Alma-Ata Declaration 1978: Primary Health Care for All Explained
In short: The 1978 Alma-Ata Declaration called for 'Health for All by the Year 2000' through primary health care — essential, affordable, community-based services. The 2018 Astana Declaration renewed that commitment.
The conference
In September 1978, 134 countries met in Alma-Ata (now Almaty, Kazakhstan) at a conference organised by WHO and UNICEF. The declaration described health as a human right and called the gross inequality in health 'politically, socially and economically unacceptable'.
Elements of primary health care
The declaration listed eight essential elements: health education; food and nutrition; safe water and sanitation; maternal and child health including family planning; immunisation; prevention and control of endemic diseases; treatment of common diseases and injuries; and essential drugs. It stressed community participation, appropriate technology and intersectoral action.
Selective vs comprehensive PHC
Soon after, some donors promoted 'selective' PHC focused on a few cost-effective interventions such as GOBI (growth monitoring, oral rehydration, breastfeeding, immunisation). Critics argued this narrowed the original vision.
Astana 2018 and Nepal
The 2018 Astana Declaration reaffirmed primary health care as the foundation of universal health coverage. In Nepal, health posts, FCHVs, PHC outreach clinics and the basic health service package are direct descendants of the Alma-Ata vision.
Key takeaways
- Alma-Ata (1978) set the goal of Health for All by 2000.
- It listed eight essential elements of PHC.
- Astana (2018) renewed PHC as the base of UHC.
Common questions
What are the principles of PHC?
Equitable distribution, community participation, intersectoral coordination, appropriate technology and a focus on prevention.
Was Health for All 2000 achieved?
No, but it shaped health systems worldwide and its goals continue through UHC and the SDGs.
References
Educational content by PHC-Nepal. It does not replace advice from a qualified health professional.