E-mail: (Tony Elujoba) [email protected] . This philosophy was reinforced at the Alma Ata declaration of when it became obvious that the large. The Alma-Ata Declaration of emerged as a major milestone of the twentieth century in the field of public health, and it identified primary health care as the. PDF | The Alma Ata declaration on Primary Health Care (PHC) which was made in is meant to address the *Corresponding Author: [email protected] com Ata declaration of is a grass-root approach The main anti- corruption interventions and strategies evidenced to date include: 1) incentives for health.
However, this is not unquestioned.
Health Sector Reform is criticised as being driven by economic and political ideology. As Whitehead et al point out, "The actual outcomes of previous and current market-oriented reforms have often been contrary to stated objectives, as economic access for poor people has declined and total costs have increased". Advocates of PHC are drawn largely from non-government organisations, academics and community groups within developing countries who argue that PHC was not given a chance to establish itself as a viable system or methodology.
A reasonable criticism of PHC is that it did not establish whether it was actually bringing about a quantifiable change in the health of populations in the early s.
Its data, analysis and evaluation systems were weak at a time when there was a demand for evidence-based demonstrations in health status. But was this sufficient reason to stifle a methodology that gave a sense of participation in and equity of access to a healthcare service over which communities had some control? Conclusion As the world reviews healthcare services beyond23 work continues on reducing health inequities for poor people.
Concern is being expressed that people living in absolute poverty still do not have access to basic services or a healthy environment. There are now calls to give "voice" to the poor so they have a greater say in how healthcare services are delivered.
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Further, as we reflect on recent world events, surely we must address the underlying causes. If those funds were expended on the provision of an equitable and comprehensive PHC system and the relief of the massive debt burden, this would be a major step in addressing the prevailing sense of frustration in resource-poor countries.
It is time to put political and economic ideology aside and determine the methodology that will yield the greatest gains and provide access to even the most basic of services for All People Beyond the Year Braveman P, Tarimo E. Social inequalities in health within countries: Soc Sci Med ; Primary health care and developing countries. Soc Sci Med ; 13A: Benyoussef A, Christian B.
Health care in developing countries. Pierce N, Hirschhorn N. Oral fluid — a simple weapon against dehydration in diarrhoea: WHO Chron ; The Mahler revolution [editorial]. Public health in Papua New Guinea.
University of Queensland, Public health in Papua New Guinea: Cambridge University Press, World Health Organization global strategy for health for all by the year The evolution of selective primary health care. Unger J, Killingsworth J.
Selective primary health care: New Internationalist ; 31 Jan: Tarimo E, Webster EG. Primary health care concepts and challenges in a changing world. World development report Oxford University Press, Primary Health Care An international meeting celebrating 20 years after Alma-Ata. Almaty, Kazakhstan, 27—28 November The World Health Report Decline of mortality in children in rural Gambia: The high level of patronage of patent medicine vendors may not be unconnected with the absence of any public or private health facility within the community.
The perennial lack of drugs in government owned health facilities and the low socioeconomic status of the study population may be added reasons for the preferential use of patent medicine vendors. Thus with meagre resources, under-five care givers can obtain treatment from nearby patent medicine vendors drugs no matter how inadequate the care may be. It is also important to underscore that most of the providers in the patent medicine stores lack any form of formal education that qualifies them to prescribe or dispense drugs.
Unfortunately, in spite of their being major sources of health care provision, especially in rural areas where they may be the only sources of health care, there has been hardly any attempt by government to build their capacity for improved qualitative care provision.
This is one area that the health sector reform agenda of the present the government of Nigeria and the national health insurance need to address in this country.
Given the comparatively low patronage of public health facilities by the residents of the study community for the treatment of their children's illnesses, this shows that their investment in the health of their children is very low.
However, the values obtained may be grossly inadequate for giving direction in informing policy decisions on how much funds government need to provide under the national health insurance scheme for the provision of the proposed package of under-five care.
This is because the amount of household out-of- pocket expenditure on health to a large extent is determined economic status. While others may explore out- of- pocket expenditure as a financing option given its merits in terms of mobilising resources, promoting efficiency, sustainability and private sector development, the pervading poverty in the land continue to pose a serious threat to its popularity especially among the poor.
