Chapter Seven Health Systems principled integrated care To meet the formidable challenges described earlier, this chap- ter calls for the reinforcement of health systems to be based on the core principles of primary health care as outlined Alma-Ata in 1978: universal access and coverage on the ba sis of need; health equity as part of development oriented to social justice; community participation in defining and imple menting health agendas; and intersectoral approaches to health. These principles remain valid, but must be reinterpreted in light of the dramatic changes in the health field during the past 25 years. Four important issues that health systems must confront are examined: the global health workforce crisis, in adequate health information, lack of financial resources, and the stewardship challenge of implementing pro-equity health policies in a pluralistic environmentHealth Systems: principled integrated care 103 Chapter Seven Health Systems: principled integrated care To meet the formidable challenges described earlier, this chap￾ter calls for the reinforcement of health systems to be based on the core principles of primary health care as outlined at Alma-Ata in 1978: universal access and coverage on the ba￾sis of need; health equity as part of development oriented to social justice; community participation in defining and imple￾menting health agendas; and intersectoral approaches to health. These principles remain valid, but must be reinterpreted in light of the dramatic changes in the health field during the past 25 years. Four important issues that health systems must confront are examined: the global health workforce crisis, in￾adequate health information, lack of financial resources, and the stewardship challenge of implementing pro-equity health policies in a pluralistic environment