## Alma-Ata Declaration (1978) — Core Principles **Key Point:** The Alma-Ata Declaration established eight core principles of Primary Health Care that form the foundation of modern PHC globally and in India. ### The Eight Core Principles of PHC (Alma-Ata) | Principle | Description | | --- | --- | | **Accessibility** | Health services must be geographically, economically, and culturally accessible | | **Affordability** | Services must be affordable to all, especially the poor | | **Acceptability** | Services must be culturally acceptable and appropriate | | **Availability** | Adequate resources, personnel, and supplies must be present | | **Community Participation** | Active involvement of the community in planning and implementation | | **Self-reliance** | Communities empowered to solve their own health problems | | **Intersectoral Coordination** | Collaboration across health and non-health sectors | | **Integration** | Curative, preventive, promotive, and rehabilitative services combined | **High-Yield:** The option "Centralized planning with minimal community involvement" directly contradicts the PHC philosophy of **community participation and decentralization**. PHC explicitly rejects top-down, centralized approaches without community engagement. **Clinical Pearl:** India's National Health Mission (NHM) and Ayushman Bharat scheme are built on these Alma-Ata principles, emphasizing community health workers (ASHA, ANM) and grassroots participation. **Mnemonic:** **AAACISI** — Accessibility, Affordability, Acceptability, Availability, Community participation, Intersectoral coordination, Self-reliance, Integration.
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