This underscore the need for more pro-poor policies like the proposed under-five social health insurance programme of the National Health Insurance Scheme.
However, the success of this programme will depend on evidence-based information as well as adequate involvement of stakeholders in the conceptualisation and implementation of this programme. Health for all series, No 1.
Bioline International Official Site (site up-dated regularly)
World Bank Report Washington Hoare, G. Health Policy and Planning2 1 The build up to the crisis Contact ,No Shaw, R. Financing Health care in Sub-Saharan Africa through user fees and insurance. World Bank, Washington State of the world children. How well do Health programme reach poor.
Nigeria Primary Health care delivery System: The Challenge of Implementation. Mutual health organisations, five years experience in West Africa. Ephedrine from Ephedra sinica was discovered for asthma from the Traditional Chinese Medicine in the 20th century. The first British Pharmacopoeia of contained descriptions of crude drugs including Digitalis, Datura, Belladona and Hyoscyamus. There is therefore little or no doubt that ethnographic ethnopharmacognosy research can provide important clues leading to new drugs for the modern Pharmacies.
It is the herbal medicine among other alternative therapies available in the U. Curricula of some 80 US medical schools had included some topics in Complimentary and Alternative Medicine.
In the USA, over 1, herbal drugs approximately worth of billion US dollars were sold annually and in the United Kingdom, the annual expenditure on Complimentary and Alternative Medicine was 2. As a whole, the annual market value of herbal drug products is close to USD 43 billion which is more than the total annual budget of many Africa countries Enwonwu, Therefore, the most workable health agenda for Nigeria is the institutionalization of traditional medicine in parallel not in complete fusion with orthodox medicine, within the national health scheme in order to move the health agenda forward.
Effective health agenda for Nigeria can never be achieved by orthodox medicine alone unless it is complemented by traditional medicine practice. Relevance of the World Health Organisation W.
O The World Health Organization, has for several decades, supported, promoted and assisted the development of traditional medicine in the bid to move the African health agenda forward, particularly for the less-developed countries of the world. This philosophy was reinforced at the Alma Ata declaration of when it became obvious that the large majority of the developing countries of the world were unable to provide health care to the populations using the imported orthodox health facilities.
Since then, the W. O, utilizing several expert committees' policy decisions and resolutions, etc. The Regional Office in Brazzaville, responsible for the specific needs of the African Region in this regard has since carried out several activities toward the promotion of traditional medicine. The current trend in the recognition and development of Herbal Medicine in Africa by various international organizations calls for positive response from all the medical and pharmaceutical research scientists of African origin.
Firstly, the African Heads of States have since declared the next ten 10 years as a period for Traditional Medicine development in Africa and this has been tagged as the "Decade of Traditional Medicine in Africa". Hence the 31st of August every year is to be observed and celebrated as the African Traditional Medicine Day in all the countries of the Continent. This is a very important event which should be accorded due recognition, support and commemoration by all the stakeholders engaged in the development of African Traditional Medicine.
The theme befits the occasion because Africa has, over the centuries, moved the health agenda forward with traditional medicine in that it has been with us before the advent of conventional medicine.
African people have used traditional medicine to combat disease affecting the health of their families since time immemorial. It was the only form of medicine used for the prevention, diagnosis and treatment of social, mental and physical illnesses. It is acceptable, accessible and affordable by the majority of African people. Even though traditional medicine was often denigrated as backward practice during the colonial era, it has continued to thrive because it is culturally accepted by the African population.
For some communities, it is the only system available because western medicine is too costly and sometimes unavailable. While the World Health Organization recognizes and respects traditional medicine, it also has a responsibility to ensure that quality, safe, effective and affordable traditional medicines are produced in Africa for Africans and the world. Because of this, WHO has developed various guidelines for the development and delivery of quality traditional medicine services.
Traditional Medicine reduces poverty by increasing the economic well-being of communities and developes health systems by increasing the health coverage to the people. The major challenge is that scientifically-based evidence on Traditional Medicine, quality standards and regulations are not being developed at the same pace as the demands for the medicines.
