The need is for an effective primary health care and maternal health care system accessible to all. The necessary education, curative services and referrals must be provided in order to maintain good health in a target population. Primary health care systems that are practical, community-based, scientifically sound, socially acceptable and appropriate to needs and meet basic health needs of clean water, safe food and sanitation should be developed and strengthened.
It is assumed that health care includes sanitation, nutrition and care of the environment in which people live. Thus, primary health care often involves volunteer community health workers as well as health professionals.
This strategy features in the framework of Agenda 21 as formulated at UNCED (Rio de Janeiro, 1992), now coordinated by the United Nations Commission on Sustainable Development and implemented through national and local authorities. Agenda 21 recommends promotion of primary health and environmental care at the local level, including training for local communities in appropriate water management and sanitation techniques and primary health care.
The conference "Health for All by the Year 2000", held by WHO and UNICEF at Alma-Ata in 1978, launched today's primary health care movement.
Viewing specific health problems in their social context allows more accurate diagnosis and the likelihood of more effective treatment, especially when the community at large is involved in developing and maintaining the programme.
The primary health approach to health care requires extensive involvement by the bureaucracies funding it in the lives and issues of small, local neighbourhoods and communities.
Because of the universal weakness of the linkage between central bureaucracies and local service units, many efforts at primary health care fail.