Fulfilling the Alma Ata Summit Primary Health Care

Primary health care is a policy that was born at the Alma Ata Health Summit in 1978, in the same town in the former Soviet Union. It is the conclusion that was adopted to fulfill its slogan: "Health for All in the Year 2000".

In the past, the measurement for health services was limited to the care of diseases (sick people). Alma Ata indicated to the world that health services were also, as a priority, to give health to the world population. It was to give health to individuals and families so that we would have the capacity to care for the sick (the personnel, the buildings, the apparatus, the medicines and medical-surgical material) and to make the budgets work.

Alma Ata also indicated that primary care teams, health personnel who go to each home, should be made to attend to each family and each person with total population coverage.

The measure had to be defined; it would be one person from each health care profession for every five thousand inhabitants. In our country, the Bolivarian Republic of Venezuela, the average number of people per family is five, therefore (five thousand out of five) one primary care team for every thousand families. However, in Venezuela the base is one team. A primary care team was defined for 250 families, with an average coverage of 1,250 people.

Faced with this request for the formation of primary care teams, we had to adapt with the necessary personnel of the order of this Summit of Alma Ata: the staff that attends to patients in each country was insufficient.

State planning should be done based on the number of families in each country. In Venezuela, with thirty million people, some six million families, some twenty-four thousand primary care centers, public health must be adapted to the same number of primary care teams.

In our country, primary health care is provided from each of the Regional Directorates of the Outpatient Network and from Barrio Adentro, which is the second one created in this century to have specialized primary health care functions.

In each one of these institutions, the patient is attended in the premises of each clinic, Integral Diagnostic Center, Popular Consultations, called specialized function. The second is the attention in the community, in each home, called communal function.

There must be a primary care team consisting of a medical professional, a nurse, your nurse's aide, a dental professional, your dental aide, a nutrition and dietetic professional and your nutrition aide, a social work professional, a health advocate .

One primary care team for each primary care center (250 families for each team).

If we do an exercise with Venezuela

If we have thirty million inhabitants, an average of five people per family, we have six million families.

For Venezuela then, if each primary care nucleus is made up of two hundred and fifty families, we have to make up twenty-four thousand primary care nuclei (we divide the number of families by 250).

Consequently, we need twenty-four thousand doctors, nurses, dentists, social workers, the last three with their twenty-four thousand assistants and twenty-four thousand health defenders to cover primary health care in Venezuela.

For the particular case of our entity, the state of Zulia, which has four million inhabitants, we divided four million by five (average number of people per family) and it results in eight hundred thousand families. We divide eight hundred thousand by two hundred and fifty families and it ensures the development of three thousand two hundred primary care centers. In this western state, at least five hundred postgraduate doctors of General Integral Medicine (MGI) were prepared. This postgraduate degree provides training in the development of the work of providing health to the people and fighting diseases in the community. There is a deficit of about 2,700 medical professionals for primary health care. The Regional Directorate of the Outpatient Network of the Regional Health System provides about five hundred medical professionals for community work.

The Barrio Adentro system must provide one thousand seven hundred medical professionals to give full coverage of primary health care from its extensive network, with its Consultorios Populares and Centros de Diagnóstico Integral (CDI's).

The national strategy of each country of higher education in the Health Sciences (Medicine, Nursing, Nutrition and Dietetics, Dentistry) is clear: the subject of primary health care must be included in the training, with training in the precepts of Alma Ata, to give health to the people and attend to their diseases, starting from their natural space, their home and their community. In addition to taking into account the reference unit for the administration of health-disease, the family, as the basis of society and health.

Thus, general or community physicians should be trained to work in the community as a basic job and to continue training specialists in the area of General Comprehensive Medicine. In September of this year it was forty-two years since the Alma Ata Summit and the same time of not complying with its precepts. In Venezuela, the work to provide total coverage and "health for all" proclaimed by the World Health Summit began.