primary care to the health is a very important fact for the wellbeing of the community because this is based mainly on promotion and prevention of diseases, providing the populations means to improve health and increase control over it, through the intervention of the determinants of health and reducing inequality

1. PRIMARY CARE TO THE HEALTH OF A POPULATION
Essay by Josué M. Pedraza C.
INTRODUCTION
We can say that healthisphysical,mentalandsocial wellbeingandnotmerelythe absence of disease or
infirmity.
In thisfact the role of primarycare to the healthisa veryimportantfactfor the wellbeingof the
communitybecause thisisbasedmainlyonpromotionandpreventionof diseases,providingthe
populationsmeanstoimprove healthandincrease control overit,throughthe interventionof the
determinantsof healthandreducinginequality.
Thistakesplace mainlythroughthe followingfields:publicpolicyformulation,creatingsupportive
environmentsforhealth,strengtheningactionandcommunityparticipation,developmentof healthy
personal attitudesandreorientinghealthservices;fortheirFeaturesThe healthpromotionisastrong
intersectoral actionthatmakesthe social mobilizationrequiredtotransformhealthconditions.
The primarycare to the healthreferstothe kindof care providedatthe firstpointof contact withthe
healthcare system.
The primarycare to the healthwasoriginatedwiththe Declarationof AlmaAtaaimingtoachieve Health
for All bythe Year 2000. The principlessetoutin thisDeclarationare the essence of whatiscalled
comprehensive universal primarycare of the health.Thisis essentialhealthcare basedonpractical
methodsand technologies,scientificallysoundandsociallyacceptable,available toall individualsand
familiesinthe communitythroughtheirfullparticipationandata cost that the communityandcountry
can affordto maintainat everysingle stagesof developmentinaspiritof self-reliance andauto-
determination.
A yearafterthe declarationof Alma Alta,WalshandWarren(1993), raisedthe strategyof selective PHC
(PrimaryHealthCare) asan interimalternative thatwouldallow startimplementingPHC.Thisstrategy
arguedthat the bestway to improve healthwastofightadisease basedoncost-effectiveness.Thus,
these authorsidentifiedfourfactorstoguide the selectionof the diseaseswiththe aimof prevention
and treatment:prevalence,morbidity,mortality,andviabilitycontrol (includingeffectivenessandcost).
Thisnarrow selectionof the specificconditionsforthese populationswasdesignedtoimprove health
statistics,butabandonedthe approachof AlmaAta onthe social equityandhealth,basedonthis
approach the conceptof comprehensiveprimarycare iscreated,whose maincomponents are a concern
to improve the qualityof life,equityandaccesstocare as guidingprinciples(Lawnetals,2008).
For some authors,the transformative potentialfromaselective primarycare a comprehensive health
care has remainedlargelyuntapped(Magnussenetal,2004). However,there were someimportant

2. successes,especiallyinthe 1980s where PHC coverage wasincreasedandhealthstatusof the
populationwasconsiderablyimproved(Streefland&Chabot,1990).
The keysto these achievementswere relatedtothe political will tomeetbasichealthneedsof all
citizens,active participationof the populationinthe efforttoachieve thisgoal byimprovingsocial and
economicequity(Baum&Sanders,1995 ).
In September2003, after25 yearsof AlmaAta, PAHOaftermeetingfoundthatthe APSwere being
consideredinAmerica,justasaform of entryto healthservices,butnotasa developmentstrategyto
achieve betterlevelsof care.
However,althoughthe objectiveswere notbeingfullymet,progresswas checkedinhealthlevelsand
are able toestablishsome lessons,andfinallygoalsforthe future were established(Montenegro,
Girard, Duarte & Oyarzun,2007).
PRIMARY CARE TO THE HEALTH
PrimaryHealthCare (PHC) isa strategyto ensure healthforall anduniversal andequitableaccessto
medical service systemsothatitsimplementationrequirescompetentprofessionalstoperform
responsiblyineachof itslevelsof complexity.
Thus,the primaryhealthcare isessential healthcare toall individualsandfamiliesinthe communitycan
access throughacceptable meanstothem, withtheirfull participationandatan affordable costtothe
communityandthe country.It isthe core of the healthsystemof a countryand an integral partof
overall socio-economicdevelopmentof the community.
By the way,the PrimaryHealthCare providesawayto organize all healthcare,fromhouseholdsto
hospitals,where preventionisasimportantascure, and withresourcesinvestedrationallyatdifferent
levelsof care.
The basic principlesof PrimaryHealthCare are:the equitabledistributionof resources,asall groupsin
societyhave the same rightsto health,includingeconomicaccesstoservices;appropriatetechnology;
primaryhealthcare shouldbe basedon affordable,ethical andculturallyacceptablemethods forthe
individualsandthe community,andbe appropriate tothe conditionsthatare tobe applied;Cooperation
betweendifferentsectors,collaboratingandfollowingcommonstrategieswithothersectorswhose
policiesare relatedtohealth,suchasagriculture,educationandhousingandcommunityparticipation
that isresponsibleforencouragingandgive opportunitytopeopleactivelyinvolvedindecisionsabout
theirownhealthandhealthservicesfortheircommunity.
The PrimaryHealthCare,has soughtto encourage communityparticipationinsolvinghealthproblems
and the exercise of the enforcementof law andparticipationunderstoodasthe abilityof the population
to take effectiveanddignifiedpartindecisionsof healthcare andthe implementationof programsand
projectsthatleadto it.
SOCIAL PARTICIPATION

