Primary Health Care in the World: Results of the 40-year Implementation of the Almaty Declaration (1978) and Future Development According to the Astana Declaration (2018)

Abstract

The article presents the results of the development of primary health care from the aprovement of the Almaty Declaration in 1978 to the signing of the Astana Declaration of 2018. It is emphasized that despite the actions taken, the pace of development and strengthening of primary health care is unsatisfactory, which is confirmed by numerous reports. According to reports of World Health Organization 50% of the world’s population still partially or completely do not have access to basic medical services, including treatment and prevention of infectional and non-communicable diseases, reproductive health, protection of women and children’s health. Taken into accaunt the current situation, WHO held the Global Conference on Primary Health Care, where the reports from world leaders and ministries on this issue were represented. The article discribes the generalized results in the development of primary care in the world according to the submitted reports. It is emphasized that in some countries today, the levels, rates of development of PHC and its financing are insufficient. Patients are forced to pay for basic medical services from their own funds. The negative consequences of paying for services from one’s own funds are felt by more people than 15 years ago. About 925 million people spend more than 10% of the income on medical care, and 200 million spend more than 25% of their income on it. At the same time, indicators of impoverishment as a result of payment for medical care increased among all groups of the population, except the extremely poor. WHO sets one of the global health goals for all countries to increase the cost of primary health care by at least 1% of its gross domestic product .The specified goals, principles and objectives of the PHC that WHO sets for the future are detailed. The full text of the Astana Declaration 2018 is given. The role and participation of the World Association of Family Doctors (Wonca) and Ukraine are described. In general, primary health care has been and will be at the forefront of the world’s health systems priorities, its further development and strengthening is a priority task posed by the World Health Organization for all countries of the world, which will lead to the protection and strengthening of the health of all people, the formation of effective affordable health care for all.