Which of the following is NOT a core principle of Primary Health Care as defined by the Alma-Ata Declaration (1978)?

Explanation

## Core Principles of Primary Health Care (Alma-Ata, 1978) **Key Point:** The Alma-Ata Declaration established PHC as the foundation of health systems, emphasizing equity, accessibility, and community involvement — NOT specialist tertiary care as the starting point. ### The Eight Core Principles of PHC | Principle | Description | |-----------|-------------| | **Accessibility** | Health services within reach of all (geographic, economic, cultural) | | **Affordability** | Services at cost the community can sustain | | **Acceptability** | Culturally appropriate and community-approved | | **Accountability** | Health workers responsible to the community | | **Community Participation** | Active involvement in planning, delivery, and evaluation | | **Self-Reliance** | Communities empowered to solve own health problems | | **Integration** | Preventive, promotive, curative, and rehabilitative services unified | | **Intersectoral Coordination** | Health linked to education, water, sanitation, agriculture | **High-Yield:** Tertiary care (specialist hospitals) is the **apex** of a health system pyramid, NOT the foundation. PHC sits at the base and is the entry point for 80–90% of health needs. **Clinical Pearl:** The Alma-Ata vision explicitly rejected the "hospital-first" model prevalent in developed nations and advocated for community-centered, preventive-first systems — especially critical for resource-limited settings like India.