Health sector challenges and responses beyond the Alma-Ata Declaration: a Caribbean perspective

Mullings, Jasneth; Paul, Tomlin J.
February 2007
Revista Panamericana de Salud Publica;Feb/Mar2007, Vol. 21 Issue 2/3, p155
Like the rest of the world, the Caribbean has been witness to the drastic increase of nutritional diseases and transmissible and non-transmissible chronic diseases. Nevertheless, in the Caribbean this change has coincided with a new dynamic, created by the emergency of transmissible disease, like the HIV and AIDS infection, together with health problems related to older age, cardiovascular disease, and violence and injuries, among others. In the article, a revision of the history of health care in the Caribbean is included, and the challenges and focuses of the health care sector, as well as the new direction of attention to primary health care, are explored. The observations presented are based on work with the public. In the Caribbean, the Declaration of Alma-Ata serves as an important change of direction, and offers orientation, support, and a way to measure how countries shape their health care services to meet their needs. Creativity and inventiveness arise as distinct characteristics of the Caribbean focus on the restoration of primary health care, in the presence of the economic, social, human resource, political and cultural challenges that confront it. The strengthening of institutional capacity, the extension of social programs, national health insurance plans, health promotion programs, and the expansion of the supporting investigation of the development of policy, continue to make apparent the efforts of the Caribbean to respond to these crucial epidemiologic challenges. In spite of these challenges, alliances inside and outside of the Caribbean have been established. Furthermore, the Caribbean Charter for Health Promotion has served as a critical element for the development of primary health care.


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