Hello Neil thanks for sharing this interesting and educative piece on PHC and CHW and Alma Ata and SDGs. [ https://www.hifa.org/dgroups-rss/update-publications-and-events-related-... ]
GOBI continues to be useful but only partially so, because what happened in our environments, and I suspect in many other LMICs is that Development agencies concentrated on delivering parallel projects to the exclusion of other critical aspects of an integrated comprehensive PHC which Alma Ata was / is about, and the neglect of even the education of CHWs/CHP.
Communities in these countries suffer lack of potable water, lack of safe access to care, lack of power to preserve the vaccines, poorly trained CHWs in delivering promotive, preventive PHC, poorly skilled CHW of families and people who manage to attend the often dilapidated facilities, lack of understanding of anti microbial stewardship, etc. All of these deficiencies are compounded by poor health literacy, bad cultural and religious beliefs about how the body functions and the causes of diseases, and rampant poverty!
In many countries the easiest route to poverty and lack of care remains having one major illness of a family member, which drains all their income and savings!!
Many of us fear that that lofty UN Goals like UHC and SDG risk being unachieveable unless the member countries and development agencies refocus to a comprehensive, indicators and sectors inclusive Primary health care (PHC). Stop parallel programnes in LLMICs. Encourage Health in All policies policy (HiAPP) bringing non health sectors into health and motivate and support CHW/ CHPs.
Imagine how long HIFA has been struggling to get some major stakeholders in global health to assist with its mission on getting accurate health information to All (carers, patients, families).
HIFA profile: Joseph Ana is the Lead Senior Fellow/Medical Consultant at the Centre for Clinical Governance Research and Patient Safety in Calabar, Nigeria, established by HRI Global (former HRIWA). He is a member of the World Health Organisation's Technical Advisory Group on Integrated Care in primary, emerggency, operative, and critical care (TAG-IC2). As the Cross River State Commissioner for Health, he led the introduction of the Homegrown Quality Tool, the 12-Pillar Clinical Governance Programme, in Nigeria (2004-2008). For sustainability, he established the Department of Clinical Governance, Servicom & e-health in the Cross River State Ministry of Health, Nigeria. His main interest is in whole health sector and system strengthening in Lower, Low and Middle Income Countries (LLMICs). He has written six books on the 12-Pillar Clinical Governance programme, suitable for LLMICs, including the TOOLS for Implementation. He served as Chairman of the Nigerian Medical Association's Standing Committee on Clinical GovGovernance (2012-2022), and he won the Nigeria Medical Association's Award of Excellence on three consecutive occasions for the innnovation. He served as Chairman, Quality & Performance, of the Technical Working Group for the implementation of the Nigeria Health Act 2014. He is member, National Tertiary Health Institutions Standards Committee of the Federal Ministry of Health. He is the pioneer Secretary General/Trustee-Director of the NMF (Nigerian Medical Forum) which took the BMJ to West Africa in 1995. Joseph is a member of the HIFA Steering Group and the HIFA working group on Community Health Workers. ( http://www.hifa.org/support/members/joseph-0http://www.hifa.org/people/s...). Email: info AT hri-global.org and jneana AT yahoo.co.uk