Strategies of Primary Health Care and Health Promotion for Strengthening Health Systems

The Basic structures of current health system in many low and middle income countries were established based on a global strategy of Primary Health Care (PHC) that was declared at Alma-Ata in 1978. However, it had been degenerated during 1980s and 90s partly due to economic recession and severe debt crisis, as well as the structural adjustment policy that claimed to reduce public budget for health. Additionally, the HIV/AIDS and tuberculosis pandemic and health professional drainage accelerated under economic and traffic globalization resulted in heavy load on the health systems. Hence, global health society has been challenging to health system strengthening (HSS) during the past two decades.

The World Health Assembly in 2001 made the resolution which reaffirms that WHO made a commitment to the objectives of the health for all strategy in particular the achievement of equitable, affordable, accessible and sustainable health system in all member states. It indicates that the development of the health system needs to be driven by the principles of PHC in order to progress towards the goal of improving population health.

On the other hand, WHO elaborated the new public health strategy, Health Promotion (HP), which enables people to increase control over their health and a wide range of determinants of health and thereby improve their health. Since the year 1986 of the declaration of this strategy, many efforts have been dedicated to individual behavioral changes and healthy community development through intersectoral and multisectoral collaborations beyond health sector. WHO noticed that health system can be instrumental in involving other sectors as partners in HP and has thus attempted to develop the global framework of HP including its relevance to the component of HSS.   

In that ways, recently, PHC is an integral wisdom to achieve HSS, meanwhile HP plays a crucial role for HSS.