“To respond effectively and appropriately to needs and expectations, health services need to be organized around close-to-community networks of people-centred primary care…” WHO 13th General Program of Work
The global health community first made widescale investments in community health workers (CHWs) more than 40 years ago. But last month, I left the 71st World Health Assembly wondering whether we had learned anything from CHW experiences over the last several decades.
The 1978 Declaration of Alma-Ata underscored the central role of bringing health care “as close as possible to where people live and work” as part of achieving universal primary health care. The declaration, which is being revamped for its 40th anniversary later this year, defined primary health care (PHC) as “essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination.”