By Isaac Ato MENSAH
Accra- 29 October, 2018.
From 25-26 October, Astana 2018, the World Health Organisation (WHO) conference on primary health care (PHC) was held successfully in Kazakhstan.
Forty years ago in 1978, the WHO met in Kazakhstan in a first ever conference on primary health care.
‘Although the world is a healthier place for children today than ever before, close to six million children die every year before their fifth birthday mostly from preventable causes, and more than 150 million are stunted,’ said Dr Henrietta Fore, UNICEF executive director. ‘We as a global community can change that, by bringing quality health services close to those who need them.’
From Alma-Ata, Ghanaian students and health workers began to focus on PHC.
And the Ghanaian media popularized the catchphrase, “Health for All by the Year 2000″, which was used to galvanise the public into action.
Of course “Health for All by the Year 2000” failed……and Jerry Rawlings was then appointed UN ambassador for malaria!
Forty years on, in Astana, Kazakhstan, there seems to be a new conceptualisation, nay, a new focus on PHC.
The UNICEF press release issued on the opening day said, ‘Health resources have been overwhelmingly focused on single disease interventions rather than strong, comprehensive health systems – a gap highlighted by several health emergencies in recent years.
It has since been replaced by the Millennium Development Goals (MDGs) and now by the Sustainable Development Goals (SDGs).
But most importantly, we have to remember that whatever we have put in place over the past 40 years in the area of PHC are only INTERVENTIONS; they are not the standard.
Today, our focus is on the Community Based Health Planning and Services (CHPS) compounds and the Insecticide Treated Bed Nets aka Impregnated Mosquito Nets.
We have to remind politicians that the CHPS compound is only a LIMITED health INTERVENTION.
As the back cover of the book Community Nursing in Developing Countries- A Manual for the Community Nurse says, ‘The vicious cycle of poverty, ignorance and disease must be attacked from many sides by the establishment of [AN] effective health service’.
So, the young CHPS compounds must become part of an efficient and effective health service.
It’s unfortunate that that this year Ghana’s Ministry of Health (MoH) and its “media partners” did not emphasise Astana 2018 and the importance of PHC.
PHC is for us- the poor developing countries with poor sanitation.
Forty years after the Alma-Ata Declaration, what is our score on maternal mortality, infant mortality and Under-5 mortality?
And what today is happening to our “BABY FRIENDLY HOSPITAL INITIATIVE (BFHI)” implemented in Ghana since 1995?
By early 2013, the Ghana Health Service (GHS) had admitted that “The BFHI, which had become virtually dormant over the past few years has been revived in the face of evolving challenges especially with regards to the reduction of the exclusive breastfeeding rate from 63 percent in 2003 to 46 percent in 2011, as revealed by the 2011 Multiple Indicator Cluster survey.”
Have we forgotten the joyous media and community occasions and the fanfare which greeted a hospital or clinic being declared a 24-HOUR BABY FRIENDLY FACILITY?
It was a joy for PHC nurses to bring community folk to rehearse a drama which was often mimed on such occasions for everyone to understand.
If Alma-Ata is our alma mater, then let us save our mothers, wives and sisters from needless maternal deaths, and our children from the five killer diseases.
Twenty years ago, a sachet of water was supposed to be an INTERVENTION from water tied in a plastic bag which was itself also an INTERVENTION for ice water served in cups by the streets.
Back then we drank safe tap water in our homes and schools and only used the sachet as an INTERVENTION when we got to town.
Today, we’re exporting bags of sachet water across the Aflao border!
Yes, hand washing campaigns in our basic schools, but there is no running water.
So many years ago, a nurse IMPROVISED the VERONICA BUCKET as an INTERVENTION, but today in hospitals in Accra, government buildings and in almost all basic schools, we have displayed the Veronica bucket prominently as a standard!
‘If these things happen when the tree is green, what will happen when it is dry?’ (Luke 23:31).
Astana 2018 has given us four main PHC INTERVENTIONS chief among which is, ‘ Make bold political choices for health across all sectors’.
Indeed, ‘Underdevelopment has many manifestations,’ my mentor will say as often as he can.
Doesn’t it reflect in the quality of education, health system, water supply, sanitation, architecture and food supply?
Changes with significant improvements can only occur if we make the proper political choices across all sectors.
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