Reinventing primary health care: the need for systems integration

The world has come a long way since the Alma Ata Declaration 30 years ago. However, achievements have fallen short of expectations. This is therefore the time to launch a renewed eff ort to strengthen health systems as the fundamental strategy for integrating primary health care.The origins of the idea of primary care probably date back to the Dawson Report, published in the UK in 1920. This report introduced the notion of three levels of care—primary health centres, secondary health centres, and teaching hospitals—which is still the basis of the pyramidal regionalisation of health services that prevails nowadays.

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