Author:
Henrique das Neves Martins Pires Paulo
Abstract
In 1984, Portugal was a middle-income country, developing the primary health care system, based on family doctors, health centres and health posts, reaching almost all population, with infectious diseases as one of the main health problems. In 2006, Mozambique was a low-income country, with a national health service attaining 60% of the population (40% in rural areas), with a double burden of disease (infectious and non-communicable diseases). Working in primary health care in Europe and Africa, we compare several experiences of family medicine practice in rural populations, different in context, time, and methods: Portugal 1984–2006 and Mozambique 2007–2020, all with a strong component of community health education. Our descriptive case studies, summarise strategies, interventions, and results, reviewing reports and articles. Population’ health indicators, and quality of life have improved, in different contexts with culturally tailored approaches. Participative societal diagnosis and multidisciplinary interventions are necessary to improve rural population health. Different rural populations and cultures are ready to learn and to participate in health promotion; empowering rural populations on health issues is an affordable strategy to better health indicators and services. Family Medicine is effective to extend primary health care to all rural populations, aiming universal health cover.
Reference32 articles.
1. Rifkin SB. Alma Ata after 40 years: Primary Health Care and Health for All—from consensus to complexity. BMJ Glob Health 2018;3:e001188. doi:10.1136/bmjgh-2018-001188.
2. Flinkenflogel M, Kiguli-Malwadde E, De Maeseneer J. From Alma Ata to Astana: Family Medicine is at the centre of the progress that has been made in developing primary health care in sub-Saharan Africa. Africa Health, January 2019. p11-14.
3. Carter M, Emmet A. The Global Community Has Pledged to Achieve Universal Health Coverage: What’s It Going To Take? Global Health Policy. September 23, 2019. DOI: 10.1377/hblog20190920.827005.
4. Wallerstein N (2006). What is the evidence on effectiveness of empowerment to improve health? Copenhagen, WHO Regional Office for Europe (Health Evidence Network report). http://www.euro.who.int/Document/E88086.pdf.
5. U.S. Preventive Services Task Force. Screening and Behavioral Counseling Interventions to Reduce Unhealthy Alcohol Use in Adolescents and Adults: Recommendation Statement. American Family Physician June 15, 2019. Volume 99, Number 12. www.aafp.org/afp.