In October 2018, global health leaders met in Astana, Kazakhstan, to reaffirm their commitment to primary health care (PHC) as a key strategy for achieving universal health coverage (UHC) and the Sustainable Development Goals (SDGs). The result was the Astana Declaration, a historic document that outlines a renewed vision for PHC and sets forth a series of action steps for achieving it.

 

The Astana Declaration recognizes that PHC is the foundation of any strong health system, and that UHC cannot be achieved without ensuring that everyone has access to high-quality, comprehensive, and people-centered primary health services. It acknowledges the many challenges facing PHC today, including inequities in access and quality, inadequate financing and resources, and the need for greater political commitment and community engagement.

 

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To address these challenges, the Astana Declaration lays out a series of commitments and action steps that governments, health systems, and communities can take to strengthen PHC and achieve UHC. These include:

 

1. Increasing political commitment and financing for PHC, including through the development of national policies and strategies and the allocation of sufficient resources to support PHC services and infrastructure.

 

2. Improving the quality of PHC services, including through the development of standards and guidelines, the strengthening of health systems and workforce capacity, and the integration of health services to provide comprehensive and coordinated care.

 

3. Ensuring equitable access to PHC services, particularly for vulnerable and marginalized populations, by removing financial barriers, improving geographic access, and addressing social determinants of health.

 

4. Engaging communities and patients in the design and delivery of PHC services, and promoting health literacy and self-management to empower individuals and families to take control of their health.

 

5. Strengthening PHC as a platform for delivering public health interventions, including disease prevention, health promotion, and emergency preparedness and response.

 

The Astana Declaration represents a major step forward in the global effort to achieve UHC and the SDGs. By reaffirming the importance of PHC and outlining a clear vision and roadmap for its advancement, it provides a framework for action that can guide policymakers, health systems, and communities around the world. However, the success of the Astana Declaration will depend on the commitment and action of all stakeholders, and on the sustained investment and attention to PHC as a priority for health and development.

 

Image courtesy : UNAIDS