The Alma-Ata declaration was produced in the year 1978 at the International Primary Health

Care Conference in Kazakhstan. The declaration was written during the period of the Cold
War, where priority healthcare was given to victims of war. This left significant challenges in
accessing healthcare ton non-military personnel. The goal of primary healthcare is to ensure
that citizens of a country and by extension the world is given access. Contrary to popular
belief that good health means being void of disease and infirmity, the World Health
Organization (WHO) defines good health as having a complete state of mental, physical and
social well-being. Additionally the following points must be adhered to in order to achieve
the primary health care goal. Firstly, reduction and/or elimination of social disparities with
the healthcare system. Secondly, the needs and expectations of the citizens must be the
driving force of the organization of health services. Thirdly, healthcare must be integrated
within the sectors of society. Fourth, there must be full participation of all stakeholders within
the healthcare system. Lastly, there must be dialogue with regards to the initiation of policy.
This article examines the healthcare system in Trinidad and Tobago based on the
contributions of the Alma-Ata declaration and discusses improvements that can be made to
the system moving forward.
The first Caribbean Conference on health promotion was convened in the year 1993. This
was the culmination of initiatives that were previously taken since 1978, when the Alma-Ata
declaration was first proclaimed. Please note that initiatives adopted by the Caribbean were in
line with the global healthcare promotion concepts. The following strategies were executed
by all the islands within the Caribbean region. Firstly, public health policies were
implemented. Secondly healthcare services were reoriented throughout each island. Thirdly,
communities were empowered to achieve well-being. Fourth, supportive environments were
created. Fifth, the health skills of the various personnel were developed. Lastly, special
emphasis was placed on forming relationships with the various aspects of the media.

The Ministry of health is the body that is responsible for the administration and execution of
healthcare policies and projects in Trinidad and Tobago. Based on information sourced on the
Ministrys website, the major documented policies regarding healthcare are; Infection
Prevention and Control, National Oral Health, National HIV Testing and Counselling. In each
case this polices were executed at each health care facility including hospitals, health centres,
clinics and special care facilities. Additionally, joint action committees have been
implemented at each reginal authority and by extension each health care facility. Please note
that the policies are also regularly reviewed.
The reorientation of health services shifts from the focus from corrective and remedial health
care to addressing the social needs of individuals. In Trinidad there is an Arrive Alive
campaign which promotes health safety. Arrive Alive is a non-governmental organisation.
Driving under the influence (DUI) classes are conducted weekly. Additionally party patrons
are invited to take voluntary breathalyser tests before leaving the venue. DUI was recently
passed into the Trinidad and Tobago legislation in an attempt to curb road fatalities.
The Ministry of Health introduced point of care (POC) testing in the year 2010. POC
facilitates the diagnosis patients at a faster rate because mobile testing equipment that have
the same accuracy as laboratory equipment are used. This initiative was introduced at the
health centres and hospitals under the control of the South West Reginal Health Authority.
This means. This means that communities within the South West region will have access to
early health detection. This is one of the ways that a community is empowered to achieve
well-being.
Fusion and is an adventure race that was introduced within the last ten years which is hosted
and sponsored by a state company. The race is a true test of teamwork, fitness and mental

strength and has attracted fitness enthusiasts alike. This adventure race and activities that are
similar in nature have nurtured and supported an environment of wellness.
The Trinidad and Tobago National Workplace Policy on HIV Interaction was drafted in the
year 2010. Committees were arranged in each ministry to actively and aggressively reinforce
sex education and HIV and AIDS awareness with specific reference to office relations.
Besides conventional methods of educating the public via the distribution of literature, a
series of plays were performed to reflect the messages. This was a very creative way to
develop personal health skills.
Despite the implementation of policies and programs coupled with the use of technology in
primary healthcare, there is still an unanswered question. How strong of an impact is this
actually making on the overall healthcare system? In the 21st Century was a newspaper
headlines which read Mother-to-be spent an agonising 16 hours sitting on a hospital chair
waiting for attention which came too late as her baby was delivered dead. Trinidad and
Tobago Newsday article, by Anna Lisa Paul, March 27th 2011. One may argue that all the
facts may not be presented in the article, however this headline should have no place in the
newspapers. Infant mortality is one of the major problems plaguing the Trinidad and
Tobagos healthcare system. This is due to mistakes that were made at the health institutions
as well as improper health practices by young inexperienced women (specifically teenage
pregnancy). A greater effort needs to be made train teenagers how to deal with pregnancies
from the social and healthcare perspectives. This is because each person does not grasp
concepts in the same way.
It is often said that charity begins at home. Therefore all citizens of the country are required
to adopt a health conscious attitude. It is only then that that the policies and programs would

realize its full potential. Additionally healthcare practitioners should be held accountable for
their performance.