Astana Declaration: A Call to Action
By Edmund Atweri Doudu, WHO Young Leader on Primary Health Care, Ghana
40 years ago in Almaty, global leaders met and the Declaration of Alma Ata on Primary Health Care (PHC) was adopted, and primary health care declared as key to attaining health for all. While the 1978 Declaration of Alma-Ata laid a foundation for primary health care, progress over the past four decades has been uneven. At least half the world’s population lacks access to essential health services — including care for non-communicable and communicable diseases, maternal and child health, mental health, and sexual and reproductive health (WHO 2018).
The Global Conference on Primary Health Care, co-hosted by the Government of Kazakhstan, WHO, and UNICEF, in Astana last month, commemorated the milestone of the 40th anniversary of the Declaration of Alma Ata. The event aimed to redesign some of the concepts and reaffirm the original principles of PHC. The conference also served as an opportunity to renew political commitment of various governments to placing PHC at the heart of achieving Universal Health Coverage (UHC) and the Sustainable Developmental Goals by the year 2030. Over 2000 delegates and participants from governments, Civil Society Organizations (CSOs), and youth leaders from over 150 countries were in attendance. A Youth Preparatory Workshop was held on the 24th of October, prior to the main conference on the 25th and 26th.
Ghana as a country has been implementing a strategy known as the Community Based Health Planning Services (CHPS) since 2003, where community health officers are posted in the communities to provide PHC services, including immunization, health promotion, home visits and disease surveillance activities. In his speech during a parallel session on “Integrating Primary Health Care Based Service Delivery”, the minister of health for Ghana, Honorable Kwaku Agyemang-Manu, discussed the success of the CHPS program in the Ghanaian context. He emphasized the need for PHC to be preventive rather than curative. I also met with the minister briefly during the conference, and we discussed full implementation of the new Astana Declaration in Ghana. We concluded that community health nurses need to be fully resourced to work efficiently.
Role of the government: To ensure full implementation of the Astana Declaration, the Government of Ghana has to be committed and ensure policies are well implemented and resources provided for community health nurses. The National Health Insurance Scheme (NHIS) which is more curative, should also focus on preventive measures.
Role of CSOs: CSOs are well mentioned in the Astana Declaration as stakeholders, and they have to advocate for PHC to help Ghana achieve UHC. CSOs in Ghana are able to do social mobilization, engage government, community leaders and community health officers to ensure the full realization of the new declaration. Civil society have the biggest role to play, especially in domestic increase of health financing for health.
Role of the youth: Although the Astana Declaration fails to recognize the youth as stakeholders, youth are the future of the declaration. As Young Leaders on Primary Health care, our presence at the Conference alone means we are stakeholders hence our voice and engagement need to be valued. The youth are major users of PHC and face barriers such as lack of youth-friendly health services in Ghana. Honorable Kwaku Agyemang-Manu has agreed to meet with us on 14th November, 2018, to hear the voice of the youth on the way forward for the declaration.
All stakeholders should be committed to the Astana Declaration which is a call to action to help Ghana achieve UHC and SDG 3 by the year 2030.
