Introduction 介绍
One of the sectors in economies across the globe that continue to receive significant attention both different sections of society is the healthcare sector. In reference to Doeksen and Schott (2003), a health population plays a critical role not only in reducing the cost of healthcare but also in ensuring available of a healthy workforce, who significantly contribute to economic growth and development. Therefore, governments, leaders and institutions such as non-governmental organisations have over the years convened meetings, seminars and conferences to deliberate on the best approach to promote a healthy global society. Among these deliberations was the International Conference that was held between September 6 and 12, 1978, in Almaty, Kazakhstan (Green, 2007). At the end of this conference, the Declaration of Alma-Ata was adopted in a bid to urge the global community, governments and all development and health workers to support and safeguard the health of everyone in society irrespective of their social, cultural and economic status (Green, 2007). This paper evaluates this declaration, and particularly focuses on its goal that sought to encourage governments to “launch and sustain primary health care as part of its comprehensive national health system” in collaboration with other sectors. As such, the paper examine why it is difficult to achieve this goal in most countries across the globe, both developed and developing, and how it can be achieved.
医疗保健部门是全球各经济体中继续受到社会各界高度关注的部门之一。参考Doeksen和Schott（2003），健康人口不仅在降低医疗成本方面发挥着关键作用，而且在确保提供健康劳动力方面也发挥着关键作用，他们对经济增长和发展做出了重大贡献。因此，政府、领导人和非政府组织等机构多年来召开了各种会议、研讨会和会议，讨论促进健康全球社会的更佳方法。其中包括1978年9月6日至12日在哈萨克斯坦阿拉木图举行的国际会议（Green，2007年）。本次会议结束时，通过了《阿拉木图宣言》，以敦促全球社会、各国政府和所有发展和卫生工作者支持和保障社会中每个人的健康，不论其社会、文化和经济地位如何（Green，2007年）。本文件对该宣言进行了评价，并特别关注其目标，即鼓励各国政府与其他部门合作“启动和维持初级卫生保健，将其作为综合卫生系统的一部分”。因此，本文研究了全球大多数（包括发达和发展中）为何难以实现这一目标，以及如何实现这一目标。
Primary health care 初级保健
To begin with, primary health care was the core theme in the 1978 Alma-Ata Declaration. In reference to WHO (2018), primary health care entails caring for people in society rather than just seeking to treat specific medical conditions or diseases. With this in mind, primary health involves preventive approach to health, enhanced management of chronic diseases and conditions, as well as palliative care. In reference to Greenhalgh (2013), primary care can also be defined as a situation where an ill person, a person who would like to avoid getting ill, or the one who thinks is ill, consults a professional in the health care sector in a community setup for treatment, tests, advice or referral to the care of a specialist. Speaking from this perspective, primary care goes beyond a person seeking medical attention to the establishment of a relationship between health care professionals and the community at large.
首先，初级保健是1978年《阿拉木图宣言》的核心主题。参照世卫组织（2018年），初级卫生保健需要照顾社会中的人们，而不仅仅是寻求治疗特定的医疗条件或疾病。考虑到这一点，初级保健包括对健康采取预防措施，加强对慢性病和慢性病的管理，以及姑息治疗。参考Greenhalgh（2013），初级保健也可以定义为一种情况，即患者、希望避免生病的人或认为自己生病的人向社区卫生保健部门的专业人员咨询，以获得治疗、测试、建议或转诊给专家。从这个角度讲，初级保健不仅仅是寻求医疗照顾的人，而是在保健专业人员和整个社区之间建立关系。