ABSTRACT
The Experience and Global Context One of the main strategies of Health for All (HFA) is Primary Health Care (PHC). PHC is essential health care made universally acceptable to individuals and families in the community by means acceptable to them, through their full participation and at a cost that the community and country can afford. It forms an integral part both of the country’s health system of which it is a nucleus, and of the overall social and economic development of the community.Operationally, PHC is based on the following principles:• Food, water and shelter are essential to maintain and improve health;• Health is indivisible and has to be seen as the responsibility of self-reliant individuals, families and communities, not just the health services;• There is a need to make optimum use of available resources in the community; and,• All community members have the right to access essential health care that is affordable, socially acceptable, relevant and jointly planned and monitored by the health services.Many of these principles call for the full involvement of the community and imply intersectoral support to meet the basic needs required for health. The implementation of the policy in many countries focuses on the extension of PHC services and the delivery of specific public health programs such as immunization, TB control, nutrition, maternal and child health, and water and sanitation. Major efforts have been made to build the capacity of the health services by training health workers to deliver discrete health interventions and by training health teams to plan and manage health programs at the local levels. Unfortunately, for the most part, these efforts in capacity building have been short term and usually tied to donor-funded programs. The result therefore has been unsustainable fragmented approaches to health services development and policy implementation.
