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This article discusses the role of primary care strategies in maternal, newborn, and child health (MNCH). The authors outline a strategy that links community based NMCH interventions in underserved populations to increased access to referral facilities that can provide more medically complicated treatments such as Caesarian sections. Health indicators from Uganda and Pakistan are analysed to develop recommendations for the integration of primary and specialised medical care in the treatment of NMCH issues. INSETS: Panel 1: Effect of primary health-care interventions on...;Panel 2: Effect of primary health-care interventions on....

This article discusses efforts to integrate primary medical care for mothers and children in the public health systems of developing countries and impoverished regions. Research indicating the importance of combining capacity building efforts with the development of community based health interventions to ensure the effectiveness of care is addressed. The long term health effects and financial benefits of integrating medical care for the women and infant children is framed in terms of the need for intergovernmental cooperation and sensitivity to the needs of health care providers and local communities. The conflict between donor desire for statistically measurable results and the inherently long term nature of building health infrastructure and intergovernmental relationships is noted. INSETS: Key messages;Panel 1: Barriers to effective implementation of integrated...;Panel 3: Strengthening health systems in poor settings;Panel 4: Integration of maternal, newborn, and child health...

This article discusses research into health outcomes in countries that have focussed on primary care since the 1978 Alma-Ata, Kazakhstan conference established universal health care as an international goal. The countries assessed have made the most dramatic changes in their child mortality rates since 1978. These countries are then analysed in terms of the relationship between their health outcomes and their per capita gross national income. Successful countries improved their life expectancy statistics faster than their GNI grew. Issues of governance, violence and political stability are cited as explanations for the different performances of different countries. INSETS: Panel 1: Thailand's progress in primary health care and...;Panel 2: Composite lessons learned from countries that are....

This article discusses the role of community participation in medical care for mothers and their newborn children. The role of community participation in public health administration is framed as a goal established by the 1978 Alma-Ata, Kazakhstan Declaration on primary care in public health. Controversy regarding the relative importance of targeted interventions and community based health services in international aid to medical care is described. Community based efforts to develop public health interventions are framed in terms of their small scale compared to commodity based approaches that provide products such as mosquito netting and oral rehydration formula to treat diarrhoea. INSETS: Panel 1: Projects in rural India and Kenya which influenced...;Panel 2: Building community empowerment;Panel 3: Case study of how women's groups are addressing first....

This article discusses public health interventions designed to cope with the chronic disease burdens faced by developing countries and impoverished regions. The ageing of populations in these countries and the proliferation of chronic diseases such as AIDS are assessed as challenges facing public health administration. efforts to improve health risk assessment, diagnostic, and early intervention strategies for the treatment of chronic illness are described. The authors encourage the integration of this treatment method within existing primary medical care systems directed toward high risk populations. INSETS: Key messages;Panel 1: Chronic diseases and global mental health;Panel 2: Scaling-up of HIV treatment;Panel 3: Mexico's Veracruz initiative for diabetes awareness...

This article presents a systematic review of research into the administration and financing of public health interventions in developing countries and impoverished regions. The development of financing programs for primary care systems is assessed in terms of the implementation of user fees and the use of financial incentives to encourage health outcomes. The importance of task shifting, and emphasis on the devolution of primary care from professional doctors and nurses onto allied health personnel is emphasised. The importance of small scale interventions in the development of public health resources for the administration INSETS: Key messages;Panel 1: Taxonomy of governance, financial, and delivery...;Panel 2: Assessing the applicability to low-income and...;Panel 3: Key messages from systematic reviews of implementation..

This article discusses efforts to reduce the incidence of child mortality by two-thirds by 2015 under the auspices of the United Nations Millennium Project. The significance of improved maternal health care and obstetrics in achieving this goal is noted. The promising results presented by a study, published elsewhere in this issue, of the efficacy of community-based newborn care programs in rural India are noted. The administrative limitations of overstretched and undercompensated community health care workers in developing countries is noted. Challenges faced by people interested in adapting this process for application in urban areas and in Africa are noted.

The article discusses the global HIV/AIDS policy and its impact on public health. According to officials of the United Nations Joint Programme on HIV/AIDS (UNAIDS), the global incidence of HIV infections peaked in the late 1990s as a result of natural trends in the HIV epidemic and prevention programs. Other factors reported for the decline of new cases, as of 2007, are the use of antiretroviral therapies (ARTs). An overview of how the trend of declining HIV infections necessitates a re-balancing in global health funding between AIDS treatment and HIV prevention is presented, which includes a discussion on the costs of universal access treatment, allocation of health assistance to developing countries, and how countries maximize a population's health status for a given amount of funding.

This article reviews the public health goals and interventions developed following the Alma-Ata, Kazakhstan declaration on primary health care in 1978. The difficulties faced by public health administrators in developing health care infrastructure in line with this declaration are addressed. The challenges posed by changing economic circumstances and chronic diseases such as AIDS and tuberculosis to the development of primary health care programs are presented. The 2008 World Health Organisation report on primary health care is presented as a guiding document for continuing efforts to implement the Alma-Ata goals.

The author discusses the management of the Global Fund to Fight AIDS, Tuberculosis and Malaria after the 2012 resignation of executive director Michael Kazatchkine. She argues that the organization's focus on long-term sustainability and efficiency may hamper its ability to address urgent public health crises. Issues discussed include the dependence of poor countries on the fund, the reluctance of donors to increase funding, and the 2011 report of the independent review of the fund.