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Primary
health care
In 1978, only four years after the Declaration of Alma-Ata,
a team from Université Laval embarked on a
large-scale operation to promote primary healthcare in the
Islamic Federal Republic of the Comoros. This operation
lasted 14 years.
Primary healthcare has evolved considerably since, and the
CCISD has been able to contribute:
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In
Peru (Lima: Independencia district), where it helped urban
community groups with nutrition, nutritional monitoring,
vaccination and personnel training programs
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In
Benin (more specifically: Ouidah) where it helped the
Regional Center for Health and Development set up an
experimental basic healthcare pyramidal structure which
included cross‑referencing between community health
centers and the district’s hospital. This experiment had
to factor in national programs and strategies, the need
for self‑financing, as well as the population’s
decentralized decision structure.
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in the Democratic Republic of the Congo (Nsele health care
district, province of Kinshasa), where it helped the
organizational and physical rehabilitation of support
structures and health care facilities. The challenge
consisted in providing adequate support to health center
personnel in all three of the district’s health zones, in
an effort to measurably increase the access to quality
preventive and curative care, and this, in the context if
widespread poverty, and in a very large but sparsely
populated area. In addition to providing reinforcement to
national healthcare facilities, the project:
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improve
the long-term availability of essential drugs;
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contribute
to the training and supervision of healthcare personnel;
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reinforce preventive measures and health promotion;
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provide
support and supervision to community mobilization and
preventive programs.
Despite results in certain fields, such as vaccination, the
Bamako initiative for essential drug self‑financing, and
increasing generic drug use, the ideal of equity (the basis
for primary healthcare) is far from satisfactory and
accessible financing is becoming scarcer. The CCISD is
therefore taking a pragmatic approach by:
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relying on local resources, both human and material, and
respecting national strategies
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ensuring that changes have a long‑lasting effect
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ascertaining that programs consider the context of primary
healthcare. The AIDS Project is highly indicative of this
concern.
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