Reinventing primary health care: the need for systems integration
Julio Frenk, Harvard
The Lancet, Volume 374, Issue 9684, Pages 170 - 173, 11 July 2009
Available online at:
“……..The world has come a long way since the Alma Ata Declaration 30 years ago. However, achievements have fallen short of expectations. This is therefore the time to launch a renewed effort to strengthen health systems as the fundamental strategy for integrating primary health care.
“…………..In particular, the developments in telecommunications such as mobile phones are mobilising cutting-edge innovations that are now available even in the poorest communities. Appropriate technology should no longer be identified with primitive methods. Nowadays a patient can be diagnosed and treated in the first level of care in a rural community by a provider working in a high-specialty urban hospital.
Therefore, we should be able to launch a fundamental shift from the rigid pyramidal structures that have prevailed in the health sector to adaptable networks that improve access to all levels of care. A related transformation means moving beyond health centres, which by definition concentrate human and technological resources, into health spaces, which extend the reach of comprehensive care into schools, workplaces, recreational areas, and the homes of those who live with a chronic condition.
The present interest by major global health actors in strengthening health systems offers a unique opportunity. We have to take advantage of this opportunity to reinvent primary health care for the 21st century. We should leave behind the ideological debates of the past and focus instead on developing primary care networks that are seamlessly integrated into the rest of the health system.
The vision is thus to assure that high-quality services are provided on the basis of a defined population, through proactive strategies, favouring continuity of care, guaranteeing an explicit set of entitlements, and assuring universal social protection in health. Therein may lie the key to finally unlocking the full potential of
* * *
This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues. [DD/ KMC Area]
“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
Equity List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html
IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please notify us immediately by email to firstname.lastname@example.org, and please dispose of and delete this transmission. Thank you.