Questions and answers: understanding primary health care

What is primary health care (PHC)?

Primary health care is a community’s first and main point of contact with the health system. It’s about helping people to live the healthiest lives possible and, when they need health care, providing the right care, at the right time, right in their communities.

Strong PHC can address the vast majority of people’s health needs throughout their lives, from preventing and treating illness, to managing chronic health conditions, to delivering essential health services like vaccinations and reproductive, maternal, newborn and child health care.

Back to top

Why is PHC important?

By addressing the vast majority of people’s health needs across a lifetime, PHC is among the most cost-effective approaches we have to drive better health outcomes and improved quality of services while contributing to reduce inequities in health along the life course.

Health systems built on strong primary health care empower individuals and communities, respond to day-to-day needs and foster trust in health workers. In times of crisis, strong PHC boosts resilience and enables a faster, more effective response.

When we invest in primary health care, we build the foundation of an effective, efficient and equitable health system and accelerate progress towards universal health coverage. This makes strengthening PHC in every community and country both a moral and strategic imperative.

Back to top

What is the Alma-Ata declaration from 1978 and what progress have we made in the past 40 years?

The landmark 1978 Declaration of Alma-Ata was the first time that world leaders committed to prioritize primary health care and a pivotal milestone for "Health for All."

We have made remarkable health progress since 1978, thanks to increased investment, continuous research and innovation and tireless efforts of health professionals worldwide. We have eradicated small pox and nearly eradicated polio, confronted and reduced the burden of the HIV/AIDS epidemic, and drastically improved mothers’ chances of surviving childbirth and for families to raise a healthy child.

From the adoption of the Sustainable Development Goals to the renewed focus on universal health coverage, there is bold new consensus that everyone, everywhere should have access to quality health services without financial hardship.

Read the Alma-Ata Declaration

Back to top

What challenges remain?

The world’s health looks very different today compared to 1978. We have eradicated small pox, nearly eradicated polio, reduced the burden of HIV/AIDS, and drastically improved maternal and newborn health. Now, we are facing new challenges posed by weak health systems, rising inequality, ageing populations, the expanded toll of non-communicable diseases, the globalization of health threats, and increased pressures from urbanization and rising health care costs.

Far too often, PHC is the most overlooked and under-resourced part of a country’s health system, with the biggest gaps affecting the poorest and most marginalized communities. As a result, for too many people, PHC is far away, expensive, fragmented, ill-suited to local needs, or non-existent.

Back to top

How have countries in the WHO European Region used Primary Health Care as an opportunity to innovate and strengthen their health systems?

Many countries in the Region have been very successful in translating primary health care into reality, enabling them to innovate and better respond to their population’s health needs. Some country examples include:

  • Turkey has established migrant health centres in areas heavily populated by Syrian refugees in order to provide effective and efficient preventive care and essential health care services, remove language and cultural barriers to access, and improve the overall accessibility of services.
  • In Scotland (United Kingdom), a significant innovation has been the integration of health- and social-care services. Local authorities and health boards work together to plan and deliver social care, community health services and acute services for adults.
  • In 2013, Georgia introduced a national UHC programme that aims to protect citizens from catastrophic health expenditures and gives all citizens access to a basic benefit package. As a result, utilization of outpatient services has increased and out-of-pocket payments have declined, thereby improving financial protection.
  • In many countries across Eastern Europe and central Asia, such as Kazakhstan and the Russian Federation, diverse telemedicine initiatives have quickly multiplied to reach underserved and remote areas with specialized cardiology, pulmonology and neurology care.

Find more country cases in the report ”From Alma-Ata to Astana: primary health care – reflecting on the past, transforming for the future”.

Back to top

What can we expect from the Global Conference on Primary Health Care in October 2018?

At the Global Conference on Primary Health Care in Astana, Kazakhstan, policymakers, advocates, providers, patients and people committed to a healthier world will launch a renewed movement for primary health care in the 21st century.

Participants will endorse a new Astana Declaration that builds on the spirit of the 1978 document and commits its signatories to strengthening primary health care globally as part of the collective effort to achieve universal health coverage.

It will build a foundation for action, advocacy and accountability on the journey toward health for all, from International UHC Day on 12 December 2018 to the High-Level Meeting on Universal Health Coverage in September 2019 and beyond.

Learn more about the Global Conference on Primary Health Care

Back to top

What can we do to make quality PHC accessible and affordable for everyone, everywhere?

The Declaration of Alma-Ata affirmed health as a fundamental human right and put social justice at the heart of public health policy for the first time.  It launched a revolutionary movement for its time, but one that has not yet fulfilled its promise.

Now is the time to recommit to primary care as the foundation and the future of health for all.

  • Governments must make bold policy choices and invest in PHC towards UHC, addressing the underlying determinants of health and enacting policies to leave no one behind.
  • Communities should take an active role in their health care and hold decision-makers accountable for results.
  • Health professionals must advance quality, comprehensive, people-centered primary care that is core to integrated services for all people across the life course.
  • Global health and development partners and donors should support and align with local and national policies and strategies to strengthen PHC and improve community-based care.

Back to top