Alma Ata: Reflections and future prospects in family health strategy

Marcia Marinho,Sonia Groisman

doi:10.1590/1981-863720200003420190051

Marcia Marinho, Sonia Groisman

Open Access

https://doi.org/10.1590/1981-863720200003420190051

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Abstract

ABSTRACT The International Conference on Primary Health Care, held in Alma Ata, was one of the most significant public health events in the world, where for the first time the dependency between poverty and health status was discussed and measured. Even after 40 years of its implementation, it continues to influence directly public policies related to the principles of primary care. The aim of the present study was to carry out a review of literature based on PubMed / Medline, Virtual Health Library (BVS / Bireme / WHO-PAHO) and institutional documents of Brazilian Ministry of Health, in order to point out reflections of perceptions about Alma Ata Conference, in Brazilian public policies, tracing an evolutionary profile to the family health strategy and its future perspectives. Although the study found a strong influence of the Alma Ata Conference in Brazilian public health policies it still needs improvement to reach the global goals and objectives agreed by all countries in Alma Ata and reaffirmed in the World Health Organization’s 2030 Sustainability Agenda.

Highlights

The restructuring of the Brazilian Unified Health System to achieve the principles of universality, wholeness and equity, organized among the three spheres of public services management, has changed the focus of individual centered health care and curative actions of treatment, to a conception centered at the families and in the communities in order to promote; protect; cure and recover health
In 1978, the International Conference on Primary Health Care resulted in the Alma Ata Declaration, introduced the concept of health as the state of complete physical, mental and social wellness, instead of absence of disease, and established a global goal, to be achieved by the year 2000, of acceptable levels of health for all, mainly through basic care, which represents the first level of contact with the national health system of individuals, families and communities, offering preventive; curative; rehabilitation and health promotion actions [1,2]
In the two decades after Alma Ata, the neoliberal macroeconomic and social policies led to a structural adjustment, with dramatic cuts in public resources, resulting in chronic underfinancing of public health infrastructure, reducing health human resources, and, reducing people’s access to health care [3]

Summary

Introduction

The restructuring of the Brazilian Unified Health System to achieve the principles of universality, wholeness and equity, organized among the three spheres of public services management (federal, state and municipal), has changed the focus of individual centered health care and curative actions of treatment, to a conception centered at the families and in the communities in order to promote; protect; cure and recover health This restructuring was a result of Alma Ata Declaration: “Health for All in the Year 2000” and The First International Conference on Primary Health Care, open the discussion about the interaction between poverty and health status, aiming to decrease inequalities among people from different nations [1]. To achieve a state of complete physical, mental and social wellness, the individual or the group must be able to identify and fulfill their aspiration and their needs, and modify or adapt to the environment” [2]

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