Integrated people-centred primary health care in Greece: unravelling Ariadne’s thread

Christos Lionis,Sophia Papadakis,Chariklia Tziraki,Dimitra Sifaki-Pistolla,Emmanouil K Symvoulakis,Kyriakos Souliotis,Adelais Markaki,Elena Petelos,Maria Papadakakis

doi:10.1017/s1463423619000446

Abstract

The 40th anniversary of the World Health Organization Alma-Ata Declaration in Astana offered the impetus to discuss the extent to which integrated primary health care (PHC) has been successfully implemented and its impact on research and practice. This paper focuses on the experiences from Greece in implementing primary health care reform and lessons learned from the conduct of evidence-based research. It critically examines what appears to be impeding the effective implementation of integrated PHC in a country affected by the financial and refugee crisis. The key challenges for establishing integrated people-centred primary care include availability of family physicians, information and communication technology, the prevention and management of chronic disease and migrant and refugees' health. Policy recommendations are formulated to guide the primary health care reform in Greece, while attempting to inform efforts in other countries with similar conditions.

Highlights

Over the last 15 years, a large body of research has focused on the need for integrated, multidisciplinary, team-based and people-centred care
This paper focuses on the experiences from Greece in implementing primary health care reform and lessons learned from the conduct of evidence-based research
As part of the 40th anniversary of the World Health Organization’s (WHO) Alma-Ata Declaration and the recent Astana Declaration, the WHO has called for a return to its basic tenets, reaffirming the key role of primary health care (PHC) (WHO, 2018a)

Summary

Introduction

Over the last 15 years, a large body of research has focused on the need for integrated, multidisciplinary, team-based and people-centred care. Available evidence from research efforts developed with significant investment from different European funding mechanisms is more often than not overlooked or underutilised by policymakers when making decisions. This is relevant in terms of PHC and in the context of promoting tenets of the Alma-Ata and the current Astana Declaration (WHO, 2018a). These issues are important when discussing evidence-informed policy-making, especially in countries where accessibility disparities and service inequities are not systematically and adequately addressed

Objectives

Discussion

Conclusion