ArticleBMJ global health2018
Alma Ata after 40 years: Primary Health Care and Health for All-from consensus to complexity.
Article in BMJ global health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 100 papers, 7 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
100 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Insufficient evidence on the effectiveness of family physician program in Iran: a systematic review of existing literature.BMC public health · 2026Pooled it
- "It's more than just physical care": a systematic review and qualitative meta-synthesis of nurses' evolving role in providing mental health care within primary health care systems.BMC primary care · 2026Pooled it
- Performance measurement systems in primary health care: a systematic literature review.BMC health services research · 2025Pooled it
- Availability of Evidence for Predictive Machine Learning Algorithms in Primary Care: A Systematic Review.JAMA network open · 2024Pooled it
- Tools for faculty assessment of interdisciplinary competencies of healthcare students: an integrative review.Frontiers in medicine · 2023Pooled it
- Under detection of depression in primary care settings in low and middle-income countries: a systematic review and meta-analysis.Systematic reviews · 2022Pooled it
- Systematic Review of Clinical Guidelines Related to Care of Individuals With Cerebral Palsy as Part of the World Health Organization Efforts to Develop a Global Package of Interventions for Rehabilitation.Archives of physical medicine and rehabilitation · 2021Pooled it
- Australian Community Health and Primary Health Care Policies from 1970s to 2020s: A Policy Analysis of Changing Interpretations.International journal of social determinants of health and health services · 2026Article
- Strengthening Primary Health Care for Improved Population Health and Health Equity in Somalia: A Narrative Review.Public health challenges · 2026Review
- Tuberculosis Care Access Among Internally Displaced Persons in India and Nigeria: A Review of Structural Barriers and Context-Specific Interventions.Public health challenges · 2026Review
- Redesigning the model for providing primary healthcare in Iran: a grounded theory study in rural settings.Primary health care research & development · 2026Article
- Investigation of the Role of Political Participation in Health: A Scoping Review.Health science reports · 2026Review
- Changes in the Patterns of Emergency Ambulance Care During a Primary Care Model Programme in Hungary.Healthcare (Basel, Switzerland) · 2026Article
- Addressing priority gaps in access and quality of NCD services in primary care settings in Rural Kenya: a participatory approach to intervention development.BMC primary care · 2026Article
- Organisation of health services for the delivery of primary health care in the WHO African region: a future perspective.The Lancet. Primary care · 2026Review
- How to do (or not to do)… asset mapping in community health.Health policy and planning · 2026Article
- A Scoping Review of African Health Histories from the Pre-Colonial to SDG Eras: Insights for Future Health Systems.Healthcare (Basel, Switzerland) · 2026Review
- Forty Years of Primary Health Care (PHC) in Iran: Achievements, Lessons and Future Directions.Medical journal of the Islamic Republic of Iran · 2026Article
- Reclaiming the new era in global health: A proposal for an equity-centered paradigm.PLOS global public health · 2026Article
- Evolving core values in family medicine across regions: a global scoping review.BMC primary care · 2025Article
40 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Forty years ago, the 134 national government members of the WHO signed the Alma Ata Declaration. The Declaration made Primary Health Care (PHC) the official health policy of all members countries. Emerging from the conference was the consensus that health was a human right based on the principles of equity and community participation. Alma Ata broadened the perception of health beyond doctors and hospitals to social determinants and social justice. In the following years implementing this policy confronted many challenges. These included: (1) whether PHC should focus on vertical disease programmes where interventions had the most possibility of success or on comprehensive programmes that addressed social, economic and political factors that influenced health improvements; (2) whether primary care and PHC are interchangeable approaches to health improvements; (3) how equity and community participation for health improvements would be institutionalised; and (4) how financing for PHC would be possible. Experiences in implementation over the last 40 years provide evidence of how these challenges have been met and what succeeded and what had failed. Lessons from these experiences include the need to understand PHC as a process rather than a blueprint, to understand the process must consider context, culture, politics, economics and social concerns, and therefore, to recognise the process is complex. PHC needs to be examined within evaluation frameworks that address complexity. Recent developments in monitoring and evaluation have begun to respond to this need. They include realist evaluation and implementation research.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.