Health service reform is on the policy agenda throughout the world.
Since the Declaration of Alma-Ata in 1978, much of the discussion
about the role of primary healthcare (PHC) in health service reform
has centred on the political attraction to decentralised health systems. The primary goals of PHC are to make health services effective
and efficient in the improvement of people’s health by focusing on:
enhancing health status; reforming health service delivery, healthcare
provisions and financial sustainability; and strengthening the local
and national health services [3]. The philosophical commitment of the
Alma-Ata declaration was that people or service users have the right to
access essential and universal healthcare services without any personal
and institutional constraints
