Question 1

What is primary health care?

Accepted Answer

Primary health care (PHC) is both the first point of contact with the health system — providing accessible, community-based care — and a broader approach to health encompassing prevention, promotion, treatment, rehabilitation and palliative care, as well as addressing the social, economic and environmental determinants of health. WHO defines it as a whole-of-society approach ensuring the highest attainable level of health across the lifespan.

Question 2

What is the Alma-Ata Declaration?

Accepted Answer

The Declaration of Alma-Ata (1978) — adopted at the International Conference on Primary Health Care in Kazakhstan — was the first global consensus on PHC. It declared health as a fundamental human right, called for "Health for All by the Year 2000" through PHC, and defined PHC's key elements: community participation, intersectoral action, equitable distribution, and technology appropriate to communities. It remains the foundational document of global health equity.

Question 3

What is the Astana Declaration?

Accepted Answer

The Declaration of Astana (2018) — adopted at the 40th anniversary Global Conference on PHC — renewed commitment to PHC as the foundation of UHC. It called for three commitments: bold choices for health (political and financial leadership); building sustainable PHC (health workforce, infrastructure, technology); and empowering individuals and communities. It aligned PHC with SDG 3 and UHC targets.

Question 4

What is the difference between primary health care and primary care?

Accepted Answer

"Primary care" typically refers to the first level of healthcare contact — a clinic, general practitioner, health centre. "Primary health care" (PHC) is a broader concept encompassing: (1) primary care services; (2) public health and prevention functions; and (3) multisectoral action on health determinants. PHC includes clean water, food safety, nutrition, immunisation, sanitation, family planning and mental health — well beyond what a clinic provides alone.

Question 5

What are community health workers?

Accepted Answer

Community health workers (CHWs) are health workers trained from and working within their communities — trusted neighbours and family members who provide basic health services, health education, referrals and follow-up. CHWs are the backbone of PHC in many LMICs: they extend care to remote and marginalised populations, improve maternal and child health outcomes, control infectious diseases and deliver primary mental health care at a fraction of the cost of facility-based staff.

Question 6

Why is PHC the foundation of UHC?

Accepted Answer

90% of essential health service contacts can be handled through strong PHC — preventing unnecessary hospitalisation, controlling chronic diseases before complications occur, providing preventive care, and delivering essential medicines. PHC is more cost-effective per health outcome than hospital care. Countries with strong PHC systems — like Thailand, Costa Rica and Oman — have achieved health outcomes matching much wealthier nations. Every $1 invested in PHC generates $3-4 in economic returns.

Question 7

What is the UHC service coverage index?

Accepted Answer

The UHC Service Coverage Index (UHC SCI) is a composite indicator tracking coverage across 14 PHC-relevant interventions including reproductive health, child health, infectious disease management and NCD management — on a 0-100 scale. The global index was 68 in 2023, with large gaps between high-income (82) and low-income countries (45). Progress has stalled since 2019 — partly due to COVID-19 — with 4.5 billion people still lacking full essential health coverage.

Question 8

What is the PHC financing gap?

Accepted Answer

WHO and the World Bank estimate that LMICs face a PHC financing gap of approximately $1 billion per day — the additional investment needed to achieve UHC through PHC by 2030. Current domestic health spending in LMICs is heavily skewed toward hospital care. A PHC-centred reorientation — supported by development assistance — is the most cost-effective investment in global health. International financing for PHC remains far below what is needed.

Question 9

How does COVID-19 relate to PHC?

Accepted Answer

COVID-19 demonstrated both the critical importance and the vulnerability of PHC: countries with strong PHC systems responded faster (early testing, contact tracing, community vaccination), suffered less excess mortality and recovered more quickly. Simultaneously, COVID-19 caused a massive disruption of essential PHC services — vaccination, antenatal care, chronic disease management — with long-term health consequences. Rebuilding and strengthening PHC post-COVID is a global health priority.

Question 10

What is people-centred care?

Accepted Answer

WHO's integrated people-centred health services framework reorganises health systems around the needs and preferences of people — rather than around diseases, institutions or professional boundaries. It emphasises continuity of care, coordination between providers, partnership with people in their own health decisions, and health literacy. People-centred PHC consistently achieves better adherence, satisfaction and outcomes than disease-centric approaches.

Question 11

How does Georgia's health system relate to PHC?

Accepted Answer

Georgia has made significant strides in health financing and coverage since independence, with primary health care reform — including family medicine development — as a key element. PHIG's accreditation work directly addresses primary care quality. The Georgian Medical Journal covers PHC quality, health system strengthening and UHC progress in Georgia and the South Caucasus.

Question 12

How does GMJ News cover primary health care?

Accepted Answer

GMJ News tracks WHO PHC policy, UHC service coverage index data, Astana Declaration implementation, community health worker programmes and PHC financing. Primary health care is the foundation of PHIG's public health mission and directly relevant to Georgia's health system development priorities.

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