With the 5th Health Systems Research Symposium taking place in Liverpool from October 8 – 12, 2018, we once again remember Kazakhstan. 2018 celebrates the 40th anniversary of the Declaration of Alma-Ata. The Alma-Ata declaration was signed in September 1978 during the International Conference for Primary Health Care. Its main aim was and is to call all world governments, health workers and development experts to promote and protect health for all.
“To respond effectively and appropriately to needs and expectations, health services need to be organized around close-to-community networks of people-centred primary care…” WHO 13th General Program of Work
Bangladesh is an informal settlement in Nairobi. At the Bangladesh Community Health Unit, Mary Achieng gave birth to a bouncing baby boy, Michael Baraka, on 8.12.2016 weighing 4.1 kilograms. BCG and birth polio vaccinations were administered on the day of birth and they were given their next appointment a month later. Josephine, however, did not take the baby for the next appointment.
“Forget about these people in the national office,” said Maria (not her real name). “They are not in touch with reality!” Maria is a district health manager in Kenya. This was her response when I asked how closely she works with the national Ministry of Health in delivering community health services.
Since our inception, we have placed a great deal of emphasis on communications and research uptake. Our initial project planning included a stakeholder mapping and policy and practice analysis which led us to prioritise this area as an integral part of our research on community health workers.
The liberation war in Bangladesh ended in December 1971. It has left many legacies, one of which is the provision of Menstrual Regulation services. Some health systems researchers have described the post-conflict moment as a ‘window of opportunity’ when policy makers and practitioners have space within the flux of change to do things differently. In the aftermath of war in Bangladesh many women were pregnant due to rape by war perpetrators.