Primary healthcare in the time of Covid-19

Breaking the silos of healthcare provision

Bibliographic Data

ID21879195
AuthorsSusan Beth Rifkin (0000-0001-5482-7829, London School of Hygiene & Tropical Medicine, corresponding author), Meredith P Fort (0000-0003-0589-1044, Colorado School of Public Health), Meredith Fort (Colorado School of Public Health), Walaiporn Patcharanarumol (0000-0003-1798-8767, Ministry of Public Health), Viroj Tangcharoensathien (0000-0003-3235-0091, Ministry of Public Health)
Year2021
Volume6
Issue11
Pagese007721
Publication date2021-11-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueBMJ Global Health (JOURNAL)
Journal identifiersISSN: 2059-7908 • E-ISSN: 2059-7908
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2021-007721
PMID34732515
OpenAlexW3208028136
LanguageEN
Citations received11
References cited23

In 1948, the WHO was created under the aegis of the United Nations (UN) as the agency to address global health concerns. Health was defined as a ‘state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’.1 In 1978 with the Alma Ata Declaration, the member states of the UN began a process to translate this definition into reality by mandating primary healthcare (PHC) as the health policy for the organisation. PHC highlighted the principles of equity, community participation, and included multisectoral approaches.2 Over the first 40 plus years, PHC had various iterations but in most settings focused on primary care health services at the local level now linked to universal health coverage (UHC). This linear and siloed focus misses the original intent of the Alma Ata Declaration. With the COVID-19 pandemic, the focus has proved inadequate. Health services have not prevented the loss of 4 million lives3 and the loss of livelihoods of million more people.4 5 This situation also highlights the necessity of addressing health improvements in the context of the social determinants of health and governance.6 7 On the 40th anniversary of the Alma Ata Declaration in 2018, member countries of WHO signed the Astana Declaration.8 The declaration focuses on promoting PHC through (a) providing primary care services throughout the life course, (b) ensuring equity for healthcare, (c) addressing the social determinants of health, and (d) empowering citizens and communities.9 To pursue these objectives in the post-COVID-19 era, the way forward is to integrate public health systems and health services to include: clinical care, surveillance and rapid response to prevalent infectious and emerging diseases, a population health approach and a recognition of improved health as both a result of the social determinants of

Declaration · Economic growth · Geography · Global health · Health care · Political science · Social determinants of health · Global Public Health Policies and Epidemiology · Healthcare Systems and Reforms · Law · Medicine · Nursing · Public Health Policies and Education · Health Policy