<P> Although many countries were keen on the idea of primary healthcare after the Alma Ata conference, the Declaration itself was criticized for being too "idealistic" and "having an unrealistic time table". More specific approaches to prevent and control diseases - based on evidence of prevalence, morbidity, mortality and feasibility of control (cost - effectiveness) - were subsequently proposed . The best known model was the Selective PHC approach (described above). Selective PHC favoured short - term goals and targeted health investment, but it did not address the social causes of disease . As such, the SPHC approach has been criticized as not following Alma Ata's core principle of everyone's entitlement to healthcare and health system development . </P> <P> In Africa, the PHC system has been extended into isolated rural areas through construction of health posts and centers that offer basic maternal - child health, immunization, nutrition, first aid, and referral services . Implementation of PHC is said to be affected after the introduction of structural adjustment programs by the World Bank . </P>

10 primary health care program in the community