The concept of community based medicine can be directly related to the concept of primary health care. The model for primary health care was gotten from the barefoot doiters of china following their successes in improving rural health provision in china. The concept and model for primary health care is globally accepted in 1978 at the international conference in alma ata in Kazakhstan.
Based on the alma ata declaration, primary health care is defined as essential health care based on practically, scientifically sound and socially approved procedures and technology made universally accessible to individuals and families in a community via their participation and at a cost which the community and country can afford to maintain at every stage of their development in the spirit of self-dependence and self determination.
The goals of primary health care as extrapolated from the alma ata declaration include the following:
Health care provision which cuts across board and is accessible to all members of the community regardless of their social, financial or political status.
Health care provision which ensures participation of members of the community to give them a sense of belonging and ownership of the health scheme.
Provision of basic health needs of the community by experienced health professionals.
The utilization of appropriate and acceptable technology to improve health provision in the community.
The implementation of a multi-sectoral approach to improve sectors such as Education, Agriculture, Housing, Water supply etc. which have a direct impact on health.
The targets of primary health care cuts across the entire population in the community but gives emphasis to the vulnerable population of children and the elderly, thus there are numerous programs at the primary health level such as breastfeeding, immunization and family planning programs directed towards such vulnerable groups.
The Nigeria experience with community based medicine is similar to what is obtainable in other developing countries. The delivery of primary health care is still a far-cry from the expected especially in the rural areas. The effective delivery of primary health care has been hampered by problems such as inconsistency in government policies, poor financing of primary health care by government, limited number of primary health care centres, limited number of doctors, trained nurses and other health professionals at the primary health level, non-availability of drugs, limited supply of modern technological test kits and equipments etc. Other major problems hindering effective health care delivery at the grass-root include illiteracy, poor housing and water supply and the patronage of fake traditional healers, herbalists and quacks.
The situation to the challenges hindering effective community based medicine are not far-fetched but will require a multi-sectoral approach with determination and commitment from government and the members of the community. Kudos must be given to the organizations like Pro-health international, T.Y. Danjuma Foundation, COHET (imo state, Nigeria) etc who try to bridge the gap of poor primary health care by conducting regular free medical outreaches in rural communities. However, more sustainable solutions are required for effective primary health care awareness and participation, improved government policies towards primary health care and sectors with direct impact on health. Increased funding for the health sector and improvement of health awareness, education of medical professionals, essential drug provision etc will help improve the delivery of community based medicine.
In conclusion, we all have important roles to play in various capacities as individual members of our communities, so let us wake up and work together to improve community based medicine in our various communities.
Community based medicine through primary health care holds the key to effective health care delivery worldwide and as such, all hands should be on deck to ensure that the health and self-reliance of communities is promoted through effective delivery of community based medicine.