Unger J P, Killingsworth J R
Soc Sci Med. 1986;22(10):1001-13. doi: 10.1016/0277-9536(86)90200-5.
In the aftermath of the Alma Ata conference, three types of Primary Health Care (PHC), have been identified. Comprehensive PHC (CPHC) and Basic PHC (BPHC) both have a wide scope of activities, BPHC however does not include water and sanitation activities. Only one year after the Alma Ata conference, CPHC was attacked as not 'feasible' and selective PHC (SPHC) was offered as an interim alternative. SPHC only addresses 5 to 8 diseases, almost all of them falling within the realm of pediatrics. Our article critically analyses the methods and results of SPHC. It contrasts the lack of supportive data for SPHC and its methodological deficiencies with the extent of its adoption by bilateral cooperation agencies, foundations, academic and research institutions, and international agencies. We suggest that rather than health factors, the major determinants of this adoption have been political and economical constraints acting upon decision makers exposed to a similar training in public health.
在阿拉木图会议之后，人们确定了三种类型的初级卫生保健（PHC）。综合初级卫生保健（CPHC）和基本初级卫生保健（BPHC）都有广泛的活动范围，但BPHC不包括水和环境卫生活动。在阿拉木图会议召开仅一年后，CPHC就被指责为“不可行”，选择性初级卫生保健（SPHC）作为临时替代方案被提出。SPHC仅针对5至8种疾病，几乎所有这些疾病都属于儿科学领域。我们的文章对SPHC的方法和结果进行了批判性分析。它将SPHC缺乏支持性数据及其方法学缺陷与双边合作机构、基金会、学术和研究机构以及国际机构对其采用的程度进行了对比。我们认为，促成这种采用的主要决定因素并非健康因素，而是作用于接受过类似公共卫生培训的决策者的政治和经济限制。
