Abstract
Adding quality to primary care.
Highlights
There is a word missing from the 1978 Declaration of Alma Ata: a close examination reveals that “quality”, the adjective, does not appear in it
The stated definition of primary health care includes the notions of practicality, scientific soundness, and social acceptability, all elements of quality when referring to the provision of health care
The omission of the actual term could almost be taken as a foretelling sign of what happened in the four decades following the Alma Ata conference— the attainment of Health for All through community-led and participative primary health care did not come as a natural evolution for most health systems, and most importantly, health-care delivery suffered from such deficiencies that poor-quality care became a more formidable obstacle to reducing mortality in lowincome and middle-income countries than insufficient access to care
Summary
There is a word missing from the 1978 Declaration of Alma Ata: a close examination reveals that “quality”, the adjective, does not appear in it. The omission of the actual term could almost be taken as a foretelling sign of what happened in the four decades following the Alma Ata conference— the attainment of Health for All through community-led and participative primary health care did not come as a natural evolution for most health systems, and most importantly, health-care delivery suffered from such deficiencies that poor-quality care became a more formidable obstacle to reducing mortality in lowincome and middle-income countries than insufficient access to care. The world has changed drastically since 1978, and with it the health needs of the global population.
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