3. Participate inhealth meansthe sensitizing the communitytodevelopmentprograms,voluntary
contributions,ortheirabilitytoformulateprojectstoimprove the qualityof lifethroughhealthactions.
Moreover,since the focusof social policy,constitutesparticipateexpressionof democracyandlinkwith
developmentprograms.
For PrimaryHealthCare,social participationisthe rightandabilityof the populationtoparticipate
effectivelyandresponsiblyinthe decisionsof healthcare anditsimplementation.Thisparticipationis
partlya conditionforexercisingfreedom, democracy,social control overpublicaction,andtherefore,
for equity.
It is essential to ensure effectiveness and satisfaction whichis a desirable end in Practicing Self condition.
Policiestopromote participationhave beeninsertedintohealthsystemsinvariousstagesof
developmentandmeetthe social,economicandpolitical contextsof societiesthatadoptthem, where
the focusis basedonthe needsof the community,bringinghealthservicestothe population,increasing
systemefficiencyandprovidingsolutionsadaptedtolocal needs.
For PrimaryhealthCare,the participationof the communityimplyanactive processthatgenerate
sociallyacceptedhealthpractices, andprioritizetheircontributiontoachievingself-reliance andself-
managementinhealth.Andsothe participationof the communityis consideredasa meansandan end
initself.
Overall,participationbecomesaprinciple andelementof the Primarycare of the health andone of the
essential functionsof publichealth,definedasreinforcementof the powerof citizenstochange their
ownlifestylesandbecome anactive partof the processaimedatdevelopinghealthybehaviorsand
environmentssothatinfluencedecisionsthataffecttheirhealthandaccessto adequate healthservices.
It iscloselylinkedtostrengtheningthe buildingof intersectoral partnershipswithcivil societytoallow
use of all humancapital and material resourcesavailabletoimprove the state of healthof the
populationandpromote environmentsthatfosterhealthylifestyles.
There are twoimportantcomponentsParticipation:Collective andindividual.
A) The Collective isrepresentedbythe Associationsof users,Community InvolvementCommittees,
by participationinthe ethicscommitteesof publicinstitutionsandplace community
representationonthe boardsof directorsof insurersand service institutionshealth.
B) Individual isrepresentedinthe control exercisedbythe userthroughthe officesof customer
service.
From thisperspective,social participationinhealthisunderstoodasexerciseof these skillsthe duties
and rightsof the individual tobe directedtowardsthe conservationof personal,familyandcommunity
healthandcontribute tothe planning,management,evaluationandoversightinhealthservices.
However,inpractice participationisdowntoindividualservicerequest giventhe barriersthatthese
institutionspresentedtothe user;fewof themknow the mechanismsof participationandthe wayto
access them,remainsarigidexercise of powerfrominstitutionsthatdonotpromote attitudesof trust

4. and tolerance tothe proposalsanddemandsof the community.Forthisreason,participationleadsto
recognize the capacityof achievingusersasthe firststepinbuildingtrustandreciprocity.Givena
communitythatlooksaskance participationof institutions;andthe fulfillmentof commitmentsisafirst
step.
BENEFITS OF A HEALTH SYSTEM BASED ON PRIMARY HEALTH CARE:
a) Allowsaccesstohealthtoall individualsandpopulations,promotingandpreventinghealthactionin
advance throughbasichealthservicesonthe basisof the principlesof solidarityandparticipationof
individualsastheyhave withthe possibilitytodecide abouttheirownhealth.
b) Seekingequalityinhealthservicesforall citizensprioritizingpreventionandpromotingitthrough
reducedcostsand betterutilizationof facilitiestoofferabetterqualityof life.
c) Equalityof citizensof apopulationintermsof accessand provisionof healthservices.
d) Allowsformore efficientuse of resources,giventhatprioritizesmostbasicandpowerful
performance,encouragingthe use of basichealthservices,implementingarational use of them,
generatingareductionincosts,an increase inperformance andimprovedqualityof life.Especiallyin
developingcountriesanimminentincreaseinthe effectivenessof healthservicesanda reductionin
childmortalityamongotherbenefitsderivedfromthe implementationof the principlesof PHCis
presented.
e) Promotesa range of servicesadaptedtothe needsof the populationthroughadecentralizationof
resourcesthatallows,throughcitizenparticipation,the systemadaptstothe specificneedsof each
community.
f) Guidedbyvaluesof equity,solidarityandhumanrights,putscitizensthe powertodecide about
theirownhealth.Besidesdemocratizationthatimplies,thisimprovesthe legitimacyof the health
system,generatinggreaterself-reliance,promotinghealthylifestyles,changinghabitsandbehaviorsof
healthcare.
g) Thiscallsfor a positive conceptionof healththatgoesbeyondthe treatmentof disease,directly
affectingthe qualityof lifeof people.
h) Allowsremoval of economic,geographical andcultural barriers.
CONCLUSION
We can conclude bysayingthatthe PrimaryHealthCare,hasa lotof chancesto progressinall countries.
Andnowmore thanever,because there are opportunitiestostartchanginghealthsystemsandconvert
themintoprimaryhealthcare in all countries.
The difficultiesdifferincountrieswithdifferentincome levels,butthere are aspectsthatmustbe taken
intoaccount; more moneyisspentonhealththaneverand have more knowledgetoaddressglobal
healthchallenges,includingbettermedical technology.

5. Currentlyitisalsorecognizedthatthreatsandopportunitiesinhealthare commonthroughoutthe
world.
Aidisimportantforsome countries,butthe vast majorityof healthspendingcomesfromdomestic
sources.Thus,mostcountrieshave the capacityto start movingtowardsthe benefitsof primaryhealth
care and benefitfromcapacity.
In short,the strategyof PrimaryHealthCare consciouslyappliedwithinthe parametersand
considerationsthatoverthe yearshave implementedthe WorldHealthOrganization,governments,the
WorldBank, UNICEFand otherauthoritiesonthe subject, canachieve breakthe barriersof inequityin
care and leadtofulfill the purposeof arational extensionof coverage.
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