Health for All — First Principles to Action

The International Conference on Primary Health Care was held in Almaty, Kazakhstan in 1978. Nearly all of the members of the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) were in attendance. The conference culminated in the issuing of the Almaty Declaration — a major landmark in the field of public health.

The Almaty Declaration identified primary health care (PHC) as the key to achieving Health for All (HFA). Through this document, the Conference reaffirmed health as a fundamental human right and that the attainment of the highest possible level of health is a world-wide social goal whose realization requires action by various economic and social sectors. Importantly, the Almaty Declaration stated that the people have a right and a duty to participate individually and collectively in the planning and implementation of health care.1

At the 20th anniversary meeting of the Conference in Almaty, Dr. Halfdan Mahler, Director General Emeritus of the WHO, emphasized the importance of the participation of the community:

Health is not a commodity that is given. It must be generated from within. Health action should not be imposed from the outside, foreign to the people; it must be a response of the communities to problems they perceive, supported by an adequate infrastructure. This is the essence of the filtering inwards process of primary health care.2

Three years after the Almaty Declaration, many countries began to create health models aimed at realizing the overarching objective of Health for All. However, they encountered many obstacles and challenges, notably:

  • Insufficient awareness of the relationship between the health situation and comprehensive development

  • Weakness at the administrative level in implementing and applying strategies to achieve HFA

These problems stemmed from three sources:

  1. The lack of human and material resources

  2. The lack of community participation

  3. The lack of cooperation and coordination between different sectors

Both because and in spite of these problems, over the years numerous programs have been established throughout the world which aim at improving the quality of life through community-based initiatives. There are four basic types of such programs:

healthy villages

  1. healthy cities

  2. basic development needs

  3. women empowerment in health and development

Whatever the differences between them, these types of programs have several common characteristics. First and foremost is that they are based on a commitment to health. Second, they are intended to generate intersectoral action. Third, they aim to stimulate political decision-making to support Health for All. And fourth, they emphasize community.

The Healthy Villages Program in Jordan

Origins and Objectives

With the technical and financial support of the WHO, the Ministry of Health introduced the Healthy Villages program to Jordan in 1996. Initially, the program was applied in two villages. Two years later, it was expanded to 12 villages all over the Kingdom. By the end of 2010, the number of Healthy Villages had grown to 56.

The Healthy Villages Program in Jordan is a joint effort between the Ministry of Health in collaboration with international organizations such as WHO and UNICEF. The program aims at developing local communities in disadvantaged areas of the Kingdom. It also aims at improving the quality of life on all levels. The program depends heavily on the participation of members of the community and their involvement in the development process, starting with determining their needs to implementing and then evaluating its results in order to reach comprehensive, sustainable development.

The Healthy Villages Program in Jordan has two main objectives: 1) to support the state’s efforts in developing rural areas and 2) to consolidate the principle of self-reliance for both men and women. Read more specifically, the program aims to:

  • Strengthen primary health care in rural areas

  • Raise people’s health awareness

  • Establish a data center in each village relating to health, population, development, and service issues

  • Establish a community-based school

  • Making available income-generating loans to families with the aim of improving their financial, social, and health status

Activities and Achievements

Since its inception, the Healthy Villages Program has had many notable accomplishments, including:

  1. Inclusion in the program of 50 villages representing all governorates of the Kingdom.

  2. Implementation of field surveys that investigate the basic development needs of the families out priorities.

  3. Establishment of educational centers for children, which provide games, computers, equipment, and supplies for cultural centers in villages.

  4. Providing communities with materials and equipment such as computers and office furniture for information centers; Food, bags and containers for waste, and stationery for a community school.

  5. Building the capacity of community leaders and women for the success of the overall development process by holding training workshops of various kinds:

    1. Concepts related to communication skills, development, planning, project implementation, negotiation, and problem-solving and decision-making. To date, these workshops have benefitted 1,634 trainees, 40% of whom are women.

