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Primary Health Care (PHC)
PHC is the foundation of an equitable health care system. It is through a community based PHC service that people can access a range of services including hospital and specialist services.
In 1978 the World Health Organisation (WHO) at Alm Ata issued the Alma Ata Declaration of Primary Health Care that outlined a PHC model that was broad, addressing the wide range of needs that people need to be healthy and prompted the Health for All by 2000 strategy. A Chinese misinterpretation of Health for All by the Year 2000 as Health for All in 2000 Years, unfortunately may have been a more realistic assessment. The Year 2000 has been and gone, and whilst many health indicators have improved world wide, the gap between the haves and have-nots is wider than ever.
The declaration can be downloaded in PDF format.
In 1986, the WHO made the Ottawa Charter which called for all sections of the health sector to incorporate health prmotion into their practice.
The response of governments in Australia has been to establish Health Promotion units within health departments. Whist this has been useful in some situations, it has tended to compartmentalise health promotion rather than ensure that ckinical services, including hopsitals, reorient their practice to incorporate health promotion strategies.
Coalition for International Equity in Health
The implementation of community based/ controlleld comprehnsive PHC has been frustrated by the adoption of a selective PHC approach that has focused on disease rather than people. The International Peoples Health Council has been established to promote international solidarity towards a democratic and equitable health care system for all in the spirit of Alm Ata. It is an informal colaition of individuals and organisations working towards these goals.
History of PHC in Australia
Over the past 50 years a number of attempts have made in Australia to establish community controlled PHC services. The earliest of these was problaby the Meatworkers Union clinic in Footscrary, Melbourne in the 1960s. However the most long lasting and durable movement came from the Aboriginal community with the establishment of Redfern Aboriginal Medical Service in 1972. This was quickly folowed by numerous others around Australia, including in many rural and remote areas.
Core Functions of Primary Health Care
Aboriginal communities were the first in Australia to establish community controlled PHC services with Refern Aboriignal Medical Service opening with volunteer staff in 1971. Around the country other communtiies followed suit. In Central sutralia the Central Australian Aboriginal Congress was set up in 1973 in Alice Springs. (see Indigenous Health)
The dominance of professionals in the mainstream services has meant that community controlled comprehensive PHC services are almost unknown. Thus government funding agencies had difficulty understanding this model. Further the Alma Ata Declaration proved difficult ot operationalise. This led the Aboriginal Medical Services Alliance - Northern territory (AMSANT) and the NSW Aboriginal Health and Medical Research Council to produce a model that offered a framework for comrehensive PHC. This is known as the Core Fucntions of PHC. This model has been further developed to be a useful tool in developing health services with remote communities by PlanHealth.
This framework is useful to include all issues that community members raise about health issues whether part of the role of the health sector, or outside the health sector. It can also enusre a balance of health service devleopment that include clinical health services, social programs, support for PHC and community advocacy processes.
Social Preventive Programs
Support for Primary Health Care
Administration and Management
There are a number of proformas included in this manual. These are useful starting points to develop approrpaite polices and procedures in a small health service.
They can be downloaded in Word format and be modified according to local needs.
Advocacy and Policy