September 12, 2008

“Community participation in health care can be key to saving the lives of mothers, newborn babies and children under the age of five,” said Dr Zulfiqar Bhutta, Professor and Chair, Department of Paediatrics and Child Health, Aga Khan University, at an international symposium to commemorate the 30th anniversary of the signing of the Alma-Ata Declaration. “Gains can be achieved by pragmatic primary health care strategies in Pakistan, even with limited resources.” The symposium is being held at the London School of Hygiene & Tropical Medicine, supported by the UK Department for International Development and The Lancet.

A case study of Pakistan shows that interventions in primary health care settings have the potential to prevent 20 to 30 per cent of all maternal, newborn and child deaths. “We should encourage community participation while making primary health care policies. Communities can be used to help complement the government’s health care programmes and help increase sustainability. We already have these resources; we just need to make them more effective in order to be able to achieve our targets for the Millennium Development Goals (MDGs) for reducing maternal and child mortality in Pakistan.”

Dr Bhutta and his colleagues reviewed 37 key promotional, preventive and treatment interventions for maternal, newborn and child health interventions to identify what might work best in developing countries. They found that community health workers have a key role to play in delivering interventions such as immunisation and skilled birth attendance to those who need them most, and in linking households to basic health units and the health system.

The research was part of an eight-paper Series in the Alma-Ata Special Issue of the British medical journal, The Lancet. Aga Khan University, in partnership with the London School of Tropical Medicine & Hygiene, played a lead role in the research and development of the Series funded by the Partnership for Maternal, Newborn, and Child Health, the Norwegian Agency for Development Cooperation and Aga Khan University.

In other papers in the Series, the authors analysed progress across many countries by using average annual reduction in child mortality (under five years) between 1990 and 2006. Several countries such as Thailand, Nepal, Laos, Bangladesh and Guatemala – some of the world’s poorest – have made progress on child mortality starting with highly effective, selective strategies such as using community health workers to treat children at home with pneumonia and achieving high coverage with immunisation. Others such as Cuba have achieved targets with universal primary care.

The Lancet Alma-Ata Working Group calls for action: “The principles agreed at Alma-Ata 30 years ago apply just as much now as they did then. ‘Health for All’ by the year 2000 was not achieved, and the MDGs for 2015 will not be met in most low-income countries without substantial acceleration of primary health care.” Primary health care infrastructure and systems need to be revitalised and interventions across the continuum of maternal, newborn and child care introduced.

For more information, contact Syed Hassaan Akhter, Media Executive, Department of Public Affairs, Aga Khan University, Stadium Road, Karachi, on +92-21 486-2927 or hassaan.akhter@aku.edu.

Notes:

Aga Khan University
AKU was chartered in 1983 as Pakistan's first private university. Its objective is to promote human welfare in general, and the welfare of the people of Pakistan in particular, by disseminating knowledge and providing instruction, training, research and service in the health sciences, education and such other branches of learning as the University may determine. AKU also has programmes in Kenya, Tanzania, Uganda, the United Kingdom, Afghanistan, Syria and Egypt.

Alma Ata

The International Conference on Primary Health Care was convened in Alma-Ata (now Almaty), in what is now Kazakhstan, in 1978, and was attended by virtually all member states of WHO and UNICEF. The Alma-Ata Declaration “to protect and promote health of all people of the world” was a landmark event in the field of public health and it identified primary health care as the key to attainment of the goal of Health for All. To mark the 30th anniversary of the conference, the British medical journal, The Lancet, released a Special Issue – Alma-Ata 30 years on: “Health for all need not be a dream buried in the past.”

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