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In keeping with the Declaration of Alma-Ata, PHC also (Annex 2):
n
should address the main health problems in the community;
n
should provide health-promotive, preventive, curative, rehabilitative and palliative services across the 
life-course;
n
should include:
o education on prevailing health problems and on preventing and controlling them;
o promotion of good nutrition, safe water and basic sanitation;
o maternal and child health care, including family planning;
o immunization against the major infectious diseases;

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Integrating palliative care and symptom relief into primary health care
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o appropriate treatment for common diseases and injuries, including continuity of care for people 
with chronic conditions;
o basic palliative care; and
o provision of essential medicines, including essential controlled medicines such as oral and 
injectable morphine;
n
should be integrated into a referral system and information system resulting in comprehensive, 
coordinated and continuous health care for all;
n
should give priority to those most in need; and
n
should be provided by an appropriately trained team that includes physicians and nurses and also 
may include clinical officers, assistant doctors, feldshers, nurses, midwives, community workers as 
applicable, as well as traditional practitioners, as appropriate, to respond to the expressed health 
needs of the community.
Overlapping principles of PHC and palliative care
The inseparability of PHC and palliative care is evident both from the Declaration of Alma-Ata (Annex 1) and 
from more recent international documents on PHC (
16,17,18).World Health Assembly resolution WHA62.12 
in 2009 reaffirmed the principles of PHC, including equity, solidarity, social justice, universal access to 
services, multisectoral action, decentralization and community participation as the basis for strengthening 
health systems (Annex 2). All are also principles of palliative care. This resolution also emphasized putting 
people at the centre of health care by adopting delivery models focused on the local and district levels 
that provide comprehensive PHC services. These include health promotion, disease prevention, curative 
care and palliative care that are integrated with other levels of care and coordinated according to need, 
while assuring effective referral to secondary and tertiary care. PHC, like palliative care, benefits from 
participation of civil society and the community in policy formulation and accountability mechanisms to 
ensure that the health system is socially acceptable, universally accessible and affordable, and scientifically 
sound (
19). In addition, PHC and palliative care have in common an emphasis on continuity of care and 
solidarity (accompaniment), respect for patients’ values and attention not only to patients, but also to their 
families (
7, 20, 21).