Abstract
Primary health care (PHC) includes both primary care (PC) and essential public health (PH) functions. While much is written about the need to coordinate these two aspects, successful integration remains elusive in many countries. Furthermore, the current global pandemic has highlighted many gaps in a well-integrated PHC approach. Four key actions have been recognized as important for effective integration.A survey of PC stakeholders (clinicians, researchers, and policy-makers) from 111 countries revealed many of the challenges encountered when facing the pandemic without a coordinated effort between PC and PH functions. Participants' responses to open-ended questions underscored how each of the key actions could have been strengthened in their country and are potential factors to why a strong PC system may not have contributed to reduced mortality.By integrating PC and PH greater capacity to respond to emergencies may be possible if the synergies gained by harmonizing the two are realized.
Highlights
In October 2018, on the 40th anniversary of the Alma Ata Declaration, representatives from around the globe gathered in Astana, Kazakhstan to declare a renewed focus on primary health care (PHC) acknowledged in the Declaration of Astana (World Health Organization and United Nations Children’s Fund, 2018a)
By integrating primary care (PC) and public health (PH) greater capacity to respond to emergencies may be possible if the synergies gained by harmonizing the two are realized
One of the commitments proclaimed in the Declaration of Astana is to ‘build sustainable primary health care’ which is further elaborated as enhancing ‘capacity and infrastructure for primary care (PC) – the first contact with health services – prioritizing essential public health functions’
Summary
In October 2018, on the 40th anniversary of the Alma Ata Declaration, representatives from around the globe gathered in Astana, Kazakhstan to declare a renewed focus on primary health care (PHC) acknowledged in the Declaration of Astana (World Health Organization and United Nations Children’s Fund, 2018a). One of the commitments proclaimed in the Declaration of Astana is to ‘build sustainable primary health care’ which is further elaborated as enhancing ‘capacity and infrastructure for primary care (PC) – the first contact with health services – prioritizing essential public health functions’. The Declaration goes further stating, ‘We will benefit from sustainable PHC that enhances health systems’ resilience to prevent, detect and respond to infectious diseases and outbreaks’ (World Health Organization and United Nations Children’s Fund, 2018a). PHC includes both PC and essential public health (PH) functions (see Table 1) (World Health Organization, 2019). While much is written about the need to coordinate these two aspects, successful integration remains elusive in many countries (World Health Organization, 2018b; 2018c; 2019; Rechel, 2020)
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