Roemer M I
Health Policy Plan. 1986 Mar;1(1):58-66. doi: 10.1093/heapol/1.1.58.
National health policies of many countries stress priority for primary health care (PHC). This emphasis has arisen as a reaction to large expenditures on hospitals and sophisticated technology in major cities of developing countries, while vast rural populations have been virtually ignored. The paradox developed from colonial and neo-colonial emulation of European and North American medical models. In 1978, an international conference of WHO/UNICEF at Alma-Ata, USSR defined the meaning of PHC, along with several principles of organization and equity under which it should be provided. To reach rural people with PHC, thousands of community health workers have been prepared and stationed in villages. Their training, however, is very brief and, with weak supervision, their performance has been disappointing. To achieve the WHO goal of "Health for All" through PHC requires greatly expanded education of public health leaders, who can supervise and inspire community personnel.
许多国家的国家卫生政策强调初级卫生保健（PHC）的优先地位。这种强调的出现是对发展中国家大城市医院和先进技术的巨额支出的一种反应，而广大农村人口实际上被忽视了。这种矛盾源于对欧洲和北美医疗模式的殖民和新殖民模仿。1978年，世界卫生组织/联合国儿童基金会在苏联阿拉木图召开的一次国际会议界定了初级卫生保健的含义，以及提供初级卫生保健应遵循的若干组织和公平原则。为了让农村人口获得初级卫生保健，数千名社区卫生工作者已被培训并派驻到村庄。然而，他们的培训非常简短，而且由于监督不力，他们的表现令人失望。要通过初级卫生保健实现世界卫生组织“人人享有健康”的目标，需要大幅扩大对公共卫生领导者的教育，这些领导者能够监督和激励社区工作人员。
