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

Explanation

## Core Principles of Primary Health Care (Alma-Ata, 1978) **Key Point:** The Alma-Ata Declaration established eight core principles of PHC, none of which include centralized, top-down decision-making authority. ### The Eight Principles of PHC | Principle | Definition | |-----------|------------| | **Equity** | Equal access to health services regardless of socioeconomic status | | **Accessibility** | Geographic, financial, and cultural availability of services | | **Community Participation** | Active involvement of communities in planning and delivery | | **Self-Reliance** | Communities empowered to address their own health needs | | **Intersectoral Coordination** | Collaboration across health, education, water, sanitation sectors | | **Appropriate Technology** | Use of scientifically sound, culturally acceptable, affordable methods | | **Health Promotion & Prevention** | Focus on disease prevention and health education | | **Integration of Services** | Preventive, promotive, curative, and rehabilitative care in one system | **High-Yield:** PHC is fundamentally **decentralized and community-driven**, not hierarchical. Centralized, top-down authority contradicts the philosophy of community empowerment and participation. **Clinical Pearl:** The Alma-Ata approach explicitly rejects the medical model of passive patients receiving care from distant bureaucracies. Instead, it emphasizes **horizontal power distribution** and local ownership. **Warning:** Do not confuse PHC governance with the organizational structure of the health system. While health systems may have hierarchical administration, PHC *principles* demand that decision-making about health priorities be informed by and responsive to community needs, not imposed from above. [cite:Park 26e Ch 1]