The Cultural Implications of Primary Health Care and the Declaration of Alma-Ata: The Health District of Kedougou, Senegal

In 1978, the World Health Organization (WHO) and the international health community convoked a conference in Alma-Ata, Kazakhstan, to address global inequalities in health. The conference resulted in the publication of the "Declaration of Alma-Ata," which made the ambitious call "for urgent action by all governments, all health and development workers, and the world community to protect and promote the health of all the people of the world." In addition, a new tool, primary health care, was developed to carry out this project. In this research project, the author examines the district of Kedougou and the conditions of health and of primary health care therein as they are defined in the "Declaration of Alma-Ata." Kedougou provided a well-focused lens through which to analyze the principles of primary health care and the goals set out in the "Declaration of Alma-Ata"; and, conversely, the "Declaration of Alma-Ata" provided a framework through which to gauge the health problems, their causes, and the possible solutions in the district of Kedougou. Before focusing specifically on Kedougou, the author attempts to put the conditions of health of Kedougou and of Senegal into context by examining international differences in health--specifically between the United States and Senegal. The "Results" portion of this paper examines the official structures of primary health care that are concentrated in the city of Kedougou. One of the main focuses in the "analysis" portion of this paper is the "related sectors" of "community development," such as agriculture and nutrition, in the rural areas of Kedougou. Finally, because health is defined in the "Declaration of Alma-Ata" as not only "the absence of disease and infirmity," but also as a "state of complete physical, mental, and social wellbeing," the cultural practices surrounding seeking and giving health care are also briefly examined in the "Analysis." The author concludes that solutions to the main health problems of Kedougou, or of any community for that matter, are not to be found in documents. Instead, all feasible solutions and successful actions for improvement in health must be found within the community concerned. Not only are the main health problems best understood by the community itself, but any successful attempt to resolve them cannot be carried out without the active participation of the community. (Contains 21 notes.)