctionandmainfocus,andoftheoverallsocial
andeconomicdevelopmentofthecommunity.Itisthefirstlevelofcontactofindividuals,
thefamilyandcommunitywiththenationalhealthsystem,bringinghealthcareascloseas
possibletowherepeopleliveandwork,andconstitutesthefirstelementofacontinuing
healthcareprocess.

VI. PrimaryHealthCare
a. Reflects and evolves from the economic conditions and sociocultural and political
characteristicsofthecountryanditscommunitiesandisbasedontheapplicationofthe
relevant results of social, biomedical and health services research and public health
experience;
b. Addressesthemainhealthproblemsinthecommunity,providingpromotive,preventive,
curative,andrehabilitativeservicesaccordingly.
c. Includesatleast:educationconcerningprevailinghealthproblemsandthemethodsof
preventing and controlling them; promotion of food supply and proper nutrition; an
adequate supply of safe water and basic sanitation; maternal and child health care,
includingfamilyplanning;immunizationagainstthemajorinfectiousdiseases;prevention
andcontroloflocallyendemicdiseases;appropriatetreatmentofcommondiseasesand
injuries;andprovisionofessentialdrugs;
d. Involves,inadditiontothehealthsector,allrelatedsectorsandaspectsofnationaland
community development: in particular agriculture, animal husbandry, food, industry,

Declaration of Primary Health Care_WHO UNICEF World Health Assembly_Alma Ata, USSR
Human Health and Wellness_June 2005
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 education,housing,publicworks,communicationsandothersectors;anddemandsthe
coordinatedeffortsofallthosesectors;
e. Requiresandpromotesmaximumcommunityandindividualselfrelianceandparticipation
intheplanning,organization,operationandcontrolofprimaryhealthcare,makingfullest
use oflocal, nationalandotheravailableresources;andtothisenddevelopsthrough
appropriateeducationtheabilityofcommunitiestoparticipate;
f. Should be sustained by integrated, functional and mutuallysupportive REFERRAL
SYSTEMS,leadingtotheprogressiveimprovementofcomprehensivehealthforall,and
givingprioritytothosemostinneed;
g. Relies, at local and referral levels, on health workers, including physicians, nurses,
midwives, auxiliaries and community workers as applicable, as well as traditional
practitionersasneeded, suitablytrainedsociallyandtechnically toworkasahealth
teamandtorespondtotheexpressedhealthneedsofthecommunity.

VII. All governments should formulate national policies, strategies and plans of action to
launchandsustainprimaryhealthcareaspartofacomprehensivenationalhealthsystem
andincoordinationwithothersectors.Tothisend,itwillbenecessarytoexercisepolitical
will,tomobilizethecountry'sresourcesandtouseavailableexternalresourcesrationally.

a. Allcountriesshouldcooperateinaspiritofpartnershipandservicetoensureprimary
healthcareforallpeoplesincetheattainmentofhealthbypeopleinanyonecountry
directly concerns and benefits every other country. In this context the joint
WHO/UNICEFreportonprimaryhealthcareconstitutesasolidbasisforthefurther
developmentandoperationofprimaryhealthcarethroughouttheworld.

b. Anacceptablelevelofhealthforallthepeopleoftheworldbytheyear2000canbe
attainedthroughafullerandbetteruseoftheworld'sresources,aconsiderablepart
of which is now spent on armaments and military conflicts. A genuine policy of
independence,peace,dtenteanddisarmamentcouldandshouldreleaseadditional
resources that could well be devoted to peaceful aims and in particular to the
accelerationofsocialandeconomicdevelopmentofwhichprimaryhealthcare,asan
essentialpartshouldbeallotteditspropershare.

TheInternationalConferenceonPrimaryHealthCarecallsforurgentandeffectivenationalandinternational
actiontodevelopandimplementprimaryhealthcarethroughouttheworldandparticularlyindeveloping
countriesinaspiritoftechnicalcooperationandinkeepingwithaNewInternationalEconomicOrder.It
urgesgovernments,WHOandUNICEF,andotherinternationalorganizations,aswellasmultilateraland
bilateral agencies, nongovernmental organizations, funding agencies, all health workers and the whole
worldcommunitytosupportnationalandinternationalcommitmenttoprimaryhealthcareandtochannel
increasedtechnicalandfinancialsupporttoit,particularlyindevelopingcountries.TheConferencecallson
all the aforementioned to collaborate in introducing, developing and maintaining primary health care in
accordancewiththespiritandcontentofthisDeclaration

Declaration of Primary Health Care_WHO UNICEF World Health Assembly_Alma Ata, USSR
Human Health and Wellness_June 2005
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