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Harrison's Principles of Internal Medicine, 18e
| Part 1. Introduction to Clinical Medicine > |
Chapter e1. Primary Care in Low- and Middle-Income Countries
Sections: Primary Care in Low- and Middle-Income Countries: Introduction, Primary Care and Primary Health Care, Health Challenges in Low- and Middle-Income Countries, Primary Health Care in the Twenty-First Century, Conclusion, Further Readings.
Topics Discussed: developing countries; primary health care.
Excerpt:"The twentieth century witnessed the rise of an unprecedented global health divide. Industrialized or high-income countries experienced rapid improvement in standards of living, nutrition, health, and health care. Meanwhile, in low- and middle-income countries with much less favorable conditions, health and health care progressed much more slowly. The scale of this divide is reflected in the current extremes of life expectancy at birth, with Japan at the high end (82 years) and Sierra Leone at the low end (32 years). This 50-year difference reflects the daunting range of health challenges faced by low- and middle-income countries. These nations are faced not only with a complex mixture of diseases (both infectious and chronic) and illness-promoting conditions but, more fundamentally, with the fragility of the foundations underlying good health (e.g., sufficient food, water, sanitation, and education) and of the systems necessary for universal access to good-quality health care. In the last decades of the twentieth century, the need to bridge this global health divide and establish health equity was increasingly recognized. The Declaration of Alma Ata in 1978 crystallized a vision of justice in health, regardless of income, gender, ethnicity, or education, and called for "health for..."
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