Scientific Letter

Calling non-governmental organisations to strengthen primary health care: Lessons following Alma-Ata

Megan Landes, Colin Pfaff, Meseret Zerihun, Dawit Wondimagegn, Sumeet Sodhi, Katherine Rouleau, Michael R. Kidd
African Journal of Primary Health Care & Family Medicine | Vol 11, No 1 | a1945 | DOI: https://doi.org/10.4102/phcfm.v11i1.1945 | © 2019 Megan Landes, Colin Pfaff, Meseret Zerihun, Dawit Wondimagegn, Sumeet Sodhi, Katherine Rouleau, Michael R. Kidd | This work is licensed under CC Attribution 4.0
Submitted: 17 September 2018 | Published: 30 April 2019

About the author(s)

Megan Landes, Dignitas International, Zomba, Malawi; and, Department of Family and Community Medicine, University of Toronto, Toronto, Canada
Colin Pfaff, Dignitas International, Zomba, Malawi; and, Department of Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
Meseret Zerihun, Department of Family Medicine, Addis Ababa University, Addis Ababa, Ethiopia
Dawit Wondimagegn, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
Sumeet Sodhi, Dignitas International, Zomba, Malawi; and, Department of Family and Community Medicine, University of Toronto, Toronto, Canada
Katherine Rouleau, Department of Family and Community Medicine, University of Toronto, Toronto, Canada
Michael R. Kidd, Department of Family and Community Medicine, University of Toronto, Toronto, Canada; and, Southgate Institute for Health, Society and Equity, Flinders University, Adelaide, Australia; and, Murdoch Children’s Research Institute, Melbourne, Australia


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Abstract

Background: The Alma-Ata Declaration’s commitment to primary health care (PHC) reaches its 40th anniversary in 2018. Over the last 40 years, the number of non-governmental organisations (NGOs) working in low-income countries (LICs) has rapidly multiplied, and over time, NGOs have both positively and negatively impacted equity, effectiveness, appropriateness and efficiency of PHC systems in LICs.

Aim: The authors aim to demonstrate that at the 40th anniversary of the Alma-Ata Declaration’s commitment to PHC, NGOs are particularly poised to strengthen PHC in LICs.

Methods: In this letter, the authors reflect on how NGOs have both positively and negatively impacted equity, effectiveness, appropriateness and efficiency of PHC systems based on their experience working with NGOs in LICs.

Results: NGOs are poised to strengthen PHC in LICs in four distinct ways: assisting with local human resources development, strengthening local information systems, enabling community-based health services and testing innovative service delivery projects.

Conclusions: The authors call for NGOs to commit their expertise and resources to long-term strengthening of PHC in LICs and to critically examine the factors that prevent or assist them in this goal. As the principles of Alma-Ata are renewed, NGOs should be responsibly engaged in strengthening the declaration’s goal of ‘health for all’.


Keywords

global health; family medicine; primary care; primary health care; non-governmental organisations; Alma-Ata

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