Institutionalizing African Traditional Medicine in health systems is a key pillar in the promotion and development of Traditional Medicine in this 21st century.
O has developed model tools for institutionalizing African Traditional Medicine in health systems. The models are available to those who need them and may be adopted or adapted for local situations.
Government can undertake the following actions in order to move the health agenda forward with Traditional Medicine, namely: Develop policy, legal and regulatory frameworks for the practice of traditional medicine within the framework of national health policies and health legislation; b.
Promote and conduct relevant scientific research on medicinal plants in collaboration with traditional health practitioners to validate claims made on safety, efficacy and quality of traditional medicines. Ensure that intellectual property rights are priority items on the agenda of Member States to protect indigenous knowledge about Traditional Medicine; d.
Establish an enabling economic, regulatory and political environments for local production of traditional medicines as well as develop industries that can produce standardized remedies to increase access; e.
Register traditional medicines, if need be, by using the W. O African Region; f. Disseminate appropriate information to the general public to empower them with knowledge and skills for the proper use of traditional medicines; g. Build human and material resource capacity in order to carry out and accomplish institutionalization strategies.
What is the current status of the integration of traditional medicine in national health systems of countries in the African Region? Some of the key actions that are recommended to Member States for integration of TM in health systems and services include the following: This is already there as the African Summit of Heads of States and Governments have made various declarations including research on traditional medicines used for the treatment of priority diseases to be made a priority and the period as the Decade of African Traditional Medicine.
Formulation of policy, regulatory and legal frameworks: Some countries have formulated national policies, legal frameworks and regulations including mechanisms for registration of traditional medicinal products, established national expert committees, national programmes and national offices and developed training programmes for various cadres of health workers.
WHO is supporting this process in Member States through the provision of guidance in these policy issues. Conducting research on traditional medicines: WHO has developed guidelines on research methodologies and is supporting countries in this process. Collaboration and partnership arrangements: Countries such as Burkina Faso, Madagascar, Mali and Tanzania have made partnership arrangements with traditional health practitioners and the private sector as equal partners because trust among collaborators is crucial, and this holds the key to the success of integrating TM, WHO has developed memorandum of under- standing between biomedical researchers and traditional health practitioners which countries can adapt to their local situations.
How should this integration be carried out? Integration or harmonization of African Traditional Medicine does not have to be in the fashion of the Chinese, Koreans or Vietnamese. Member States need to find and develop systems of harmony between traditional and modern systems of health care in the African context, with the minimum threat to each other.
Member States working jointly with all stakeholders have to develop systems that will ensure economic survival and social acceptance of both systems of health care coverage to the majority of the population. II Research focus on African Plants Basic information as a lead to scientific probing of medicinal plants in Africa has been obtained from herbalists or traditional medical practitioners, native herb sellers and the local, indigenous people Baba, et al.
By the early nineties, screening work on African medicinal plants has advanced with publications arising from the following research areas: Phytolacca dodecandra, Tetrapleura tetraptera Table 1 and Swartzia madagascariensis had become an international research interest for the control of schistosomiasis Adewunmi, Gedunin and nimbolide, two of the several limonoids in Azadirachta indica were pruned down as the antimalarial constituents Khalid and Deddeck, The root of Cryptolepis sanguinolenta, used for treating urinary infections in Traditional Medicine is strongly antimicrobial with cryptolepine as the active principle.
The common chewing sticks used by the Africans in various communities for traditional dental care have been reported to possess actions against oral microbial flora and to contain various minerals which can hinder plaque formation in Dentistry Sofowora, b. The most outstanding of the chewing sticks, Zanthoxylum zanthoxyloides Lam. Rutaceaealso an antisickling and anticancer plant, was found to contain alkaloids: The antiviral component has been pinned down to Michelamine B.
III Local Drug Formulation and Production From African Plants The need has since been expressed for industrial drug production from medicinal and aromatic plants in Africa in order to increase the economic and health potentials as well as the social benefits from our natural resources. Ammi visnaga, Glycyrrhiza glabra, Aloe vera etc.My city Alma - Ata
Rwanda and Zimbabwe also produce pharmaceuticals from plants'essential oils.