December 2018 issue – Deadline for submissions 20-06-2018

Public Health Panorama calls for the submission of papers for a themed issue on primary health care: principles in practice towards universal health coverage. It will be published in December 2018 following the 40th anniversary of the Declaration of Alma-Ata, which will be celebrated with week-long events culminating in an anniversary conference on 25–26 October in Kazakhstan.

Primary health care: from principles to practice

A primary health care approach was first put forward 40 years ago in the Declaration of Alma-Ata. Four decades later, the Declaration holds iconic status for having advocated not only for technical changes in the way health services are delivered but also a fundamental change in the approach to health and well-being, linking them to social and economic development. The principles of equitable provision of services, community participation, health workforce development, appropriate use of technology and multisectoral collaboration have since served as a guide for health reforms and define the central tenets of primary health care.

These primary health care principles have withstood the test of time. Yet many of the challenges now dominating the global health agenda are very different from those which could have been described at the time of the Declaration of Alma-Ata. In the past 40 years, the WHO European Region has shown rapid advances in the recognition of human rights, the public’s political participation, science and technology, data availability, innovative treatment and therapies and the personalization of services in ways previously unimaginable. In parallel, countries have faced large-scale economic crises and migration; the acceleration of population ageing; rising multimorbidities and noncommunicable diseases, including the growing burden of mental health conditions and the threat of epidemics; as well as increasing risks associated with environmental pollution, obesity and antimicrobial resistance, among others.

Nonetheless, there is clear agreement that the principles of primary health care are as relevant today as ever. The health service component of Sustainable Development Goal target 3.8 on universal health coverage calls for the availability of quality, essential health services that are safe and accessible to all people and communities. A primary health care approach is crucial for making progress towards this target. In the WHO European Region, Member States have set ambitious targets not only to improve the coverage of services but also on the quality and equity of the services provided. Member States have consistently affirmed this commitment with the endorsement of the Ljubljana Charter in 1996, the Tallinn Charter in 2008, and more recently with the adoption of Health 2020 in 2012, followed by priorities for strengthening people-centred health systems in 2015 and action-oriented frameworks on integrated health services delivery in 2016 and a sustainable health workforce in 2017.

In the light of this sustained policy commitment to primary health care, but also the changes described, the 40th anniversary of the Declaration of Alma-Ata presents a unique opportunity to take stock of the know-how that has advanced since its adoption and to be forward-looking in anticipation of 2030 and beyond.

Call for papers

This themed issue on primary health care sets out to capture the progress made in advancing primary health care principles in practice in the various models of family medicine, general practice, ambulatory and first contact care across the Region. It focuses on tackling the main areas that appear to have set back the implementation of the Declaration of Alma-Ata, as recognized by the first meeting of the Region’s Primary Health Care Advisory Group members in 2017. These include the need to adopt a people-centred, integrated model of care, based on a primary health care approach, to establish continuous quality improvement systems and to advance primary health care performance measurement.

This themed issue aims to give voice to the patients, health practitioners and managers at work in health facilities and their communities as well as local, regional and national health authorities and civil society working to transform services based on a primary health care approach. Papers in the form of original research, reviews, project reports, policy analysis, case studies and short communication are welcome. Papers should address the following themes.

  • Primary health care as part of an integrated health services delivery system. In responding to changing health needs, the scope of primary health care has become increasingly fluid and the expectations of what primary health care should deliver have extended. While working to increase the responsive capacity of first contact care, a shift is needed towards primary health care that embraces its role as part of an integrated health services delivery system. Manuscripts sought under this topic include experiences of increasing the responsive capacity of primary care through integrated delivery models for primary health care and hospitals, the social sector or public health services. Manuscripts are welcome on intensified coordination between primary health care and acute, emergency services, and services for vertical programmes, including disease-specific programmes for tuberculosis, immunizations and mental health, among others.
  • Improving the quality of primary health care. Quality of care is integral to universal health coverage. There is growing recognition that poor quality of care can be a barrier to universal health coverage independent of access. Quality of care also plays an important role in raising the prestige of primary health care. Papers that explore quality of care mechanisms in practice and innovative techniques are welcome. Other areas of interest are new roles and actors for ensuring the quality of primary health care.
  • Primary health care performance and priority setting. The underinvestment in service measures and metrics to drive improvements in health outcomes has been recognized as one of the main reasons that primary health care has not advanced in many systems as might be expected. Papers that explore tools and instruments for measuring primary health care performance are welcome. This theme aims to showcase such work to enrich an understanding of data availability, frameworks and approaches to the measurement of coverage, access, quality and equity of services in primary care as well as the use of specific measures such as ambulatory care sensitive conditions and patient reported experience and outcomes.

Guidelines for submitting papers

The Regional Office will consider all papers related to the above themes. Special consideration will be given to papers that describe outcome-oriented approaches, successful practices and innovative solutions, and that adopt a health system perspective. Consideration will also be given to promoting representation of experiences across the WHO European Region. Manuscripts may be submitted in either English or Russian, and accepted papers will be published in both languages.

The deadline for submission is 20 June 2018. Authors should follow the guidelines for submission of manuscripts to Public Health Panorama and mention this call for papers in a covering letter. All submissions will undergo peer review. For further queries, please contact the WHO European Centre for Primary Health Care (eurocphc@who.int) or Public Health Panorama (eupanorama@who.int).