    2. Small business administration workshops have benefitted 359 trainees, with women constituting 55% of trainees.

    3. Female empowerment workshops have reached 214 trainees.

    4. Community schools workshops have trained 353 people, 85% of whom are women.

  6. Contributing to the reduction of problems of poverty and unemployment through the following:

    1. In accordance with the agreement signed between the Ministry of Health and the Ministry of Agriculture on 11/4/2002, small income-generating loans were offered to 371 poor families (with women constituting 51% of the beneficiaries). The loans totalled 404,827 Jordanian dinars.

    2. Vocational and craftsmanship training courses for youth and unemployed were held in order to provide them with work opportunities. As of the end of 2010, 1,250 people had benefited from these courses, with women constituting 95% of the beneficiaries.

  7. Zain mobile clinic dispatched every three months.

  8. Youth empowerment activities in the areas of politics and the economy, in collaboration with the Center for Leadership Development / Higher Council for Youth.

  9. Implementation of supervisory visits and field assessments every three months for the villages.

 

 

Project Activities

 

Value of Loans

 

Percentages of Loans

 

Value of Borrowers

 

Percentages of Borrowers

 

Male

 

Female

 

Male

 

Female

 

Animal

Production

Sheep rearing

 

262,775

 

64%

 

135,405

 

12,737

 

32%

 

32%

 

Cows rearing

 

15,270

 

4%

 

5,750

 

9,520

 

1%

 

3%

 

Rabbits

 

8,340

 

2%

 

5,340

 

3,000

 

1%

 

1%

 

Bees

 

23,400

 

5%

 

16,650

 

6,750

 

4%

 

2%

 

Chicken

 

19,000

 

4%

 

10,750

 

8,250

 

2%

 

2%

 

Total

 

328,785

 

80%

 

173,895

 

154,890

 

40%

 

40%

 

Plant

Production

Reclamation project and trees planting

 

6,250

 

1%

 

4,750

 

1,500

 

1%

 

0%

 

Drip irrigation system

 

4,000

 

1%

 

1,500

 

2,500

 

0%

 

1%

 

Medical and herbal plants

 

9,500

 

2%

 

1,500

 

8,000

 

0%

 

2%

 

Seedling planting

 

3,750

 

1%

 

3,000

 

750

 

0%

 

0%

 

Winter crops planting

 

3,750

 

1%

 

2,250

 

1,500

 

1%

 

1%

 

Fertilizers

 

3,000

 

1%

 

3,000

 

0

 

1%

 

0%

 

Total

 

30,250

 

7%

 

16,000

 

14,250

 

3%

 

4%

 

Food

Production

Dairy products

 

15,250

 

3%

 

6,000

 

9,250

 

1%

 

2%

 

Manufacturing and processing of vegetable products

 

3,000

 

1%

 

0

 

3,000

 

0%

 

1%

 

Total

 

18,250

 

4%

 

6,000

 

12,250

 

1%

 

2%

 

Rural

Development

Grocers

 

23,862.500

 

7%

 

16,750

 

7,112.5

 

5%

 

2%

 

Grocer of vegetable and fruit

 

1,500

 

0%

 

1,500

 

0

 

0%

 

0%

 

Sewing

 

2,100

 

3%

 

0

 

2,100

 

0%

 

3%

 

Shakers

 

80.000

 

1%

 

0

 

80

 

0%

 

1%

 

Total

 

27,542.500

 

10%

 

18,250

 

9,292.5

 

5%

 

5%

 

 

Grand Total

 

40,4827.500

 

100%

 

21,4145

 

190,682.5

 

49%

 

51%

 

 

1. Declaration of Alma-Ata, International Conference on Primary Health Care, Alma-Ata, USSR (September 6–12, 1978), http://.

 

2. Quoted in Jill Marsden, “Turning Point: Collaborating for a New Century in Public Health” (December 1998), p. 2, http://.