Building primary health care teams for universal healthcoverage in Africa

The Alma Ata Declaration on Primary Health Care (PHC) in 1978 defined PHC profoundly. Comprehensiveness and continuity of care, as well as coordination of referrals, were key attributes of integrated PHC. Unfortunately, African governments function with bureaucratic health systems, where top-down implementation policies, especially selective PHC vertical programmes driven by international agencies, create rigid, large, impersonalised units of PHC. Global agencies and country leaders must be challenged on this: what are they doing practically to build PHC teams for UHC in Africa?