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In Kazakhstan, agency leaders launch global study on health care inequities

© World Health Organization/2008
UNICEF Executive Director Ann M. Veneman (left), Minister of Health of the Republic of Kazakhstan Dr. Anatoliy Dernovoy and Director-General of the World Health Organization Dr. Margaret Chan launch ‘World Health Report 2008’ in Almaty, Kazakhstan.

By John Budd

ALMATY, Kazakhstan, 14 October 2008 – At the launch today of ‘World Health Report 2008’ on primary health care, UNICEF Executive Director Ann M. Veneman said an overarching theme of the report is the need to improve the effectiveness of health systems around the world.

“Maternal and newborn survival and health were key barometers of health-system effectiveness, and by those measures there was much to be done,” she said. 

The World Health Organization (WHO) report urges that health systems be reoriented to ensure that all people, rich and poor, have access to quality and affordable care.

Lack of access to health care

According to the report, inequities and inefficiencies lead to 100 million people being pushed into poverty each year as a result of trying to pay for health care. Millions more have no access to quality health care at all.

WHO Director-General Dr. Margaret Chan said the report makes the case for using a ‘primary health care’ approach to strengthening health systems in both developing and developed countries.

© UNICEF video
Community health worker vaccinates children against polio in a village in India.

“Never before has our world possessed such a sophisticated arsenal of tools and technologies for curing disease and prolonging life,” said Dr. Chan. “Yet each year, nearly 10 million young children and pregnant women have their lives cut short by largely preventable causes. Something is wrong.”

Veneman noted that the report comes at the halfway point for the achievement of the Millennium Development Goals – serving as a timely reminder of the need to develop health systems and achieve lasting improvements in public health.

Alma Ata Declaration anniversary

‘World Health Report 2008’ was launched here in Almaty, Kazakhstan, where 30 years ago, the concepts and values of primary health care were initiated at an international conference on this topic.

In the resulting Alma Ata Declaration, global health leaders defined primary health care as ensuring that all people – regardless of where they live, or whether they are rich or poor – have access to the services and conditions necessary for realizing the best possible health. 

WHO, UNICEF and the Government of Kazakhstan jointly hosted the 1978 conference, and this week health ministers from more than 60 countries will mark the anniversary in Almaty and discuss ways to revitalize primary health care.

© World Health Organization/2008
UNICEF Executive Director Ann M. Veneman and World Health Organization Director-General Dr. Margaret Chan with youth delegates to the conference marking the 30th anniversary of the Alma Ata Declaration on primary health care.

Both Dr. Chan and Veneman will participate in the discussions.

Concrete gains have been achieved in public health, particularly in child survival, since the last time global health leaders met here, said Veneman. But there is clearly much still to be done to ensure equitable and extensive coverage of essential health care services.

Intervention to redress imbalances

Dr. Chan said deliberate policy interventions would be required to redress imbalances in health systems.

“The ‘World Health Report’ sets out a better way to manage and deliver health care,” she said. “Primary health care is a people-centred approach to health that makes prevention as important as cure…. A primary health care approach is the most efficient, fair and cost-effective way to organize a health system…. Decades of experience tell us that primary health care produces better outcomes, at lower costs and with higher user satisfaction.”

Veneman added: “Though falling, the annual number of maternal deaths remains stubbornly intractable, above 500,000 per year. Each year, almost 4 million children die within the first 28 days of life. The rate of neonatal mortality is falling, but at a far slower rate than under-five mortality. This is resulting in newborns accounting for a higher share of under-five deaths.

“As the ‘World Health Report’ emphasizes, health systems are better equipped to respond to the needs of communities when they are embedded within them, said Veneman. Recruiting, training, retaining and incentivizing community health workers and skilled health personnel – and promoting social mobilization and behaviour change – are pivotal to accelerating progress.”




14 October 2008:
UNICEF correspondent Guy Degen reports on the launch of a World Health Organization report on primary health care.
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